1. Respiratory System RT 91 Chapter 3

4. Normal Two View CXR

5. Mediastinum Anatomy – Heart, Hilar region, Thyroid &Thymus glands, Nervous & Lymphatic tissues. Anatomy – Heart, Hilar region, Thyroid &Thymus glands, Nervous & Lymphatic tissues.

6. Inspiration vs. Expiration

7. Elevated diaphram

9. What do you think? Dexatracardia

10. True or False? Mr. Parkers CXR?

11. Breast Implants

12. Radiography Correct exposure factors selection is critical Correct exposure factors selection is critical Radiologists rely heavily on consistent exposure factors for serial portable radiographs Radiologists rely heavily on consistent exposure factors for serial portable radiographs Recording technique selection Recording technique selection

13. Radiography For CXR maintaining kVp and changing the mAs is the general rule For CXR maintaining kVp and changing the mAs is the general rule AEC AEC A complete patient hx is very important A complete patient hx is very important CR/DR CR/DR High kVp High kVp

14. Technique Considerations Pathology Pathology Overlapping Structures Overlapping Structures Prior Examinations Prior Examinations Lungs/Bony Structures/Line Placement Lungs/Bony Structures/Line Placement

15. CR

16. Chest Positioning PA/Lt Lat PA/Lt Lat AP AP 72 inches 72 inches Upright or Supine Upright or Supine AP or PA Decubitus AP or PA Decubitus Oblique Projections Oblique Projections Lordotic Projections Lordotic Projections

17. Incorrect line placement

18. Correct Line Placement

19. Reversed image (line placement)

20. Congenital Disorders

21. Cystic Fibrosis An accumulation of excessively thick mucous and abnormal secretion of sweat and saliva An accumulation of excessively thick mucous and abnormal secretion of sweat and saliva

22. Cystic Fibrosis

23. Cystic Fibrosis neonate

24. Hyaline Membrane Disease RDS – Respiratory distress syndrome RDS – Respiratory distress syndrome Leading cause of infant death Leading cause of infant death Premature birth before 26 weeks Premature birth before 26 weeks “ground glass” look on the radiograph “ground glass” look on the radiograph

25. RDS

26. Hyaline Membrane Disease

27. Sail Sign Enlarged thymus in an infant Sail-like appearance

28. Sail Sign

29. Congenital hiatal hernia

30. Hiatal Hernia Any structure through the hiatus of the diaphram

31. Cervical rib

32. Depressed sternum

33. ACUTE DISORDERS

34. Croup Soft tissue neck Soft tissue neck Croup is a syndrome that is produced by an acute infection of the lower air passages and is usually seen in children below age of 3 Croup is a syndrome that is produced by an acute infection of the lower air passages and is usually seen in children below age of 3 Bark like cough Bark like cough Thumb sign Thumb sign

35. Croup

38. CHF Enlarged heart Enlarged heart PA chest – Distance? PA chest – Distance?

40. CHF

43. Atelectasis Collapse of all or part of the lung due to obstruction of bronchus Collapse of all or part of the lung due to obstruction of bronchus Lung compression/consolidation Lung compression/consolidation Air, fluid, tumors, enlarged lymph nodes, ET tube below carina Air, fluid, tumors, enlarged lymph nodes, ET tube below carina

44. atelectasis caused by the obstructive effects of carcinoma of the bronchus supplying the upper lobe of the right lung.

45. atelectasis

46. Plate-like atelectasis

49. Pleural Effusion Fluid within pleural space Fluid within pleural space Response to inflammation Response to inflammation Infection, Trauma Infection, Trauma

50. bilateral pleural effusions

52. pleural effusions

53. pleural fluid layering

54. Lung Collapse

55. Pneumonia Acute infection of lung parenchyma Acute infection of lung parenchyma Impairs air exchange Impairs air exchange

56. pneumonia infiltrates

58. streptococcal pneumonia

59. aspiration pneumonia

60. Aspiration of Ba What else do we see?

61. Interlobular pneumonia

62. Pneumonia vs. Effusion

63. Pneumonia & Effusion

64. Pneumothorax Collapse of lung, air in the chest cavity Collapse of lung, air in the chest cavity Change in interthoracic pressure Change in interthoracic pressure Radiographical importance Radiographical importance Order: 2V CXR Diag: Post BX/Pneumo Order: 2V CXR Diag: Post BX/Pneumo

65. Pneumothorax

68. Free air in the abdomen

69. Hemopneumothorax

70. Lobectomy

71. Thorocotomy for TB

72. Clavicle & Rib FX

73. Subcutaneous emphysema

76. Pulmonary Embolism/Infarction Acute onset of chest pain Acute onset of chest pain

78. Lung Abscess/Empyema Pus formed in a cavity Pus formed in a cavity Disintegration of tissue Disintegration of tissue

79. Empyema

80. CHRONIC DISORDERS

81. COPD A group of disorders that cause chronic airway obstruction. A group of disorders that cause chronic airway obstruction. Chronic, inflammation process involving the lungs Chronic, inflammation process involving the lungs Ex: Chronic bronchitis, emphysema, asthma & bronchiectasis. Ex: Chronic bronchitis, emphysema, asthma & bronchiectasis.

82. Asthma

85. pulmonary emphysema Blunting of the costophrenic angles. Barrel chest Trapped air

87. emphysema

89. bronchiectasis

91. Tuberculosis

92. TB

94. Cavitatory Pulmonary TB

95. Lordotic projection for TB

96. Asbestosis Plaques

98. PNEUMOCONIOSIS

100. Lung Cancer Bronchogenic Carcinoma is the most common fatal primary malignancy in the United States. Bronchogenic Carcinoma is the most common fatal primary malignancy in the United States. Pulmonary metastases are much more common than primary lung neoplasm. Pulmonary metastases are much more common than primary lung neoplasm.

101. Mediastinum Lymphoma Lymphoma Anatomy – Heart, Hilar region, Thyroid &Thymus glands, Nervous & Lymphatic tissues. Anatomy – Heart, Hilar region, Thyroid &Thymus glands, Nervous & Lymphatic tissues.

102. Bronchogenic carcinoma right hilar mass

103. Mediastinum Adenopathy

104. Adenopathy

105. primary

107. Pulmonary metastases uterine cancer “cotton ball” appearance

109. Mets

110. calcified nodes

111. Calcified Lymph nodes

112. Calcified hilar nodes

113. Lung cancer

114. Hiatal Hernia

119. Chest hernia

120. Coin in Esophagus

121. Marbles in Esoph.