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Department of Radiology
Thorax David S. Hartman, M.D. Department of Radiology
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Identify all objects indicated by arrows on the radiolgical images
Learning Objectives: Identify all objects indicated by arrows on the radiolgical images in this presentation
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Cases can be viewed by any computer in the institution
Cases in MDL \\hersheymed.net\files\MMS\Public\education\radiology\lab-thorax pps Cases can be viewed by any computer in the institution
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PA and Lateral Chest Radiograph
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Heart Chambers Most anterior Most posterior Right boarder Left boarder
Right ventricle Left atrium Right atrium Left atrium/ ventricle Most superior Left atrium
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Heart from the Front Left atrium Left ventricle Pulmonary artery Aorta
Right Atrium Right Ventricle 204
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Right Atrium Left atrium Ventricle Right ventricle
201
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Right Atrium Left Atrium Vent- ricle
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Aortic arch Main pulmonary artery Left atrium, ventricle
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Trachea Clavicles Cardiophrenic angles Costophrenic angles
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Hilum (pleural: hila) Root of the lung Pulmonary artery
Upper lobe pul vein Bronchus (Lymph nodes)
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Right hilum Left hilum
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Right ventricle Left atrium Left ventricle Cardiophrenic angle
Costophrenic angle Left Diaphragm 219
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Right ventricle Left atrium left ventricle Diaphragm Cardiophrenic angle Costophrenic angles
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Trachea Thoracic spine
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Pulmonary Arteriogram
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Pulmonary Arteries Main PA (pulmonary trunk) off right ventricle (anterior) Right main PA longer than left main PA and runs horizontaly superior to left atrium Left main PA is short and runs over left main stem bronchus
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Right main PA Left main PA Main PA (trunk) Aorta RA RV LV
LA RA RV LV 194
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Left inferior pulmonary artery
Right main pulmonary artery Left inferior pulmonary artery Catheter in main PA
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Arch Aortogram
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Left common carotid art
Ascending aorta Aortic arch Descending aorta Brachiocephalic art Left common carotid art Left subclavian art Aortic Arch 225
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Arch Aortogram Aortic arch Brachiocephalic art Left common carotid art Left subclavian artery R L
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CT of the Heart and Mediastinum (axial images)
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View as though facing the patient
Axial section Right Left
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Axial CT image with contrast By convention we look from below
Anterior Heart Liver Right Left Lung Posterior By convention we look from below
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Right Sternum Scapula Spine Ribs
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Vascular Arch
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Vascular Arch
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Vascular Arch
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Vascular Arch
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3 Vascular Arches Arch Structure below arch Aorta Left pulmonary
artery 3. Azygos vein Pulmonary artery, vein Left main bronchus Right main bronchus
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The brachocephalic vein runs anterior to the branches of the aorta
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Frontal of the brachiocephalic vein and aortic arch
195
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Brachiocephalic artery Left common carotid artery
Aortic arch Brachiocephalic artery Left common carotid artery Right brachio-cephalic vein Left brachio-cephalic vein Superior vena cava Trachea 195
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The trachea is just ventral to the esophagus
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Brachiocephalic artery Left common carotid artery
Trachea Brachiocephalic artery Left common carotid artery Left subclavian artery Esophagus Branches of the aorta 196
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Origin of the great vessels above the aortic arch
195
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Origin of the great vessels above the aortic arch
Right
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Left brachio-cephalic vein
Right brachio-cephalic vein Brachiocephalic artery Left common carotid artery Left subclavian artery Tracheal area Esophagus Right
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The azygos arch passes over the right main-stem bronchus
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Superior vena cava Right atrium Right ventricle Inferior vena cava
DIAPHRAGM 208
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Right main pulmonary art Right pulmonary veins Right atrium
Superior vena cava Azygos arch Right bronchus Right main pulmonary art Right pulmonary veins Right atrium Azygos vein 208
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Level of the aortic arch
195
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Level of the aortic arch
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Aortic arch Superior vena cava Trachea Azygos arch Esophagus Vertebra Level of the aortic arch
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The left pulmonary artery passes over the left main-stem bronchus
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Left main pulmonary art Left atrium Left ventricle
Aortic arch Left main pulmonary art Left atrium Left ventricle LEFT DIAPHRAGM 219
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Left main pulmonary artery Left mainstem bronchus Left pulmonary veins
Aorta Left main pulmonary artery Left mainstem bronchus Left pulmonary veins Left atrium 219
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Level below the aortic arch (top of the left pulmonary artery
SVC ASCENDING AORTA PULMONARY ARTERY 201
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Level below the aortic arch (top of the left pulmonary artery
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Top of left pulmonary artery Descending aorta Azygos vein
Ascending aorta Main pulmonary artery Superior vena cava Right pul art Right bronchus Left bronchus Top of left pulmonary artery Descending aorta Azygos vein BACK WALL OF BRONCHUS
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Level at the root of the aorta and main pulmonary artery
Top of the right atrium Ascending Aorta Pulmonary artery 201
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Ascending aorta Main pulmonary artery Right atrium Rt pulmonary artery
Right bronchus Left bronchus Lt lower lobe PA Descending aorta Azygos vein Back of the left bronchus
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The pulmonary trunk is anterior to the aorta root
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The arota arises from “center” of heart
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Heart from the Front Left atrium Aorta Pulmonary artery Left ventricle
Right Atrium Aorta Pulmonary artery Right Ventricle Left ventricle 204
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Level at the top of the ventricles
Right Atrium Left Ventricle Right ventricle 201
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Level at the top of the ventricles
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Right ventricle Right atrium Ascending aorta Left ventricle Left atrium Descending aorta Azygos vein Level at the top of the ventricles
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Heart Chambers Most anterior Most posterior Right boarder Left boarder
Right ventricle Left atrium Right atrium Left atrium/ ventricle Most superior Left atrium
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Level through all 4 heart chambers
Right ventricle Right atrium Left ventricle Left atrium Pulmonary veins Descending aorta Azygos vein Level through all 4 heart chambers 230
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Level through all 4 heart chambers
Right Atrium Left Ventricle Right ventricle 201
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Right ventricle Right atrium Left ventricle Left atrium Aorta Azygos vein
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Level at the bottom of the heart (below left atrium)
Right Atrium Left Ventricle Right ventricle 201
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Level at the bottom of the heart (below left atrium)
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Right ventricle Inferior vena cava Left ventricle Aorta Azygos vein Level at the bottom of the heart (below left atrium)
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Follow a drop of blood from the left arm to the head
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TO THE LEFT BRACIOCEPHALIC VEIN
X MS 211 CT 7 NORMAL CHEST CT
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INTO THE SVC X
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SVC X
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SVC X
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SVC X
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SVC X
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SVC X
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SVC X
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SVC X
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SVC X
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TOP OF THE RA X
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RA X
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RA X
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INTO THE RV X
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RV X
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RV X
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RV X
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RV X
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RV X
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RV X
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RV X
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RV OUTFLOW X
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RV OUTFLOW X
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RV INTO MAIN PA X
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MAIN PA X
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RT AND LT PA’S X
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RT AND LT PA’S X X
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FROM LUNG TO LA X
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LA X
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LV X
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LV TO OUTFLOW X X X
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INTO ASCENDING AORTA X
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ASCENDING AORTA X
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ASCENDING AORTA X
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ASCENDING AORTA X
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INTO AORTIC ARCH X
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AORTIC ARCH X
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AORTIC ARCH X
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INTO BRACHIOCEPHALIC ARTERY
X
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INTO THE CAROTIDS X X
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Department of Radiology
Thorax David S. Hartman, M.D. Department of Radiology
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