Which is right and left in a chest x ray

WHICH IS RIGHT AND LEFT IN A CHEST X RAY FOR FREE

Now for the CasesвЂ¦ RememberвЂ¦ be systematic!Дў4 PA view: RML consolidation and loss of right heart silhouette

Upper right heart border / ascending aorta (anterior RUL) Aortic knob (Apical portion of LUL ) Upper left heart border (anterior LUL) Right heart border (medial RML) Left heart border (lingula anterior) Anterior hemidiaphragms (anterior lower lobes)Дў2 Lung Fields: Fissures The fissures can also help you to determine the boundaries of pathology Major Oblique Fissure Separates the LUL from the LLL Right Major Fissure Separates the RUL/RML from the RLL Right Minor Fissure Separates the RUL from the RML

Silhouette / Structure Contact with Lung Upper right heart border/ascending aorta Anterior segment of RUL Right heart border RML (medial) Upper left heart border Anterior segment of LUL Left heart border Lingula (anterior) Aortic knob Apical portion of LUL (posterior) Anterior hemidiaphragms Lower lobes (anterior)Дў1 Lung Fields: Using Structures / Silhouettes To help you determine abnormalities and their locationвЂ¦ Use silhouettes of other thoracic structures Use fissuresДў0 Lung Fields: Using Structures / Silhouettes

WHICH IS RIGHT AND LEFT IN A CHEST X RAY FOR FREE

Right is normally higher than left Check for free air, gastric bubble, pleural effusions Mediastinal and Hilar contours for increase densities or deformitiesДЎ7 Findings 11. Soft tissue and bony structures Check for SymmetryДeformities Fractures Masses Calcifications Lytic lesionsДЎ6 Findings 10. Pitfall Due to Angulation Apical lordotic Same patient, not lordotic A film which is apical lordotic (beam is angled up toward head) will have an unusually shaped heart and the usually sharp border of the left hemidiaphragm will be absentДЎ5 Findings 9. Angulation Clavicle should lay over 3rd rib 1 2 3 Medial ends of bilateral clavicles are equidistant from the midline or vertebral bodiesДЎ2 If spinous process appears closer to the right clavicle (red arrow), the patient is rotated toward their own left side If spinous process appears closer to the left clavicle (red arrow), the patient is rotated toward their own right sideДЎ3 Quality Control 8. Poor inspiration can crowd lung markings producing pseudo-airspace disease 9-10 posterior ribs are showing 9 With better inspiration, the вЂњdisease processвЂќ at the lung bases has cleared Should be able to count 9-10 posterior ribs Heart shadow should not be hidden by the diaphragm 1 2 3 4 5 6 7 8 9 10Д© About 8 posterior ribs are showing 9-10 posterior ribs are showing Pulmonary markings more prominent than they actually are Penetration Should see ribs through the heartД«arely see the spine through the heart Should see pulmonary vessels nearly to the edges of the lungsД¦ Overpenetrated Film Lung fields darker than normal-may obscure subtle pathologies See spine well beyond the diaphragms Inadequate lung detailД§ Underpenetrated Film Hemidiaphragms are obscured Which view(s) do you have? PA / AP, lateral, decubitus, AP lordoticДҐ Quality Control 5. VCU / Fairfax Family Practice July 13, 2005ДЈ } } } The 12-Step Program Pre-read Quality Control Findings 1: NameДў: Date 3: Old films 4: What type of view(s) 5: Penetration 6: Inspiration 7: Rotation 8: Angulation 9: Soft tissues / bony structures 10: Mediastinum 11: Diaphragms 12: Lung Fields Pre-read } Quality Control } FindingsД¤ Pre-Reading 1.

Which is right and left in a chest x ray