Normal Respiratory Structures on Chest Radiograph

Normal respiratory structures on chest radiograph. What is an x-ray? Chest radiograph or x-ray is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Like all methods of radiography, chest radiography employs ionizing radiation in the form of x-rays to generate images of the chest The main regions where a chest X-ray may identify problems may be summarized as ABCDEF by their first letters: Airways, including hilar adenopathy or enlargement Breast shadows Bones, e.g. rib fractures and lytic bone lesions Cardiac silhoutte, detecting cardiac enlargement Costophrenic angles, including pleural effusions Diaphragm, e.g. evidence of free air Edges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaques Extrathoracic tissues Fields (lung parenchyma), being evidence of alveolar filling Failure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions

HOW DIFFERENT TISSUES APPEARS ON X-RAY CHEST AIR ------JET BLACK (AIR IN LUNG AND GUT) FAT------MODERATELY BLACK (FAT IN S/C TISSUE) WATER ----- GRAY (NEITHER BLACK NOR WHITE) MUSCLES---- SLIGHT WHITE BONES ----- WHITE CALCIFICATION---- DENSE WHITE DIFFERENT VIEWS PA view (poster anterior view) AP view (anteroposterior view) Lateral view NORMAL MEDIASTINAL ANATOMY

NORMAL LUNG ANATOMY

NORMAL HEART ANATOMY

NORMAL CHEST WALL ANATOMY SKELETAL LOCALIZATION COUNTING OF ANTERIOR AND POSTERIOR RIBS NORMAL CHEST X-RAY Breast shadow in female

MEDIASTINAL ANATOMY SUPERIOR MEDIASTINUM

MAJOR VESSELS, TRACHEA AND TRACHEO- BRONCHEAL ANATOMY INFERIOR MEDIASTINUM

ANTERIOR MEDIASTINUM RETROSTERNAL SPACE MIDDLE MEDIASTINUM HEART, GREAT VESSELS POSTERIOR MEDIASTINUM DTA, ESOPHAGUS, IVC FALSE WIDENED MEDIASTINUM LATERAL SURFACE AND RADIOGRAPHIC NORMAL MEDIASTINAL AND LUNG ANATOMY FRONTAL SURFACE AND RADIOGRAPHIC NORMAL CARDIAC ANATOMY Cardiothoracic ratio The transverse diameter of the heart, as determined by x-ray examination, compared with that of the thoracic cage, used to help determine enlargement of the heart. CARDIOPHRENIC ANGLES AORTIC KNUCKLE - AOA

NORMAL OUTLINE OF TRACHEA NORMAL OUTLINE OF MAIN BRONCHI

BRONCHOVASCULAR MARKINGS RIGHT LATERAL VIEW – RIGHT LUNG RIGHT UPPER LOBE RIGHT MIDDLE LOBE RIGHT LOWER LOBE

R I G H T M I D D L E L O B E LEFT LATERAL VIEW – LEFT LUNG LEFT UPPER LOBE LEFT LOWER LOBE CENTRAL HILAR STRUCTURES NORMAL DIAPHRAGM SHOWING: LEVELS OF DIAPHRAGM COSTOPHRENIC ANGLES