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Ray)
Miscellaneous " ← ممكن حاجة منHeart أوchest" أغلب الحالت
30 من الدرجة% → comment " Items"
70 من الدرجة% → Diagnosis, III, شغل نظرى
Com ment:-
1. Type of X. Ray:-
a) Plain
b) e contrast → Barium swallow ( LT atrial enlargement)
a) female " Breast shadow" lung الـ درجة بياض تزيد كل ما تنزل تحت
b) male
c) child
3. view:-
False cardiomegally
False congestion
c) lat. View → ًغالبا → R.t ventric. enlargement
→ L.t atrial enlargement
4. centralization:-
N.B
Ant half of ribs don’t reach midline as it continues with costal
cartilage → radiolucent.
فىركز
← من المام وليس الخلفHorizontal Ribs ←COPD حالت
Horizontal ← كده كدهpost Ribs لن
Post Half " ← 1st Rib " تمثل الـBony thorax •منأعلى نقطة فى
الخلف
Horizontal Ribs ← •نعد من الخلف
Post Half " ← 1st Rib " تمثل ال الـBony thorax أعلى نقطة فى
•من
المام
oblique Ribs ← تيجى معاه على أدام وتعد من المام•
خطأ
• 1st Rib
concavity of theAppear Cavity
As
• Appear
Medical edge of scapula shadow
As
6. Diaphragm : - " items"
1. Borders
2. contour
3. level
4. costophrenic Angle
5. cardiophrenic Angle
1. Borders:-
Normally: Black
Acute Angles
Abnormally: White
Obliterated e.g. pleural effusion
5. cardiophrenic Angles:
* Structures of Hilum:
a) L.N ل يرى
b) Main Bronchi ل ترى
c) B.vs" Plum arteries and veins" →ترى
* CCC of normal Hilum:-
* Smooth and concave
* Branching
* appears as dots if end on view
* Diameter of R.t pulm 16m.m
L.T Plum 18mm
* Symmetrical density
* Causes of Hilar enlargement:-
L.V enlargement → festooned "lobulated"
Bronchogenic → unilat, ill defined
Pulm Hypertension → bilateral oligaemic lung"
7. Mediastinum:-
a) L.T ventricle
- ↑ cardiothoracic Ratio
- Apex shifted out and downward
- Obtuse L.t cardiophrenic angle
- dipping in the diaphragm
b) Right ventricle:-
- ↑ cardiothoracic Ratio
- Apex shifted out wand, Rounded and uplifted
- Acute left cardiophrenic Angle
- dipping in the diaphragm
الهم On lat view
- obliterated Retrosternal space
← أكيدspace لكثر من1/2 الجزء السفل من ذلك
← ممكنspace لكثر من1/3 الجزء السفل من ذلك
c) Left Atrial enlargement:-
- Normally: most posterior structure عامل زى الكورة
- obliteration of cardiac waste " Mitralization "
Straight
أو
Convex
- Double contour: In cases of huge lt atrium appears behind R.T Atrium
On lat View with Barium Swallow:
الهم
Back words Indentation of barium swallow
d) Right Atrium:
- Increase cardiothoracic ratio
- Cardiac shadow takes more then 1/3of right hemi thorax
Plum Artery
* Plum dilatation :
- Main Plum cone → at 2nd space أكبر
- Hilar pulm vessals كبيرة
- Lung field → Lung oligeaemia
* Plum congestion :
pulm vascular markings more in lower half than upper Halfالمفروض
المرحلة الولىa) early upper half = lowerhalf
المرحلة الثانيةb) Hypoxia at lower half→ V.C
: upper half > lower half
( Redistribution , cephelization , Moustach sign)
المرحلة الثالثةc) Transudation around B.Vs
→ interstitial pulm edema
( ground glass appearance )
المرحلة الخيرةd) intra – alveolar edema
( Bat wings appearance)
Valves
But
* Homogenous opacity
1) Total lung opacity
2) Lobar opacity
3) Opacity obliterating costophrenic Angle
4) Opacity with fluid level
5) coin shape opacity
6) Wedge shaped opacity "plum infarction"
* Heterogeneous opacity
- Linear - Reticulo nodular - Ring shadow
- Flossy cotton - Miliary shadow
(Homogenous opacity)
1) Total lung opacity lung الـ يعنى تلقى
Heart كلها بيضاء لدرجة مش باين منها
Causes
- massive pleural effusion →Trachea pushed to opposite side
- total lung collapse → trachea pushed to the same side
- total lung consolidation → normal trachea Air Bronchogram
تبان سوداء على خلفية بيضاء Bronchi تفريعة الـ
2) Opacity obliterating costophrenic Angle:
- Pleural effusion:
Surface and Rising laterally toward axilla and well defined
But may be with Horizontal level if the condition is Hydropneumothorax
3) Opacity with fluid level:
a) Hydropneumothorax
Upper 1/2 → as pneumothorax
Lower 1/2 → as pleural effusion
b) Lung Abcess: cavity with fluid level
But
Lung fibrosis
- It is Retractile Tissue
- Diagnosed in X. Ray By
1) Reticulonodular shadow