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RESPIRATORY TRACT
AND MEDIASTINUM
Rista D. Soetikno, dr, SpR
Radioanatomy
Studies of human body seeing through the
roentgenologic examination
Respiratory Tract
Upper air passage (Cav. Nasi and pharynx)
Larynx
Trachea and bronchus
Lung + Vascular (lymph)
Thoracic wall + diaphragm
Lung anatomy-Right
Superior Lobe
Medial Lobe
Inferior Lobe
Lung Anatomy-Left
Superior Lobe
Lingula
Inferior Lobe
Apical (5)
Antero medial basal (6)
Latero basal (7)
Postero basal (8)
Contact person
Cough > 2 weeks
Recurrent respiratory infection
Hemaptoe
Ekstra pulmonary TBC
Erytema nodosum / conjuntivitis phlyctenularis
Fissure/fistula anichronicum
DM
Precautionary indication
X-ray Examination
Routine : PA
Special :
Lateral
Left
Right
AP
Oblique - Left
- Right
Lateral decubitus
Tomografi
Bronchografi
USG
CT scan
MRI
PA Position
Place patient between film X ray source
Have the patient stand backward to the X- ray
Soft tissue
Costae and clavicle
Trachea
Size, shape and position of heart
Lung
Hillous
Bronchovaskuler marking
Lung field :
Lung apex
Lung top field
Lung middle field
Lung lower field
superposition
Retrosternal space
Retrocardial space
Costophrenic sinus
Cardiophrenic sinus
Mediastinum Borders
- Superior: Apertura thoracis sup.
- Dorsal : Vertebral Column.
- Ventral : Sternum.
- Inferior : Diaphragm.
- Lateral : Mediastinal pleura.
1.
2.
3.
4.
5.
6.
7.
8.
Mediastinal
Mediastinal Studies
1.
2.
Radiograph :
Chest film: - PA.
Lateral.
esophageal contrast studies.
Fluoroscope :
To study pulsation
To study placement of organ in chest
cavity
3.
4.
5.
6.
Tomografi.
Angiografi Usually with
CT.
CT Scan / MRI.
USG : Mass close to
diaphragm / Pericard effusion.
7.
Location of mediastinal
disorder
Anterior superior med
Aneurisma aorta
Thymus Hyperplasia
Lymphoma
Intrathoracal Struma
Thymoma
Dermoid
Teratoma
Thymoma.
Pericardial cyst.
Hernia diafragmatica.
Superior Mid. Med
Aneurisma.
Dermoid.
Teratoma.
Mediastinal trauma
Middle Mediastinal
Dermoid
Teratoma
Lymphoma
Oesophageal disorder
Aneurism
Neurinoma, neurofibroma.
Pancoast tumor
Middle Mediastinal
1. Infection
Sarcoidosis
TBC
Mycosis.
Erythema nodosum
2. Tumor Metastasis
3. Lymphoma
Posterior mediastinal
Esophagus disorder:
Diverticle.
Achalasia / Chalasia
Pancoast tumor
Aneurisma.
Neurogenic tumor (Neurofibroma,
Neurinoma)
Neurogenic tumor.
Diaphragmatic hernia.
4.
Intrathoracal Struma
40 years
Usually compress : trachea,
oesophagus, phrenic nerve.
Ro:
Lung apex mass compress
trachea.
Mediastinum anterior medius
Dermoid cyst: Tumor that consist of
multiple tissue hair, teeth
benign.