Radiology of Thorax (Chest)
Summary
TLDRIn this educational video, the presenter delves into the radiological anatomy of the thorax, emphasizing the importance of reading chest X-rays. They explain the standard posterior-anterior (PA) view, detailing its advantages over the anterior-posterior (AP) view for accurate cardiac assessment. The script outlines key structures to identify, including the trachea, lungs, and heart, and discusses the significance of the costophrenic angle in detecting pleural effusions. It also covers the identification of bones, the heart's silhouette, and potential deformities, providing a comprehensive guide to understanding chest X-rays.
Takeaways
- 📚 The video discusses the radiological anatomy of the thorax, focusing on how to read chest X-rays.
- 🎥 It suggests watching a previous video for understanding the radiological anatomy of the upper limb.
- 🔍 The X-ray type discussed is a plain film, requiring no special positioning or radio-opaque dye.
- 🏥 The standard view for chest X-rays is the posterior-anterior (PA) view, which is preferred for accurate cardiac size assessment.
- 📏 The PA view minimizes magnification, showing the heart's true size, unlike the anterior-posterior (AP) view which can overstate it.
- 🌟 The video introduces the 'abcd' method for remembering structures to identify: Airway (trachea), Breathing (lungs), Bones, and Circulation (heart).
- 🌈 The color effect in X-rays depends on tissue absorption of the X-ray beam, with less absorption appearing darker, as seen in the lungs.
- 💨 The trachea is identified as a midline dark shadow in the upper part of the mediastinum.
- 🫁 The lungs are identified by their air content, which appears dark, and the cardiac notch helps differentiate the left lung from the right.
- 🦴 Ribs, clavicle, sternum, and cervical vertebrae are among the bones visible in a chest X-ray.
- 🧡 The heart's shadow in the mediastinum helps identify the right and left borders, and any enlargement may indicate cardiomegaly.
- 🔑 The costophrenic angle is clinically important for diagnosing pleural effusion, as fluid accumulation can obliterate this angle.
Q & A
What is the main topic of the video 'Viva Wars of Anatomy'?
-The main topic of the video is the radiological anatomy of the thorax, focusing on how to read chest X-rays.
What is the first step in analyzing a chest X-ray according to the video?
-The first step is to describe the type of radiological film, which in this case is a plain film because no special position is required and no radio-opaque dye is used.
What is the standard view for a chest X-ray and why is it preferred over the AP view?
-The standard view for a chest X-ray is the posterior-anterior (PA) view. It is preferred over the AP view because it allows for accurate assessment of the heart size due to minimum magnification as the heart lies closer to the X-ray plate at an optimum distance.
What does the acronym 'ABCD' stand for in the context of describing the structures seen in a chest X-ray?
-In the context of the chest X-ray, 'ABCD' stands for Airway (trachea), Breathing (lungs), Circulation (heart), and Deformity (any bone fractures or soft tissue abnormalities).
Why does the trachea appear as a midline dark shadow in the upper part of the mediastinum on a chest X-ray?
-The trachea appears as a midline dark shadow because it contains air, which absorbs the least amount of the X-ray beam, resulting in a darker appearance on the radiograph.
How can you differentiate between the left and right lungs on a chest X-ray?
-The left and right lungs can be differentiated by the presence of the cardiac notch on the left lung, which is a feature that helps identify the left lung from the right lung.
What is the clinical importance of the costophrenic angle on a chest X-ray?
-The costophrenic angle is clinically important because it contains the costophrenic recess, which is the most dependent part of the lung. In cases of pleural effusion, fluid accumulates in this area, and the angle may appear as a white shadow or obliterated on the X-ray.
What does the term 'cardiomegaly' refer to and how can it be diagnosed from a chest X-ray?
-Cardiomegaly refers to an enlarged heart. It can be diagnosed from a chest X-ray if the maximum horizontal diameter of the heart is more than half the width of the thoracic cavity.
What structures can be seen in the lower part of the mediastinum on a chest X-ray?
-In the lower part of the mediastinum on a chest X-ray, you can see the heart shadow, including the right and left borders of the heart, and the aortic arch, which is known as the aortic knuckle.
How can you identify the presence of a pleural effusion on a chest X-ray?
-A pleural effusion can be identified on a chest X-ray by the obliteration or whitening of the costophrenic angle, which indicates the accumulation of fluid in the pleural cavity.
What is the significance of the aortic knuckle in a chest X-ray and why is it more prominent in older individuals?
-The aortic knuckle, or the arch of the aorta, is a convex shadow seen in the left border of the heart on a chest X-ray. It is more prominent in older individuals due to the calcification of the aortic wall, which makes it more visible on the X-ray.
Outlines
📚 Introduction to Thorax Radiological Anatomy
The video script begins with an introduction to the radiological anatomy of the thorax, emphasizing the importance of understanding how to read chest X-rays. It suggests viewers refer to a previous video on the radiological anatomy of the upper limb for foundational knowledge. The script then delves into the specifics of reading a plane-type X-ray of the thorax, explaining the standard posterior-anterior (PA) view and its advantages over the anterior-posterior (AP) view for accurate cardiac size assessment. The PA view minimizes magnification, providing a true representation of the heart's size. The script also introduces the concept of the color effect in X-rays, which depends on tissue absorption of the X-ray beam, and outlines the initial structures to identify in a thorax X-ray, such as the trachea as a midline shadow.
🔍 Detailed Examination of Thorax X-ray Structures
This paragraph continues the discussion on thorax X-ray interpretation, focusing on the identification of key structures. It uses the mnemonic 'ABCD' to remember the structures: 'E' for the airway (trachea), 'B' for breathing (lungs), and the distinction between the left and right lungs using the cardiac notch and lingula. The script describes the importance of recognizing the silhouettes and outlines of the lungs, such as the heart borders and diaphragmatic domes, and introduces the costophrenic angle, which is significant in detecting pleural effusion. The paragraph also touches on the identification of bones, including ribs, clavicle, sternum, and cervical vertebrae, and mentions the scapula and its parts. It concludes with the 'C' for circulation, discussing the heart's shadow and its position in the mediastinum.
🏥 Advanced Radiological Analysis of the Thorax
The final paragraph of the script provides an advanced analysis of the thorax X-ray, concentrating on the circulatory aspect represented by the heart's shadow. It explains how to trace the heart's borders and identifies specific features like the aortic knuckle. The paragraph teaches how to measure the heart's size and diagnose cardiomegaly by comparing the heart's width to the thoracic cavity's width. It also briefly mentions the 'D' for deformity, which could include fractures, dislocations, or soft tissue abnormalities like pleural effusion or cardiomegaly. The script concludes with an invitation for viewers to like, share, and subscribe for regular updates on anatomy.
Mindmap
Keywords
💡Radiological Anatomy
💡Chest X-ray
💡Posterior Anterior (PA) View
💡Magnification
💡Mediastinum
💡Trachea
💡Lungs
💡Costophrenic Angle
💡Pleural Effusion
💡Heart Shadow
💡Cardiomegaly
💡Circulation
💡Deformity
Highlights
Introduction to the radiological anatomy of the thorax and the importance of understanding how to read chest X-rays.
Description of the type of radiological film used for chest X-rays, emphasizing the plain film type without special positioning or radio-opaque dyes.
Explanation of the posterior-anterior (PA) view as the standard for chest X-rays and its advantages over the anterior-posterior (AP) view.
The rationale behind using the PA view for more accurate cardiac size assessment due to minimum magnification.
Introduction of the 'abcd' mnemonic for remembering structures in thorax X-rays: Airway, Breathing, Circulation, and Deformity.
Identification of the trachea as the central structure in the upper mediastinum, appearing as a midline dark shadow.
Discussion on the color effect in X-rays based on tissue absorption of the X-ray beam, with air appearing darkest and bones appearing white.
Description of the lung as the primary breathing organ, with the left lung distinguished by the lingula and cardiac notch.
Importance of identifying lung edges and silhouettes, including the heart and diaphragm borders, for a comprehensive X-ray analysis.
Significance of the costophrenic angle in detecting pleural effusion and its clinical implications.
Identification of ribs, clavicle, sternum, and cervical vertebrae as key bony structures in a chest X-ray.
Overview of the heart's position in the mediastinum and its borders, including the aortic arch and cardiophrenic angles.
Method for diagnosing cardiomegaly by measuring the heart's horizontal diameter in relation to the thoracic cavity width.
Discussion on deformities and disabilities, such as fractures, dislocations, and pleural effusion, visible in chest X-rays.
Conclusion summarizing the key points of radiological anatomy of the chest or thorax, emphasizing the importance of understanding X-ray interpretation.
Transcripts
hello friends welcome to the viva wars
of anatomy today we discuss the
radiological anatomy of a thorax
but
first of all you have to know how to
read the radiological film of a chest or
a thorax
for this you can see our previous video
radiological anatomy of upper limb
whose link is given below
now we discuss
the radiological anatomy of a forex or a
chest
the first of all how to read the x-ray
the first you have to describe
a type
the type of a radiological film of this
x-ray
is of a plane type because there is a no
special position is required and no any
radio opaque die is used
the second is a view the view taken
for this x-ray is a posterior interior
view
the standard view for the
x-ray thorax or x-ray chest is a
posterior anterior view
in which
patients stand with their anterior part
of a chest against the x-ray film
and the x-ray tube is placed
six feet behind
the patient
so the x-ray passes from the posterior
to anterior direction
now
why we are taking the pa view over the
ep in the x-ray of a thorax
the first reason
in the pa view
we have seen the position of the patient
in the peer view the heart
of the patient lies nearer to the x-ray
plate
at the optimum distance that is a six
feet
so accurate assessment of a hard side
size cardiac size
due to minimum magnification is done
the heart shadow appear as it is
there is a no magnification occur in the
paving as the heart is lies nearer to
the x-ray plate
in the ap view
there is a
magnificent slide magnification of the
hard side and the media steno is
occurred
due to venous distension
so we are taking the pa view over the ap
view for the
accurate cardiac side
third you have to describe is a reason
of course this is the
chest region of the chest or a thorax so
it is a plane type
now what structure you have to describe
in this x-ray you have to
remember
abcd
the structure
uh describing the thorax is
abcd the first is e
e for the rv
airway which seen in this x-ray is a
trachea
so the trachea is appear as a
midline shadow you can see the midline
dark shadow
in the upper part of the mediastinum
mediastinum lies between the
two
uh shadow of the two lungs
so in the
upper part of the mediastinum in the
midline you can see the dark shadow this
is the shadow of the trachea
okay
now we understand the color effect of
the different structure
in the x-ray
the color effect of the different
structure in the radiograph depends on
on the tissue absorption of the x-ray
beam
if the tissue
absorbs less amount or least amount of
the x-ray beam it appear as a darker
like a lung
trichya
air
which contain the mostly the air air
will absorb the least x-ray beam so it
will appear as a darker structure
if the tissue is absorbed the more
amount of the extra beam it appear as a
white structure
like a bones
okay
some soft tissue
so this this is the color effect
depending on the absorption of a x-ray
beam
now the soft tissue other soft tissue
like a muscle fat is appear as a gray
structure it is not as wide as a bond
not dark as a
air
so this is the first structure seen in
the x-ray
chest is a trachea mid-line dark shadow
in the upper part of the media steno
the second structure scene
you can remember from
b
b for breathing b for balls
the breathing organ is a lung so
the organ you can able to see
is a look
okay
the two leg you can clearly see as a
dark shadow because it contain the air
which appear as a dark that we have seen
why it is appear as a dark
now you have to identify which is a left
lung which is the right length which is
easily identified by the cardiac note
and this is the lingula this is the
cardiac note which is present in the
left lung
this is the left lung this is the right
lung
now
in relation to the
edges of the lung
you can able to see for important
silhouettes or
outlines these are the silhouette of
right
heart border
left
heart border
right hammy diaphragm
and left hemi diaphragm
okay or a
uh shadow of a right
dome of diaphragm
shadow of a left dome of diaphragm
okay now you can see below the left dome
of diaphragm or shadow of a left hemi
diaphragm you can see the dark shadow
which is a normal
again dark shadow is due to air and
these are is present in the fundus of
the stomach which is present below the
left dome of diaphragm
right
now
this dome of the diaphragm
literally
shadow of the dome of the diaphragm both
the shadow literally literally moved it
form an angle with the shadow of the rib
this is the side of the rib and it
formed an angle this is the right side
and the left side
this shadow
this angle
is known as a
coastal means rib franny means diaphragm
coastal frannic
angle
angle on the both the side
now what is the clinically important of
this costophrenic angle frequently asked
in the viva
the clinically important the
is that
it contain the cost
plural
costophrenic races costophrenic recess
is the most dependent part of the luck
so when the plural effusion occur plural
effusion means the accumulation of the
fluid in the pleural cavity so in the
pleural effusion the fluid accumulate in
the most dependent part that is a
costophrenic resist so in the pleural
effusion in the x-ray of the thorax this
costophrenic angle will appear as a
white shadow or you can say it is
obliterated
okay and the
obliteration
among uh degree of the obliteration is
depend on the amount of the fluid
so this is the importance of a
costophrenic angle
we have seen the b for breathing that is
the lung shadow second b for the bone
all the possible bond you have to
describe
so first you can able to see the ribs
you can count the rib from the above
this one is a
side of the first ring
secondary
third fourth fifth
six
seven
eight
nine
ten
ten rib you can able to see
this is the shadow of the clavicle
medial end which articulate with the
sternum the shadow of the sternum is
overlapping with the mediastinal shadow
and the vertebral side
literally
articulate with the acromion process
this is the acromion process
so this is
a scapula over here
the scapula side of the scapula is
clearly seen
this is the glenoid cavity
this is the coracoid process and see the
slightly the head of the humerus
and here in the neck you can see
cervical vertebrae
you can clearly see the transverse
process
okay so this is the bee for the
breathing that is lungs
and a bones
now
the third thing
is a c for the circulation
uh circulation circulatory function is
of a heart so you can see c for
circulation that is a hard shadow earth
shadow is seen as a mediastinum in the
lower part of the mediastinum between
the two heart
uh two side of the lungs
this is the heart shadow you can see the
right border of heart
the left border of the heart
if you trace the left border of the
heart you can see the convex
shadow right side this is a shadow of a
arch of the aorta
which is known as a aortic knuckle which
is more prominent
in the old age
now this heart shadow below it make an
angle with the diaphragm which is known
as a cardiophrenic angle this one
and this one is a cardiophrenic angle
now
the size of the heart
is can be
measured in the thorax
you can
measure or identify if the heart is
increase in the size or not which is
known as a cardiomegaly
that can be how will you diagnose the
cardiome megaly
the maximum width of the heart that is a
horizontal diameter maximum horizontal
diameter if
it is more than the
half of the width of the thoracic cavity
this is the
half
of a total width of the thyroid cavity
if this width is more than of
this width then it is said
patient is having a cardiomegaly
so this is about the c c for the
circulation
and the last part is a d
the d for deformity any deformity or
disability so you can able to see
the fracture or the dislocation of the
bone
or the disability related to the soft
tissue plural effusion
cardiomegaly etc
so this is all about a radiological
anatomy of a chest or a thorax
thank you if you like our video click on
the like button and share with your
friends to get the regular updates on
anatomy video by viva boss of anatomy
subscribe to our channel and click on
the bell icon
Weitere ähnliche Videos ansehen
Assessment of CXR Positioning & Views - How to Read a Chest X-Ray (Part 4) - MEDZCOOL
Cardiac Silhouette - How to Read a Chest X-Ray (Part 7) - MEDZCOOL
Anatomy of a Chest X-Ray - How to Read a Chest X-Ray (Part 1)
Diaphragms and Pleural Effusion - How to Read a Chest X-Ray (Part 8) - MEDZCOOL
ABCs of Reading a Chest X-ray - How to Read a Chest X-Ray (Part 2) - MEDZCOOL
Cardiac Tamponade - pericardial effusion, causes, pathophysiology, investigations and treatment
5.0 / 5 (0 votes)