kuliah radio anatomi ok
DESCRIPTION
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RADIO ANATOMY RESPIRATORY TRACTAND MEDIASTINUM
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RadioanatomyStudies of human body seeing through the roentgenologic examination
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Respiratory Tract1. Upper air passage (Cav. Nasi and pharynx)2. Larynx3. Trachea and bronchus4. Lung + Vascular (lymph)5. Thoracic wall + diaphragm3,4,5 Chest x-rayLung !
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Lung Anatomy-Right
Superior Lobe Apical Segment (1)Posterior Segment (2)Anterior Segment (3)Medial Lobe Lateral Segment (4)Medial Segment (5)Inferior LobeApicobasal Segment (6)Mediobasal Segment (7)Anterobasal Segment (8)Laterobasal Segment (9)Posterobasal Segment (10)
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Lung Anatomy-Left
Superior LobeApicoposterior Segment (1)Anterior Segment (2) LingulaSuperior Segment (3)Inferior Segment (4) Inferior LobeApical (5)Antero medial basal (6)Latero basal (7)Postero basal (8)
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X-ray / Fluoroscopy IndicationContact personCough > 2 weeksRecurrent respiratory infectionHemaptoeEkstra pulmonary TBCErytema nodosum / conjuntivitis phlyctenularisFissura/fistula anichronicumDMPrecautionary indication
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X-ray ExaminationRoutine : PASpecial : Lateral Left RightAPOblique Left RightLateral decubitus
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Special methode of examinationTomografiBronchografiUSGCT scanMRI
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PA PositionPlace patient between film X ray sourceHave the patient stand backward to the X- ray source, chest close to film with hand on the hip, with elbow flexed.Distance between film and X-Ray Lung 1,5 m Heart 2 mRay concentrated at - TH 6-7 - KV 50-60 - MAs 10-20
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Good chest X-Ray Depend on:1.Good film qualityDepending on :KVMasProcessing2. Symmetry3. All part of thorax are included4. Identity /Marking5.No artifact6.No motion artifact7. Maximal inspiration
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What studied in chest x-raySoft tissueCostae and clavicleTracheaSize, shape and position of heartLung Hilum Bronchovascular marking
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Lung field :Lung apexLung top fieldLung middle fieldLung lower field
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Lateral chest filmIndicationTo study abnormality that is not visible on PA filmTo study mediastinal disorderHeart studies
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Lateral chest procedurePlace patient between film and X-ray sourcePlace lateral side of chest (left/right) on filmHands behind the headRay centered on Th 6-7
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What studied on lateral chest filmTrachea and main bronchial branch - radioluscentHeart, aortic arch, asc/ desc aorticLeft/ Right Lung bronchovascular marking superpositionRetrosternal spaceRetrocardial spaceCostophrenic sinus Cardiophrenic sinus
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Antero posterior (AP) chest filmIndication : Severely ill patient Children / babiesObese, pregnancy, ascites, abdominal tumorProcedure:Place patient lying down on table with elbow above headPlace film on patients back Centered ray on Th 6-7
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Top lordotic chest x-rayIndication :To studies disorder located on apex / medial lobe - clavicle turn upwardProcedure:Place patient between film and x-ray source, have the patient face the x-ray sourceHave the patient stand 30 cm in front with back placed on the cassetteSet top part of the cassette 1 inch above the shoulderCentered ray on manubrium sterni
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Oblique chest film:Indication :Heart studiesTo study abnormality that is not yet clear on PA studiesProcedurePlace patient between film and ray sourcePut ventral left/right side of the patients thorax on the cassette making 45 0 angleCenter ray on Vert. Th 6-7
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Lateral Decubitus Chest FilmIndication :To study fluid in pleural cavity that is around 100-200 ccOr fluid accumulation that is not yet determined on PA studiesProcedureHave the patient lying down on left/right side with elbow above the head Center ray on vert. Thoracal 6-7 from anterior /posterior aspect
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Mediastinum Studies1. Radiograph :Chest film: - PA.Lateral.Esophageal contrast studies.2. Fluoroscopy :To study pulsationTo study placement of organ in chest cavity
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To study mass relation with adjacent organDiaphragmEsophagus.Heart and major vesselTo study pericardial effusion.
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-To study pericardial effusion.3. Tomografi.4. Angiographies Usually with CT.5. CT Scan / MRI.
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6. USG : Mass close to diaphragm / Pericardial effusion.7. Nuclear med. Radioisotop.Radio isotop angiogram.To study localisation of tumor.Eq : thymoma, thyroid, lymph node.
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Mediastinum Borders- Top: Apertura thoracis sup.- Dorsal: Vertebral Column.- Ventral: Sternum.- Inferior: Diaphragm.- Lateral: mediastinal pleura.
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Mediastinum 1. Anterior superior med2. Anterior medius med3. Anterior inferior med4. Superior medius med5. Middle med6. Posterior superior med7. Posterior medius med8. Posterior inferior med
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Location of mediastinal disorderAnterior superior medAneurisma.Tymus HyperplLymphoma.Intrathoracal StrumaAnterior middle med. Dermoid. Teratoma.
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Ant. Inferior. Med Thymoma. Pericardial cyst. Hernia diafragmatica.Superior Mid. Med Aneurisma. Dermoid. Teratoma. Mediastinal trauma
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Middle Mediastinal Dermoid. Teratoma. Lymphoma. Tumor metastasis
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Post superior med. Oesophageal disorder Aneurism Neurinoma, neurofibroma. Pancoast tumor.
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Post medius med. Neurogenic tumor. Bronchial defect enteric cyst.
Post inferior med. Neurogenic origin primary tumor. Hernia diaphragmatica.
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BibliographyShort textbook of clinical imaging.,David Sutton, Jeremy W.R Young, 1990Rontgen sign in diagnostic imaging col 4 (chest) Meschan Thn 1997Essentials of Coffeys Pediatric X-ray diagnosis, 1990.