thorax david s. hartman, m.d. department of radiology
TRANSCRIPT
Thorax
David S. Hartman, M.D.Department of Radiology
Learning Objectives:
Identify all objects indicated by
arrows on the radiolgical images
in this presentation
Cases in MDL
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Cases can be viewed by any computer in the institution
PA and Lateral Chest
Radiograph
Heart Chambers
Most anterior
Most posterior
Right boarder
Left boarder
Right ventricle
Left atrium
Right atrium
Left atrium/ ventricle
Most superior Left atrium
Heart from the Front
Left atrium
Left ventricle
Pulmonary artery
Aorta
RightAtrium
RightVentricle
204
RightAtrium
Right ventricle
Left atriumVentricle
201
RightAtrium
Left AtriumVent-ricle
Aortic arch
Main pulmonary artery
Left atrium, ventricle
Trachea
Clavicles
Cardiophrenic angles
Costophrenic angles
Hilum (pleural: hila)
1. Root of the lung
2. Pulmonary artery
3. Upper lobe pul vein
4. Bronchus
5. (Lymph nodes)
Right hilum
Left hilum
Right ventricle
Left atrium
Left ventricle
Cardiophrenic angle
Costophrenic angle
LeftDiaphragm
219
Right ventricle
Left atrium left ventricle
Diaphragm
Cardiophrenic angle
Costophrenic angles
Trachea
Thoracic spine
Pulmonary
Arteriogram
Pulmonary Arteries
1. Main PA (pulmonary trunk) off right ventricle (anterior)
2. Right main PA longer than left main PA and runs horizontaly superior to left atrium
3. Left main PA is short and runs over left main stem bronchus
Right main PA
RA
RV LV
Main PA(trunk)
Left main PA
194
Aorta
LA
Catheter
in main PA
Right main pulmonary artery
Left inferior
pulmonary
artery
Arch Aortogram
Ascending aorta
Aortic arch
Descending aorta
Brachiocephalic art
Left common carotid art
Left subclavian art
225Aortic Arch
R L
Aortic arch
Brachiocephalic art
Left common carotid art
Left subclavian artery
Arch Aortogram
CT of the Heart and Mediastinum
(axial images)
Axial section
LeftRight
View as though facing the patient
LeftRight
By convention we look from below
Posterior
Anterior
Axial CT image with contrast
Liver
Heart
Lung
Right
Sternum
Scapula
SpineRibs
Vascular Arch
Vascular Arch
Vascular Arch
Vascular Arch
3 Vascular Arches
1. Aorta
2. Left pulmonary
artery
3. Azygos vein
Pulmonary artery,vein
Left main bronchus
Right main bronchus
Arch Structure below arch
The brachocephalic vein runs anterior to the
branches of the aorta
195
Frontal of the brachiocephalic vein and aortic arch
Aortic arch
Brachiocephalic artery
Left common carotid artery
Right brachio-cephalic vein
Left brachio-cephalic vein
Superior vena cava
Trachea
195
The trachea is just ventral to the esophagus
Trachea
Brachiocephalic artery
Left common carotid artery
Left subclavian artery
Esophagus
196Branches of the aorta
195
Origin of the great vessels above the aortic arch
Right
Origin of the great vessels above the aortic arch
Right
Left brachio-cephalic vein
Right brachio-cephalic vein
Brachiocephalic artery
Left common carotid artery
Left subclavian artery
Tracheal area
Esophagus
The azygos arch
passes over the
right main-stem
bronchus
RIGHTDIAPHRAGM
Superior vena cava
Right atrium
Right ventricle
Inferior vena cava
208
Superior vena cava
Azygos arch
Right bronchus
Right main pulmonary art
Right pulmonary veins
Right atrium
Azygos vein
208
195
Level of the aortic arch
Level of the aortic arch
Aortic arch
Superior vena cava
Trachea
Azygos arch
Esophagus
Vertebra
Level of the aortic arch
The left pulmonary
artery passes
over the left
main-stem bronchus
Aortic arch
Left main pulmonary art
Left atrium
Left ventricleLEFT
DIAPHRAGM
219
Aorta
Left main pulmonary artery
Left mainstem bronchus
Left pulmonary veins
Left atrium
219
Level below the aortic arch (top of the left pulmonary artery
SVC
PULMONARY ARTERY
ASCENDINGAORTA
201
Level below the aortic arch (top of the left pulmonary artery
Level below the aortic arch (top of the left pulmonary artery
Ascending aorta
Main pulmonary artery
Superior vena cava
Right pul art
Right bronchus
Left bronchus
Top of left pulmonary artery
Descending aorta
Azygos vein
BACK WALLOF BRONCHUS
Pulmonary artery
AscendingAorta
201
Top of the right atrium
Level at the root of the aorta and main pulmonary artery
Ascending aorta
Main pulmonary artery
Right atrium
Rt pulmonary artery
Right bronchus
Left bronchus
Lt lower lobe PA
Descending aorta
Azygos veinBack of the
left bronchus
The pulmonary trunk
is anterior to
the aorta root
The arota arises
from “center”
of heart
Heart from the Front
RightAtrium
RightVentricle
204
Aorta
Pulmonary artery
Left ventricle
Left atrium
RightAtrium
Right ventricle
Left Ventricle
201
Level at the top of the ventricles
Level at the top of the ventricles
Right ventricle
Right atrium
Ascending aorta
Left ventricle
Left atrium
Descending aorta
Azygos vein
Level at the top of the ventricles
Heart Chambers
Most anterior
Most posterior
Right boarder
Left boarder
Right ventricle
Left atrium
Right atrium
Left atrium/ ventricle
Most superior Left atrium
Right ventricle
Right atrium
Left ventricle
Left atrium
Pulmonary veins
Descending aorta
Azygos vein
230Level through all 4 heart chambers
RightAtrium
Right ventricle
Left Ventricle
201
Level through all 4 heart chambers
Right ventricle
Right atrium
Left ventricle
Left atrium
Aorta
Azygos vein
RightAtrium
Right ventricle
Left Ventricle
201
Level at the bottom of the heart (below left atrium)
Level at the bottom of the heart (below left atrium)
Right ventricle
Inferior vena cava
Left ventricle
Aorta
Azygos vein
Level at the bottom of the heart (below left atrium)
Follow a drop of bloodfrom the left arm
to the head
X
TO THE LEFT BRACIOCEPHALIC VEIN
X
INTO THE SVC
X
SVC
X
SVC
X
SVC
X
SVC
X
SVC
X
SVC
X
SVC
X
SVC
X
TOP OF THE RA
X
RA
X
RA
X
INTO THE RV
X
RV
X
RV
X
RV
X
RV
X
RV
X
RV
X
RV
X
RV OUTFLOW
X
RV OUTFLOW
X
RV INTO MAIN PA
X
MAIN PA
X
RT AND LT PA’S
X
X
RT AND LT PA’S
X
FROM LUNG TO LA
X
LA
X
LV
XXX
LV TO OUTFLOW
X
INTO ASCENDING AORTA
X
ASCENDING AORTA
X
ASCENDING AORTA
X
ASCENDING AORTA
X
INTO AORTIC ARCH
X
AORTIC ARCH
X
AORTIC ARCH
X
INTO BRACHIOCEPHALIC ARTERY
XX
INTO THE CAROTIDS
Thorax
David S. Hartman, M.D.Department of Radiology