3. 2. TYPE OF FILM AND POSITION
CHECK THE TYPE OF FILM
- POSITION AND DIRECTION
- PA, AP, LATERAL, LATERAL DECUBITUS
IS THE PT UPRIGHT OR LYING
- UPRIGHT PT; YOU MUST SEE FLUID LEVEL IN THE
STOMACH
25/04/22
Bsc.CS
3
5. 3. TECHNICAL QUALITY
TECHNICAL QUALITY
-RIP
- ROTATION; - IS THERE EQUAL DISTANCE BETWEEN MEDIAL END OF
CLAVICLE AND MIDLINE. – SPINOUS PROCESSES HALF WAY
BETWEEN CLAVICLE HEADS. – THEREFORE, NORMALLY ROTATED.
- INSPIRATION; - ADEQUATE INSPIRATION: 5-7 ANTERIOR RIB
INTERSECT DIAPHRAGM. MORE RIBS MEANS LUNGS ARE HYPER-
INFILTRATED, OFTEN SEEN IN COPD. ALSO THERE SHOULD 1-10
POSTERIOR VISIBLE RIBS.
- PENETRATION/EXPOSURE; IT MAY BE OVER/UNDER (TOO
BRIGHT/TOO DARK) PENTRATED/EXPOSED. OR ADEQUATE
EXPOSURE/PENETRATION.
25/04/22
Bsc.CS
5
6. 4. LOOK AT THE BIG PICTURE
LOOK AT THE BIG PICTURE
• CAN YOU IMMEDIATELY SEE ANY LARGE LUNG MASS
OR OBVIOUS ABNORMALITY.
25/04/22
Bsc.CS
6
7. 5. ABCDEFGHI APPROACH
A; AIRWAY
➢NORMAL; CENTRALLY LOCATED AND OPEN
➢CAN DEVIATE AWAY/TOWARD PATHOLOGY
02/05/22
Bsc.CS
7
8. B; BONES (AND TISSUES)
- START FROM TOP, COUNT
- CHECK FOR FRACTURES. –RIB FRACTURES
- LESIONS? FOR EXAMPLE, IN MULTIPLE MYELOMA
- CHECK EXTERNAL SOFT TISSUE FOR ANY ABNORMALITY. FOR EXAMPLE,
SUBCUTANEOUS EMPHYSEMA
02/05/22
Bsc.CS
8
9. C; CARDIAC SILHOUTE/SHADOW
- IN PA; THE CARDIOTHORACIC RATIO <50%(HALF).
- NORMAL; CARDIOPHRENIC ANGLE; VISIBLE, SHARP
- IF THERE AN ENLARGED CARDIAC SILHOUTTE;
CARDIOMEGALLY
- THEN THERE ARE OTHER ABNORMALITIES;
PERICARDIAL EFFUSION “WATER-BOTTLE SIGN”,
RIGHTVENTRICULAR ENLARGEMENT, LEFT
VENTRICULAR ENLARGEMENT, CCF, PULMONARY
HTN, MITRAL STENOSIS ALL HAVE OTHER
ABNORMALITIES.
02/05/22
Bsc.CS
9
10. D; DIAPHRAGM
- NORMAL; HAS SHARPLY VISIBLE BORDER THAT
CURVES DOWN THE EDGES OF THE COSTOPHRENIC
ANGLE.
- VISIBLE, DOM SHAPED, ANGLES INTACT.
- ABNORMALITY INCLUDE; OBLITERATION OF
COSTOPHRENIC ANGLE
10
Bsc.CS
04/05/22
11. E; EDGE OF THE HEART
- SILHOUTE SIGN?
- IF THERE IS CONSOLIDATION =>EITHER RIGHT/LEFT
MIDDLE/LOWER LOBE CONSOLIDATION.
- ANY OTHER ABNORMALITIES;
- OR ARE THEY CLEAR?
19-Jun-22
Bsc.CS
11
12. F; FIELDS OF THE LUNGS
- NORMAL LUNG FIELDS ARE ROUGHLY SYMMETRICAL. WITH LUNG
MARKING, LUNG TISSUE PARENCHYMAL
- WHEN DESCRIBING LUNG FIELDS THERE ARE NO CORRECT
TERMINOLOGIES.
- CAN YOU SEE WHERE LUNG MARKINGS ARE ABSENT? DEVIATED FROM
PARENCHYMAL?
- IS THERE ABNORMAL SHADOWING, OPACITIES, FLUID LEVELS
- NORMAL LUNG MARKING, ARE THEY?
19-Jun-22
Bsc.CS
12
13. G; GASTRIC BUBBLE
- NORMAL BUBBLE IS A SMALL DARK AREA UNDER THE
DIAPHRAGM WITH THE FLUID LEVEL.
- IF THERE IS HIATUS HERNIA IT WILL BE ABOVE
DIAPHRAGM
19-Jun-22
Bsc.CS
13
14. H; HILAR
- NORMALLY ONLY PULMONARY BLOOD VESSELS ARE
VISIBLE.
- VISIBLE LYMPH NODES ARE AN ABNORMAL
FINDINGS, e.g HILAR LYMPHADENOPATHY
- LOOK OUT FOR MASSES, CAUSIFIED AREAS
19-Jun-22
Bsc.CS
14
15. I; INSTRUMENTS
- THINGS DOCTORS PUT INTO/ON PATEINTS
- e.g TUBES, PACEMAKERS, WIRES, SOMETIMES YOU
CAN EVEN KNOW WHAT IT IS?
19-Jun-22
Bsc.CS
15
16. SUMMARY
- IT’S A GOOD IDEA TO GO BACK AND SUMMARIZE
YOUR FINDINGS
19-Jun-22
Bsc.CS
16
18. ▪ THIS IS AN UPRIGHT PA CHEST FILM OF Mr EMERSON. TAKEN ON
THE FIRST OF JANUARY THIS YEAR. EXPOSURE IS ADEQUATE. THE
PT IS NOT ROTATED AND THERE IS NO MOTION BLURRY. AIRWAY
IS CENTRAL AND PATENT. THERE ARE FRACTURES, LESIONS OR
DEFCTS VISIBLE IN THE BONES. CARDIAC SILHOUTE/SHADOW IS
NOT ENLARGED. BOTH HEMIDIAPHRAGNS APPEAL NORMLAAND
WITH NO BLUNTING OF THE COSTOPHRENIC ANGLES. THE EDGES
OF THE HEART AND MAJOR VESSELS ARE CLEARLY VISIBLE. LEFT
AND RIGHT LUNG FIELDS ARE CLEAR THROUGHOUT. THE
GASTRIC BUBBLE IS VISIBLE AND THERE IS NORMAL HILAR
SHADOWING.
▪ IN SUMMARY, THIS IS A NORMAL UPRIGHT CHEST FILM.
19-Jun-22
Bsc.CS
18
