ANATOMY FOR PLAIN CHEST X-RAY (POSTEROANTERIOR AND LATERAL VIEWS)

PREPARED BY: NUR LIYANA BT AB AZIZ 5077

BRIEF INTRODUCTION ABOUT POSTEROANTERIOR AND LATERAL VIEWS While there are many possible views that can be taken of the chest, the two most common are the PA view and the lateral view. The PA view, or Posterior-Anterior view, positions the beam at the patient's back. The radiation then travels through the spine, lungs, heart, and finally skin until it meets the detector or film anterior to the patient. The advantage of a PA film over an AP, or anterior-posterior, view is a reduction in the enlargement of the cardiac silhouette. Since the heart is closer to the film, its shadow is less distorted. The PA view is often taken simultaneously with a lateral view. The benefit of having two views is that the radiologist is better able to visualize abnormalities in 3-D space with two views. Otherwise, there is a chance that two abnormalities can be in the same sagittal plane, yielding only one shadow on the PA view. The lateral view would distinguish between these two lesion. In other words, the PA view tells you where things are, medial to lateral, while the lateral view tells you where things are in an anterior to posterior sense. The lateral chest radiograph is taken with the patient's left side of chest held against the x-ray cassette (left instead of right to make the heart appear sharper and less magnified, since the heart is closer to the left side). It is taken with the beam at 6 feet away, as in the PA view

POSTEROANTERIOR VIEW

Rotation: The right and left lung fields having nearly the same diameter, and the heads of the ribs (end of the calcified section of each rib) at the same location to the chest wall, which indicate absence of significant rotation. Inspiration: About 9 ribs can be seen on each side indicating good inspiration. Penetration: Detailed spine and pulmonary vessels are seen behind the heart, the exposure is correct. Airway: The airway is patent and midline. The carina, where the trachea bifurcates (divides) into the right and left main stem bronchi also can be seen. Bones: No fractures, lesions, or defects can be seen. Cardiac silhouette: A normal cardiac silhouette occupies less than half the chest width. Diaphragms: The right diaphragm is normally higher than the left, due to the presence of the liver below the right diaphragm. Edges of heart: The heart border is normal. Fields of the lungs: The lungs are symmetry, absence of any mass, nodules, infiltration, and fluid. Gastric bubble: Gas bubble is present in the left upper abdominal quadrant. Hila: The left pulmonary artery is more superior than the right, making the left hilum higher.

LATERAL VIEW

Airway: The carina, where the trachea bifurcates (divides) at the level of T4 into the right and left main stem bronchi also can be seen. Bones: No fractures, lesions, or defects can be seen. The sternum is normal. Cardiac silhouette: A normal cardiac silhouette can be seen. Diaphragms: The right diaphragm is normally higher than the left, due to the presence of the liver below the right diaphragm. The diaphragm is dome shaped and normal. Edges of heart: The heart border is normal. Fields of the lungs: The lungs are symmetry, absence of any mass, nodules, infiltration, and fluid. Gastric bubble: Gas bubble is present in the left upper abdominal quadrant. Hila: The left pulmonary artery is also can be seen normally.

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