![]() As a result, it is more common for inhaled foreign objects to become lodged in the right side bronchial tree as the route is more direct. The right main bronchus is generally wider, shorter, and more vertically oriented than the horizontally oriented, longer, left main bronchus. This bifurcation of the trachea is an important landmark when assessing nasogastric tube placement, as the NG tube should pass distal to the carina in a vertical, midline, orientation. On a good quality CXR this division should be visible. The carina is located at the point at which the trachea divides into the left and right main bronchus. Rotation of the patient can give the appearance of a deviated trachea, so as mentioned above, check the clavicles to rule out rotation as the cause. large pleural effusion / tension pneumothorax / mediastinal mass If the trachea is deviated, look for anything that could be pushing or pulling the trachea. The trachea is normally located centrally or just slightly to the right of midline. There are often a variety of tubes, catheters, and other artifacts that alter the appearance of the portable chest x-ray.įigure 5.5 ODIN link for Normal Portable Chest x-ray: /odin/?caseID=20170114100724626 Also, the patient is often unwell resulting in inferior anatomic positioning and sub-optimal inspiration. The portable chest x-ray is a less optimal imaging strategy as there are factors that alter the appearance of the image due to patient positioning and altered magnification of some anatomic structures. A lateral view is not obtained using this image strategy. The source of the x-rays for portable imaging enters the patient from the anterior anatomy and the x-ray detection plate is posterior to the patient i.e. The portable chest x-ray unit can be deployed to the patient’s bedside. It was Roentgen who coined the term “x-ray”.Īn alternative imaging acquisition strategy is available for those patients who are unable to attend the Imaging Department and stand or sit upright for the standard images. The radiograph produced is referred to as a roentgenogram and named after Wilhelm Konrad Roentgen who received the first Nobel Prize for Physics in 1901 for his work in defining the major properties of x-rays and the conditions necessary for their production. When the x-rays penetrate the tissues of the patient, they stimulate an x-ray detector that alters the energy of the x-ray beam into a digital pixel grid. ![]() The standard upright views of the chest are made when a patient is typically placed between an x-ray source and an x-ray detector. ![]() Detection of an abnormality, or abnormalities, will allow facilitate the diagnosis of clinical conditions that may require medical attention. Remember, abnormalities on imaging are simply aberrations of normal anatomy. Repetitive viewing of images will help establish a baseline of normality and normal variation that will represent an internal yard stick for the detection of variation from normal. With time, and repetition, the process will become subconscious. Consistency and thoroughness are good general strategies. There is no correct way to analyze chest x-ray images. \)Īn approach to reviewing a chest x-ray (CXR) will create a foundation that will facilitate the detection of abnormalities.
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