SA Anatomy Thorax

7/27/2019 SA Anatomy Thorax

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Introduction to Thoracic

Radiology

Dr. LeeAnn Pack

Dipl. ACVR


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Indications

Coughing

Dyspnea/ Tachypnea

Heart Murmur, Collapse

Primary or Secondary Neoplasia

Check for metastasis

Thoracic Trauma Chest Wall Mass

Exercise Intolerance, Weight Loss


3/22

Technical Factors

Potential for Movement Decrease mAs

High inherent contrast

area High kVp

Collimation

Centering caudal

scapula Thoracic inlet to

diaphragm

Pull forelimbs forward


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Determining the Phase of

Respiration Always expose at peak inspiration

Maximizes lung contrast

Inspiratory lateral view Caudodorsal aspect of lung caudal to T12

Increased aeration of accessory lung lobe

Separation of heart silhouette and diaphragm

Inspiratory VD/DV view Diaphragmatic cupola caudal to mid T8

Lung tips caudal to T10


5/22

Inspiratory vs. Expiratory Lateral

Note the space inside thetriangle


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Inspiratory vs. Expiratory VD

Easy to see the difference in wellvisualized lung


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DV vs. VD

DV Less stressful, better for heart

Diaphragm rounded

Caudal pulmonary vessels better visualized Better to see small amount of pleural air

VD Better for lungs

Hear appears elongated Flat diaphragm Mickey Mouse ears

Better to see small amount of pleural fluid


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DV vs. VD


9/22

Right vs. Left Lateral etal.

Right Lateral

Better cardiac detail

R crus forward

See Cava go into it

Left Lateral

Heart appears round

L crus forward

See Cava go past

Anesthesia

Breed Differences


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The Effects of Lateral

Recumbency Lung lesions (mass, nodule, infiltrate)

may only be seen on 1 view!!!

Only the non-dependent (up) lung canbe critically evaluated

Dependent lung loses aeration

(atelectasis) Increases in opacity

Silhouettes with lesions


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Interpretation of Thoracic

Radiographs Heart

Lungs

Mediastinum

Pleural space

Chest wall Bones, Abdomen,Neck


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Normal Cardiac Silhouette

Subjective

Dog = 2 - 3 intercostal spaces

Cat = 2 2 intercostal spaces

65% or less on VD/DV view

Objective

Buchanan method


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Clock Face

11-1 Aortic Arch

1-2 Main Pulmonary Trunk

2-3 Left Auricle 2-5 Left Ventricle

5-9 Right Ventricle

9-11 Right Atrium Centrally Left Atrium


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Lateral View

Make a Plus sign

Bermuda triangle

Left atrium

Left Ventricle

Right Ventricle


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Thoracic and Pulmonary

Vessels Aorta

Caudal Vena Cava

Cranial pulmonaryvessels

Proximal third rib

Caudal pulmonary

vessels

9th rib where crosses

Veins are ventral and

central


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Trachea, Bronchial Tree

Carina then splits to the main stem

bronchi then lobar bronchi

Tracheal rings can mineralize

Decreased tracheal diameter

Tracheal narrowing (stenosis, extramural

compression), Tracheal hypoplasia,Tracheal collapse


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Lungs

Normal anatomy

Left

Cranial (cranial

subsegment) Cranial (caudal

subsegment)

Caudal

Right

Cranial Middle

Caudal

Accessory


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The Mediastinum

Cranial, middle, caudal compartments

Routinely visible structures:

Heart, trachea, cvc, aorta, +/- thymus, +/-

esophagus

Cranioventral mediastinal reflection

Caudoventral mediastinal reflection Aka phrenopericardiac ligament


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Mediastinal reflections


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Extrathoracic Structures

Sternum

Vertebrae

Ribs Adjacent soft

tissues

Diaphragm


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The Diaphragm

Cupola

Cranioventral convex

portion

Right and left crura Attach to cranioventral

border of L3 and body of

L4

May cause irregularity on

these surfaces Appearance depends on

centering of X-ray beam


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The Diaphragm

SA Anatomy Thorax

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