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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
\\hersheymed.net\files\MMS\Public\education\radiology\lab-thorax-8-2007.pps
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
Right
Atrium
Right
Ventricle
204
Right
Atrium
Left atrium
Ventricle
Right ventricle
201
Right
Atrium
Left
Atrium
Ventricle
Aortic arch
Main pulmonary artery
Left atrium, ventricle
Trachea
Clavicles
Cardiophrenic
angles
Costophrenic
angles
Hilum (pleural: hila)
1.
2.
3.
4.
5.
Root of the lung
Pulmonary artery
Upper lobe pul vein
Bronchus
(Lymph nodes)
Right hilum
Left hilum
Right ventricle
Left atrium
Left ventricle
Cardiophrenic angle
Costophrenic angle
Left
Diaphragm
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
Left main PA
Right main PA
Main PA
(trunk)
Aorta
LA
RA
RV
LV
194
Right main
pulmonary artery
Left inferior
pulmonary
artery
Catheter
in main PA
Arch
Aortogram
Ascending aorta
Aortic arch
Descending aorta
Brachiocephalic art
Left common
carotid art
Left subclavian art
Aortic Arch
225
Arch Aortogram
Aortic arch
Brachiocephalic art
Left common carotid
art
R
L
Left subclavian artery
CT of the Heart
and Mediastinum
(axial images)
View as though facing the patient
Axial section
Right
Left
Axial CT image with contrast
Anterior
Heart
Right
Liver
Lung
Left
Posterior
By convention we look from below
Right
Sternum
Scapula
Spine
Ribs
Vascular Arch
Vascular Arch
Vascular Arch
Vascular Arch
3 Vascular Arches
Arch
1. Aorta
Structure below arch
Pulmonary artery,
vein
2. Left pulmonary Left main
bronchus
artery
3. Azygos vein
Right main
bronchus
The brachocephalic vein
runs anterior to the
branches of the aorta
Frontal of the brachiocephalic vein and aortic arch
195
Trachea
Aortic arch
Brachiocephalic
artery
Left common
carotid artery
Right brachiocephalic vein
Left brachiocephalic vein
Superior vena cava
195
The trachea is just ventral
to the esophagus
Trachea
Brachiocephalic artery
Left common carotid
artery
Left subclavian artery
Esophagus
Branches of the aorta
196
Origin of the great vessels above the aortic arch
195
Origin of the great vessels above the aortic arch
Right
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
Superior vena cava
Right atrium
Right ventricle
Inferior vena cava
RIGHT
DIAPHRAGM
208
Superior vena cava
Azygos arch
Right bronchus
Right main pulmonary
art
Right pulmonary veins
Right atrium
Azygos vein
208
Level of the aortic arch
195
Level of the aortic arch
Level of the aortic arch
Aortic arch
Superior vena cava
Trachea
Azygos arch
Esophagus
Vertebra
The left pulmonary
artery passes
over the left
main-stem bronchus
Aortic arch
Left main pulmonary art
Left atrium
Left ventricle
LEFT
DIAPHRAGM
219
Aorta
Left main pulmonary
artery
Left mainstem
bronchus
Left pulmonary veins
Left atrium
219
Level
Levelbelow
belowthe
theaortic
aorticarch
arch
(top
(topofofthe
theleft
leftpulmonary
pulmonaryartery
artery
ASCENDING
AORTA
SVC
PULMONARY ARTERY
201
Level below the aortic arch
(top of the left pulmonary artery
BACK WALL
OF BRONCHUS
Ascending aorta
Main pulmonary
artery
Superior vena cava
Right pul art
Right bronchus
Left bronchus
Top of left pulmonary
artery
Descending aorta
Azygos vein
Level at the root of the aorta
and main pulmonary artery
Top of the
right atrium
Ascending
Aorta
Pulmonary artery
201
Back of the
left bronchus
Ascending aorta
Main pulmonary
artery
Right atrium
Rt pulmonary artery
Right bronchus
Left bronchus
Lt lower lobe PA
Descending aorta
Azygos vein
The pulmonary trunk
is anterior to
the aorta root
The arota arises
from “center”
of heart
Heart from the Front
Left atrium
Right
Atrium
Aorta
Right
Ventricle
Pulmonary artery
Left ventricle
204
Level at the top of the ventricles
Right
Atrium
Left
Ventricle
Right ventricle
201
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
Level through all 4 heart chambers
230
Level through all 4 heart chambers
Right
Atrium
Left
Ventricle
Right ventricle
201
Right ventricle
Right atrium
Left ventricle
Left atrium
Aorta
Azygos vein
Level at the bottom of the heart (below left atrium)
Right
Atrium
Left
Ventricle
Right ventricle
201
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 blood
from the left arm
to the head
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
RT AND LT PA’S
X
X
FROM LUNG TO LA
X
LA
X
LV
X
LV TO OUTFLOW
X
X 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
X
INTO THE CAROTIDS
X
X
Thorax
David S. Hartman, M.D.
Department of Radiology