THORAX NORMAL
Anatomi thorax normal identik gambaran radiologi (Imaging Thorax normal). Mahasiswa harus sudah menguasai anatomi thorax (jantung-paru-vaskularisasi & organorgan yang terlibat). Gambaran normal thorax kelainan
RIBS - HEART
Anatomi Paru-Paru
Anatomi Thorax, PA
FAKTOR POSISI
INTERPRETASI
PA (berdiri) AP (berbaring)
DASAR PENILAIAN : 1. SCAPULA (DILUAR PARENKIM PARU) 2. CLAVICULA (curam) 3. UDARA FUNDUS GASTER
(MEGENBLASE)
PA
AP
AP versus PA
The Effect of Magnification
In a PA film, the heart is closer to the film and thus less magnified
In an AP film, the heart is farther from the film and is more magnified
AP versus PA
The Effect of Magnification
FAKTOR SIMETRISASI
Jarak ujung clavicula dengan processus spinosus (simetris/tidak)
CARA :
JARAK YANG SAMA ANTARA PROCESSUS SPINOSUS KE SENDI STERNOKLAVIKULA KANAN DAN KIRI
Rotation
If the spinous process of the vertebral body is equidistant from the medial ends of each clavicle, there is no rotation
If spinous process appears closer to the right clavicle (red arrow), the patient is rotated toward their own left side
If spinous process appears closer to the left clavicle (red arrow), the patient is rotated toward their own right side
Severe rotation may make the pulmonary arteries appear larger on the side farther from the film
FAKTOR INSPIRASI
DASAR PENILAIAN :
PENAMPAKAN DIAFRAGMA PATOKAN :
VT X / COSTA BELAKANG 10 /COSTA DEPAN 6
INTERPRETASI :
CUKUP KURANG TERLALU DALAM
Inspiration
10
About 8 posterior ribs are showing Poor inspiration will crowd lung markings and make it appear as though the patient has airspace disease
Same patient
About 8 posterior ribs are 9-10 posterior ribs are showing showing Better inspiration and the disease at the lung bases has cleared
KONDISI PULMO KESELURUHAN (LUSENSI PARENKIM PARU) VERTEBRA THORAKALIS TAMPAK I-IV (< VT II KURANG, > VT VI KERAS) PROCESSUS SPINOSUS TAMPAK 3 ATAU 4
INTERPRETASI :
KERAS (TERLALU HITAM/LUSENS) CUKUP KURANG (TERLALU PUTIH/OPAQUE)
kondisi
You should be able to just see the thoracic spine through the heart.
INFERIOR:
SINUS COSTOPHRENICUS DAN DIAFRAGMA
IDENTITAS
IDENTITAS SISI
MARKER (L ATAU R)
IDENTITAS REGISTRASI
NAMA, UMUR, NO. REGISTER,TANGGAL FOTO
LAYAK / TIDAK ?
f.
Cor : CTR
INTERPRETASI
APEKS TENANG/ BERSIH APEKS TERDAPAT INFILTRAT ( UKURAN DAN BENTUK, DENSITAS)
APEKS TENANG
CORAKAN BRONKHOVASKULER
CARA PENILAIAN
BAGI PARU DARI TEPI MENJADI 3, LIHAT BAGIAN 1/3 LATERAL
NORMAL :
CORAKAN BRONKHOVASKULER TIDAK MELEBIHI 2/3 MEDIAL (1/3 LATERAL TAMPAK BERSIH)
INTERPRETASI:
NORMAL /MENINGKAT
CORAKAN BRONKHOVASKULER
NORMAL
MENINGKAT
PARENKIM PARU
GAMBARAN PARENKIM PARU
PARENKIM PARU
SINUS COSTOPHRENICUS
INTERPRETASI LANCIP ATAU TUMPUL NORMAL : LANCIP BILA TUMPUL PASTIKAN ADA KELAINAN ATAU TERPOTONG
SINUS COSTOPHRENICUS
TERPOTONG
EFUSI PLEURA
Normal R costophrenic angle Blunted L costophrenic angle When 200-300cc of fluid accumulate in pleural space, the usually acute costophrenic angle (sulcus), as seen on the right in this person, becomes blunted (as seen on the left in this person)
DIAFRAGMA
NORMAL : Kanan lebih tinggi dari kiri (jantung menekan) Selisih <3 cm)/ atau sebagai patokan tidak lebih dari 2 vertebra Licin
JANTUNG
LOKASI BENTUK JANTUNG CTR : NORMAL < 0,5 UNTUK BERDIRI /PA
Cardio-thoracic Ratio
CTR= (a+b) /c = < 50%
a
One of the easiest observations to make is the cardio-thoracic ratio which is the widest diameter of the heart compared to the widest internal diameter of the rib cage
b
c
Enlarged or not?
Yes
Enlarged or not?
Yes
Enlarged or not?
No
di
kedua
Abdomen Normal
Hal-hal yang harus diperhatikan pada Foto Polos Abdomen, adalah :
Gambaran udara Usus Gambaran jaringan lunak (soft tissue) Gambaran organ-organ intra abdominal
Hepar Lien Renal Tract Urinarius dan Genitalia
A Normal plain film of the abdomen. The lower margins of the posterior portion of the liver, the hepatic angle (H), and the lower part of the spleen (S) are delineated by a fat shadow. Both kidneys (K) and the psoas muscle shadows (arrowheads) are outlined by a fat shadow. The properitoneal fat stripe is also shown bilaterally (arrows). B Diagram of normal abdominal plain film.
Gas in a few loops of small bowel D = 2.5 CM Gas in rectum or sigmoid ALMOST ALWAYS
Erect Abdomen
Gambaran Udara pada usus halus (sentral) dan usus besar perifer (foto abdomen dengan kontras)