Today our topic of discussion is Normal Finding in Chest X ray.

Normal Finding in Chest X ray

Normal Findings

The vertebral column is visible vertically through the middle of the thorax.
The two hemidiaphragms normally appear rounded, smooth and sharply defined, with the right hemidiaphragm slightly elevated above the left
The junction of the rib cage and the diaphragm, called the costophrenic angle is normally clear visible and angled.
Heart tissue is dense and appears white but less intensely white then bony structures.
The heart shadow is normally clearly outlined and extends primarily onto the left side of the thorax and occupies no more than one third of the chest width
Close observation shows the trachea in the upper middle chest almost superimposed over the cervical and thoracic vertebrae.
The trachea bifurcates at the level of the forth thoracic vertebra into the right and left main stem bronchi
The pulmonary blood vessels, bronchi and lymph nodes are located in the hilum on both the right and left sides of the midthorax
Lung tissue appears black on X-ray film.
Vascular lung structures are visible as white, thin, wispy strings fanning out from the hilum.

Standard Positions Used

Adult chest X-ray studies are taken with the clients standing or sitting facing the X-ray film, with the chest and shoulder in direct contact with the film cassette .
The shoulders are rotated forward to pull the scapulae away from the lung field
The X-ray cathode penetrates from the posterior. This position is called the posteroanterior (PA) position
The radiograph is usually taken at pull inspiration, which causes the diaphragm to move downwards
Radiographs taken on expiration are sometimes requested for demonstrating the degree of diaphragm movement or for assisting in the assessment and diagnosis of pneumothorax (Figs. 29.28A to 1).

Portable Chest X-ray

For clients unable to be transported to the radiology department, portable chest radiography may be taken
Portable radiographs are usually taken with the film placed behind the client, and the X-ray beam penetrates from the front of the chest anterioposterior (AP) position
Because the X-ray beam enters from the anterior chest, the heart will appear larger than it reality is and larger than on a PA view.

Lateral View

It usually accompanies a standard PA view. It is taken from either the right or left side of the chest
The arms are raised above the head, and the side of the chest is placed against the film visualization of the heart
The lateral view allows better and diaphragm dome
When used in conjunction with a PA film, a lateral position gives a three-dimension view, allowing more specific identification of an abnormality’s location.

Lateral Decubitus Position

This position may be used when it is necessary to determine whether opaque areas on the pleura are due to solid or liquid media
This view is taken with the client lying on either the right or left side, depending on which side of the chest is being assessed
In a left lateral decubitus position, the client is lying on the left side.
The term decubitus refers to a lying-down position.

Oblique Position

This position is used to see behind and around underlying structures.
The shoulders are rotated either to the right or left of the film
By turning the client, the angle at which the X-ray beam passes through the chest is shifted In a right oblique position, the right side is closest to the film.
The view may be taken from either an anterior or posterior position

Lordotic Position

This position is useful if clearer visualization of the upper lung fields is needed
This angle of the X-ray cathode is lowered and the beam
directed at an upward angle
This angle removes the clavicles and first and second rbs from the field of vision

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