by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
Identify: Parietal & Visceral Pleura The Pleura lubricates and prevents friction during respiration. The partial pleura lines the chest wall, mediastinal and diaphragmatic surfaces, while the visceral pleura lines the lungs and fissures.
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
Evaluate for Appearance – Thickening Thickening of the pleura is usually a result of inflammation. Evaluate for Appearance – Calcifications Calcification is a result of a previous emphysema or pneumothorax. Evaluate for Appearance – Mass Pleural and...
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
4. Evaluate for Effusion Mediastinal Shift A mediastinal shift can occur if there is tension. In this image, notice the collapsed right lung. This patient requires a chest tube to relieve the pressure.
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
1. Evaulate for Effusion – Meniscus In an uncomplicated effusion, fluid is usually higher laterally than medially, thus forming a meniscus with the pleura. A horizontal fluid line will be seen only with a mixture of air and water in the pleura space...
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
3. Evaluate for Effusion – Fluid Pooling Pooling of fluid can first be seen posteriorly. If there is enough it will then move laterally. This is why the lateral film is most sensitive for pleural effusion. A lateral decubitis view will show the effusion in a...
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
2. Evaluate for Effusion – Blunted Angles/Thickening Blunting of the costophrenic angles (see normal sharp angles) generally indicates a pleural effusion. Blunting can also indicate thickening of the pleura.
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
4. Evaluate for Diaphragm – Free Air Free air under the diaphragm suggests pneumonperitoneum (i.e. bowel perforation). Right image indicates where free air is located.
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
2. Evaluate for Diaphragm – Elevation An elevated hemidiaphragm can be caused by a diaphragm paralysis, lung resection/pneumectomy, atelectasis and pregnancy. A pleural effusion may also result in an apparent elevation. No image available
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
3. Evaluate for Diaphragm – Depression A depressed hemidiaphragm can be the result of asthma, COPD, a tumour or a large pleural effusion. The image below depicts flattened diaphragms as a result of bullous emphysema.
by Tim Milligan | Nov 12, 2015 | Pleura & Diaphragm
1. Evaluate for Diaphragm On the lateral film the costophrenic (CP) angle of each hemidiaphragm (HD) should be sharp. Right Image: Close up of CP angle of each HD. (RD = right HD and LD = left HD)
