Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

I sorry for the delay. Um Yeah, it should be working now. So just give me one more second. OK. Um Are you guys able to see this right now? All right. OK. So I'll just go ahead and start. Hi guys. So today we're gonna be uh doing this a session on interpreting uh chest X rays. Uh Yeah, so OK. So essentially, yeah, so the main thing that we need to uh look uh we need to understand when it comes to inter chest rays, uh chest X rays is to really make uh make sense of what the different colors mean. So essentially the uh this diagram gives you a good overview as to what uh what each, what each color represents, what kind of material it represents. So essentially what happens is, as you can see here, air is, is uh extremely black whereas metal is white. So what happens is what basically it means is that the brighter or whiter, it is the less dense the material is. So therefore, I is essentially going to be um um sorry, sorry. Um If it's brighter or whiter, it's gonna be the de the material is gonna be more dense. So essentially, as is essentially gonna be black because it's less dense and bone essentially is gonna be seen roughly a grayish um uh color and fat and soft tissue would be slightly darker than bone, but uh less dark than a. So then another thing that we need to uh not take note of when looking at chest x rays is essentially the projection of the chest X ray itself. So this is essentially how a chest X ray would be taken from a patient where essentially the patient is gonna be uh uh having to press the chest or the back against the x-ray film. And the x-ray tube will essentially shoot some rays. And that's how you get um your chest radiograph. So essentially, so since in this diagram, the the patient is essentially the patient's chest is against the chest uh with the X ray film. So what happens is essentially the, the image that would be produced will be a posterior anterior film because the rays are essentially going from the back to the front of the patient. Whereas if the patient was um was turned around and his back was against the xray film, it essentially would be an AP film, which is basically an anterior posterior film. And that's just because the rays are going in from going from the front to the back of the patient. And these uh diagrams the on the right, essentially these uh chest X rays on the right will uh are essentially what you would get if uh a chest X ray is a pa or an AP. So, yeah, this is just for um greater uh clarity and we'll come back to this slide in just a moment. But essentially, uh these are, is uh essentially the, what you should be uh seeing on a chest X ray and what the different parts of the chest X ray uh represent and we'll come back to it in a bit. And the thing is uh with uh chest X rays, reading them is not as complicated as uh you might make it out to be because there's a clear structure to approaching uh the reading of a chest X ray. And that is essentially right plus ABCD E so ripe essentially is um acronym for to essentially to be, to determine the quality of the chest X ray. So what right uh essentially means R stands for rotation and I'll go through what each of it means uh in further detail in a bit, uh I stands for inspiration, P stands for projection and E stands for exposure. OK. So moving on, moving back to the previous slide. So this is essential we can use this diagram to sort of like understand what the different uh what you should be looking out for in the different um in the different parts of the right acronym. So this essentially would be mm So what you have in this uh chest X ray is uh the first thing that you need to look at is going to be a rotation. And what essentially rotation means is that there should be equal space between the medial aspect of the clavicle to the spinus prostate of the vertebra. Uh And also the spinus process should be vertically oriented against the vertebral bodies. So what do I mean by this? So essentially um as you can see in this uh chest X ray, this bit over here uh labeled in green, that's essentially a clavicle and on both sides. And sorry, let me just go back to the previous slide. Yeah, that's essentially a clavicle. And if you can see this in the center, there's essentially a rectangle with a sort of like a oval uh shaped object in the middle. And that's essentially the spinus process and the rectangle itself is the vertebra. So in rotation, what you need to be looking out for is basically, if this medial end of the clavicle roughly around here. Uh and these two eyes essentially equidistant from the spinus process. And the reason why we look for that is to make sure that the pa patient is not uh awkwardly twist uh twisting his bo their body. And uh when they're taking the chest X ray. And if, because if that's the case, then uh your interpretation of the chest X ray would be wrong as it can affect uh different parts of the x-ray. And secondly, um we have inspiration. So within inspiration, what you need to be looking out for is basically if you can see more than seven and anterior ribs or more than and roughly nine posterior ribs. So in this, in this image, this image is basically a posterior anterior film. So meaning that the it's essentially going from uh back to front. So the thing is with uh in terms of determining whether it's um a PA or AP film, you don't really need to uh learn that at your uh at your stage. But what will happen is uh the radiograph itself would be labeled, saying either pa or ap uh film. So what we can then look at is essentially anti, we can look at anterior ribs and posterior ribs. So essentially, if you look at these uh yellow markings, uh yellow annotations, that's essentially a posterior ribs. And whereas the blue markings essentially like this curved bits uh towards the side, that's essentially your anterior ribs. And the reason for that is quite simple because just because the chest X ray is going, is going from the back uh to the front. Essentially, what you'll first see is a posterior ribs before you essentially see the anterior ribs, which is like sort of behind the posterior ribs just the way because that, that's just the way the rays are picking up the um the different structures there. So if you can look at this, essentially, this, you can just look, take a um a look at um post rib five. If you just a trace this um x-ray, it's essentially, you can see that you can see the curvature of the, of the rib and it's essentially going like this and all the way here. And this is essentially your anterior rib. And whereas this is your posterior rib. So what you should be looking out for in this, in this uh in this bit of the right acronym is that you should have essentially roughly like 99 posterior ribs and um at least seven anterior ribs, uh that should be seen if you see slightly more than that. I think that's, that's still fine. But you should, um there is, there will be a point where you should um if you see more than um a certain number that will essentially mean that there is an issue with the uh with the patient. So, uh P stands for projection. And as I've talked about earlier, it's basically either you, you essentially need to determine whether the film is AP or PA. And that for the uh for your stage is essentially just be labeled on the chest radiograph itself. And so what hap you can just read off, read it off and see if it's AP or PA and finally, we have exposure. So the exposure essentially is um basically what you need to look at in exposure is um two main things if you can see the mm the vertebral bodies behind the heart and a left hemidiaphragm. So, what we can uh what uh I'll look at, I'll first talk about the vertebral bodies behind the heart. So, in a chest X ray, you won't, uh you won't just be seeing your lungs, which is essentially, you know what the lungs are. It's this and this. Uh but you'll also be able to see, um, the, uh, the silhouette of the heart and that is that the heart essentially is, is.