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252 Chapter 9

Lung apex

Trachea Sternum

Aorta
Scapula

Posterior ribs
(superimposed)

Hilar region

Heart shadow
© Cengage Learning 2014 vertebrae Costophrenic © Cengage Learning 2014
Thoracic
Diaphragm

angle

Figure 9-10 A normal lateral chest radiograph and corresponding anatomical structures.

TABLE 9-5 Normal and Abnormal Chest Radiograph Appearance

Normal Chest Radiograph Appearance Abnormal Appearance and Probable Cause

1. Midline trachea and mediasternum Shift of trachea or mediasternum may occur
due to patient rotation during taking of
X-ray.
Shift of trachea or mediasternum to affected
side (e.g., atelectasis, pulmonary fibrosis) or
to the unaffected side (e.g., tension
pneumonthorax)

2. Dark lung parenchyma with mild scattered Infiltrates (large amount of white shadows)
white shadows (normal lung tissues and suggest accumulation of secretions,
small vessels) atelectasis.

3. Sharply pointed right and left costo- Blunted costophrenic angle suggests
phrenic angels accumulation of fluid in pleural space
(e.g., pleural effusion, hemothorax, empyema)

4. Smooth and continuing bony structures Jagged appearance suggests fracture or
broken bones.

5. Cardiac shadow along the diaphragm Congestive heart may cause the cardiac
line is , 50% of the distance between the shadow to exceed 50% of the distance
right and left costophrenic angles. between the right and left costophrenic angels.
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