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RADIOLOGI BLOK KDS I

RADIOLOGI BLOK KDS I. RADIOLOGI THORAX-ABDOMEN NORMAL. Tujuan Instruksional Umum. Pada akhir praktikum mahasiswa diharapkan mampu : Mengidentifikasi anatomi radiologi (imaging) pada foto polos thorax normal. Mengidentifikasi anatomi radiologi (imaging) pada foto polos abdomen normal.

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RADIOLOGI BLOK KDS I

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  1. RADIOLOGI BLOK KDS I RADIOLOGI THORAX-ABDOMEN NORMAL

  2. Tujuan Instruksional Umum • Pada akhir praktikum mahasiswa diharapkan mampu : • Mengidentifikasi anatomi radiologi (imaging) pada foto polos thorax normal. • Mengidentifikasi anatomi radiologi (imaging) pada foto polos abdomen normal

  3. Tujuan Instruksional Khusus • Pada akhir praktikum mahasiswa diharapkan mampu : • Mengidentifikasi anatomi radiologi (imaging) pada foto polos thorax normal. • Posisi • Simetrisasi • Inspirasi • Kondisi • Mengidentifikasi anatomi radiologi (imaging) pada foto polos abdomen • Posisi • Organ-organ dalam rongga abdomen (dinding abdomen, hepar, renal out line, sistema tulang) • Distribusi udara pada saluran pencernaan

  4. THORAX NORMAL • Anatomi thorax normal identik gambaran radiologi (Imaging Thorax normal). • Mahasiswa harus sudah menguasai anatomi thorax (jantung-paru-vaskularisasi & organ-organ yang terlibat). • Gambaran normal thorax kelainan

  5. RIBS - HEART

  6. Anatomi Paru-Paru

  7. Anatomi Thorax, Lateral kiri

  8. Anatomi Thorax, PA

  9. Gambaran Thorax Normal Posisi Posteroanterior & Lateral • Pada Foto thorax normal, hal-hal yang perlu diperhatikan adalah : • Posisi • Simetrisasi • Inspirasi • Kondisi

  10. Gambaran Thorax Normal Hal-Hal yang Harus diperhatikan : • Posisi • Simetrisasi • Inspirasi • Kondisi

  11. FAKTOR POSISI INTERPRETASI • PA (berdiri) • AP (berbaring) DASAR PENILAIAN : • SCAPULA (DILUAR PARENKIM PARU) • CLAVICULA (curam) • UDARA FUNDUS GASTER (MEGENBLASE)

  12. PA AP

  13. AP versus PAThe Effect of Magnification • In a PA film, the heart is closer to the film and thus less magnified • The standard chest x-ray is a PA film • In an AP film, the heart is farther from the film and is more magnified • Portable chest x-rays are almost always done AP

  14. AP versus PAThe Effect of Magnification AP portable film makes theheart look larger than it does… On this PA film done on the same patient an hour later

  15. FAKTOR SIMETRISASI Jarak ujung clavicula dengan processus spinosus (simetris/tidak) CARA : JARAK YANG SAMA ANTARA PROCESSUS SPINOSUS KE SENDI STERNOKLAVIKULA KANAN DAN KIRI

  16. Rotation If the spinous process of the vertebral body is equidistant from the medial ends of each clavicle, there is no rotation

  17. 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 

  18. Pitfall Due to Marked Rotation Severe rotation may make the pulmonary arteries appear larger on the side farther from the film

  19. FAKTOR INSPIRASI DASAR PENILAIAN : PENAMPAKAN DIAFRAGMA PATOKAN : VT X / COSTA BELAKANG 10 /COSTA DEPAN 6 INTERPRETASI : • CUKUP • KURANG • TERLALU DALAM

  20. Inspiration • About 10 posterior ribs visible is an excellent inspiration • In many hospitalized patients 9 posterior ribs is an adequate inspiration

  21. Anterior vs. Posterior Ribs Anterior ribs will be visible but are harder to see. They run more or less at a 45 degree angle downward toward the feet. Posterior ribs are those that are most apparent on the chest x-ray. They run more or less horizontally. How to tell the difference between the anterior and the posterior ribs

  22. 10 Ten posterior ribs showing is an excellent inspiration

  23. 8 About 8 posterior ribs are showing Pitfall Due to Poor Inspiration Poor inspiration will crowd lung markings and make it appear as though the patient has airspace disease

  24. 8 9 About 8 posterior ribs are showing 9-10 posterior ribs are showing Same patient Better inspiration and the “disease” at the lung bases has cleared

  25. KONDISI FOTO THORAX DINILAI DARI : • 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)

  26. kondisi You should be able to just see the thoracic spine through the heart.

  27. TERPOTONG ATAU TIDAK DASAR PENILAIAN: • SUPERIOR: TAMPAK VERTEBRA CERVIKALIS VI/VII • INFERIOR: SINUS COSTOPHRENICUS DAN DIAFRAGMA • SAMPING KANAN DAN KIRI: AXILLA TAMPAK

  28. IDENTITAS • IDENTITAS SISI MARKER (L ATAU R) • IDENTITAS REGISTRASI NAMA, UMUR, NO. REGISTER,TANGGAL FOTO LAYAK / TIDAK ?

  29. Hal-hal yang harus diperhatikan dalam Pembacaan Foto Polos Thorax • Jaringan lunak, tulang • Corakan bronkhovaskuler • Parenkim paru Keadaan hilus • Sinus costofrenikus • Diafragma • Cor : CTR

  30. SISTEMA TULANG DAN JARINGAN LUNAK LOKASI DAN GAMBARAN SISTEMA TULANG : • COSTA, • CLAVICULA • SCAPULA LOKASI DAN GAMBARAN JARINGAN LUNAK • MAMMAE, • normal: sistem tulang intak

  31. KEDUA APEKS PARU PENILAIAN : • TENTUKAN LOKASI APEKS PARU • GAMBARAN APEKS INTERPRETASI • APEKS TENANG/ BERSIH • APEKS TERDAPAT INFILTRAT ( UKURAN DAN BENTUK, DENSITAS)

  32. KEDUA APEKS PARU APEKS TENANG TERDAPAT PENINGKATAN DENSITAS DI APEKS KANAN

  33. 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

  34. CORAKAN BRONKHOVASKULER NORMAL MENINGKAT

  35. GAMBARAN PARENKIM PARU APABILA TERDAPAT INFILTRAT: TENTUKAN : LOKASI, UKURAN, JUMLAH, BENTUK PARENKIM PARU

  36. PARENKIM PARU

  37. SINUS COSTOPHRENICUS INTERPRETASI • LANCIP ATAU TUMPUL • NORMAL : LANCIP • BILA TUMPUL PASTIKAN ADA KELAINAN ATAU TERPOTONG

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