THORAX IN FUNNEL THORAX IN FUNNEL The heart is located anteriorly in the thorax

and is bordered by the tongue of the left lung.

The difference in density between the heart

In patients with a pectus excavatum, the right
heart border may be poorly defined, but this is
normal.
INTEGRANTES
It produces a silhouette sign and, therefore,
Geraldin Téllez simulates a consolidation or atelectasis of the
right middle lobe.
Jhennyfer torres
The side view is useful in such cases.
María Isabel Pectus excavatum is a congenital deformity of
the ribs and sternum that produces a concave
Adriana Castiblanco
appearance of the anterior chest wall.
and the air in the lung allows us to see the
silhouette of the left ventricle.
When there is something in the lingula with
the same 'water density' as the heart, the
normal silhouette (blue arrow) will be lost.
When there is pneumonia in the left lower
lobe, which is located further back in the
chest, the left ventricle will still be air bordered
in the lingula and we will still see the
silhouette of the heart (red arrow).

INSTRUCTORA
RUTH ILIAM
SIDE VIEW

SILHOUETTE SIGN In a normal lateral view, the contours of the

SENA REGIONAL TOLIMA CENTRO heart are visible and the IVC is seen to enter
the right atrium.
DE COMERCIOS Y SERVICIOS
This is a very important signal. It allows us to The retrosternal space must be radiolucent,
TECNÓLOGO EN IMÁGENES find subtle pathologies and locate them inside since it only contains air. Any radiopacity in
the chest. this area is suspected of a process in the
DIAGNOSTICAS anterior mediastinum or in the upper lobes of
Loss of the normal silhouette of a structure is
the lung.
MATERIA: INGLES called a silhouette sign.

Here is an example to explain the sign of the

silhouette:

2020
As it progresses from superior to inferior over
the vertebral bodies, these should darken,
because generally there will be less soft
tissue and more radiolucent lung tissue (red
arrow).
If this is not the case, carefully look for
pathology in the lower lobes.
THE RIGHT AND LEFT
DIAPHRAGM
They must be visible to the
anterior chest wall (red arrow).
We actually see the interface
between the air in the lungs and
the soft tissue structures in the
abdomen.
It can only be seen up to a point It is not clear from the PA view whether this is
due to dilated vessels or enlarged lymph
where it borders the heart (blue nodes.
arrow).
In the lateral view there are round structures
Here the interface is lost, since in areas where vessels are not expected. So
we can conclude that we are dealing with
the heart has the same density as enlarged lymph nodes.
the structures below the
This patient has sarcoidosis.
diaphragm.
Also note the widening of the paratracheal
line (or stripe) as a result of enlarged lymph
nodes.
THE PULMONARY ARTERY
The left main (in purple) passes over the left
main bronchus and is higher than the right
pulmonary artery (in blue) that passes in front
of the right main bronchus.
In the lateral view, spondylosis can simulate a
lung mass.
Any density in the area of the vertebral bodies
should take you to the PA film to look for
spondylosis, which is usually found on the
right side (arrows).
SIDE VIEW ABNORMALITIES
On the left side, osteophyte formation is
hampered by pulsations of the aorta.
Once you know what normal hilar structures
look like in a lateral view, it is easier to detect
abnormalities.
In this case, in the PA view there is a hilarious
magnification.