X-ray Identification of

Thoracic Injuries
Skill Station IV

Thoracic anatomy

Bronchus anatomy

Trachea

Pleura
visceral

Pleura: Parietal-Visceral
Pleura parietal

Pleura
visceral
Cavum pleura

Hemothorax

Hemothorax

Paru
mengembang

Hemothorax
Massive
hemothorax
Blood > 1500 cc

Thoracic drain/tube

Kearah
Cranioposterior
Insertion of the
chest tube

Chest tube

SIC 5

Perbedaan penempatan chest tube

Lipat payudara
bawah
Papilla
Mammae
( SIC 5 )

Posisi
insertia
chest
tube
m.Serratus anterior
*Pria : Papilla mamae

Fossa Axillaris

SIC 5
*Wanita : Lipat payudara bawah

m.Serratus posterior

Lokasi sayatan
Linea Axillaris anterior

Linea Axillaris posterior

Linea Axillaris media

Procedure of thoracic tube

Costae 4

SIC 5

Long kelly

Pleura parietal
Costae 5
Cavum pleura

Kearah Cranioposterior

Index Finger
Pleura viceral

Pleura parietal

Chest tube

Expansion of thoracic pleura

DL // DH

Normal Anatomy of Thoracic

Pneumothoracic
Air

Collapsed lung

Visceral pleural ruptured/perforated

Pneumothoracic/Collapsed of
the lung

Tension pneumothoracic
(Pergeseran Mediastinum)

Gerakan tertinggal

Jugular external dilatasi

Trachea tergeser

Vesiculer / menghilang

O2
Perkusi Hipersonor

Paru collaps

Shock

X-ray Anatomy
LUCENT

Air

Blood

LESS LUCENT

Soft tissue

LESS OPAQUE

Bone

OPAQUE

X-ray particle

Film x-ray

Normal Chest x-ray

How to identify this x-ray ?

Aortic knob

Pleura
parietal

Pleura
visceral

Broncho
vasculer

Broncho
vasculer

Thoracic X-ray Identification

E Soft tissue

Airway

B Breathing

E Costae

C Circulation

Diaphragma

E Soft tissue/ Costae

AIRWAY

(A)
SOFT TISSUE

(E)

BREATHING

(B)

PLEURA
PARIETAL

CIRCULATION
PLEURA
VISCERAL

(C)
DIAPHRAGMA

COSTAE

(E)

CAVUM PLEURA

(ect) * SOFT TISSUE/COSTAE

(D)

Pneumothorax

Pleural
Parietal

Pleural
visceral

Air

Collapsed of right lung

Collapsed of
right lung

Inspeksi gambaran
cedera

Tension Pneumothorax

Trachea tergeser

Pleura Parietal
Bercak vasculer
Pleura Visceral

Tepi lateral jantung

Pharenchym paru

menghilang

SUMMARY

X-ray Identification of Thoracic

Injuries
AIRWAY
(A)
SOFT TISSUE

(E)

BREATHING

(B)

PLEURA
PARIETAL

CIRCULATION
PLEURA
VISCERAL

(C)
DIAPHRAGMA

(D)
COSTAE

(E)

CAVUM PLEURA

E * SOFT TISSUE
* COSTAE

X-ray Identification of Thoracic

Injuries
AIRWAY

SOFT TISSUE

(A)

(E)

BREATHING

(B)

PLEURA
PARIETAL

CIRCULATION
PLEURA
VISCERAL

(C)
DIAPHRAGMA

(D)
COSTAE

(E)

CAVUM PLEURA

E * SOFT TISSUE
* COSTAE

Thank-you

Glasgow Coma Score (GCS)

Eye Opening

Spontaneous = 4
To Voice = 3
To Pain = 2
None = 1

Verbal Response

Oriented = 5
Confused = 4
Innappropriate Words = 3
Incomprehensible Words = 2
None = 1

Motor Response

TOTAL Glasgow Coma Score =_____

Obeys Commands = 6
Localizes Pain = 5
Withdraws from Pian = 4
Decerebrate (Flexion) to
pain = 3
Cedorticate (Extension) to
Pain = 2
None =