Interpretasi Thorax Foto
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![Page 1: Interpretasi Thorax Foto](https://reader030.fdocuments.net/reader030/viewer/2022012308/552b1f464a795927588b459a/html5/thumbnails/1.jpg)
INTERPRETASI THORAX FOTO
ZULKARNAINI2005730080
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GAMBARAN THORAX NORMAL POSISI POSTEROANTERIOR & LATERAL
Pada Foto thorax normal, hal-hal yang perlu diperhatikan adalah :
1. Posisi2. Simetrisasi3. Inspirasi4. Kondisi
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GAMBARAN THORAX NORMAL
Hal-Hal yang Harus diperhatikan :
1. Posisi2. Simetrisasi3. Inspirasi4. Kondisi
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FAKTOR POSISI
INTERPRETASI PA (berdiri) AP (berbaring)
DASAR PENILAIAN :1. SCAPULA (DILUAR PARENKIM PARU)
2. CLAVICULA (curam)
3. UDARA FUNDUS GASTER(MEGENBLASE)
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PA AP
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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
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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
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FAKTOR SIMETRISASI
Jarak ujung clavicula dengan processus spinosus (simetris/tidak)
CARA :JARAK YANG SAMA ANTARA PROCESSUS SPINOSUS KE SENDI STERNOKLAVIKULA KANAN DAN KIRI
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FAKTOR INSPIRASI
DASAR PENILAIAN :PENAMPAKAN DIAFRAGMAPATOKAN :VT X / COSTA BELAKANG 10 /COSTA DEPAN 6
INTERPRETASI : CUKUP KURANG TERLALU DALAM
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Inspiration
About 10 posterior ribs visible is an excellent inspiration
In many hospitalized patients 9 posterior ribs is an adequate inspiration
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Anterior vs. Posterior Ribs
Posterior ribs are those that are most apparent on the chest x-ray. They run more or less horizontally.
Anterior ribs will be visible but are harder to see. They run more or less at a 45 degree angle downward toward the feet.How to tell the difference between
the anterior and the posterior ribs
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10
Ten posterior ribs showing is an excellent inspiration
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Pitfall Due to Poor Inspiration
Poor inspiration will crowd lung markings and make it appear as though the patient has airspace disease
About 8 posterior ribs are showing
8
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Same patient
Better inspiration and the “disease” at the lung bases has cleared
9-10 posterior ribs are showing
9
About 8 posterior ribs are showing
8
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KONDISI FOTO THORAX
DINILAI DARI :1. KONDISI PULMO KESELURUHAN (LUSENSI
PARENKIM PARU)2. VERTEBRA THORAKALIS TAMPAK I-IV (< VT II
KURANG, > VT VI KERAS)3. PROCESSUS SPINOSUS TAMPAK 3 ATAU 4
INTERPRETASI : KERAS (TERLALU HITAM/LUSENS) CUKUP KURANG (TERLALU PUTIH/OPAQUE)
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kondisi
You should be able to just see the thoracic spine through the heart.
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TERPOTONG ATAU TIDAK
DASAR PENILAIAN: SUPERIOR:
TAMPAK VERTEBRA CERVIKALIS VI/VII INFERIOR:
SINUS COSTOPHRENICUS DAN DIAFRAGMA SAMPING KANAN DAN KIRI:
AXILLA TAMPAK
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IDENTITAS
IDENTITAS SISIMARKER (L ATAU R)
IDENTITAS REGISTRASINAMA, UMUR, NO. REGISTER,TANGGAL FOTO
LAYAK / TIDAK ?
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HAL-HAL YANG HARUS DIPERHATIKAN DALAM PEMBACAAN FOTO POLOS THORAX
a. Jaringan lunak, tulangb. Corakan bronkhovaskuler c. Parenkim paru Keadaan hilus d. Sinus costofrenikus e. Diafragma f. Cor : CTR
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SISTEMA TULANG DAN JARINGAN LUNAK
LOKASI DAN GAMBARAN SISTEMA TULANG : COSTA, CLAVICULA SCAPULA
LOKASI DAN GAMBARAN JARINGAN LUNAK MAMMAE,
normal: sistem tulang intak
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KEDUA APEKS PARU
PENILAIAN : TENTUKAN LOKASI APEKS PARU GAMBARAN APEKS
INTERPRETASI APEKS TENANG/ BERSIH APEKS TERDAPAT INFILTRAT ( UKURAN DAN BENTUK,
DENSITAS)
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KEDUA APEKS PARU
APEKS TENANG TERDAPAT PENINGKATAN DENSITAS DI APEKS KANAN
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CORAKAN BRONKHOVASKULER
CARA PENILAIANBAGI 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
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CORAKAN BRONKHOVASKULER
NORMAL MENINGKAT
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PARENKIM PARU
GAMBARAN PARENKIM PARU
APABILA TERDAPAT INFILTRAT:TENTUKAN :LOKASI, UKURAN, JUMLAH, BENTUK
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PARENKIM PARU
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SINUS COSTOPHRENICUS
INTERPRETASI LANCIP ATAU TUMPUL NORMAL : LANCIP BILA TUMPUL PASTIKAN ADA KELAINAN
ATAU TERPOTONG
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SINUS COSTOPHRENICUS
TERPOTONG EFUSI PLEURA
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When 200-300cc of fluid accumulate in pleural space, the usually acute costophrenic angle (sulcus), as seen on the
right in this person, becomes blunted (as seen on the left in this person)
Normal R costophrenic angleBlunted L costophrenic angle
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DIAFRAGMA
NORMAL : Kanan lebih tinggi dari kiri (jantung
menekan) Selisih <3 cm)/ atau sebagai patokan tidak
lebih dari 2 vertebra Licin
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JANTUNG
LOKASIBENTUK JANTUNGCTR : NORMAL < 0,5 UNTUK BERDIRI /PA
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Cardio-thoracic Ratio
CTR= (a+b) / c
= < 50%
One of the easiest observations to make is the cardio-thoracic ratio which is the
widest diameter of the heart compared to the widest internal diameter of the rib
cage
One of the easiest observations to make is the cardio-thoracic ratio which is the
widest diameter of the heart compared to the widest internal diameter of the rib
cage
a
b
c
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Enlarged or not?
Yes
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Enlarged or not?
Yes
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Enlarged or not?
No
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CONTOH PEMBACAAN FOTO THORAX NORMAL Foto Thorax PA,errect,simetris, inspirasi dan
kondisi cukup Tidak ada soft tissue swelling Sistema tulang intak tampak kedua apex paru tenang tampak corakan bronkhovaskuler di kedua lapangan
paru normal sinus costophrenicus kanan-kiri lancip Diafragma kanan dan kiri licin Cor : CTR kurang dari 0,56
Kesan : Paru dan cor dalam batas normal
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Terima kasih