Aparate Si Proteze Utilizate in Chirurgia Orala Si Pt Studenti - Copy
Scheme Pt Studenti
Transcript of Scheme Pt Studenti
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LOBII PULMONARI
LSD
LM
LID
Profil D Profil GFace
LIG
LSGPS
GSGS
H H H
AV G AV
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Proiectia lobilor pulmonari
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TD PA
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TD PA
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TD PA
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TS PA
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TS PA
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REPERELE PT SCIZURI
• Corp vertebral T3 pt pct superior al scizurii oblice (numai pe profil)
• Sp intercostal anterior IV pentru scizura orizontala (sau mijlocul hilului drept)
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DE RETINUT
• LOBUL MEDIU DREPT- vine in contact cu inima sterge conturul cardiac drept- un proces de umplere alveolara lobar drept nu opacifiaza SCD dr
• CORESPONDENTUL LOBULUI MEDIU DREPT= LINGULA IN STANGA
• SEGMENTUL APICAL AL LOBULUI INFERIOR DREPT (SEGM 6)- deservit de o bronsie cudata- pneumonia sau abcesul Fowler- proiectat pe rgr PA un pic deasupra si dedesubtul planului scizurii orizontale, mai mult inspre extern decat spre medial-profil drept= varful LID
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Ce incidente folosim pentru aprecierea rgr a cordului:
PA, TS, OAD, OASCare sunt cu esofag baritat: TS, OAD
Ultima litera= partea cu care sta pacientul lipit de film/caseta
OAD cu ce?
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Anatomie radiologica – incidenta PA
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PA
Cand dam Ba in incid PA?
VN d transvers crosa ≤ 2.5 cm
X
2X
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Anatomie radiologica: TSAnatomie radiologica: TS
VD
VS
AoA
APu
AS
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TS
Masurarea AS-VN:
-FEMEI SUB 36MM
-BARBATI SUB 40MM
-CONSIDERAT PATOLOGIC CAND DEPASESTE 38, RESPECTIV 42MM
APu
APu
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OAD
Anatomie radiologica: OAD
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Anatomie radiologica: OAD
>1200AoA
APu
VD
VSAD
AS
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Anatomie radiologica: OAS
VSVD
ASAD
AoA
crosa
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Ce apreciem la cord pe o rgr?
• NU folosim termeni de hipertrofie sau dilatare
• MARIRE:
1. E sau nu marita cavitatea cu pricina? (dg calitativ)
2. Cat de mult e marita? (dg cantitativ)
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ATRIUL STANG
• Dg calitativ: a. OAD-vad amprentarea si dislocarea spre post a E
baritatb. PA (unghiul bronsic>750)+urechiusa stg bombata (1/2
inf a golfului inimii sau a arcului mijlociu stg)• Dg cantitativ:a. PA DIAMETRUL Higgins + gradele de marire
(dublu contur concentric, excentric, arc inf drept dat de AS care NU ajunge la diafragm)
b. TSd antero-posterior
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AS
Max 7cm
-Dublu contur concentric
Diametrul Higgins
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VENTRICUL STANG
• DG CALITATIV: PA (arc inferior stg dep ½ a diafragmului)
• DG CANTITATIV: TS (mariri incipiente), OAS (grade)
- grad I: conturul VS ajunge la marginea ant a corpilor vertebrali
- grad II: depasirea marginii ant a c. vertebrali
- grad III: bombare mult in spate+umplerea spatiului retrosternal inferior
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Semnul Hoffman-Riegler Mariri incipiente ale VS
VCIContur VS
PATOLOGIC:
Dist B scade
Dist A creste
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ATRIUL DREPT
• PA
MAI MULT DE 2X
ALUNGIREA SI BOMBAREA ARCULUI INF DREPT
MARIREA AD AJUNGE LA DIAFRAGM
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AD
x
>>2x
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VENTRICUL DREPT
• UNITATE FUNCTIONALA IMPREUNA CU TR. ARTEREI PULMONARE
• DG CALITATIV: semne indirecte pe toate incidentele
• DG CANTITATIV: umplerea golfului inimii– Std I: arc 2 stg rectiliniu– Std II: arc 2 stg convex spre pl– Std III: arc 2 stg mult bombat spre pl
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ADVDAPu---capil pulm---VPASVS
VERSANT ARTERIAL
1.OLIGEMIE- ST Apu- Hipovolemie- Cardiopatii cu sunt dr-stg- Tamponada cardiaca
2.HIPEREMIE- Insuficienta Apu- Cardiopatii cu sunt stg-dr- hipervolemie
3.HTAP- BPOC- Emfizem- HTPV
VERSANT VENOS
1. STAZA VENOASA
- St Mi, IMi, IVStg
- Mixom atrial, tromb intra-atrial
2. EPA
3. HEMOSIDEROZA
HTPV se complica in timp cu HTAP!!!!
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HTPV
• GRAD I: - venele devin vizibile, in special intercleidohilarliniile lui Silla
- egalizare circulatiei: baze = varfuri
- micsorarea mantalei lui Felix
• GRAD II: - inversarea circulatorie : varfuri> baze
- pastile vasculare
- liniile Kerley B= edem interlobular
- transudat pleural, in special pe dr
• GRAD III: EPA-ARIPI DE FLUTURE
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HTPA
• HILI mariti (> 1 sp ic si latimea a 2 corpi vertebrali0
• Aspect amputat al hililor
• APu dr >15-16mm diametru in portiunea ei intermediara
• Umplerea golfului inimii
• Largirea mantalei lui Felix
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Pericardite fibroase
• Cr constrictiva- concretio cordis- simfizarea foitelor+ingrosare- cord mic sau mare- sdr de VCS si Inf- calcificari pericardice: santurile coronarelor, AV, fundurile de sac pericardice-pulsatii reduse
• Cr adeziva, neconstrictiva- acretio cordis- simfiza pericard parietal cu pleura mediastinala si fascia endotoracica- contur cardiac sters, festonat de partea cu simfiza- tractionare hemidiaf, stern, simfizarea unghiurilor CF- pulsatii nemodificate
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Etiologie:- post-chirurgie cardiaca si R-Terapie- tbc- boli ale tes conjunctiv- neoplazica- idiopatica
Pericardita constrictiva
-Grosime pericard > 4 mm -Ca frecvent asociate
- Semne asociate : VD tubular (volum diminuat), morfologia SIV (sigmoida, convexitate spre stg), Htrofie VS, ascita, sdr de VCI