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enseignants",{"title":54,"url":55},{"title":57,"url":58},{"title":186,"group":48,"menu":187},"Produit",[188,189,190,191,192,193,194],{"title":38,"url":7},{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":15,"url":77},{"title":195,"url":10},"Tarification",{"title":197,"group":48,"menu":198},"Mentions légales",[199,200,201,202,203],{"title":197,"url":84},{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":205,"group":48,"menu":206},"Service client",[207,208,209],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},{"content":211,"related":283,"meta":355,"internal":365},{"title":212,"leadIn":213,"category":214,"elements":217,"becomeAnExpert":251,"author":273,"readDuration":281,"readDurationFormatted":282},"Getting into the chest x-ray (part 3): The importance of shapes and key landmarks ","In this video from our Chest X-ray Essentials course, you will learn how shapes and structures are formed on a chest x-ray.",{"id":215,"name":216},1,"Course previews",[218,229,234,239,246],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},282,{"platform":223,"name":224,"url":225,"size":226},"Vimeo","CXR_promo_3.mp4","https:\u002F\u002Fvimeo.com\u002F142182557",{"width":227,"height":228},480,270,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},22.666666666666668,"\u003Cp class=\"lead\">In this video from our \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Fchest-x-ray-essentials\">Chest X-ray Essentials course\u003C\u002Fa>, you will learn how shapes and structures are formed on a chest x-ray. Key landmarks are structures such as the trachea, the aorta, and the heart. These landmarks exhibit very characteristic shapes that vary between the PA image and the lateral image. Knowing about these basic principles is important if you want to master the interpretation of the chest x-ray.\u003C\u002Fp>\u003Cp class=\"lead\">This video is part 3 in a 4-part series on chest x-ray problems:\u003C\u002Fp>\u003Cul> \u003Cli>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fmagazine\u002Fgetting-chest-x-ray-importance-greyscale-part-1\">Watch video #1: The importance of grayscale \u003C\u002Fa>\u003C\u002Fli> \u003Cli>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fmagazine\u002Fgetting-chest-x-ray-importance-overlap-part-2\">Watch video #2: The importance of overlap\u003C\u002Fa>\u003C\u002Fli> \u003Cli>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fmagazine\u002Fgetting-chest-x-ray-how-pathology-changes-greyscale-part-4\">Watch video #4: How pathology changes the grayscale\u003C\u002Fa>\u003C\u002Fli> \u003C\u002Ful>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},11.466666666666667,"Join our Chest X-ray Essentials course now!","\u003Cp class=\"lead\">If you want to take your chest x-ray skills to the next level, then check out our \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Fchest-x-ray-essentials\">Chest X-ray Essentials course\u003C\u002Fa>, which was specifically designed for non-radiologists who want to use the chest x-ray in order to make better clinical decisions.\u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":230,"data":247},{"readDurationInSeconds":248,"title":249,"text":250},135.2,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:00] \u003C\u002Fstrong>What will I again from this video? After watching this video, you will know how to identify anatomical structures based on their radiological shape. When a light beam shines on an object, the object will cast a shadow. By understanding the shape of the object and the direction of the light beam, we can predict the shape of the shadow. There are analogies to this also in the x-ray world. We take a solid cylinder in standard upright. \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:30]\u003C\u002Fstrong> If we shine a light beam on the cylinders, so that the beam direction is perpendicular to the cylinder, the shape of the shadow is a rectangle. If the cylinder is positioned parallel to the x-ray beam, the shadow produced is a circle. If the cylinder is hollow and vertical, the shadow remains a rectangle. If the cylinder is hollow and horizontal, the shadow is a circle. If the cylinder is curved the shadow will be \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:00] \u003C\u002Fstrong>an arch. If the object is a sphere, the shadow will always be a circle. If we take this hollow cylinder and now bring it closer to the light beam, we get magnification of the rectangle. If the cylinder is now further away from the light beam, there is less magnification. The thoracic anatomical structures are three dimensional and course in various directions. Depending on their anatomical \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:30]\u003C\u002Fstrong> course in geometry and a direction of the x-ray beam, they will form shapes that are predictable. This forms the basis of object recognition on chest x-ray examination. Shapes that can be identified on x-ray are rectangles, both black and white, circles, both black and white and white arches. The trachea is a hollow cylinder. If the x-ray beam direction is perpendicular to the trachea, we can predict \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:02:00]\u003C\u002Fstrong> that the shape of the trachea on the x-ray will be a rectangle. And this is both on the PA and on the lateral projections. Air is black. So the shape that we can expect on a PA x-ray is a black rectangle. This also holds true for the lateral x-ray, the trachea will look like a black rectangle. Blood vessels have the shape of cylinders and course in various directions. If the course of the blood \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:02:30] \u003C\u002Fstrong>vessel is vertical, then we can predict that the radiological shape will be a rectangle. On this x-ray examination, adjacent to the right heart border, we see vertical white rectangles, which represent branches of the right pulmonary artery. Because the aorta arches, we can predict that its shape will be that of a white arch or white candy cane. Know that even though we do not see the medial border of the aorta, we can still \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:03:00] \u003C\u002Fstrong>perceive its shape. The reason we don't see the medial border is because the medial border of the aorta is silhouetted with other anatomical structures within the mediastinum. The aortic arch can also be seen on the lateral x-ray as a white arch coursing from front to back. Because of its shape and greyscale, the trachea can be easily identified on the chest x-ray. We can now \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:03:30] \u003C\u002Fstrong>use the trachea as a landmark to learn about and to identify other anatomical structures such as the carina, the superior vena cava, the right paratracheal stripe, the aortic arch, and the left pulmonary artery. All anatomical structures that we will be discussing in future videos. So in summary, recognition of normal and abnormal anatomical structures on a chest x-ray depends on identifying the \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:04:00] \u003C\u002Fstrong>radiological shapes formed by these structures. An anatomical shape will be recognizable only if interfaces outline the structure. Remember, an interface will only occur if there is enough density difference between structures that are adjacent to each other. In the example of the aortic arch, we could not identify the medial border because the medial border of the aorta has the same radiodensity as other mediastinal \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:04:30] \u003C\u002Fstrong>structures. Changes in position of the patient or direction of the x-ray beam can change the expected shape of an anatomical structure.\u003C\u002Fp>",{"courses":252,"showAwardsBelow":48},[253],{"id":254,"isFreeCmeCourse":255,"title":256,"type":257,"specialization":258,"teachers":260,"cmeCredits":262,"teacherIllustration":263,"backgroundImage":264,"relativeUrl":265,"lastChanged":266,"created":267,"description":268,"relativeURL":265,"meta":269},2306,false,"Chest X-ray Essentials","course",[259],"Imaging",[261],"Julian Dobranowski, MD FRCPC FCAR",7,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55ee1-2bf6-4868-b522-41b77b292f87","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55ee1-fab8-4cd9-8802-795e1f366ede","\u002Fcourses\u002Fchest-x-ray-essentials","1769602519","1444327895","Being able to interpret the basic findings on a chest x-ray (CXR) is one of the most important clinical skills. Whether it’s pulmonary congestion, pneumonia, pleural effusion, or cardiomyopathy, many common and life-threatening problems can be readily diagnosed with the help of a chest x-ray. In this course, you'll learn the most essential chest x-ray interpretation skills. Come in and become an expert.",{"duration":270,"quizzes":271,"lessons":272},18759,12,78,{"id":274,"name":261,"image":275,"profession":276,"relativeUrl":279,"specializations":280},2307,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43ceff-b005-4edc-8fb3-8afbb49b8f7e",{"name":277,"description":278},"Diagnostic imaging specialist","Chief of Diagnostic Imaging at Niagara Health in Ontario, Canada. \r\nProfessor and Chair of the Department of Radiology, McMaster University.","\u002Fteachers\u002Fjulian-dobranowski-md-frcpc-fcar",[259],182,"4m",[284,312,331],{"id":285,"title":286,"text":287,"image":288,"author":296,"path":305,"readDuration":306,"readDurationFormatted":307,"internal":308},1350,"How to Recognize INOCA (ANOCA) on an Exercise Stress Test ","Angina, abnormal stress test, clean coronaries—that's INOCA (or ANOCA), and it carries real risk. Learn to recognize and report it with exercise stress ECG.",{"alt":289,"title":290,"size":291,"location":293},"Illustration of the heart's coronary vasculature showing large coronary arteries and the extensive network of smaller vessels affected in INOCA (ischemia with nonobstructive coronary arteries).","",{"width":292,"height":292},1200,{"bucket":294,"key":295},"public-drupal-medmastery-assets-production","\u002F2026-05\u002FC17(1)_magazine image_0.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":302,"weight":304},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":303},"Internist",4,"\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,"3m",{"created":309,"updated":310,"published":311},1778115738,1778118425,1778118255,{"id":313,"title":314,"text":315,"image":316,"author":322,"path":324,"readDuration":325,"readDurationFormatted":326,"internal":327},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":317,"title":290,"size":318,"location":320},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":319,"height":319},600,{"bucket":294,"key":321},"\u002F2026-04\u002FC121_magazine image.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":323,"weight":304},{"name":303},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":328,"updated":329,"published":330},1777403036,1777572381,1777412421,{"id":332,"title":333,"text":334,"image":335,"author":340,"path":349,"readDuration":350,"readDurationFormatted":282,"internal":351},1347,"Outpatient care for COPD exacerbations","Most acute COPD exacerbations can be managed with outpatient treatment. Learn how to treat mild and moderate COPD exacerbations—and when to escalate care.",{"alt":336,"title":290,"size":337,"location":338},"Older patient using a handheld nebulizer to inhale bronchodilator medication during an acute COPD exacerbation",{"width":319,"height":319},{"bucket":294,"key":339},"\u002F2026-04\u002FC133(4)_ exacerbations_magazine image.png",{"id":341,"title":342,"relativeURL":343,"image":344,"professionLong":345,"profession":346,"weight":348},5365,"Siamak Moayedi, MD","\u002Fteachers\u002Fsiamak-moayedi-md","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cf02-1064-4074-817b-0eb5de6ded74","Professor and Director of Medical Student Education, University of Maryland and Course Director, Essential and Critical Procedures, Emergency Medicine.",{"name":347},"Emergency medicine physician",1533,"\u002Fmagazine\u002Facute-copd-exacerbation-treatment",191,{"created":352,"updated":353,"published":354},1776705362,1776710540,1776710541,{"seo":356,"og":358},{"title":357,"description":213},"Getting into the chest x-ray (part 3): The importance of shapes a | Medmastery",{"title":359,"description":213,"image":360},"Getting into the chest x-ray (part 3): The importance of shapes and key landmarks  | Medmastery",{"alt":290,"title":290,"size":361,"location":363},{"width":362,"height":362},220,{"bucket":294,"key":364},"\u002Fmigrated-images\u002Fmagazine_151017.jpg",{"id":366,"created":367,"updated":368,"published":367},72,1445005830,1735914075]