YT YouTube2Text

YouTube2Text → Transcripts → Introduction to CT Chest - Anatomy and Approach

Introduction to CT Chest - Anatomy and Approach — Transcript

by Navigating Radiology · 4,353 words · 845 segments · language en · Watch on YouTube

Open in transcriber Summarize with AI Download SRT/VTT

Full transcript

0:00this interactive video series is
0:02designed to get you comfortable reading
0:04ct scans of the chest
0:06by interactive i mean that you'll be
0:08able to scroll through full ct cases on
0:11your phone or computer as you follow
0:14along
0:15in this first video we'll cover basic
0:17anatomy and an approach to reading ct of
0:21the chest
0:22in future videos we'll cover how to read
0:24a ct pulmonary angiogram or ctpa
0:28including how to diagnose acute and
0:30chronic pulmonary emboli
0:32and then cover basic patterns of lung
0:34disease like consolidation ground glass
0:37nodules septal thickening etc
0:40and the associated differentials that
0:42you need to know
0:44to open up the ct chest that we're
0:46looking at you can use your phone camera
0:49to scan the qr code on the screen
0:52and then scroll through the case on your
0:54phone while you follow along
0:57or if you're on a computer you can click
0:59the link in the description and open up
1:01the case in a separate browser alongside
1:03the video
1:05the cases will look something like this
1:08and you can access the different series
1:11on the left
1:13or if you're on your phone you'll see an
1:15icon in the top left that you can click
1:17to bring up the various series
1:21before watching this i strongly suggest
1:24watching our video a practical
1:25introduction to ct
1:28also if you want to support the channel
1:30join our patreon at patreon.com
1:33navigating or become a member of our
1:35youtube channel by clicking join in the
1:37description
1:39here you'll have access to case-based
1:41courses that we are building including
1:43an abdominal and pelvic mri course and
1:46other scrollable ct and mri teaching
1:50cases
1:51all right so let's get started so this
1:54is a ct scan of the chest and again if
1:57you'd like to follow along you can open
1:59up the case via qr code
2:02or the link in the description
2:05so this ct scan of the chest was
2:07performed with iv contrast with a
2:10routine protocol
2:12but there are a number of ways that you
2:14can image the chest with ct so there are
2:17multiple protocols and we won't get into
2:20too much detail but for now
2:22you should understand the basics of
2:24contrast timing and how that affects
2:27what the images look like
2:29so you can have a
2:30non-contrast ct chest i.e no iv contrast
2:34was administered
2:36notice that there's no contrast here in
2:38the heart or vessels
2:41if we give iv contrast how long we wait
2:44after injection practically speaking is
2:47going to determine the phase of contrast
2:50after we inject contrast into a vein
2:54it travels to the
2:55right heart
2:57and then into the pulmonary arteries
3:01so if we image really really early at
3:03that stage about 15 seconds or so after
3:06injection the pulmonary arteries would
3:08be filled with contrast and look
3:10very very bright
3:12this would be a ctpa or ct pulmonary
3:15angiogram protocol
3:17the scan that we want when we're looking
3:19for pulmonary emboli
3:22if we waited a little bit longer about
3:2320 seconds after injection or so
3:25contrast moves from the pulmonary
3:27arteries into the lungs
3:29back to the the pulmonary veins in the
3:31left heart
3:32and then into the aorta and other
3:35arteries
3:36if we image then it would be a cta or a
3:40ct angiogram of the chest with the aorta
3:44and other arteries very bright
3:46we use this to assess the arterial
3:49vasculature for example when ruling out
3:51an aortic dissection
3:54if we waited even longer the contrast
3:56would distribute further
3:58and we'll have more optimal enhancement
4:00of soft tissues around 60 to 70 seconds
4:03or so
4:04this is a routine contrast enhanced ct
4:07of the chest
4:09now we've intentionally oversimplified
4:11things here for now and left out
4:13protocols like low dose ct chest and
4:15high resolution ct chest
4:17but that's the basic principle that you
4:19want to understand for now and we'll get
4:21to the rest later
4:23for now let's get back to this ct and
4:25start looking at the anatomy in detail
4:31so when we scroll through these axial
4:33images of the chest
4:35most of what we're interested in here is
4:37within the thoracic cavity
4:40and the thoracic cavity is this entire
4:43cavity
4:44that is surrounded by chest wall which
4:47includes the bones and muscles that
4:49surround the cavity
4:52the thoracic cavity extends all the way
4:54up
4:55to this opening
4:57at the top of the thoracic cavity called
4:59the
5:00thoracic inlet
5:01basically it's the hole at the top
5:04bordered by the first ribs which are
5:06here
5:10and the manubrium
5:17and the thoracic cavity extends all the
5:18way down to the thoracic outlet
5:22which is closed by the diaphragm and
5:25borders the inferior aspects of the
5:28ribcage
5:29and to the bottom of the sternum
5:38in the thoracic cavity we have the right
5:41lung and the left lung
5:44and between the lungs is the mediastinum
5:48which we'll cover first
5:52the mediastinum is split up into
5:54compartments which are very important to
5:56know clinically
5:58because different processes happen in
6:00each of the compartments
6:02and so the differential diagnosis for
6:04things in each of the compartments is
6:06going to be different
6:08there are a bunch of ways to split up
6:10the mediastinum but the easiest and most
6:13logical way is to use the fibrous
6:15pericardium as your landmark so it's
6:18worth knowing a little bit about the
6:20pericardium
6:22so the pericardium is the sac that the
6:25heart sits in with the fibrous component
6:28being the outermost layer which you can
6:31actually see here on the ct
6:37it inserts into the diaphragm inferiorly
6:40here
6:44and up all the way to the level of the
6:47roots
6:48of the great vessels
6:53here is the fibrous pericardium on the
6:55sagittal images
7:01so everything superior
7:05to the pericardium
7:07and below the thoracic inlet
7:12is considered the superior mediastinum
7:15the superior mediastinum contains
7:17trachea
7:19esophagus
7:20and a bunch of vasculature that we'll
7:22talk about later
7:27the anterior mediastinum
7:29is anterior to the pericardium
7:34so this space
7:35right here
7:39in adult patients it contains mostly
7:41fatty attenuation notice the attenuation
7:43here is similar to the subcutaneous
7:46tissues
7:47but in younger patients it can contain
7:50the thymus
7:51it can also contain lymph nodes and
7:53sometimes thyroid
7:55which is up here if it extends
7:57inferiorly
8:03so that's why when you see an anterior
8:05mediastinal mass the classic
8:07differential includes thymic lesions
8:09like thymoma
8:11thyroid lesions and lymphoma amongst
8:15other things like teratoma and other
8:17germ cell tumors
8:20the middle mediastinum is within the
8:24pericardium
8:25mostly the heart
8:26and the vessels joining the heart
8:30including part of the ascending aorta
8:33and the pulmonary trunk
8:35the svc
8:37it also contains the tracheal
8:39bifurcation
8:41and some lymph nodes
8:44and lastly the posterior mediastinum
8:47is
8:47posterior to the pericardium the
8:50posterior mediastinum of course contains
8:52the spine
8:55the paraspinal nerves the vasculature
8:58back here
8:59and the esophagus
9:02the differential for a posterior
9:04mediastinal mass is logical if you know
9:06the anatomy with neurogenic tumors being
9:09the most common
9:12let's look through this anatomy in a bit
9:13more detail starting with the middle
9:15mediastinum and the heart
9:18so this here is the right atrium which
9:21is where the major systemic veins drain
9:24namely the inferior vena cava
9:28or ivc
9:30which defines the right atrium
9:33this is coming from the lower body and
9:36the superior vena cava
9:40from above
9:43this here is the right atrial appendage
9:47and you can see this structure here as
9:50well called the crista terminalis
9:53which is a muscular ridge running from
9:55the superior vena cava down to the ivc
9:59it's a normal structure and not a clot
10:03this is the right ventricle
10:07notice that normally it is pretty thin
10:09walled
10:11not so important for this introductory
10:13talk but important in general
10:15the right ventricle
10:17is defined by the moderator band
10:20which is this band coming from the
10:22interventricular septum here
10:25and extending towards the margin
10:27of the right ventricle also known as the
10:30septomarginal trabecula
10:33you may not see it very well on routine
10:35ct and for now don't worry about it too
10:38much
10:40the right ventricle pumps blood into the
10:43pulmonary artery
10:46so this is the pulmonary trunk
10:48and the right
10:50and left pulmonary arteries
10:52from here blood goes into the lungs
10:55and then drains into the pulmonary veins
11:02these are pulmonary veins that i'm
11:04pointing out
11:10the pulmonary veins drain into the left
11:12atrium which sits posteriorly here
11:17this is the left atrial appendage
11:22the left atrial appendage is a common
11:25location for blood clots to form it's
11:28also a common area where you can see
11:30mixing artifact
11:32the left atrium is normally less than
11:34four centimeters or so in ap dimension
11:38lastly this is the left ventricle here
11:42notice the relatively thick wall
11:44compared to the right ventricle
11:47you'll also notice the papillary muscles
11:50here
11:51the left ventricle pumps blood into the
11:54aorta so this is the aortic valve
11:57and the ascending aorta
12:01okay and that's a nice segue to move
12:03from the heart to the vascular anatomy
12:06so starting with the arteries again this
12:08is the aorta with the aortic valve
12:12ascending aorta
12:14aortic arch
12:17and descending aorta
12:21important arterial branches to know
12:23include the coronary arteries
12:27so this is the left coronary artery here
12:29with the left anterior descending
12:32that extends down the interventricular
12:33septum
12:36and the circumflex
12:40as well as the right coronary artery
12:42which arises from the right coronary
12:44cusp
12:48the three major branches of the aorta
12:52are first
12:53the brachiocephalic
12:55trunk
12:57which splits into the right subclavian
13:04and
13:05the right common carotid artery that i'm
13:07following now
13:12the second major branch is the left
13:15common carotid artery
13:19and the third major branch is the left
13:22subclavian artery
13:27other clinically important arteries to
13:29be aware of
13:31two arising from the subclavian vein are
13:35first the vertebral artery
13:39which i'm following now
13:43and second is the
13:46internal thoracic artery
13:50here it is on the left
13:52extending inferiorly along the anterior
13:55chest wall
13:59lastly the intercostal arteries are
14:01important to be aware of clinically
14:04they travel along the under surface of
14:07the ribs
14:09even if you don't see them that well
14:11they're important to know clinically for
14:13example if there is trauma and there's
14:15active extravasation or bleeding coming
14:17from
14:18this location you know it's arising from
14:20an intercostal artery
14:23all right moving along we briefly talked
14:25about the pulmonary artery here
14:26including the pulmonary trunk right and
14:29left pulmonary arteries
14:31we'll cover the rest of the pulmonary
14:32artery branches all the way to the
14:34segmental level in a future video on ct
14:37pulmonary angiogram
14:40major veins to know include
14:42the left jugular vein
14:48which joins the left subclavian vein
14:50here
14:51to become the left brachiocephalic vein
14:56similar on the right the right
14:58subclavian vein and right jugular vein
15:01joined to make the
15:03right brachiocephalic vein
15:06the two brachiocephalic veins joined to
15:08become the superior vena cava
15:12which joins the right atrium
15:16the arch of the azages
15:19here
15:20joins the superior vena cava
15:23just above the level of the right main
15:25stem bronchus so this is the right main
15:27stem bronchus here just above it is this
15:29arch of azagus joining into the
15:32superior vena cava
15:34the
15:36azages itself
15:38comes from inferiorly here
15:40and extends up to the level of the arch
15:43and it runs along the right side of the
15:44aorta and the posterior mediastinum
15:48we mentioned the inferior vena cava
15:51that joins the red atrium inferiorly
15:54one other vein i didn't mention earlier
15:56is the largest cardiac vein also known
15:58as the coronary vein here
16:02that runs along the posterior heart and
16:04drains into the right atrium as well
16:09moving along to the airways this is the
16:11trachea
16:14that
16:16bifurcates into the right main stem
16:19bronchus and the left main stem bronchus
16:22the tracheal bifurcation is also known
16:25as the carina
16:27notice that the right main stem bronchus
16:29here is a lot shorter than the left
16:34also know that the right main stem
16:35bronchus usually has more of an inferior
16:38angulation to it compared to the left
16:43which is why foreign bodies and
16:44aspiration tend to go down the right
16:47side more than the left
16:48this here posteriorly is the esophagus
16:54extending all the way down
16:56to the level of the ge junction and
16:58stomach
17:01before we go on to the lungs one last
17:03important thing to touch on here are the
17:05lymph node stations
17:08and we'll cover the most clinically
17:10important ones
17:12so starting with the supraclavicular
17:15lymph nodes
17:19as well as the low cervical lymph nodes
17:21which are low in the neck
17:24the prevascular nodes
17:27anterior to the great vessels here
17:33the aortal pulmonary zone or ap window
17:36which is just inferior to the aorta and
17:39above the pulmonary artery hence a for
17:42aorta p for pulmonary artery window
17:46this space here
17:49we have paratracheal nodes which are
17:51surrounding the trachea
17:55and that includes left paratracheal
17:57nodes
17:58you can see a normal appearing lymph
18:00node here on the left for example
18:02and right paratracheal nodes
18:04the dividing line between left
18:06paratracheal and right paratracheal is
18:09the left lateral border of the trachea
18:14so left paratracheal nodes are out here
18:16and right paratracheal nodes are
18:18anterior and to the right
18:21as we scroll down here past the carina
18:24we have the subcorinal
18:27station this is a normal subcorina lymph
18:29node
18:34and then more inferiorly and posteriorly
18:36we have para esophageal nodes if they
18:39happen to be present
18:45we also have bilateral hilar nodes
18:47adjacent to the main stem bronchi
18:51and then we have interlobar lobar
18:54segmental and subsegmental nodes as you
18:57go outwards but don't worry about those
18:59for now just understand the naming
19:00convention in the mediastinal nodes for
19:02now
19:05other important lymph nodes to be aware
19:06of in the chest include axillary nodes
19:10bilaterally
19:13internal thoracic nodes
19:15along the internal thoracic chain
19:19and
19:20cardiophrenic nodes
19:21down here
19:26okay so let's move on to the lungs
19:27themselves so we'll start with the right
19:30lung which is separated into three lobes
19:33by the fissures
19:35so here on the sagittal
19:37images you can see the oblique fissure
19:39here
19:42and the horizontal fissure here
19:45which separates the lungs into the right
19:47upper lobe
19:49right middle lobe
19:50and right lower lobe
19:55when i scroll through the axial images
19:58we are in the upper lobe here
20:03i can see the
20:05oblique fissure here
20:10and so all this posterior to the oblique
20:12fissure just like on the
20:14sagittal image as you can see are part
20:16of the lower lobe here
20:20as i scroll down you'll start to see the
20:22horizontal fissure which is this line
20:24here
20:27and so now we have the right upper lobe
20:30this is above the horizontal fissure
20:33right middle lobe between the horizontal
20:35and oblique fissure down here and this
20:38is all right lower lobe
20:43on the left
20:45we have only the oblique fissure
20:48separating the
20:49left upper lobe
20:51from the left lower lobe posteriorly and
20:55inferiorly
20:58on the axials here again you can see the
20:59oblique fissure
21:01this is all upper lobe and posteriorly
21:04and inferiorly this is all lower lobe
21:07the inferior part of the
21:10left upper lobe is called the lingula
21:13here near the heart
21:15now if you're going into radiology
21:17you'll probably need to know the
21:18segmental anatomy of the lungs as well
21:21so we'll cover that in detail in the
21:23ctpa video but let's briefly go through
21:26it now
21:27if this is your first time hearing this
21:28stuff don't worry if it's over your head
21:30you'll probably need to review this on
21:32your own and it just takes time and
21:33you'll get it eventually
21:35so the right lung is split into ten
21:37segments and the left into eight
21:41on the right starting with the upper
21:43lobe
21:45the upper lobe is split into
21:47three
21:48so we have the apical segment we're
21:51going to follow the bronchi to see where
21:52we're going so this is the apical
21:54segment here
21:58we have the
21:59anterior segment
22:03and we have the
22:05posterior
22:07segment
22:12in the right middle lobe
22:15again following the bronchi to indicate
22:17where i'm going
22:18in the right middle lobe we have a
22:21medial segment
22:23and a
22:24lateral segment notice that it splits
22:26into a medial and lateral bronchi here
22:33and the right lower lobe is split into
22:36five segments
22:38so this is right lower lobe here
22:40this posteriorly and superiorly is the
22:43superior segment
22:45of the right lower lobe
22:47pretty high in the chest
22:51and then as i scroll down it splits into
22:55four basal segments
22:56the anterior
23:00the medial
23:04the posterior
23:07and the lateral
23:09basal segments
23:12so again three in the red upper lobe
23:15apical anterior and posterior
23:18two in the right middle lobe medial and
23:20lateral and five in the right lower lobe
23:23superior and then the four basal
23:26logically anterior medial posterior
23:29lateral
23:31the left is split into eight segments
23:34with a few differences from the right
23:36so the left upper lobe basically you're
23:38just combining the apical and posterior
23:41segments
23:43so you have the apico posterior
23:48segment
23:50and then you also have
23:52an anterior segment
23:55so anterior is here and apico posterior
23:58is all this
24:01the lingula
24:02which is down here
24:04is instead of medial and lateral like
24:06the right middle lobe split into the
24:08superior
24:09you'll see a bronchus coming off here so
24:11the superior
24:13and then inferior
24:17segments
24:21so we're at four so far
24:23and then the left lower lobe again has a
24:26superior segment
24:30up here
24:34and then we have basal segments and on
24:36the left we only have three instead of
24:38four
24:39the anterior and medial segments are
24:42combined
24:45and then we have our lateral
24:49and posterior basal segments
24:56so the major differences between the two
24:58lungs are that we have the apico
25:00posterior
25:01combined
25:02in the left upper lobe and the
25:06anteromedial
25:07in the lower lobe
25:09which gets rid of the two segments
25:10making it eight on the left and ten on
25:12the right
25:13the other difference is that the
25:14lingular
25:15are separated into superior and inferior
25:18instead of the
25:19medial and lateral in the right middle
25:21lobe
25:23again if you're new to that and this
25:24terminology is new that's likely way too
25:26much for now don't worry it's not that
25:28important at this point and we'll go
25:30through it again when we talk about
25:31pulmonary emboli
25:36okay so surrounding each of the lungs is
25:38a double layer of pleura
25:41you don't actually see them when you
25:43have normal pleura on ct
25:45but the space between these layers is
25:47called the pleural space
25:49so you're going to be looking for things
25:50like pleural effusions that will fill
25:52that space dependently
25:54and when it's filled with gas and
25:56pneumothorax amongst other pathology
26:00all right so that's the meat and
26:01potatoes of the anatomy that i wanted to
26:03cover
26:04a few other things to briefly mention
26:07we can see the lower neck here as well
26:10on cts of the chest including the
26:13thyroid gland
26:14notice how bright it is
26:18we also have the entire chest wall which
26:21includes subcutaneous fat musculature
26:25and bones
26:28starting with the bones
26:30we have our ribs
26:32starting from the first rib
26:36all the way down to the
26:3812th rib
26:43we have our spine posteriorly here
26:50we have our manubrium
26:53and sternum anteriorly here
26:59we have our bilateral clavicles
27:05the acromioclavicular joints up here can
27:07sometimes be seen
27:09this is the scapula back here
27:12and then we can often see part of the
27:15humerus
27:21on sagittal images
27:24the spine
27:26and the sternum
27:29there are many muscles that you can see
27:30on ct of the chest that are beyond the
27:32scope of this talk including pectoralis
27:35major here
27:37and pectoralis minor
27:39bilaterally
27:41rotator cuff muscles back here
27:45paraspinal muscles
27:49we can also see quite a bit of the upper
27:52abdomen here and we covered the anatomy
27:54here in detail in our ct abdomen and
27:56pelvis talk
27:59okay so that's it for the anatomy let's
28:01move on to a brief approach
28:04so usually i start by looking at the
28:06scout image that's because the scout
28:08image often covers more anatomy than
28:11does the ct itself looking for any
28:13incidental findings
28:14then i start by looking at the soft
28:17tissue window
28:19first looking for any medical devices
28:21things like pacemakers
28:24lines tubes
28:28staying on soft tissue window
28:30i then look at the chest wall
28:33including
28:34all the way up to the lower neck
28:38which also includes the thyroid looking
28:40for incidental thyroid nodules
28:43or thyroid masses
28:45as part of my scan of the chest wall on
28:49soft tissue windows i'll quickly look
28:51down the spinal canal for any incidental
28:53findings
28:55and then start looking at the thoracic
28:56cavity itself starting with
28:59the heart and mediastinum
29:02so generally when i'm looking at the
29:04heart itself i'm looking for specific
29:06chamber enlargement
29:09or other pathology like clot or tumor
29:14i'm looking
29:16in the pericardial space here posterior
29:18to the fibrous pericardium
29:21for
29:22any evidence of pleural effusions
29:24pleural thickening pleural calcification
29:29as i'm scrolling up here i look for
29:31coronary calcifications on non-gated
29:34routine cts
29:36it's difficult to assess the coronary
29:38arteries much more than looking for
29:40calcifications most of the time so
29:42knowing the anatomy is important to pick
29:43up on what is coronary calcifications or
29:46stents
29:49i then look at the mediastinal vessels
29:51so specifically looking at the aorta and
29:54pulmonary artery to start
29:57starting with the pulmonary artery i
29:59usually measure the pulmonary artery
30:01here in this axis
30:03the pulmonary trunk is considered
30:05enlarged if it's over three centimeters
30:08which would also indicate pulmonary
30:10hypertension
30:12i also then follow the pulmonary
30:14arteries themselves when we give an iv
30:16contrast even if it's a routine ct like
30:19this
30:20because we'll often pick up on
30:21incidental
30:23pulmonary emboli
30:27i also measure the diameter of the
30:29ascending aorta only if it looks big to
30:32me
30:33and your eye will get and your eyes will
30:35get used to what is too big and if it's
30:38over four centimeters that's considered
30:40aneurysmal for the ascending aorta
30:43i'm gonna follow
30:44the
30:46aortic arch and
30:48down to the descending aorta looking for
30:50any other aortic pathology
30:54as well as briefly following the major
30:56branches of the aorta
31:05i'm looking at the esophagus in the
31:06posterior mediastinum
31:12and as i'm looking at all these things
31:13i'm also looking for any obvious
31:15mediastinal masses in each of the
31:16compartments that we mentioned
31:19in the anatomy section
31:22i then look for lymph nodes i'm looking
31:24through all of the chains that we
31:26mentioned so starting with the lower
31:29neck bilaterally and looking closely for
31:31supraclavicular lymph nodes
31:33in the mediastinum the prevascular chain
31:37ap window
31:40paratracheal nodes
31:44sub subcorinal nodes
31:48paraesophageal nodes
31:52looking for hilar nodes
31:56along the internal thoracic
31:59bilaterally
32:01cardiophrenic
32:04then on soft tissue window i'm looking
32:06at the pleura
32:09for any pleural effusions dependently
32:11pleural thickening calcification
32:14masses
32:17and then switch to lung window to look
32:19for
32:20pneumothorax
32:22first
32:24in the setting of trauma you're going to
32:25pick up little tiny pneumothoracies
32:27looking anteriorly and medial here
32:31or posterior medial here this is also
32:33non-dependent
32:36for this part of the lung
32:40while i'm still on lung window i'm
32:41looking at the airways
32:46and then i start to look at the lungs
32:50and so everyone has their own search
32:51pattern for how they look through the
32:52lungs
32:54i tend to start by doing a quick
32:56overview of both lungs to look for any
32:58obvious pathology
33:00i usually split it into halves on the
33:01axial cuts so i'm looking right anterior
33:04first
33:07and then right posterior
33:12and then the same on the left
33:15left anterior
33:19and left posterior
33:24i then take my time and look at the
33:27lungs in more detail looking for smaller
33:29lung nodules
33:31i tend to use the mip images if they're
33:33available
33:35mip images are maximum intensity
33:37projections with thicker slices so as
33:40you can see the vessels look very
33:42elongated and linear
33:45that is contrary to what a long nodule
33:48would look like
33:51so for example there is a lung nodule
33:54it doesn't look linear like these
33:55vessels so lung nodules will pop up as
33:57dots
33:58amongst all of these connecting linear
34:01structures that are the vessels
34:06so when i'm looking at the mips
34:07depending on your plane i actually split
34:09the chronos into three so i'm looking
34:11superiorly here first
34:14from front to back middle
34:16and then inferiorly scrolling relatively
34:19slowly here's another nodule for example
34:22and then do the same on the left
34:25if you happen to identify
34:27a nodule on the mips
34:30the next step is to then cross correlate
34:33and find that same nodule on
34:37your normal axial cuts
34:42i then switch to bone window to look at
34:44the bones
34:47looking at the ribs i generally split
34:49them into posterior and anterior so i'm
34:51looking posteriorly on the right here
34:57and then anteriorly or anterior
34:59laterally here on the right
35:03same thing on the left repeat
35:07looking at both clavicles here
35:11the manubrium and sternum
35:17i tend to look at the axial images for
35:20the spine as well
35:22and the
35:23scapulae
35:24as well as the humeral heads here
35:28and then i do pull up the sagittal
35:29images as well
35:31to look at the spine
35:34and sternum again
35:40lastly on soft tissue window
35:43i'm looking at the upper abdomen
35:45for incidental findings and we went
35:47through an approach on the abdomen and
35:49pelvis talk but again looking at the
35:50liver or what i can see of it
35:53the gallbladder
35:55pancreas
35:57spleen
35:59adrenals
36:02and kidneys
36:05remember lung cancers like to
36:07metastasize to the adrenals so you're
36:08specifically looking for adrenal nodules
36:11when looking at cases of lung cancer
36:13i also follow the
36:15stomach to the duodenum or what i can
36:17and have a look at the bowel
36:19as well as for any incidental lymph
36:21nodes in the upper abdomen but again
36:22watch the ect adamant and pelvis talk
36:24and this will take you a very short
36:27amount of time to look through
36:31all right so that's the end of this
36:32video in the next video we'll cover how
36:34to look at ct pulmonary angiogram with a
36:38more detailed look at segmental anatomy
36:41and how to diagnose acute and chronic
36:44pulmonary emboli thanks a lot

About this transcript

This page contains the full transcript of Introduction to CT Chest - Anatomy and Approach by Navigating Radiology, generated from the public captions YouTube serves with the video. The transcript has 4,353 words across 845 segments, with the original timestamps preserved so you can click any line to jump to that moment in the embedded player.

What you can do with it

Use the transcript to take notes, quote the speaker, build a study guide, generate a summary with ChatGPT or Claude via the YouTube Summary tool, or export it as a timed subtitle file with YouTube to SRT. You can also re-open it in the transcriber to translate the transcript into 100+ languages.

Free YouTube transcript tool

YouTube2Text is a free YouTube transcript generator — no signup, no daily limit. Paste any YouTube link and get the full transcript instantly, with timestamps, click-to-jump, translation to 100+ languages, AI prompts for ChatGPT, Claude, and Gemini, and exports to TXT, SRT, VTT, or Markdown.