0:01

The next case is a very similar history of chest pain.

0:05

And here you can see as you look at the lung fields, again,

0:08

starting through our checklist, that the left lung is essentially clear,

0:13

but we see that there is a paucity of lung markings throughout the right hemithorax

0:18

with a totally collapsed lung here along the mediastinum.

0:22

And so again, in terms of providing information for an air gap,

0:26

we can measure the apical component, which measures 17.5cm.

0:32

If you want to go a lateral component,

0:35

you're close to another 10cm there as well.

0:38

Again, you want to look for evidence of tension.

0:41

And here, when we look at the distance between the ribs,

0:45

the alignment of the trachea, we're actually in pretty good condition

0:49

for not having a significant amount of tension.

0:53

So this is an example of a large, right

0:56

pneumothorax without any significant degree of tension.

1:00

And the point here is to remember that you can have very large pneumothoraces

1:05

without tension, and conversely, you can have smaller pneumothoraces with tension.

1:09

So the issue of tension, you always want to be able to provide

1:13

to the clinicians and it can vary depending on size.

1:17

And in this case, we have both a PA and a lateral view.

1:21

So you never want to not look at your images or all of your images.

1:25

So we want to take a look at this as well.

1:27

Although we're able to make the full

1:29

diagnosis on the frontal view, you do get information on the lateral view.

1:34

So what I like to do on the lateral view

1:36

is you get a free look at the vertebral bodies.

1:39

And while this is not a trauma case, this is not something we're concerned about,

1:43

the vertebrae, it's good to get into the habit of each time looking at those.

1:48

Again, you can take a look at the ribs and you see that they're pretty well aligned.

1:52

There's not necessarily any evidence of splaying.

1:54

You take a look at the mediastinum,

1:56

the heart outline, and you're able to look at some aspects of the ribs.

2:00

Again, take a look underneath

2:01

the diaphragm and you'll see that there's normal bowel gas pattern that's there.

2:05

So again, not a lot of information here,

2:07

but just as a force of habit, get into the habit of looking at all

2:12

of your images and take a look at the lateral view.