Chest x-ray anatomy

Tutorial introduction

This tutorial demonstrates some of the important anatomical structures visible on a chest x-ray. These structures are discussed in a specific order to help you develop your own systematic approach to viewing chest x-rays.

By the end of the tutorial you will be familiar with all the important structures of the chest, which should be checked whenever you look at a chest x-ray. The tutorial also discusses anatomical structures that are not easily seen, but become visible when abnormal due to disease. You will learn more about these structures and diseases in the tutorial on chest x-ray pathology.

Before you start, have a look at the normal chest x-ray below.

Tutorial key points

  • Some anatomical structures in the chest should be assessed on every chest x-ray
  • Each of these anatomical structures should be viewed using a systematic approach
  • There are also important structures that are obscured or become visible only when abnormal
Hover over image

Chest x-ray anatomy

  • How many anatomical structures can you see on this x-ray ?
  • Can you think of any important structures in the chest that are difficult to see on the x-ray ?

Visible structures

  • 1 - Trachea
  • 2 - Hila
  • 3 - Lungs
  • 4 - Diaphragm
  • 5 - Heart
  • 6 - Aortic knuckle
  • 7 - Ribs
  • 8 - Scapulae
  • 9 - Breasts
  • 10 - Bowel gas

Important obscured/invisible structures

  • Sternum
  • Oesophagus
  • Spine
  • Pleura
  • Fissures
  • Aorta
Click image to align with the top of the page

Chest x-ray anatomy

Many structures of the chest are readily visible on a chest x-ray, but others, are difficult to see. In fact, some important structures, such as the phrenic nerve, are not visible at all.

Other anatomical structures, such as the pleura, only become clearly visible when abnormal.

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