Chris Warrington, DVM

Dept. of Medical Imaging

College of Veterinary Medicine
University of Minnesota

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

CVM 6101 [Imaging Anatomy]

 Goals & Expectations:
 Identify specific structures or parts thereof
 Understand why the views (projections) look as they do
 Keep in mind that the items listed in the “to know” lists 
are from the perspective of practicing radiologists
 If asked, be able to describe what soft‐tissue (muscle, 
tendon, ligament, vessel, or alimentary/parenchymal) 
structure(s) attach to, pass through, or lie in contact with 
a given anatomic landmark or region

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Challenging?  Yes
 Thoracic radiographic interpretation is consistently 
difficult for students AND veterinarians.
 Tremendous variation in normal – small vs. large 
dogs, short vs. tall dogs, fat vs. lean dogs
 Even in the same patient – inspiration vs. 
expiration, right lateral vs. left lateral recumbence

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

1
 Normal Thorax - Lateral
Dorsal

Cranial Caudal

Ventral

Normal Thorax – Cranial

Ventral Dorsal

Right Left

Caudal

Normal Thorax

Right Lateral
VD

2
 Normal Cat

Normal Cat

Normal Lateral View:

inspiration vs. expiration

3
 Normal Ventral Dorsal View:
inspiration vs. expiration

To Know List
 1) heart, left atrial region
 2) heart, left ventricular region
 3) heart, right atrial/aortic root/pulmonary trunk region
 4)  heart, right ventricular region
 5) caudal vena cava
 6) lobar pulmonary arteries
 7) lobar pulmonary veins
 8) approximate lung lobe location [cranial, middle, caudal, accessory]
 9) left and right diaphragmatic crura
 10) diaphragmatic cupola
 11) costochondral junctions, bodies, and costal cartilages of the ribs
 12) manubrium sterni
 13) xiphoid of the sternum
 14) trachea
 15) mainstem bronchi
 16) aorta
 17) approximate area of the cranial vena cava
 18) approximate area of the esophagus
 19) larynx & pharynx (oral and nasal portions and epiglottis)
 20) understand the “potential space” concept of and know the contents of:
‐ pleural space
‐ mediastinum

Interpretive Background: THORAX

Heart and Vessels

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Veterinary Medical Center

4
 Heart – Lateral Perspective

Cardiac Margins –
Clock Face Diagram

Cardiac Margins –
Clock Face Diagram
 12:00 = just ventral to tracheal bifurcation
 12:00‐2:00 = left atrium
 (2:00‐3:00 = caudal vena cava)
 2:00‐5:00 = left ventricle
 (5:00 = apex of the heart)
 5:00‐9:00 = right ventricle
 9:00‐12:00 = right atrium/auricle (~9‐10), 
pulmonary trunk (~9‐10), aortic root (~10‐11)

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Veterinary Medical Center

5
 Lateral Heart

Lateral Heart Diagram Key

 A, AO = aorta
 AV = aortic valve
 CV = cranial vena cava
 LA = left atrium
 LAU = left auricle
 LPA = left pulmonary artery
 LV = left ventricle
 MV = mitral valve
 PA = main pulmonary trunk (artery)
 PC = caudal vena cava
 PV = pulmonary veins
 RAU = right auricle
 RPA = right pulmonary artery
 RV = right ventricle
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Veterinary Medical Center

Heart – Ventral Dorsal Perspective

6
Cardiac Margins – VD clock face

* = left atrium

Cardiac Margins – VD clock face

 11:00‐1:00 = aortic arch
 1:00‐2:00 = main pulmonary trunk
 2:00‐3:00 = left auricle
 2:00‐apex = left ventricle
 (5:00‐6:00 = apex of the heart)
 apex‐9:00 = right ventricle
 9:00‐11:00 = right atrium

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Heart – Ventral Dorsal Perspective

7
 VD Heart Diagram Key
 AO = aorta
 CV = cranial vena cava
 LAU = left auricle
 LV = left ventricle
 PA = main pulmonary trunk (artery)
 PC = caudal vena cava (post‐cava)
 RA = right atrium
 RAU = right auricle
 RV = right ventricle

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Interpretive Background: THORAX

 Thoracic Circulatory Pattern:
cranial/caudal* vena cava 
right atrium*  tricuspid valve 
right ventricle*  pulmonary trunk* 
lobar pulmonary arteries* 
lobar pulmonary veins*  left atrium* 
mitral valve  left ventricle*  aorta*
 * sufficiently visible to be survey radiographically useful

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Interpretive Background: THORAX

 Intrapulmonary Circulatory Pattern:

 ARTERY / BRONCHUS / VEIN TRIAD
(one in each major lung lobe) 
 Used as indirect indicator of left heart function
 Lobar pulmonary arteries
 Dorsal to veins on lateral views
 Lateral to veins on VD/DV Views
 Lobar pulmonary veins
 Ventral to arteries on lateral views
 Medial to arteries on VD/DV Views

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Veterinary Medical Center

8
 Veins are Ventral
Veins are Central
 On the lateral radiograph, the CRANIAL 
lobar pulmonary veins are ventral to the 
artery & bronchus.
 On the VD/DV radiographs, the CAUDAL 
lobar pulmonary veins are central (medial) 
to the artery & bronchus

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Lung Vessel Diagram [lateral view]

Normal
Thorax -
Lateral

9
Normal
Thorax - arteries

Lateral

veins

Normal
Thorax -
Lateral

bronchi

Normal
Thorax –
Ventral
Dorsal

10
Normal
Thorax –
Ventral
Dorsal
arteries

veins

Normal
Thorax –
Ventral
Dorsal
bronchi

Cranial Vena Cava

(Not visible on survey radiographs)

11
Normal Cranial Vena (CrVC)
Cavogram (dog)

CrVC

Caudal Vena Cava

(Normally visible on survey radiographs)

Caudal Vena Cava

(Normally visible on survey radiographs)

12
 Normal Caudal Vena (CaVC)
Cavogram (dog)

CaVC

Interpretive Background: THORAX

Airways

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Veterinary Medical Center

Interpretive Background: THORAX

 Upper Airways (extrapulmonary):
 nasal passages  nasopharynx  pharynx
 larynx
 oral cavity         oropharynx    pharynx
 Lower Airways (extrapulmonary):
 extrathoracic trachea 
intrathoracic trachea 
proximal mainstem bronchi (left & right)
 Intrapulmonary Airways: 
 distal mainstem bronchi  bronchioles

[airways distal to 3rd order bronchi are not normally 

visible on radiographs]
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Veterinary Medical Center

13
Normal Upper Airways

Normal Upper Airways

nasopharynx

oropharynx

Normal Upper Airways

pharynx
larynx

14
 Normal Upper Airways

soft palate
epiglottis

Interpretive Background: THORAX

Lungs

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Interpretive Background: THORAX

 Left Lobes (radiologist’s functional perspective):
 cranial portion of left cranial (left cranial)
 caudal portion of left cranial (left middle)
 left caudal (left caudal)
 Right Lobes:
 right cranial
 right middle
 right caudal
 accessory

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Veterinary Medical Center

15
Lung Diagram [Lateral view]

Normal Dog Lateral View

Normal Dog Lateral View

Cranial (L&R)
Middle (L&R)
Caudal (L&R)
Accessory (R)

16
 Lung Diagram [VD view]

Normal Dog VD View

Normal Dog VD View

Cranial Portion of Left 
Right Cranial Cranial (Left Cranial)

Right Middle Caudal Portion of Left 
Cranial (Left Middle)

Right Caudal Left Caudal

Accessory

17
 Diagram:
Airway
Subdivisions
[dog & cat]

Visible on radiograph
---------------------------------------
Too small to see on radiograph

Barium aspiration
outlining airways

CVM 6101 [Imaging Anatomy]

 Diaphragm: Broad Anatomic Regions
 Right crus
 Left crus
 Cupola (dome)

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Veterinary Medical Center

18
 CVM 6101 [Imaging Anatomy]
 Diaphragm:
 VD/DV and RL/LR views
 Beware of superimposed structures including 
vertebrae, ribs, sternebrae, lungs, stomach, 
nipples, fascial planes, etc.
 Remember, the diaphragm is a sling‐like 
muscle that “actively” contracts (caudally) 
and “passively” relaxes (cranially) [numerous 
influences such as lungs, abdominal fat, etc.]

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

CVM 6101 [Imaging Anatomy]

 Diaphragm:
 Appearance changes depending on DV vs. VD views 
(with the X‐ray beam centered on the heart):
○ On DV views, the diaphragm usually has one broad dome 
which corresponds to the cupola
○ On VD views, the diaphragm usually has “3 humps” 
corresponding to the two crura and the central cupola
○ Appearance related to beam divergence and diaphragm 
orientation relative to the diverging beam

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Diaphragm Appearance:
VD vs. DV (From Grandage)

DV  DV 
Thorax Abdomen

VD  VD 
Abdomen Thorax

19
 Normal Dog Thorax
VD/DV

Normal Dog Thorax

VD/DV

Right crus Cupola Left crus

CVM 6101 [Imaging Anatomy]

 Diaphragm:
 Appearance changes depending on R vs. L recumbent 
lateral views (with the X‐ray beam centered on the 
heart): 
○ On R lateral views, the diaphragmatic crura are usually 
parallel, with the R crus more cranial and blending with the 
caudal vena cava
○ On L lateral views, the diaphragmatic crura usually cross, with 
the L crus being more cranial, but the R crus still blends with 
the caudal vena cava 
○ Appearance related to right crus usually being more cranial, 
but the down‐side crus is forced forward by visceral weight

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Veterinary Medical Center

20
 Diaphragm Appearance:
Right vs. Left Lateral (From Grandage)

Right Lateral Left Lateral

Right vs. Left Lateral

Right vs. Left Lateral

Right crus Cupola Left crus

21
CVM 6101 [Imaging Anatomy]

 Diaphragm: Specific 
Morphology
 Hiatus for caudal 
vena cava
 Hiatus for aorta
 Hiatus for esophagus 
(esophagus, vagal n)

Diaphragm
 Caudal Vena Cava hiatus

Diaphragm
 Aortic hiatus

22
 Diaphragm
 Esophageal hiatus

Interpretive Background: THORAX

Thoracic Wall

UNIVERSITY OF MINNESOTA
Veterinary Medical Center

Thoracic Wall
 13 pairs of ribs
 Ribs have head, body, costochondral 
junction, and costal cartilage portion
 Thoracic wall includes all musculature, 
vessels, nerves between and overlying the 
ribs, spine, and sternum.

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Veterinary Medical Center

23
Normal
Thorax

Rib heads

Normal
Thorax

Rib bodies

Costochondral 
junctions

Manubrium  (1st Costal 
Xiphoid (8th
sternebra) cartilages
sternebra)

Interpretive Background: THORAX

 Thoracic “Spaces” [not normally visible]:
 Pleural space:
○ “potential” space between the visceral pleura (directly 
surrounding the lungs) and the parietal pleura (lining the 
thoracic cavity and reflecting over the mediastinum)

 Mediastinal space:
○ “potential” space between the right and left mediastinal 
(parietal) pleural reflections

 Pericardial sac:
○ sac that directly surrounds the heart

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Veterinary Medical Center

24
Interpretive Background: THORAX

 Pleural space:
 Small volume normal fluid (few mL)
 Otherwise contains NOTHING
 Negative pressure to promote lung inflation

 Mediastinal space: 
 Contains EVERYTHING except the lungs and the 
caudal vena cava with its accompanying right 
phrenic nerve

 Pericardial sac: 
 Contains only the heart

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Veterinary Medical Center

Thoracic “Spaces”
1-3: parietal pleura
1: costal pleura
2: mediastinal pleura
3: diaphragmatic pleura
4: visceral pleura
5: diaphragm
6: parietal and visceral
pericardium
7: cranial mediastinum
8: caudal mediastinum
9: plica vena cavae
10: costodiaphragmatic
recess

Interpretive Background: THORAX

Mediastinal Space

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25
Mediastinal Reflections
 Cranial mediastinum
 Marked with black arrows
 Commonly contains fat and 
can appear widened in 
normal to obese mature dogs
 Caudoventral mediastinal 
reflection
 Marked with red arrows
 Left‐sided attachment to 
diaphragm

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Veterinary Medical Center

Mediastinum
Esophagus 
(region of )

Trachea / 
bifurcation

Aorta

Cranial 
Vena Cava 
(region of )

Mediastinum
Esophagus 
(region of )

Trachea / 
bifurcation

Aorta

Cranial 
Vena Cava 
(region of )

26
Mediastinum
Esophagus 
(region of )

Trachea / 
bifurcation

Aorta

Cranial 
Vena Cava 
(region of )

Mediastinum
Esophagus 
(region of )

Trachea / 
bifurcation

Aorta

Cranial 
Vena Cava 
(region of )

Mediastinum
Esophagus 
(region of )

Trachea / 
bifurcation

Aorta

Cranial 
Vena Cava 
(region of )

27
 Mediastinum

Esophagus 
(region of )

Trachea and 
bronchi

Aorta

Cranial 
Vena Cava 
(region of )
VD

Mediastinum

Esophagus 
(region of )

Trachea and 
bronchi

Aorta

Cranial 
Vena Cava 
(region of )
VD

Mediastinum

Esophagus 
(region of )

Trachea and 
bronchi

Aorta

Cranial 
Vena Cava 
(region of )
VD

28
 Mediastinum

Esophagus 
(region of )

Trachea and 
bronchi

Aorta

Cranial 
Vena Cava 
(region of )
VD

Thymic “Sail” Sign (VD)

Thymus
‐Sometimes seen in puppies
‐Usually regresses by 5‐6 months of age

Thymic “Sail” Sign (VD)

Thymus
‐Sometimes seen in puppies
‐Usually regresses by 5‐6 months of age

29
 Mediastinal
Lymph Nodes

Cranial 
mediastinal LN(s)

Tracheobronchial 
mediastinal LNs

Sternal mediastinal 
LN(s)

Mediastinal Lymph Nodes

Interpretive Background: THORAX

Pleural Space

Remember, the pleural space is a 
“potential” space, and is not 
normally visible on radiographs.

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Veterinary Medical Center

30
 Lung Diagram [VD view]

Pleural space 
(fissures) are at 
boundaries of lungs

Lung Diagram [Lateral view]

Pleural space 
(fissures) are at 
boundaries of lungs

Normal Thorax - Lateral

Approximate 
location of 
pleural fissures 
on a lateral 
radiograph

31
 Normal Thorax –
Ventral Dorsal

Approximate 
location of pleural 
fissures on a VD 
radiograph

Interpretive Background: THORAX

Pericardial Sac

•Remember, the pericardium is closely 
associated with the surface of the heart, 
and cannot normally be identified as a 
separate structure on radiographs.

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Veterinary Medical Center

Normal Thorax - Lateral

32
 Normal Thorax –
Ventral Dorsal

VD

Pericardial Sac
6: parietal pericardium,
outer fibrous layer
tightly adhered to inner
serous layer

7: visceral pericardium,
adherent to heart
(epicardium)

Pericardial Effusion

33
 References: THORAX
 Burk RL, Feeney DA.  Small Animal Radiology and 
Ultrasonography.  Saunders/Elsevier, Philadelphia, 2003.
 Dyce KM, Sack WO, Wensing CG.  Textbook of Veterinary 
Anatomy. Saunders/Elsevier, Philadelphia, 2002.
 Grandage J.  Radiology of the dog’s diaphragm. J Small 
Anim Pract 15:1, 1974.
 Suter PF, Lord PF.  Thoracic Radiography: A Text Atlas of 
Thoracic Diseases of the Dog and Cat. Wettswil, 
Switzerland, 1984.
 Thrall DE (ed).  Textbook of Veterinary Diagnostic 
Radiology.  WB Saunders, Philadelphia, 2002.

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Veterinary Medical Center

Questions?

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Veterinary Medical Center

Labeled Axial Images

College of Veterinary Medicine
University of Minnesota

Slides on CT of the Canine Thorax are for additional

perspective of normal thoracic anatomy – no CT images will
be used for quiz or exam questions

34
1. Right caudal lung
2. Right kidney
3. Spleen
4. Body of L2
5. Abdominal aorta
6. Portal vein
7. Caudal vena cava

1. Left caudal lung

2. Body of L1
3. 12th rib
4. Aorta
5. 13th rib

1. Left caudal lung

2. Right caudal lung
3. Mediastinum
4. Gas in fundus of
stomach
5. Body of T13

35
1. Body of T12
2. Right 12th Rib
3. Right caudal lung
pulmonary artery
4. Right caudal lung
pulmonary vein
5. Right medial liver lobe

1. Body of T11
2. Aorta
3. Right caudal lung lobe
4. Accessory lung lobe
5. Caudal vena cava
6. Esophagus

1. Body of T10
2. Azygous vein
3. Esophagus
4. Caudal vena cava
5. Plica vena cava
6. Pulmonary metastasis
7. Gallbladder
8. Xiphoid

36
1. Body of T9
2. Pulmonary arteries
3. Pulmonary veins
4. Accessory lung lobe
bronchus
5. Caudoventral
mediastinal reflection
6. Cranial extent of
diaphragm

1. Body of T8
2. Left caudal lung lobe
pulmonary vein
3. Right caudal lung lobe
pulmonary vein
4. Left main caudal
bronchus
5. Right main caudal
bronchus
6. Apex of heart (left
ventricle)

1. Body of T7
2. Left caudal lung lobe
pulmonary artery
3. Right caudal lung lobe
pulmonary artery
4. Air in the esophagus
5. Right middle lung lobe
bronchus
6. Right middle lung lobe

37
1. Body of T6
2. Left atrium
3. Left ventricle
4. Papillary muscle in left
ventricle
5. Right ventricle
6. Caudal vena cava
7. Interventicular septum

1. Body of T6
2. Left cranial lung lobe
bronchus
3. Left cranial lung lobe
artery
4. Azygous vein

1. Body of T5
2. Left atrium
3. Left ventricle
4. Right ventricle
5. Right atrium

38
1. Body of T5
2. Left cranial lung lobe
3. Right cranial lung lobe
4. Body of right scapula

1. Body of T5
2. Main pulmonary artery
3. Right atrium
4. Right ventricle

1. Body of T4
2. Right ventricle
3. Right ventricle outflow
tract
4. Main pulmonary artery
5. Aortic root

39
1. Body of T4
2. Right ventricle
3. Main pulmonary artery
4. Ascending aorta
5. Cranial vena cava

1. Body of T4
2. Pulmonary artery of
the cranial segment of
the left cranial lung
lobe
3. Pulmonary vein of the
cranial segment of the
left cranial lung lobe
4. Spine of the left
scapula

1. Body of T2
2. Left subclavian artery
3. Brachiocephalic trunk
artery
4. Cranial vena cava

40
1. Left cranial lung
2. Right cranial lung
3. Cranioventral
mediastinal reflection
4. Body of T2

1. Left cranial lung lobe

2. Right cranial lung lobe
3. Cranioventral
mediastinal reflection
4. Body of T1

1. Body of C7
2. Left cranial lung
3. Right cranial lung

41
1. Body of C6
2. Left cranial lung lobe
3. Manubrium
4. Gas in the esophagus

42