Exam I: Radiology Of The Airway Flashcards

1
Q

Most common x-ray perioperatively (outside of OR)

A

PA (posterior to anterior)

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2
Q

Most common X-ray taken in OR

A

AP (anterior to posterior, front to back)

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3
Q
  • real time, live images
  • digital phenomenon
  • helps with alignment of tools and implants
A

Fluoroscopy

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4
Q

Common x-ray views of c-spine

A
  • lateral
  • AP
  • open-mouth odontoid
  • oblique
  • pillar
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5
Q

X-ray views

A
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6
Q

Interruption C4 - C5

A
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7
Q

Fluoroscopy C-Arm

A
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8
Q

Unit of X-ray exposure

A

Roentgen (R)

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9
Q

Unit of x-ray absorbed by tissue (must state where)

most practical term for our use because its purpose because it represents the actual dose

how much radiation is actually absorbed by the part being radiographed

A

Rad (r)

Radiation Absorbed Dose

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10
Q

Unit for exposure equivalent relative to other forms of ionizing radiation

A

REM

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11
Q

The amount of radiation that produces a specific amount of ionization of 1cc of air at STP

A

Roentgen

Used as measure of radiation exposure

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12
Q

REM stands for

A

Roentgen Equivalent (in mammals)

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13
Q

Bone (depicted as white on an x-ray) cause more/less radiation particles to get through?

A

Less

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14
Q

Increased attenuation of x-ray particles will result in what type image?

A

Opaque (radio-opaque)

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15
Q

A medium that allows greater passage of x-ray particles is said to be ____.

A

Radioluscent

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16
Q

A radioluscent material will appear ____ on an x-ray.

A

Black (no visible component: air)

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17
Q

Metal>Bone>Fluid/Fat/Soft Tissue>Air

High to low OR low to high attenuation?

A

High to low

Metal: Very white
Bone: White
Fluid: Lightly white or grayish/some blackening
Air: Black

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18
Q

Bone and metal are radio-____.

A

Opaque

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19
Q

ABCDEFG X-ray Assessment

A

Assessment/Airway
Bones
Cardiac Silhouette
Diaphragm
Equipment
Fields of Lung
Gastric Bubble/Great Vessels

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20
Q

Common X-Ray Views

A
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21
Q

Which x-ray view will cast a larger shadow of heart?

A

AP, because it casts a larger shadow

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22
Q

What 3 variables do we assess when conducting the “Assessment” portion of the X-ray?

A
  • Rotation
  • Inspiration
  • Penetration

RIP

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23
Q

“Rotation” assessment x-ray

A
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24
Q

How to assess Inspiration on x-ray

A
  • count 5-7 Anterior ribs (OK)
  • count 9+ Posterior Ribs (OK)
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25
Q

ID ribs for inspiration X-ray

A
26
Q

What should we see on an x-ray if “Penetration” is adequate

A
  1. Spaces between the vertebrae
  2. Pulmonary vessels
27
Q

T. Pneumothorax x-ray

A
28
Q
A

Croup with Steeple Sign

Common in children

29
Q
A

Acute Epiglottitis (enlarged epiglottis)

30
Q

X-ray Examples

A
31
Q

Escaping air into skin is called?

A

Subcutaneous Emphysema

32
Q

What is most important when evaluating bones on X-ray?

A

Number & smooth continuous lines (no fractures)

33
Q

Cardiac silhouette should occupy ____% of chest wall

A

50%

34
Q

Labeled x-ray

A
35
Q
A
36
Q
A

Extra fluid in pericardial sac

37
Q

With pulmonary HTN, what side of heart is larger?

A

Right

Due to increased pressure in lungs, therefore causing RV to pump harder to circulate blood to lungs

38
Q
A

Pulmonary HTN (on right)

  • LV turned posteriorly in chest, therefore in pulmonary HTN, RV enlargement will be prominent (anterior) on on x-ray
39
Q

Diaphragm Assessment

A

If fluid is present in lungs, we can lose the “costaphrenic angle”

40
Q
A

COPD

  • Increased lung field view (hyper-inflated)
  • possibly flatter diaphragm
41
Q

A good diaphragm view includes what?

A
  • Not flat
  • clear costophrenic angles
  • fairly symmetrical
42
Q
A

L Pleural Effusion

43
Q

High hemidiaphragm implies ____.

A

Decreased lung volume

44
Q

Potential causes of high hemidiaphragm

A
  • phrenic nerve paralysis
  • conditions causing chest pain (splinting)
  • Extrapulmonic processes (enlarged spleen, liver, pancreatitis or subphrenic abscess)
45
Q

What do we assess when evaluating the lung fields?

A
  • roughly symmetrical
  • have faint fuzzy lung markings
  • view apices to diaphragm
46
Q

If gastric bubble is observed, patient is likely ____.

A

Upright

47
Q

A gastric bubble viewed in the area of the esophagus implies what?

A

A hiatal hernia

48
Q

Normally, lungs are more lucent at the ____.

A

Apex

49
Q

Well expanded lungs should appear ____.

A

Radiolucent with lung markings

50
Q

If a patient has CHF or pulmonary hypertension, the ____ lungs should appear more opaque.

A

Upper

Due to engorgement of the pulmonary veins in upper lung zones

51
Q

R main stem angle?

A

25-30 degrees

(Steeper than left)

52
Q

Left main stem angle

A

45-50 degrees

53
Q

Trachea extends from cricoid cartilage to carina at what vertebrae?

A

T5

54
Q

ETT should be what diameter of the tracheal lumen?

A

2/3

55
Q

ETT tip should be placed how high above the carina?

A

2-3 cm

56
Q
A

Right Mainstem

57
Q

Limitations of x ray

A
  • 3D images projected in 2D
  • details of internal objects masked by shadows of overlying and underlying structures
58
Q

CT uses ____ as energy source

A

X-rays

59
Q
  • Provides great images of bone and blood
  • can scan entire thorax in one breath hold
  • helical
A

CT

60
Q
  • shows no bone detail
  • giant electromagnet
  • great for soft tissue
A

MRI

61
Q
A

Epiglottis