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RAD 415 > the chest radiographic appearances > Flashcards

the chest radiographic appearances Flashcards

1
Q

how should you read a chest XR

A

in appropriate lighting conditions

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2
Q

what must be checked when reading a chest radiogrpahy

A

name
date
time
orientation (l and r markers)
how radiograph was taken

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3
Q

what is the ABC method when reading a chest xray

A

A - airways
B - bones
C - cardiac silhouette
D - diaphragm
E - effusions
F - fields
G - gastric gas bubbles
H - hilar appreances
S - soft tissue

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4
Q

what is the hilar appearance on an xray

A

hilar region reveals a shadow that consists of the combination of lymph nodes, the pulmonary arteries, and the pulmonary veins.

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5
Q

what might it mean if you cannot see the trachea and bronchi on chest radiography

A

surrounded by fluid

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6
Q

what is an air bronchogram

A

refers to the phenomenon of air-filled bronchi (dark) being made visible by the opacification of surrounding alveoli (grey/white)

air in the bronchi but fluid in surrounding tissue

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7
Q

what are something to look out for when looking at bones on an chest xray

A

ribs and clavicle:
- are the ribs symmetrical/ evenly spaced on both sides
- any erosion or deposits
- any notching of ribs (deformation of superior or inferior surface of rib)
- fractures of callus formation

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8
Q

what is coarctation of aorta

A

birth defect in which aorta is narrower than usual

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9
Q

what are some things to look out for when looking at the cardiac outline

A
  • is size within normal limits
  • shape norma?
  • uniform opacity on either side of spine
  • normal position or pushed/pulled to either side of spine
  • evidence of calcification in pericardium/valves
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10
Q

what is the cardiac-thoracic ratio

A

cardiothorcic ratio AA should be at least half of BB
in other terms
width of heart should be at least half of the width of the thorax as seen on xray

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11
Q

what might it mean if the mediastinum is pushed or pulled by the lung

A

pushed = increased pressure in one semi thorax
pulled = loss of pressure in one semi-thorax

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12
Q

how can you tell that theres fluid in the lungs through an xray

A

when the cardiac borders are not clearly defined = ‘fluid’ in lungs

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13
Q

what are some things to consider when looking at the diaphragm on CXR

A
  • is right higher than left
  • are domes curved
  • do they form sharp boundary to lung
  • is there abnormally large gas bubble in stomach or colon
  • any free gas under diaphragm
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14
Q

why might the right diaphragm be higher than the left

A
  • liver is beneath
  • gas below right semi-diaphragm
  • damage in phrenic nerve
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15
Q

what might cause a fuzzy diaphragm appearance on xray

A
  • localised pleural effusion
  • fluid
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16
Q

define erect, supine, semirecumbent

A

erect = standing up, arms by side
supine = horizontally on back
prone = horizontally on torso
semirecumbent = elevated upper body , half laying down half sitting up

17
Q

whats the difference between transudative and exudative pleural effusions

A
  • Transudative effusions are caused by some combination of increased hydrostatic pressure and decreased plasma oncotic pressure.
  • Exudative effusions result from increased capillary permeability, leading to leakage of protein, cells, and other serum constituents.
18
Q

how does fluid move in pleural space when in a supine, semirecumbant position

A

supine = fluid extends throughout the pleural space
semirecumbant = no fluid level, might increase density of lower lobes

19
Q

what is a sub pulmonary effusion

A

accumulation of fluid between the base of the lung and the diaphragm
- easier to see on erect position

20
Q

why is a sub pulmonary effusion easier to see on the left

A

because distance between stomach air and lung is normally narrow

21
Q

what is pleural plaque

A

areas of thickened tissue that form in the lining of the lungs

22
Q

what do you look at when considering lung fields on an xray

A

costophrenic and cardiophrenic angles
- apices (tip of lung) (equal shape and radiolucency)
- periphery
- vascular pattern, symmetry etc

23
Q

what is costophrenic and cardiophrenic angles

A

costophrenic = a sharply-pointed, downward indentation (dark) between each hemi-diaphragm (white) and the adjacent chest wall (white)
cardiophrenic = the angle between the heart and the diaphragm

24
Q

what is the only lung lobe to tough the right heart border

A

middle lobe

25
Q

whats the only lobe to touch the diaphragm

A

lower lobes

26
Q

whats the only lobe to touch the left heart boarder

A

upper lobe

27
Q

what is right middle lobe pneumonia

A

right middle lobe collapse

28
Q

what is an azygous lobe

A

formed when the right posterior cardinal vein, which is one of the precursors of the azygos vein penetrates the right lung apex, rather than migrating over it.

29
Q

what should you look out for when looking for gastric gas in CXR

A
  • look for bowel loops between diaphragm and liver
  • beware of hiatus hernia (body part pushes thru weakness of muscle)
  • check correct positions
30
Q

what about the hilum on a CXR can indicated disease

A

if either hilum are at different heights or different shape

31
Q

enlarged nodes are ball like (at the hilum area)

A
32
Q

when can a bronchi be visible on a chest xray

A

when they are surrounded by fluid (not good)

33
Q

what are somethings to look out for when lookout at soft tissues in an xray

A
  • are the breast muscles/shadows equal in size and density
  • any evidence of mastectomy
  • are there calcifications or radio-opacities
34
Q

pulmonary hypertension = pulmonary oedema

A
35
Q

what is hypertrophy

A

the increase in the volume of an organ or tissue due to the enlargement of its component cells.

36
Q

what section of the lungs will have greater blood flow

A

more blood flow in lower lung vessels than apex

37
Q

pulmonary vessels create minimum resistance to blood flow

A
38
Q

what does CCF stand for and what is it

A

congestive cardiac failure
Congestive heart failure, or heart failure, is a long-term condition in which your heart can’t pump blood well enough to meet your body’s needs.

39
Q

what are Kerley B lines

A

thickened, edematous interlobular septa often due to pulmonary edema.
These are thin lines 1-2 cm in length in the periphery of the lung(s).
interstitial fluid (oedema or lymph node congestion)

RAD 415 (19 decks)

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