20. Intro to Chest X-Rays Flashcards Preview

Year 1 - Term 2: Carriage of Oxygen > 20. Intro to Chest X-Rays > Flashcards

Flashcards in 20. Intro to Chest X-Rays Deck (20):
1

Briefly describe how X-Rays work.

X-ray machine sends X-rays to chest, dense/hard tissue stops most x-rays, some light lands on photographic plate making a negative picture

2

What kinds of things make the different shades of grey A-E?

Q image thumb

A: black - air

B: dark grey - fat

C: light grey - soft tissues/organs/muscles

D: white - bone/fluid

E: bright white - metal

3

What are the 8 things to look for during the 'first look' at an X-ray?

1. patient details (top/bottom of film)

2. date/time of x-ray

3. Orientation: PA or AP (PA most common, preferred, performed in radiology,  AP = mediastinum larger, performed on wards/bedbound)

4. coverage - good = lung apices, costophrenic angles

5. rotation - spinous processes should be straight and lie mid-way between head of clavicles

6. inspiration - can count 7 anterior ribs

7. skill 

8. penetration - vertebrae just visible behind heart

4

Determine whether A and B are PA or AP Xrays and why.

Q image thumb

 

A: AP because scapula lies over lung fields and clavicles are horizontal, ribs more horizontal, heart shadow larger

B: PA because clavicle in lung field, ribs slanted, scapula outwards from lung field, heart shadow smaller

5

Label 1-10

Q image thumb

1: trachea

2: hilum 

3. lungs

4. diaphragm

5. heart

6. aortic knuckle

7. Ribs (P and A)

8. scapulae

9. breasts

10. stomach

6

How do you distinguish posterior and anterior ribs on an Xray?

Posterior = more horizontal and articulate with midline

7

Are these Xrays rotated?

Q image thumb

A is, B isn't

Spinous processes should be straight and lie mid-way between medial head of clavicles.

With A : clavicles asymmetrical, no clear spinous process in middle

8

How would you describe the following two Xrays?

Q image thumb

A: underpenetrated

B: overpenetrated

9

What system is used for image interpretation?

Airways, Breathing, Circulation, Diaphragm, Everything else

10

Label A-E

What part of the X-ray examination is this?

Q image thumb

A: R. main bronchus

B: trachea

C: aorta

D: L. main bronchus

E: carina

 

Airways

11

What has happened in this Xray?

List possible causes.

Q image thumb

Pushed airway

Masses, tension pneumothorax

A image thumb
12

What has happened in this Xray?

List possible causes.

Q image thumb

Pulled airways.

collapse of lobe, loss of lung volume, consolidation, fibrosis

A image thumb
13

Describe how you would assess the 'breathing' part of the Xray examination.

Divide lungs into zones (U/M/L), compare and look for asymmetry e.g. lung fields and hilar. Lungs must fill thoracic cavity and markings must extend to chest wall.

A image thumb
14

What 3 things must you look for in the 'circulation' part of the Xray examination?

1. mediastinum (aortic knuckle, not widened)

2. heart contours (if not clearly seen, may be due to pathology in adjacent lung)

3. cardiothoracic ratio (heart size compared to thoracic cavity) (>50% is considered abnormal - cardiomegaly)

A image thumb
15

What can you observe here?

Q image thumb

Metal wires from cardiothoracic surgery (top arrow)

Valve replacement (bottom arrow)

In aorta- breakdown of epithelial cell wall, get pale lumen, aorta swollen with blood, 

16

What is the usual appearance of the diaphram on an Xray?

Where must you look?

 

dome shape, R higher due to liver, +/- gastric bubble (air in fundus)

Look above - blunting of cardiophrenic and costophrenic angles? Look below - air under diaphragm?

17

Label A, B and C

Q image thumb

A: costophrenic recess

B: costophrenic angle

C: cardiophrenic angle

18

What does this Xray show and what could have caused it?

Q image thumb

Blunted costophrenic angle (L and R)

Can be caused by fluid in pleural cavity - pleural effusion

19

What do you look for in the 'everything else' category of Xray examination?

Soft tissue - neck, shoulder, axilla, breasts

Foreign bodies

Tubes

Lines

Clavicle

Ribs

Vertebrae

20

What is this line?

Q image thumb

Visceral pleural edge

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