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Radiologic Examination of the Chest > chapter 7 > Flashcards

chapter 7 Flashcards

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1
Q

what is an air cyst?

A

A thin walled radiolucent area surrounded by normal lung tissue

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2
Q

What is a Bleb?

A

A superficial air cyst protruding into the pleura: also called bulla

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3
Q

What is a Bronchogram?

A

An outline of air-containing bronchi beyond the normal point of visibility. An air Bronchogram develops as a result of an infiltration or consolidation that surrounds the bronchi, producing a contrasting air column on the radiograph-that is , the bronchi appear as dark tubes surrounded by a white area produced by the infiltration or consolidation.

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4
Q

What is a Bulla?

A

A large, thin walled radiolucent area surrounded by normal lung tissue.

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5
Q

What is the cavity?

A

A radiolucent (dark) area surrounded by dense tissue (white). A cavity is the hallmark of a lung abscess. A fluid level may be seen inside a cavity.

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6
Q

What is Consolidation?

A

The act of becoming solid; commonly used to describe the solidification of the lung caused by a pathologic engorgement of the alveoli, as occurs in acute pneumonia.

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7
Q

What is homogenous densiity?

A

Refers to a uniformly dense lesion (white area); commonly used to describe solid tumors, fluid-containing cavities, or fluid in the pleural space.

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8
Q

Describe Honeycombing?

A

A coarse reticular (netlike) density commonly seen in pneumoconiosis.

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9
Q

What does infiltrate mean?

A

A poorly defined radio density (white area); commonly used tto describe an inflammatory lesion.

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10
Q

What is interstitial density?

A

A density caused by interstitial thickening.

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11
Q

What is a lesion?

A

Any pathologic or traumatic alteration of tissue or loss of function of a part.

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12
Q

What does opacity mean?

A

State of being opaque (white); an opaque area or spot; impervious to light rays, or by extension, x-rays; opposite of translucent or radiolucent.

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13
Q

What is pleural density?

A

A radio-density caused by fluid, tumor, inflammation, or scarring.

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14
Q

What is pulmonary mass?

A

A lesion in the lung that is 6 cm or more in diameter; commonly used to describe a pulmonary tumor.

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15
Q

What is a pulmonary nodule?

A

A lesion in the lung that is less than 6 cm in diameter and composed of dense tissue called a solitary pulmonary nodule or “coin” lesion because of its rounded, coin-like appearance.

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16
Q

What is radioidensity?

A

Dense areas that appear white on the radiograph; the opposite of radiolucency.

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17
Q

what is radiolucency?

A

The state of being radiolucent; the property of being partly or wholly permeable to x-rays; commonly used to describe darker areas on a radiograph such as an emphysematous lung or a pneumothorax.

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18
Q

What is Translucent mean?

A

Permitting the passage of light; commonly used to describe darker areas of the radiograph.

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19
Q

What is radiography?

A

The making of a photographic image of the internal structures of the body by passing x-rays through the body by passing x-rays through the body to an x-ray film, or radiograph.

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20
Q

How are x-rays formed?

A

When electrons with sufficient energy collide with matter in any form.

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21
Q

How are x-rays produced?

A

With an X-ray tube

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22
Q

List the the components used to make an x-ray.

A
  • Vacuum-sealed glass tube that has a cathode an anode.
  • 1/2 inch tungsten square plate (target) is fixed to the end of the rotating anode in the center of the tube.
  • When the cathode is heated, electrons “boil off”
  • High voltage is applied and electron are driven into the rotating plate
  • the sudden deceleration converts energy into x-rays
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23
Q

The ability of the x-ray to penetrate matter depends on?

A

the density of the matter.

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24
Q

Dense objects absorb?

A

more x-ray’s and will be more opaque (white or gray) on the film.

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25
Les dense objects will not absorb?
as many x-rays, the x-rays will penetrate the film and appear more radiolucent (black).
26
What are the 5 densities seen in thee chest?
1. Air 2. Water 3. Fat 4. Bone 5. Metal ( contrast material)
27
Standard radiograph of the chest includes two views, while standing. Name the two.
1. Postero-anterior (PA) projection | 2. Lateral Projection
28
If the patient is seriously ill or immobile, a PA film may not bee possible. What would you do instead?
Anteroposterior (AP) projection
29
Explain how the Posteroanterior (PA) radiograph is taken.
- Patient is in a upright position, standing or sitting - Anterior of patient's chest against film plate with shoulders rotated forward. - distance between X-ray tube and film is 6 feet - x-ray taken during a full inspiration
30
Describe how a lateral projection is taken?
- side of the patient's chest is against cassette - arms raised and resting on head - taken on inspiration
31
Explain how to take a anteroposterior (AP) radiograph?
- Usually taken by a portable x-ray machine | - Film is placed behind the patient's back and the x-ray machine is about 48 inches from the film.
32
What are the disadvantages to the anteroposterior radiograph?
- heart and superior portion of the mediastinum is magnified - less resolution and more distortion - lower lobes may appear hazy - often have extraneous shadows from ventilator tubing, indwelling catheters and ECG lines
33
What is lateral Decubitus Radiograph?
- x-ray is obtained with patient lying on right or left side - named for the side the patient is laying on - useful in diagnosing accumulation of fluid in the pleural space (pleural effusion)
34
When inspecting the chest radiograph what must you check?
_ be sure you have the correct patient - Check positioning - Check exposure quality - Check level of inspiration - Identify normal landmarks
35
Check your positioning. What should you look for?
- Vertebral column should be precisely in the center between the medial ends of the clavicles - Distance between the right and left costophrenic angle and the spine should be even - small rotations can create a false image
36
What should the exposure quality be?
- Normal exposure verified by determining visibility of spinal processes behind the heart
37
What does it look like if the exposure quality is overexposed?
Heart and lungs become more radiolucent (darker) - heavily penetrated - burned out
38
What if the exposure quality is unerexposed?
- heart and lungs become more dense or whiter
39
A CXR should be taken on?
full inspiration
40
The diaphragmatic domes should be at?
The level of the 9th and 111th rib posteriorly
41
When x-ray is taken on expiration lungs will appear?
denser and heart larger
42
List the sequence of the examination.
- Mediastinum - Trachea - heart - hilar region - lung parenchyma - pleura - diaphragm - gastric air bubble - bony thorax - extrathoracic soft tissue
43
When checking the mediastinum . What should you check?
-check for width, contour and shift from midline
44
The trachea should always be?
Midline
45
If the trachea is shifted away from affected area it indicates?
Fluid or gas inn pleural space
46
if the trachea is shifted toward the affected area, it means?
Lung collapse or fibrosis
47
The heart on the PA film the cardio-thoracic ratio should be?
<1:2
48
On the x-ray a small portion of the heart should be seen on the right side of the vertebral column. Two bulges seen on the right heart border is?
- superior vena cava | - right atrium
49
There is three bulges on the left side of he heart.What are they?
- Aorta - Main pulmonary artery - left ventricle
50
Is the left hilum about to 2 cm higher than the right?
Yes
51
What can increased densities on the hilum indicate?
Signify vascular engorgement
52
Vertical displacement of the hilum suggests?
volumes loss in the corresponding upper lobes
53
Why look for the lymph nodes when looking at the hilum region?
Enlarged lymph nodes may push or pull the hilar region out of its normal area
54
When looking at the lung parenchyma look at the lung systematically from top to bottom comparing one lung with the other. What should you see?
Tissue markings throughout the lungs
55
If there is loss of tissue markings in the lung parenchyma, what does it mean?
-pneumothorax, air-trapping,pneumonectomy, and overexposure.
56
What does it mean when there is excessive marking in the tissue on the lung parenchyma?
fibrosis, edema, lung, compression, underexposure
57
When looking at the pleura, examine for?
pleural thickening, presence of fluid or air, or the mass lesions
58
When inspecting the pleura, inspect the costophrenic angle look for?
Blunting of this angle may signify a pleural effusion
59
Diaphragms should have what kind of shape?
- upwardly convex, domed shaped contour | - Right and left costophrenic angles should be clear
60
Right diaphragm is how much higher than the left? | what causes the right diaphragm to be higher than the left?
- the right is approx. 2 cm higher than the left | - Due to the position of the liver
61
if the diaphragm is depressed, what does that indicate?
Air trapping
62
If the diaphragm is elevated, what does it indicate?
- Lung collapse - Nerve Damage - Spinal Curvature
63
What is the gastric bubble?
A stomach bubble commonly seen under the left hemi-diaphragm When looking at the gastric bubble look for indications of excessive free air.
64
When inspecting the bony thorax, inspect the?
Inspect the ribs, vertebrae, clavicles, sternum, and scapulae.
65
When looking at the intercostal spaces, what should you look for?
Look for intercostal spaces to be symmetrical and equal over each lung field.
66
If the intercostal spaces are too close together, what does that indicate?
- Loss of muscle tone
67
If the intercostal spaces are too far apart, what does that indicate?
- alveolar hyperinflation
68
When looking at the bony thorax look at the ribs for what?
Rib fractures and deformities
69
When looking at extra-thoracic soft tissue, what will it indicate?
- When looking at it, it will indicate the gender the patient. - look for free air it will indicate subcutaneous emphysema.
70
List the other Radiologic Tecchniques.
- Computed tomography (CT) - Positron Emission Tomography (PET) - Magnetic Resonance Imaging (MRI) - Pulmonary Angiography - Ventilated/Perfusion scan - Fluoroscopy - Bronchography
71
What is computed tomography?
provides a series of cross-sectional (transverse ) picture of the structures within the body at numerous levels
72
Why is the computed tomography useful supplement to the CXR?
- detects lesions - detects masses and nodules - cavities - small pneumothorax
73
What is Positron Emission Tomography?
- Shows both the anatomic structures and the metabolic activity of the tissues and organs scanned. - Used to detect early cancerous lesions
74
How does Positron Emission Tomography work?
- The patient is injected with glucose, tagged with a radioactive isotope. - Cancer cells metabolize glucose at an extremely high rate. - Glucose breaks don and produce positrons - Positrons produce gamma rays - Gamma rays are converted to dark spots to the PET scans
75
What is Magnetic Resonance Imaging?
- Uses magnetic resonance as its source of energy to take cross-sectional (Transverse, sagittal, or coronal) images of the body. - Used as a supplemental to CT to study the mediastinum and hilar region.
76
What is pulmonary angiogaphy?
- Injection of radiopaque contrast medium through a catheter that has been passed though the right side of the heart and into the pulmonary artery. - rapid serial pulmonary angiograms - shows abnormalities in pulmonary circulation
77
Describe the perfusion scan.
Radioactive material injected into blood stream an is distributed into pulmonary circulation. -lungs then scanned with a gamma camera that produces a picture.
78
Describe the ventilation scan.
- Patient breathes a radioactive gas from a closed circuit spirometer . - gamma produces a picture
79
A ventilation/perfusion scan can detect?
Pulmonary emboli
80
What is a Fluoroscopy?
- Technique by which x-ray motion pictures of the chest are taken. - uses larger doses of x-rays than standard radiography.
81
What is an example of the use of a fluoroscopy?
- Assessment o abnormal diaphragmatic movement | - Localization of lesions to be biopsied during fiberoptic bronchoscopy.
82
What is bronchography?
- Instillation of a radiopaque material into the lumen of the tracheobronchial tree - CXR is then taken
83
When would you use a bronchography?
- Diagnosis of bronchogenic carcinoma | - determine presence or extent of bronchiectasis

Radiologic Examination of the Chest (1 decks)

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