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CLASP Radiology > Chest > Flashcards

Chest Flashcards

1
Q

x-ray air

A

black

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2
Q

X-ray fat

A

grey

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3
Q

x-ray soft tissue/muscle

A

grey/white

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4
Q

x-ray bone

A

white

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5
Q

x-ray metal

A

bright white

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6
Q

how does x-ray make an image

A

compares densities - more dense = darker, less dense = lighter

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7
Q

what to look at to tell if x-ray is technically accurate

A

projection
inspiration (anterior ends of at least 6 ribs should be visible eg. diaphragm should be low)
rotation
penetration (is there enough radiation)

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8
Q

how is the cardiothoracic radio measures

A

PA x-ray

not AP as objects close to the X-ray tube are enlarged so heart looks bigger

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9
Q

what is the air underneath the diaphragm on the left

A

stomach bubble (gastric bubble)

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10
Q

what are the lung hila

A

junctions between heart and lungs where pulmonary arteries and bronchi enter and the pulmonary veins exit the lungs

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11
Q

which hilum sits higher than the other

A

left bc left pulmonary artery comes out over the top of the bronchus and right goes underneath

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12
Q

which side of the diaphragm sits higher and why

A

right because it sits above the liver

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13
Q

what is the upper zone of lungs

A

up to second ribs anteriorly

curvy ribs are anterior and straight ribs are posterior

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14
Q

what areas need reviewed

A

Apices (pan coast tumour, pneumothorax)
Behind the heart
Below the diaphragm
Bones and soft tissues

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15
Q

what is lobar collapse

A

when there is obstruction of a lobar bronchus so that lobe os no longer ventilated

looses volume, collapses like balloon

become collapse down and is more dense so is no longer black, is now more white

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16
Q

which lung has 3 lobes

A

right

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17
Q

which lung has a lingula

A

left lower lobe - separates from upper lobe

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18
Q

sign of a lower lobe

A

sale sign

triangle sale shape coming down from centre

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19
Q

sign of a left lower lobe collapse

A

sail sign

triangle sale shape coming down from centre

20
Q

what does a left upper lobe collapse look like

A

can no longer see the border of the left side of the heart

volume loss - left lung smaller

diaphragm gone up

veil like capacity??

21
Q

what happens when the right upper lobe collapses

A

right horizontal fissure is pulled up the way

clarity losses in the superior aspect of the right side of the mediastinum

22
Q

what happens when the middle lobe collapses

A

loss of clarity of the right heart border but preservation of the hemidiaphragm

23
Q

why do right middle and lower lobe often collapse together

A

because they are supplied by the same part of the bronchus

loss of right heart border clarity PLUS loss of clarity of hemidiaphragm

24
Q

what is pulmonary consolidation

A

follows same pattern as collapse without the volume loss

obstructs the same parts and the lobe collapses do making them cloudy

25
Q

what are some pleural space abnormalities

A

pleural effusion

26
Q

when is the pleural cavity visible

A

only if there’s something wrong - pathological

27
Q

what is pleural effusion

A

fluid in the pleural space

often collects at the bottom of the chest

meniscus sign visible - fluid is collecting the the costophrenic angle

tend to be all the same colour of white

28
Q

what is a pneumothorax

A

air in the pleural space

air tends to rise up towards the apexes

black crescent overlying edge of the lung that has no lung markings

can see the lung edge - the pleural space is black and the lung has the lung markings

in normal cxr lung marking should go right to the edge

29
Q

what is a tension pneumothorax

A

when the pneumothorax is so big is squashes the lungs so that the patient cannot ventilate

pushes everything over to other side on a CXR

30
Q

what does heart failure look like on CXR

A

Pleural Effusion

dilation of the upper lobe vessels/cardiomegaly

interstitial opacities 
airspace opacification 
-fluid overspilling into interdiction 
-lots of lines in lungs 
-looks like cotton wool once it gets into the alvioli

pleural effusion

31
Q

signs of heart failure ABCDE

A 
A -alveolar oedema 
B- Kelley b lines 
C- cardiomegaly 
D- dilated upper lobe vessels 
E - pleural effusion
32
Q

normal endotracheal tubes

A

5 cm above the carina

width - 2/3 of tracheal diameter

cuff should not expand the trachea

33
Q

malposition of endotracheal tubes

A

Tip may pass the carina (were main bronchus splits)

tip may be in the right main bronchus (will ventilate right lung but occlude left causing complete collapse)

may have entered….

34
Q

where should nasogastric tubes be placed

A

sit beneath the diaphragm overlying the gastric bubble

should be 10cm below gastro-oesophageal junction

u know its in the oesophagus if it is passed the carina

35
Q

where should central venous catheters be

A

can be inserted via right and left internal jugular or subclavian veins

tip MUST ALWAYS BE ON RIGHT SIDE OF PATIENT (SVC is always on right side)

tip should be around the 2nd intercostal space anteriorly

should be at the cavoatrial junction

36
Q

what are miliary nodules

A

tiny ones, heavily calcified, stable?

<2mm

37
Q

what size is a pulmonary mass

A 
>30 mm 
solitary 
soft tissue density 
new 
haemoptysis
38
Q

what is a pulmonary nodule

A

7-30mm
soft tissue density
more towards the base of the lungs

39
Q

most common place for a primary lung cancer

A

apical - in smokers as smoke rises up

40
Q

how is lung cancer staged

A

TNM

tumour size
nodes
metastasis

41
Q

what imaging is used to show tumour size and metastasis

A

contrast enhanced CT

42
Q

what is used to look at smaller metastasis

A

FDG-PET CT shows distant nodal metastasis

43
Q

what is pneumoperitoneum

A

perforation of a hollow viscus (stomach, duodenum, small or large bowel) resulting in gas in the peritoneal cavity

44
Q

what does pneumoperitoneum look like on CXR

A

gas interposed between the diaphragm and the liver

thin black line of air

45
Q

what imaging is done for PE

A

CXR
CTPA
V/Q scan

46
Q

what does PE look like on CTPA

A

dilated right heart
heart septum moves towards left
large clot stops blood flowing through the pulmonary veins

47
Q

what does PE look like on V/Q

A

mismatch of ventilation and perfusion

CLASP Radiology (3 decks)

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