Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CLASP Radiology > Chest Imaging > Flashcards

Chest Imaging Flashcards

(75 cards)

Start Studying
1
Q

what are the different densities on CXR

A 
air- black 
fat- grey 
soft tissue/ muscle- grey/ white
bone- white 
metal - bright white
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

is the cardiothoracic ratio (CTR) measure on a PA or AP CXR

A

PA (not done on AP as makes heart look bigger)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the CTR

A

ratio of maximal horizontal cardiac diameter to maximal horizontal thoracic diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a normal CTR

A

less than 0.5 (heart half of thoracic width)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how many ribs should be present on CXR when fully inspired

A

the anterior ends of at least 6 ribs should be visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how do you know a CXR is correctly centred

A

the medial ends of the clavicles should be equidistant form the spinous processes of the upper thoracic vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the mediastinal borders

A 
aorta
pulmonary artery 
left auricle 
left ventricle 
right atrium 
trachea 
hemidiaphragm 
stomach bubble 
horizontal fissure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the pulmonary hila

A

junctions between the heart and the lungs

where pulmonary arteries and bronchi enter and the pulmonary veins exit the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which hilum is higher

A

the left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the dominant structure in the hilum

A

pulmonary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which diaphragm is higher

A

right side 1.5cm higher than left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the zones of the lung

A

each has upper (to 2nd rib), middle (2nd to 5th rib) and lower- not the same as lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which lung has only two lobes

A

left- although has lingula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you tell the anterior from posterior part of ribs

A

anterior curved, posterior straight (horizontal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what pathologies occur in the lung apices

A

masses (pancoast tumour), pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what pathologies occur behind the heart

A

consolidation, masses, hiatus hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what pathologies occur below the diaphragm

A

free gas, misplaced lines and tubes, gastric distention, bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what in the bones and soft tissues is often misses on CXR

A

fractures, masses, mastectomy, subcutaneous emphysema, evidence of previous surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the review areas on CXR

A

common areas for missed findings- lung apices, behind heart, below the diaphragm, bones and soft tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what causes lobar collapse

A

obstruction of a lobar bronchus (tumours, foodstuffs, mucus impaction)
lobe no longer ventilated, air gets resorbed, volume loss, collapses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does a collapsed lobe look like on CXR

A

density increases

adjacent major fissure dragged out of position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what does a left lower lobe collapse look like on CXR

A

volume loss on left, elevation of the hemidiaphragm
increased density in left retrocardiac region (white sail sign)
loss of clarity in medial aspect of left hemidiaphragm
left hilum displaced downwards
left hemithorax looks smaller

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does a left upper lobe collapse look like on CXR

A

volume loss on the left, elevation of the left hemidiaphragm
loss of clarity of heart shadow
veil like diffuse opacification of the left hemithorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does a right upper lobe collapse look like on CXR

A

volume loss on the right
loss of clarity of the upper right mediastinum
density in the right upper zone
elevation of the horizontal fissure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what does a right middle lobe collapse look like on CXR
loss of clarity of the right heart border density in the right lower zone right hemidiaphragm PRESERVED (small lobe)
26
what does a right lower lobe collapse look like on CXR
``` volume loss on the right loss of clarity of the right hemidiaphragm density in right lower zone depression of the horizontal fissure (can still see right heart border) ```
27
what does the bronchus intermedius mean for lobar collapse
is the common origin for bronchus to both the middle and lower right lobes, if obstructed both will collapse
28
what does a combined right middle and lower lobe collapse look like on CXR
volume loss on the right loss of clarity of the right hemidiaphragm and right heart border density in right lower zone depression of the horizontal fissure and oblique fissue
29
what pattern does consolidation follow
same positions and obscuring same borders as lobar collapse but without the volume loss
30
what is the lingula adjacent to
the left heart border
31
what does right middle lobe consolidation look like
increased density in tight lower zone loss of clarity of the right heart border right hemidiaphragm preserved
32
what does consolidation of the lingula look like
obscures the left heart border | left hemidiaphragm preserved
33
what does left upper lobe consolidation look like
increased density in left upper zone loss of clarity of the left upper mediastinum volume preserved air bronchograms
34
what is an air bronchogram
where the bronchus contains air but the surround lung doesnt- is filled with blood/ pus/ etc air filled bronchi running through fluid filled alveoli
35
when can you see the pleural cavity on CXR
only when it is filled with air (pneumothorax) or fluid (pleural effusion)
36
what does fluid in the pleural space look like
collects at lung bases forms curved appearance of a meniscus at the lung edges blunts the costophrenic angles
37
what causes a pneumothorax
rupture of the visceral pleura
38
what do pneumothoraxes look like on CXR
small- dark cresent without lung markings bounded medially by the lung edge, often at epex larger- will have larger black air space with no lung markings normally lung markings go all the way to the edge of the thorax
39
what does a tension pneumothorax look lik
displaced mediastinum large air space in thorax with no lung markings depressed hemidiaphragm collapse lung (squashed by the air, unable to be ventilated)
40
what results from heart failure in the lungs
pulmonary oedema
41
what are the radio-logical signs of pulmonary oedema due to heart failure in order of occurrence/ severity
1. dilation of upper lobe vessels/ cardiomegaly 2. interstitial opacities (peribronchovascular cuffing (doughnut sign, haziness around bronchioles) and septal line (kerly B lines- peripheral lines usually at lung bases) 3. airspace opacification (alveoli fill with fluid, when severe and acute has a perihilar/ batwing appearance, air bronchograms) 4. pleural effusion
42
what is the mnemonic for the x rays signs of heart failure
``` ABCDE A- alveolar oedema (bat wing opacities) B- kerly B lines C- cardiomegaly D- dilated upper lobe vessels E- pleural effusion ```
43
what is the correct placement for an endotracheal tube
tip 5 cm above the carina width 2/3rds trachea diameter cuff should not expand the trachea
44
when is an endotracheal tube malpositioned
if extends beyond carina - commonly goes into right main bronchus (more vertical than left) (causes early collapse of unventilated lung) may have entered oesophagus
45
what is the correct position of an nasogastric tube
subdiaphragmatic in stomach (overlying gastric bubble on CXR) at least 10 cm from gastro-oesophageal junction passes carina in the midline
46
how might an NG tube be misplaced
tip remaining in oesophagus in bronchus or lung coiled in upper airway intracranial insertion (skull base trauma/ surgery)
47
where are central venous lines inserted
right and left internal jugular/ subclavian veins
48
where are peripherally inserted central catheters inserted
cephalic, basilic or brachial veins
49
where should the tip of a central venous catheter be
at the cavoatrial function- right side | bend in line should be at 2nd anterior intercostal space
50
how can a central venous catheter be misplaced and what might this cause
tip too high- proximal SVC- risk of thrombus formation tip too low- distal right atrium/ right ventricle- increased risk of arrhythmia coiled or displaced in another vein
51
where should a peripherally inserted central catheter go
up arm towards axilla under clavicle towards heart tip ends at cavoatrial junction/ in central vein
52
how might a peripherally inserted central catheter be misplaced
tip too high: superficial upper limb vein tip too low: distal right atrium or right ventricle tip in the right internal jugular vein tip in the azygos vein
53
what are the different types of sizes of pulmonary masses
miliary nodules: <2 mm pulmonary micronodule: 2-7 mm pulmonary nodule: 7-30 mm pulmonary mass: >30 mm
54
what are the morphologies of pulmonary nodules
solid pulmonary nodules - calcified pulmonary nodules partly solid pulmonary nodules ground glass pulmonary nodules
55
what are the possible distribution of pulmonary nofules
perilymphatic pulmonary nodules - perifissural pulmonary nodules centrilobular pulmonary nodules random pulmonary nodules
56
what does a basal predominance of pulmonary modules suggest
cancer- mets
57
does calcification of nodules suggest cancer
no
58
where in lung do primary lung cancers tend to be
apical- smoker
59
what does TNM stand for in lung cancer staginf
tumour size intrathoracic lymph Node staging metastases
60
what does a contrast enhanced CT do in lung cancer
assess tumour size shows mets guides biopsy of peripheral lesions
61
what does a FDG-PET CT do in lung cancer
``` shows nodal mets distant mets (not brain) delineated tumour in an area of collapse ```
62
what is a pneumoperitoneum
when perforation of a hollow viscous (stomach, duodenum, small/ large bower) causes gas in the peritoneal cavity
63
what is seen on CXE in penumoperitoneum
when patient in erect position gas rise up under the diaphragm - think black line between diaphragm and subdiaphragmatic structures (easier to see on right)
64
what is the presentation of a PE
dyspnoea either at rest or on exertion pleuritic chest pain, cough, orthopnoea and haemoptysis if caused by deep vein thrombosis, calf/thigh pain and swelling may occur
65
what Ix for a PE
D-dimers can be useful in low-risk patients to rule out a VTE Chest radiographs are often performed to look for alternative causes for symptoms and to decide on appropriateness of V/Q scan (only if CXR normal) CTAP to visualise the clot V/Q scan (ventilation perfusion scan) to look for mismatched perfusion defect caused by clot
66
what might be seen on CXR in PE
non specific findings- plerual effusion, cardiomegaly, atelectasis (collapse of lung due to reduced/ absent gas exchange)
67
how do you tell CXR is PA not AP
scapular will not be over the film
68
how can you tell a CXR has good exposure
(enough radiation) | can see spine behind heart, left hemidiaphragm is visible to the spine
69
what is a silhouette sign
loss of a silhoutte e,g loss of heart borders
70
if you can see all the heart borders where must a lesion be on the left side
lower lobe
71
is blood white on CT
no- unless clotted | if blood white on CT then will have had contrast/ be clotted
72
what is white on CT
bones and metal
73
what is black on CT
air
74
what is seen in lung on CT in COPD
emphysema- seen as black holes: smokers in apices, alpha def in bases
75
what lymph nodes should be check in lung cancer
tracheobronchial- bronchopulmonary- supraclavicular

CLASP Radiology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions