Chest Radiology - slides 2-10 Flashcards Preview

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Flashcards in Chest Radiology - slides 2-10 Deck (28)
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1
Q

Upright _______ view X-ray of chest the plate is in front and the beam comes from the back. The direction of the beam is from the back to the front. X-rays hit it first, spine gets diluted out in the picture and the cartilage sillhohette appears, which is much easier to read. Will push your shoulders right against the plate

A

PA (Posterior Anterior) View X-ray

2
Q

_______ view X-ray: arms are upward holding on.

A

Lateral view X-ray

3
Q

The patient is positioned to face the X-Ray ______, with his/her arms out of the projectory of the beam.

A

plate

4
Q

In a PosteroAnterior (PA) Chest X-ray, the bones of the spine are further away from the plate, so their density is diffused and does not obscure the ______

A

mediastinum.

5
Q

Sick, bedridden patients often require a bedside film, an ______ view with their back against the plate. In this kind of projection, the heart is magnified.

A

AP (Anterior-Posterior)

6
Q

In an AP X-ray film, the heart is grossly ___, so if you want to measure size of heart this would not be the proper way.

A

Magnified

7
Q

When reading films: Make sure that

A: It’s the correct ____

B: It’s the correct _______ (if prior films are available, use them for comparison)

C: It’s the correct ______ (R vs L may be the patient’s R and L, or the film’s R and L)

A

patient, film, side

8
Q

If ____ X-ray films are available you can pull them up in the computer to compare them.

A

prior

9
Q

This is a normal ______ X-ray view (woman patient) of the chest.

A

PA

10
Q

This is a normal ______ X-ray view (woman patient) of the chest.

A

Lateral

11
Q

In PA and lateral chest X-rays, the heart shows up very well because the ________ isn’t so bright that it obscures the heart.

A

vertebral column

12
Q

NORMAL PA/LATERAL CXR

A satisfactory CXR includes all _____ribs, the diaphragm, both clavicles.

A

24

13
Q

NORMAL PA/LATERAL CXR

The ____ should be of optimal penetration.

The ___ follows the periphery of the film first, observing soft tissues and rib contours one by one, then the diaphragm.

Next, the ____ of the mediastinum.

Lastly, the ___ ___.

A

film, eye, contours, lung fields

14
Q

When reading an X-ray, it is important to start reading from the ___ and go inwards.

A

sides

15
Q

When reading a chest X-ray, observe soft tissues and rib contours one by one, then go to the ____.

A

diaphragm

16
Q

When reading a chest X-ray, the ___diaphragm always higher than ____ diaphragm because the liver pushes the R diaphragm up. On left side, stomach and spleen are not that big.

A

right, left

17
Q

Do not need to memorize but for your information:

The main regions where a chest X-ray identifies problems may be summarized as ABCDEF by their first letters:

  • Airways, including hilar adenopathy or enlargement
  • Breast shadows
  • Bones, e.g. rib fractures and lytic bone lesions
  • Cardiac silhouette, detecting cardiac enlargement
  • Costophrenic angles, including pleural effusions
  • Diaphragm, e.g. evidence of free air, indicative of perforation of an abdominal viscus
  • Edges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaques
  • Extrathoracic tissues
  • Fields (lung parenchyma), being evidence of alveolar flooding
  • Failure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
A
18
Q

On a chest X-ray, Start counting ribs – best counted from ____.

A

edges.

19
Q

Chest X-rays miss a lot of fractured ribs. ____ scan does not.

A

CAT

20
Q

CAT scan is $3500 and chest X-ray is $1200. Once you have evaluated the ribs, clavicle, and apices, make sure no mediastinum shift and then look at the ____. Every single part of the lung is investigated.

A

diaphragm

21
Q

If the right atrium is distended (big) it is possible that there is a problem with the ______. You may have a pulmonary artery problem. This will cause ventricle and R atrium to enlarge.

A

bicuspid valve

22
Q

R atrium sits right on top of the ______. Above that there are two lines – superior vena cava and the one you see against contour of air present in the lungs is the ascending aorta – swings to the R, crosses the mediastinum and becomes posterior after making an arch of the aorta.

A

diaphragm

23
Q

Aortopulmonary window is supposed to have small ___ ___. Normally lymph glands are <1 cm. we have hundreds of them in mediastinum. Not normally big enough to fill the space so that the air from the left lung is not good enough to overcome that area that is full. If aorta pulmonary window is full then there is a problem with nodes in the mediastinum.

A

lymph nodes

24
Q

What part of mediastinum would this be (right below the aorta) = _____ mediastinum because the angle that separates the junction between manubrium and body of the sternum –above that superior mediastinum, below that is inferior mediastinum. Angle on clavicles is the notch so the angle is there.

A

INFERIOR

25
Q

______ _________ _______ sits between the aorta and the pulmonary veins. L pulmonary artery – trunk comes out of heart and goes to R and L lung.

A

Aorta pulmonary window

26
Q

If a patient reports to ED from 90mph MVC and their x-ray shows aortic knob but huge____ full of blood – you cut open chest and fix tear in aorta.

98% of people never leave the street after an accident like this.

A

hematoma

27
Q

A patient presents to the ED after a 90mph MVA and they receive a chest X-ray. Instead of narrow line close to mediastinum on a chest X-ray – lose clear line and everything is _____.

A

opaque.

28
Q

Name the structures

A

3-ascending aorta

4- R atrium

5- aortic arch

6- L pulmonary artery

7- L ventricle