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RD1038 > Chest x-ray > Flashcards

Chest x-ray Flashcards

1
Q

what are the two fissures of the lung?

A
  • horizontal fissure
  • oblique fissure
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2
Q

when are fissures visible?

A

only visible on chest x-ray (CXR) in case of pathologies which increase fluid content in fissures eg heart failure

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3
Q

what equipment is used during chest x-ray

A
  • high output x-ray tube
  • generator with broad focus
  • image recording system (DR, CR)
  • standing aids
  • radiographic markers
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4
Q

preparation for radiography of the chest

A
  • ensure that the area under concern is free from any external artifacts such as necklaces, braces, buttons, ECG stickers etc
  • patient is ERECT against wall BUCKY
  • lead apron
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5
Q

SID

A

180cm

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6
Q

FSS

A

broad focus

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7
Q

kVp

A

125

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8
Q

mAs

A

1.25-2

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9
Q

clinical indications for a chest radiography

A
  • shortness of breath
  • heamoptysis
  • anaemia
  • pleural effusion
  • pneumothorax
  • ongoing cough
  • lung nodule
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10
Q

most commonly used routine projections

A
  • prosterior-anterior chest radiograph
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11
Q

alternative chest routine projections

A
  • anterior-prosterior chest radiograph (supine/erect)
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12
Q

describe prosterior-anterior chest positioning

A
  • patient stands facing the detector
  • chin is raised
  • hands are placed on hips, elbows flexed and brought forwards
  • median sagittal plane perpendicular to detectors
  • horizontal central ray in midline at level of T6 inferior border of scapulae
  • expose on full arrested insipiration
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13
Q

superiorly

A

lung apices

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14
Q

inferiorly

A

costophrenic angles

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15
Q

laterally

A

lateral chest wall

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16
Q

what is a poor positioned image called

A

lordotic image

17
Q

how many ribs should be visible posteriorly vs anteriorly in an x-ray within the lung field?

A

posterior - 9-10
anterior - 6-7
insipiration adequate to review radiograph

18
Q

which hilum is higher

A

left hilum of lung is always higher than the right

19
Q

when will you see the splenic fissure

A

in case of pathology - if it is full and healthy it will not be visible in an x-ray

20
Q

when would you see fissures in a radiograph

A

only in the presence of infection

21
Q

what type of focus do we use for a chest radiograph

A

broad focus

22
Q

what is one way you can distinguish between an AP radiograph

A

look at the heart shadow

23
Q

when would you do a lateral radiograph?

A
  • used for localisation of a pathology
  • if a region is shadowed
  • usually referred for CT
24
Q

FDD for lateral radiograph

A

180cm

25
Q

why would you do a left lateral side radiograph?

A
  • heart is closer to left side
  • magnification is larger
26
Q

midline of lateral radiograph

A

horizontal central ray in midline at level of T6 and level of inferior border of scapula

27
Q

consolidation of a chest radiograph

A
  • area of lung becomes dense and white
28
Q

what does consolidation indicate?

A
  • filling of alveoli and bronchioles in lung with pus (pneumonia) and fluid (pulmonary oedema) or blood
29
Q

what is pleural effusion

A

fluid within the pleural cavity

30
Q

what is seen of erect CXR pleural effusion?

A

clear fluid level seen

31
Q

what is seen of supine CXR pleural effusion?

A

increased even density over lung

32
Q

two possible causes of pleural effusion

A
  • altered intrapleural/ capillary pressure
  • impaired lymph drainage
33
Q

treatment of pleural effusion

A
  • thoracentesis; aspiration of fluid from pleural space
34
Q

what is a pneumothorax?

A
  • filling of pleural cavity with air either from outside or from alveoli
35
Q

symptoms of pneumothorax

A
  • pleuritic pain
  • increased resp rate
  • chest asymmetry while breathing
  • decreased breath sounds
  • hypoxemia
36
Q

treatment of pneumothorax

A
  • follow up x-rays
  • insertion of chest drain
  • needle aspiration
  • airtight covering
37
Q

what is tension pneumothorax

A
  • one way valve forms in lung
  • air enters pleural space = trapped
  • pressure rises collapsing lung and pushes heart away from injured side
  • vena cava = kinked
  • blood cannot return to heart and cardiac output falls
38
Q

what are interstitial lung diseases

A

involvement of supporting tissues of lung parenchyma –> fine or coarse reticular opacities or small nodules

39
Q

what is atelectasis

A

partial collapse of lung due to decrease in amount of air in alveoli –> volume loss + increased density

RD1038 (3 decks)

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