Chest X Ray Introduction - Tutorial 1 Flashcards
(38 cards)
How do X rays produce an image?
High energy photon produced by x-ray tube X-rays pass through the body and are absorbed/attenuated in proportion to the density of the body part, - this appears as white X rays that have not been absorbed pass through the patient and hit an image receptor - this appears as black
What are the basic densities seen on an X ray?
Air - shows as black Fat - shows as dark grey Soft Tissue - Shows as light grey Bone - shows as White
What is a contrast study?
Injecting iodine based intravenous contrast or introducing barium suspensions into hollow viscera -Make is possible to see disease anatomy that would not be seen
For a thoracic x-ray what must the patient do?
Breath in and hold their breath.
What way do the X-rays pass through the patient?
Posterior to Anterior (PA radiograph)
Where does the heart lie in the thorax?
Anteriorly - PA radiogrpahy reduces shadowing
How are X rays carried out for those who cannot stand?
AP radiograph
How can you tell if the CXR is adequately inspired?
The anterior ends of 6 ribs should be present.
What are the pulmonary hila?
hila (lung roots) are complicated structures mainly consisting of the major bronchi and the pulmonary veins and arteries
What are the great vessels of the heart?
Superior vena cava
Inferior vena cava
Pulmonary arteries
Pulmonary veins
Aorta
What normal structures can we see on a CXR
- Heart
- Great vessels
- Pulmonary hila
- Trachea and bronchi
- Lungs
- Pleura & pulmonary fissures
- Diaphragms
- Bones
What cancer is associated with te Hila?
•common place for bronchial carcinoma to arise and because lymph nodes located there may become visibly enlarged due to disease.
When might the minor bronchi or the major bronchi be visible?
May be visible if they are calcified
- This occurs in older patients.
Describe what parts of the Right and Left anterior lung surface ?
Right
Right Upper Lobe
Right Middle Lobe
Left
Left upper lobe
Lingula
Describe what parts can be seen on the Right and Left lung posterior surface?
Right Lower Lobe
Left lower Lobe
What is seen inthis X ray?
In a healthy lung what colour is the Retrosternal space and the retrocardiac space?
The retrosternal and retrocardiac spaces should be dark on a lateral CXR.
If they are not, disease is present
What are the common disease that can be deteced on a CXR?
- Pneumonia
- Lobar Collapse
- Features of cardiac failure
- Pneumothorax
- Pneumomediastinum
- Thoracic malignancy
What is the Silhouette sign?
If a border of a viscera is silhouetted, it means that there is pathology present.
What is disease is shown in the CXR?
Right Middle Lobe Pneumonia
In pneumonia, airspaces are filled by inflammatory exudate and affected lung becomes of soft tissue density.
Using the silhouette sign the right heart border opposite can no longer be discerned, so we can predict that the right middle lobe is involved.
Note that the right diaphragm remains visible.
What disease is shown in this CXR?
Lingular Pneumonia
The lingular segments of the left upper lobe abut the left heart border, so can be thought of as anatomically equivalent to the middle lobe in the right lung.
Infection of the lingula causes the left heart border to become obscured, as shown opposite.
Describe how a lobar collapse occurs?
•This happens when there is obstruction of a lobar bronchus.
What causes a Lobar collapse?
bronchial obstruction
tumours,
aspirated foodstuffs,
mucus impaction
What does this CXR show?
Left Lobar Collpase
