Flashcards in Chest X-Rays Deck (16)
Why can't the right ventricle be seen on a chest radiograph?
It lies anteriorly so doesn't have a border on a PA radiograph
How do we assess the quality of a chest radiograph?
Rotation - assess whether thoracic spinous processes lie between the sternoclavicular joints
Inspiration - 6th ribs at the level of the hemidiaphragm
N.b. No longer need to comment on penetration of the film as this can be adjusted electronically on PACS
What is indicated by loss of the right heart border?
Loss of air in right middle lobe
What is indicated by loss of the left heart border?
Loss of air in the lingula
What is indicated by loss of either hemidiaphragm?
Loss of air in the corresponding lower lobe
What pathology causes tracheal deviation towards the affected side?
What pathology causes tracheal deviation away from the affected side?
Large pleural effusion
The carinal angle is normally 40-100 degrees. What pathology can increase the carinal angle?
Either something pushing upwards I.e. Sub-carinal mass
Left atrial enlargement, cardiomegaly, pericardial effusion
Something pulling either mainstem bronchus upwards I.e. Upper lobe collapse
What are the key defining features of consolidation?
Paths shadowing, can be localised to one lobe
Air bronchograms (air-filled bronchus surrounded by fluid filled or solid alveoli)
No loss of lung volume
What are the key features of right upper lobe collapse?
Increased density in the right upper zone
Upwards displacement of the horizontal fissure
Loss of definition of the right mediastinal margins
Right tracheal deviation
What are the key features of a middle lobe collapse?
Increased density in the right mid-zone
Loss of the right heart border
Horizontal fissure displaced downwards
What are the key features of a right lower lobe collapse?
Triangular shadowing at the right base medially
Loss of definition of the right hemidiaphragm
The right heart border is not obscured
Elevation of the right hemidiaphragm
What are the key features of a left upper lobe collapse?
Increased density in the left upper zone
Upper zone 'veil-like' shadowing with no clear border
Loss of definition of left upper cardiac border and left mediastinal margin
Left tracheal deviation
What are the key features of a left lower lobe collapse?
Sail sign - double heart shadow'
Loss of definition of the medial left hemidiaphragm
The left heart border is not obscured
What are disadvantages of AP films compared to PA films?
The mediastinum and cardiac size will appear wider due to venous distension and magnification so don't comment on cardiac or mediastinal size
The scapulae aren't rotated out of the way, whereas in a PA with patient is standing with their hands on their hips