Chest XR Flashcards
A-Alignment
Trachea position:
SP should be midline inside trachea
Heart Position:
Right:Left = 1:2
If changed to 1:1–>heart shifts to the right
If changed to 1:3–>heart shifts to the left
B: Bone
Vertebrae, ribs, clavicles, humeral head (sometime)
- Sign of fracture/dislocation/deformity
- Sign of bony lesion (black spot) indicating cancer
C: Cardiac
PA X-ray:
Cardiothoracic index= <50%
D: Diaphragm
Right hemidiaphragm=higher
Costophrenic angle–>deep and sharply defined
E: Edge & Border
Positive silhouette sign–>loss of a clear border–>pathology of the corresponding lung
Arch of the aorta= Lt Upper
Heart border= Rt middle, Lt upper lingula
Costocardiac/cardiophrenic angle=
Rt middle, Lt upper lingula
Costophrenic angle=
Rt, Lt lower
Domes of the diaphragm=
Rt, Lt lower
F: Field
lung field=dark grey
Hila=major bronchi & pulmonary arteries and veins
vascular marking–>should not appear enlarged
enlarged–> pulmonary HT, COPD, infection
Radiolucency VS opacity
Radiolucency = Blackness = Air/gas
AKA: Hyperlucent
Opacity = Whiteness = Fluid/secretion
Whiteout
ARDS
Fluffy looking white area
Pulmonary edema
A meniscus in lung field
Pleural effusion
- Concave shape typically higher lateral>medial
Increase Radiolucency+fine line on lung field
Pneumothorax
Batwing appearance
Pulmonary edema
- Increased vascular markings (bilaterally)
–> most prominent near the mediastinum and radiate outwards towards the periphery of the lungs
Image Quality
RIPE
R: Rotation
- medial end of bil. clavicles–>equidistant from the SP
I: Inspiration
- at least 9 post. ribs/ 6 ant. ribs
P: Projection
PA: standing, heart not magnified
AP: sitting/supine, heart enlarged
Exposure:
Uniformity of whole film–>too bright/dark
