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Fall24 PoA II > Chest XR pt2 Exam1 > Flashcards

Chest XR pt2 Exam1 Flashcards

1
Q

Label 1

A
  • Oblique Fissure
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2
Q

Label 2

A
  • Horizontal Fissure
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3
Q

Label 3

A
  • Thoracic spine/ Retrocardial space
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4
Q

Label 4

A
  • Retrosternal space
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5
Q

What will cause a Silhouette Sign on a CXR?

A
  • Lungs making contact with the heart or any structure (tumor, mass, lesion) that may obscure the border of a CXR.
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6
Q

Visualization of air in the intrapulmonary bronchi on a CXR is called a ________ sign.

A
  • Bronchogram
  • Bronchogram sign indicates an abnormal lung (consolidation).
  • With consolidation, pulmonary vessels are no longer visualized b/c they are surrounded by other soft tissue density material.
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7
Q

1/3rd of the heart sides on ______ side
2/3rd of the heart sides on the ______ side.

A
  • right side
  • left side
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8
Q

Lung injury or pathological states can be either a ________ or _______ process.

A
  • generalized
  • localized
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9
Q

What can cause generalized liquid density in a lung? (3)

A
  • Diffused alveolar
  • Diffused interstitial
  • Mixed/Vascular
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10
Q

What can cause localized liquid density in a lung? (6)

A
  • Infiltrate
  • Consolidation
  • Cavitation
  • Mass
  • Congestion
  • Atelectasis
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11
Q

What can cause increased air density in the lungs? (4)

A
  • Localized airway obstruction
  • Diffuse airway obstruction
  • Emphysema
  • Bulla
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12
Q

What is consolidation on a CXR?

A
  • Alveolar space filled with inflammatory exudate (bacteria/WBC/plasma/debris).
  • With consolidation, architecture remains the same and the airway is patent
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13
Q

What is obstructive atelectasis on a CXR?

A
  • No ventilation to the lobe beyond the obstruction (ie: mucous plug, right main stem intubation)
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14
Q

What are the stages of evaluating a CXR abnormality?

A
  • ID abnormal shadows
  • Anatomically localize lesion
  • ID pathological process
  • ID etiology
  • Confirm clinical suspicion (contrast, CT, MRI)
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15
Q

What are the two arrows pointing at?
What does the “^” indicate?

A
  • ETT
  • Carina

central line passing by

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16
Q

What does this CXR show?

A
  • Right mainstem intubation

radiopaque line in ETT directed down right mainstem

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17
Q

Is this a proper placement of a central line?

A
  • No, the tip (smaller red arrow) is within the right ventricle. Pt will probably experience PVCs.
  • The catheter tip should lie between the most proximal venous valves of the subclavian or jugular veins and the right atrium.
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18
Q

What is this CXR showing?

A
  • Right pleural effusion
  • Notice the loss of the costophrenic angle and leveling of fluid
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19
Q

What is this CXR showing?

A
  • RML pneumonia
  • You can rule out RLL pneumonia because there is no accumulation at the base of the lung.
  • A lateral CXR will have the best view for confirmation.
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20
Q

What is this CXR showing?

A
  • RUL pneumonia
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21
Q

What is this CXR showing?

A
  • RLL pneumonia
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22
Q

What is this CXR showing?

A
  • Free air under the diaphragm
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23
Q

What are the four arrows pointing at?

A
  • Cavitary Infiltrate
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24
Q

A lesion seen in the lung that is caused by tuberculosis.

A
  • Ghon’s Complex
  • The lesions consist of a calcified focus of infection and an associated lymph node.
  • Very hard to detect.
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25
What are the arrows pointing to in this CXR?
* Anterior Mediastinal Mass * Need lateral CXR to confirm. It's hard to see the mass in AP view.
26
What are the arrows pointing to in this CXR?
* LUL Mass
27
What is this CXR showing?
* Pulmonary Metastasis (Cancer) * The white circular object on the patient's right lung is a medication port.
28
What are the two arrows on this CXR indicating?
* Pneumomediastinum * There should never be that much air between the heart and lungs. * This can be caused by airway trauma, tracheal or esophageal rupture
29
What is this CXR showing?
* Left Pneumothorax * Notice the air trapping on the patient's left lung
30
What is this CXR showing?
* Subcutaneous Emphysema * Notice the intermittent areas of radiolucency, often representing a fluffy appearance on the exterior borders of the thorax.
31
What is the red arrow indicating?
* Deep Sulcus Sign * This is an indirect indicator of a pneumothorax.
32
If a child swallows a large coin, is it more likely to go down the esophagus or trachea?
* Esophagus
33
What is this CXR showing?
* Pulmonary Fibrosis
34
What is this CXR showing?
* Diffuse Pulmonary Edema
35
What is the classic sign on a CXR of pulmonary edema secondary to CHF?
* Bat Wing Pattern * Enlarged Heart
36
What is this CXR showing?
* Post-op Left Pneumonectomy * There is no left lung
37
What is this CXR showing?
* Transverse Aortic Arch Aneurysm
38
What is this CXR showing?
* Cardiomegaly
39
What is this CXR showing?
* Aortic Dissection * Notice the wide mediastinum and deviation of the heart to the patient's left side
40
What sign is present when a large loop of the intestine gets shoved between the diaphragm and the liver?
* Chilaiditi Sign
41
What is this CXR showing?
* Esophageal Rupture (Boerhaave's Syndrome) * Notice small bilateral lung field and infiltrates * Wide mediastinum pattern * Air visible on bilateral sides of the heart
42
What is hilar adenopathy?
* Hilar adenopathy is the enlargement of lymph nodes in the hilum. * It can be caused by conditions such as tuberculosis, sarcoidosis, drug reactions, infections, or cancer.
43
What is this CXR showing?
* Bilateral Hilar Adenopathy
44
Case Study: 35 y/o male with dyspnea, unplanned weight loss over 3 months.
* Pulmonary lesion on patient's left lung * Thin-walled cavity is noted in the left midlung. Most likely cancerous. * This finding is most typical of squamous cell carcinoma (SCC).
45
Case Study: 65y/o with a month worth of dyspnea, occasional productive cough, and fever
* LUL Atelectasis: Loss of heart borders/silhouetting. * Notice over inflation on unaffected lung * Inflammatory process or pneumonia in the LUL
46
Case Study: 30yo female with 1 week of fever and cough
* Right Middle Lobe Pneumonia * Left Upper Lobe Pneumonia
47
Case Study: 28y/o inmate for CT-guided drainage
* Cavitation: cystic changes in the area of consolidation due to the bacterial destruction of lung tissue. * Pleural Effusion in RML * Notice air-fluid level.
48
What are the two arrows indicating in this CXR?
* Tuberculosis (stretched out cotton ball appearance)
49
What is this CXR showing?
* COPD: increase in heart diameter, flattening of the diaphragm, and increase in the size of the retrosternal air space. * In addition, the upper lobes will become hyperlucent due to the destruction of the lung tissue.
50
What is this CXR showing?
* Pseudotumor: fluid has filled the minor fissure creating a density that resembles a tumor (arrow). Recall that fluid and soft tissue are indistinguishable on plain film. * Further analysis, however, reveals a classic pleural effusion in the right pleura. * Note the right lateral gutter is blunted and the right diaphram is obscurred.
51
What is this CXR showing?
* Pneumonia: a large pneumonia consolidation in the right lower lobe. * Knowledge of lobar and segmental anatomy is important in identifying the location of the infection.
52
What is this CXR showing?
* Pulmonary Edema secondary to CHF * A great deal of accentuated interstitial markings, curly lines, and an enlarged heart. * Normally indistinct upper lobe vessels are prominent but are also masked by interstitial edema.
53
What is the CXR showing?
* Chest wall lesion: arising off the chest wall and not the lung
54
What is the CXR showing?
* Pleural effusion: Note loss of left hemidiaphragm. * Fluid drained via thoracentesis
55
What is the CXR showing?
* Lung Mass
56
What is the CXR showing?
* Small Pneumothorax: LUL * Notice that thin white line, that is the lung being shoved down by the pneumothorax
57
What is the CXR showing?
* Right Middle Lobe Pneumothorax: complete lobar collapse and deep sulcus
58
What is the CXR showing?
* Metastatic Lung Cancer: Multiple nodules seen
59
What is the CXR showing?
* RUL pulmonary nodule
60
What is the CXR showing?
* TB
61
What is the CXR showing?
* Perihilar mass * Hodgkin’s disease
62
What is the CXR showing?
* Widened Mediastinum * Aortic Dissection
63
What is the CXR showing?
* Pulmonary artery stenosis with cardiomegaly likely secondary to stenosis.

Fall24 PoA II (34 decks)

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