Chest Xrays

Question 1

Radiopaque (pack)

Answer 1

Dense substances appear white or light
Ex. Bone

Question 2

What color do underexposed images appear?

Answer 2

More white

Question 3

Radiolucent

Answer 3

Low density substances appear dark/ black
Ex. air filled lung tissue

Question 4

What do overexposed images look like?

Answer 4

Black

Question 5

Is it okay to delay treatment while images are being produced and/or interpreted?

Answer 5

False

Question 6

When should you take an xray?
Max inhalation or expiration?

Answer 6

Inhalation: so you can see as much as possible

Question 7

What is the most common view of xrays?

Answer 7

PA view

Question 8

In a PA view is the xray infront or behind the patient?

Answer 8

Behind, and chest is against plate

Question 9

How many feet away does the patient stand from the machine in a PA ?

Answer 9

6 ft

Question 10

What type of imaging do we use commonly for ICU patients?

Answer 10

AP view

Question 11

How is the xray positioned for AP view?

Answer 11

Film plate is placed under patients back and xray is placed above

Question 12

What two views is the heart closer to the film?

Answer 12

Lateral view and PA view

Question 13

What special CXR view do we use to identify if pleural fluid is present?

Answer 13

Lateral decubitus

“Air rises, water falls”

Question 14

What special CXR view do we use to look closer at the middle lobe or the top (apical) regions of the lungs?

Answer 14

Apical Lordotic

Question 15

When do you take a CXR on exhalation?

Answer 15

To identify a small pnemo

Question 16

What are the two systemic approach acronym?

Answer 16

PIE
ABCDEF

Question 17

What does PIE stand for in regards to CXR interpretation?

Answer 17

Position, Inspiration, Exposure

Question 18

What does ABCDEF stand for in regards to xray interpretation?

Answer 18

Airway
Bones
Cardiac and Costophrenic
Diaphragm and Devices
Edges and Extrathorasic
Fields

Question 19

If you cannot see the heart silhouette the infiltrates are located where?

Answer 19

In the middle lobe

Question 20

If you can see the heart silhouette where are the infiltrates located?

Answer 20

In the lower lobe

Question 21

What would you see on a CXR for an air bronchogram ?

Answer 21

Visible bronchi when surrounded by consolidated alveoli

Question 22

Two types of ATX?

Answer 22

Compressive and Obstructive

Question 23

If my patient has a pleural effusion, PNX, hemothorax, or any space occupying lesion that caused ATX what type is it?

Answer 23

Compressive (because those things all apply pressure to the lung)

Question 24

If my patient has a tumor, aspirated foreign body, or mucus plugging that caused ATX what type is it?

Answer 24

Obstructive (because its obstructing the ventilation of the airway)

Question 25

What are signs of hyperinflation? and who do we see this in?

Answer 25

Increased AP diameter Large retrosternal space Flattening of diaphragm Seen in CFCBABE's

Question 26

Where are most ILD diseases contained too?

Answer 26

Interstitium

Question 27

What would you see on a CXR that indicated sarcoidosis?

Answer 27

large hilar and paratracheal lymph nodes

Question 28

What would you see on a CXR that indicated asbestosis?

Answer 28

calcified pleural or diaphragmatic nodules

Question 29

What would you see on a CXR that indicated end stage pulmonary fibrosis?

Answer 29

honey comb size cavities

Question 30

Signs of CHF on CXR?

Answer 30

Engorgement of upper lobe vessels Increased cardiothoracic ratio (>0.5) Kerley B lines

Question 31

What are two signs of pulmonary edema?

Answer 31

Bat wings or butterfly pattern

Question 32

What are the two types of pulmonary edema?

Answer 32

Cardiogenic and Noncardiogenic

Question 33

What would you see on a CXR for cardiogenic pulmonary edema?

Answer 33

Heart englargement, increased vasularity, and kerly B lines Seen in CHF patients

Question 34

What would you see on a CXR for noncardiogenic pulmonary edema?

Answer 34

normal heart size, normal vasculatity, and no kerly B lines Diffuse patchy infilitrates Seen in ARDS, inhalation of toxic agents, chlorine, ammonia, and allergic reaction to drugs

Question 35

How much fluid does the pleural space contain normally on each side?

Answer 35

appox. 30 mL

Question 36

How much fluid must be present before it can be seen on a CXR?

Answer 36

100 mL

Question 37

Blunting of the costophrenic angle Small meniscus sign Partially obscured and elevated diaphragm Are all signs of what pleural effusion on a CXR?

Answer 37

Small volume pleural effusion

Question 38

Complete or nearly complete whiteout Complete obscuring of the hemidiaphragm Are signs of what type of pleural effusion on a CXR?

Answer 38

Large volume effusion

Question 39

What is a pleural effusion an imbalance of?

Answer 39

formation of pleural fluid and rate of absorption by lymphatic system

Question 40

What is a deep sulcus sign?

Answer 40

radiolucency below the costophrenic angle seen in the presence of a pneumothorax

Question 41

What kind of pressure builds in a tension pneumothorax?

Answer 41

Typically negative, but becomes positive

Question 42

What is the most common cause of lung consolidation?

Answer 42

Bacterial pneumonia

Question 43

Do the lungs collapse with lung consolidation?

Answer 43

No

Question 44

What are signs of consolidation on a CXR?

Answer 44

Minimal loss of volume Lobar or segmental distribution Homogenous density Air bronchogram is the airway leading to the consolidated area is open

Question 45

Ground glass appearance on a CXR indicates what?

Answer 45

ARDS

Question 46

Where should the central venous pressure be placed? (CVP)

Answer 46

Right or left subclavian vein or jugular vein

Question 47

Where should the pulmonary artery catheter be placed?

Answer 47

tip at the right midlung near the hilum accidental rupture of balloon may rupture artery

Question 48

Where should NG feeding tubes be placed?

Answer 48

at the stomach or small bowel

Question 49

When do we use a CT?

Answer 49

Occupational lung diseases PNA Bronchiectasis COPD

Question 50

What is fluoroscopy?

Answer 50

Projects a continuous xray beam through the patient allowing visualization of live action

Question 51

When do we use Fluoroscopy?

Answer 51

Cardiac catheterization, bronchs, etc