CXR

Question 1

ABCDE

Answer 1

first, assess technical quality

airway
bones (& soft tissue)
cardiac (& mediastinum)
diaphragm (& gastric bubble)
effusions (& pleura)
fields

also lines, tubes, devices & surgeries

Question 2

airways

Answer 2

trachea
left main bronchus
right main bronchus

Question 3

why is PA superior

Answer 3

improved technical quality
heart size not accurate on AP

Question 4

factors affecting technical quality

Answer 4

rotation
inadequate inspiration
suboptimal penetration

Question 5

how to assess technical quality

Answer 5

look for rotation - should see some lung apices above clavicles, vertebral spinous processes bisect the distance between the medial ends of the clavicles

check for adequate inspiration - 9-10 posterior ribs visible

check exposure - ID thoracic vertebrae behind heart

Question 6

cardiomegaly

Answer 6

heart >50 % width of diaphragm

Question 7

pleural effusions

Answer 7

small may not be visible on PA film
blunting of costophrenic angle
may need lateral view