CXR interpretation lms

Question 1

difference between AP and PA in heaart size evaluation

Answer 1

AP: heart will look bigger than it actually is
PA: beams scatter only slightly so there is a good approximation of heart size

Question 2

diaphragm

Answer 2

right is about 2cm higher due to the liver
sharp and well deliniated

Question 2

a good quality film looks like

Answer 2

7-8 anterior ribs
10-11 posterior ribs
scapulae out of the lung feilds
trachea centrala
ends of clavicles symmetrical
includes costophranic angles

Question 3

diameter of the heart should be

Answer 3

50% of the maximum intrathoracic width

Question 4

systematic appraoch

Answer 4

patient details
PA/AP film
film quality: centred, penetraation, inspiration
bone/soft tissue
heart size and shape
pleural surfaces/costophranic angles
lung feilds: vascular and bronchial marks, size, shadowing

Question 5

x-ray signs of pleural effusions

Answer 5

fluid level/meniscus
very dense homogenous shadowing
costophenric angle obscured

Question 6

pneumothorax signs

Answer 6

dense black shadowing on the affected side with no lung markings and a visible lung edge which has moved away from the chest wall

Question 7

lobar collapse

Answer 7

mediastinum. / trachea shifted
diaphragm pulled up
fissures between lung lobes pulled towards collapse

Question 8

left lower lobe collapse

Answer 8

left diaphragm. surface obscured

Question 9

pneumonia

Answer 9

unwell, febrile
shodowing, consolidation

Question 10

emphysema

Answer 10

flattened diaphragms with loss of domes shape
costophrenic angless may look blunt but thats just because of the change in shape of the diaphragm
blackened lungs

Question 11

hilar enlargement

Answer 11

hilar shapes should be concave and not convex