Exam #3: X-Ray Interpretation Flashcards

1
Q

What is it called if materials of same radiographic density meet = NO border?

A

“Silhouette Sign”

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2
Q

What does ABCDEFGHI stand for?

A
  • Assess quality/airway
  • Bones
  • Cardiac
  • Diaphragm
  • Effusions/extrathoracic soft tissue
  • Fields/fissures/FBs
  • Great vessels/gastric bubble
  • Hila/mediastinum
  • Impression
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3
Q

When counting ribs, approximately how many should you see posteriorly? Anteriorly?

A
  • 9 posterior ribs

- 7 anterior ribs

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4
Q

Where can you begin counting the first posterior rib from, and how can you see this?

A

T1

- T1 transverse process is angled upwards (C7 transverse process above it is horizontal)

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5
Q

Is the left or right side of the diaphragm higher?

A

RIGHT higher

- Liver below

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6
Q

Sides of the diaphragm should be…

A

Sides equal and slightly rounded

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7
Q

What does a low, flat diaphragm indicate?

A

COPD

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8
Q

What does a unilaterally high diaphragm indicate?

A

Paralysis

- Due to nerve damage, trauma, loss of lung volume

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9
Q

On what x-ray view does the mediastinum appear thicker?

A

Mediastinum is thicker on supine AP view

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10
Q

Is the left or right hilum appear higher?

A

LEFT higher

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11
Q

What are four possible causes of mediastinal widening?

A
  • Traumatic aortic injury
  • Vascular issues
  • Pulmonary masses
  • Mediastinal LAD
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12
Q

What are 2 possible causes of mediastinal mass?

A
  • Thoracic aortic aneurysm

- Thymoma

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13
Q

What is an abnormal Cardiac:Thoracic ratio?

A

Greater than 50%

1:2

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14
Q

How should spinous processes present location wise? If they are not, what might this indicate?

A

Midway between medial ends of clavicles

- If NOT central, consider patient rotation

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15
Q

If a patient has excellent inspiration, how many ribs are visible? Adequate inspiration? Poor inspiration?

A
  • Excellent: 10+ posterior ribs
  • Adequate: 8-9 posterior ribs
  • Poor: <8 posterior ribs
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16
Q

What three CXR findings are indicative of COPD?

A
  • Hyperlucency (air trapping)
  • Flat diaphragm
  • Hyperinflation (“barrel chest”)
17
Q

What is large bullae (look like air bubbles) indicative of?

A

Bullous Emphysema/Fibrosis

18
Q

What two normal findings will NOT be visible if Pneumothorax (PTX) is present?

A
  • NO pleural markings

- NO vascular markings

19
Q

What is a common location of Pneumothorax (PTX) aka it should always be checked?

20
Q

What two symptoms are often associated with Pneumothorax (PTX)?

A
  • Acute SOB

- Pleuritic CP

21
Q

What two populations are more likely to experience a Pneumothorax (PTX)?

A
  • Young, tall

- Older

22
Q

What condition involves shift of intrathoracic structures with tracheal deviation?

A

Tension PTX

23
Q

What type of CXR is used to diagnose a Small PTX? What other test can be used?

A

Expiratory CXR

- Also, CT

24
Q

What condition involves air leaks into mediastinum? What test is used to diagnose this?

A

Pneumomediastinum

- CT

25
With a Pneumomediastinum, what should always be ruled out?
Esophageal perforation
26
What population are Pneumomediastinum most common?
Young males
27
What condition presents as dark lines following muscle/tissue planes?
Subcutaneous Emphysema
28
What exam finding is indicative of Subcutaneous Emphysema?
Crackly, “rice-crispy” sound with palpation of neck | - Like popping bubble wrap
29
What condition involves radiolucent area below diaphragm?
Pneumoperitoneum
30
What is often the cause of Pneumoperitoneum, and what might lead to this?
Disruption of wall of hollow viscous | - Often due to recent surgery, trauma, PUD, CA (bowel), acute onset abdominal pain
31
What CXR view should be used to evaluate for Pleural Effusion?
Left lateral decubitus view
32
What five sxs might present with infiltrate?
- Cough - Fever - CP - SOB - DOE
33
What finding is indicative of CHF? What two other findings may also be seen?
“Kerley-B lines” - “butterfly” sign - “bat-wing” sign
34
What condition involves “butterfly” or “bat-wing” sign?
CHF
35
What condition involves increased lung density, displaced fissures, shift of structures?
Atelectasis
36
What is the most common cause of Atelectasis, and what are three examples?
Bronchial obstruction - Neoplasms - Mucous plugging - FB aspiration
37
What four PRIMARY CAs are often associated with metastasis to the lungs?
- Breast - Colorectal - Renal cell - Uterine
38
What four findings of a Solitary Pulmonary Mass are indicative of malignancy?
- Large (15+ mm) - Irregular - Inhomogeneous (diff. densities) - Spiculated
39
What four findings of a Solitary Pulmonary Mass are indicative of benign?
- Smooth - Well-defined - Homogeneous - +calcifications