Flashcards in Intro to Chest Imaging/Radiology Deck (51):
What landmarks should you look for in a CXR?
How wide should the aortic arch be?
Width of mediastinum
What other terms can be used when trachea is midline?
When does tracheal deviation go towards the diseased side?
Agenesis of lung
When does tracheal deviation go away from the diseased side?
What is included in the other causes of tracheal deviation?
What is an indication of an enlarged aortic arch/knob?
Worrisome for dissection
What can a calcified aortic arch/knob indicate?
Can be nl variant in elderly, in young person, worrisome for CAD
What should the size of the aortic arch/knob be?
Should be 1/2 the size of lower part of the heart
Dissection until proven otherwise
Mass vs. sarcoid vs lymphadenopathy
All organ placement is reversed
Position of heart is reversed
What is the nl size of the heart
Should be 1/2 the size of the chest
When will the costophrenic angle be blunted?
What should you do if it is hard to determine costophrenic angle for obesity or large breasts?
Check the lateral image
What to check for in diaphragms
Are they blunted?
Are they at even heights?
Is one elevated? Why?
Is there free air?
What to check for in bony structures
Scapula out of lung fields?
Any fxs or other bony pathology?
Where are scapula on AP view?
Scapula medial border in lung field
What to look for in lung markings
Absent? What's filling the gap? Black or white?
Extra lines? (Kurley B)
Thickened lines? (Cephalization)
Who needs a CXR in the age range of 18-50 yrs?
Cough with fever for several days
Hx of pneumonia
Who needs a CXR >50 yo?
Cough with or without fever
Hx of pneumonia
Other indications for a CXR
Coarse breath sounds and crackles
Wheezing- reactive air dz- usually reversible
Dull to percussion
What does an obscured right heart border indicate?
What are CXR findings in emphysema?
What are indications of CHF on a CXR?
What will an advanced CHF pt have on a CXR?
Pleural effusions and cardiomegaly
What can cardiomyopathy be in a young person?
What can be confused for CHF on a CXR?
Pneumocystis jiroveci pneumonia
In rib fxs, who should get a CT instead of a CXR?
Get one with contrast in a >50 yo pt
What are CXR findings in a tension pneumo?
Blunting on affected side
Tracheal deviation to opposite side
Increased haziness on opposite side d/t shift of heart and great vessels
What is key to diagnosing pleural effusion?
Position of pt
When is pleural effusion seen?
Primarily with CHF and/or pneumonia
Also could be trauma, lung cancer, PE
Decrease in lung volume
Incomplete expansion of the lung or "collapse"
Primary finding on CXR
Deviation towards dz
Unrealistic expectation of your interpreting this
A lucent area in the lung (that may or may not contain air/fluid levlels) is surrounded by walls
What are the four types of cavitations, and what do they indicate?
Suppurative: lung abscess
Obstructive: cancer or PCP (pneumocystis pneumonia)
What does an abscess look like on a CXR?
Air fluid level with a straight line
What does an infarct look like on a CXR?
Path of the central ray
What is a crucial principle in imaging?
Get imaging in 2 positions
When do you not need protective gear from shielding?
Within 6 feet away
Make sure to shield your thyroid
What are the advantages of u/s?
Good for use in pregnant pts and children
What to take into consideration for radiation safety
Prior imaging, both recent and/or lifetime
Order exams AFTER you examine the pt
Refers to strength of radiation vs the thickness of tissue being imaged
How can you tell a good inspiration?
Should see 8 or more ribs
Increased diaphragm with good inspiration: check liver
What is black on an X-ray?
What is white and gray on an X-ray or CT?
Organs- white or gray
Bone and teeth-white
Vessels-gray or white
What is black on an u/s?
What is gray on an u/s?
When could vessels be white on an X-ray?
Left lateral CXR components
Decreases heart magnification
Arms above head
Standing or sitting upright only