Intro to Chest Imaging/Radiology Flashcards Preview

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Flashcards in Intro to Chest Imaging/Radiology Deck (51):
1

What landmarks should you look for in a CXR?

Trachea
Clavicles
Scapula
LV
Aortic arch
Costophrenic angles
Diaphragm

2

How wide should the aortic arch be?

Width of mediastinum

3

What other terms can be used when trachea is midline?

WNL
Nl
Unremarkable

4

When does tracheal deviation go towards the diseased side?

Atelectasis
Agenesis of lung
Pneumonectomy
Pleural fibrosis

5

When does tracheal deviation go away from the diseased side?

Pneumothorax
Pleural effusion
Large mass/tumor

6

What is included in the other causes of tracheal deviation?

Mediastinal masses
Tracheal masses
Kyphoscoliosis

7

What is an indication of an enlarged aortic arch/knob?

Worrisome for dissection

8

What can a calcified aortic arch/knob indicate?

Can be nl variant in elderly, in young person, worrisome for CAD

9

What should the size of the aortic arch/knob be?

Should be 1/2 the size of lower part of the heart

10

Wide mediastinum

Dissection until proven otherwise
Mass vs. sarcoid vs lymphadenopathy

11

Sinus inversus

All organ placement is reversed

12

Dextrocardium

Position of heart is reversed

13

What is the nl size of the heart

Should be 1/2 the size of the chest

14

When will the costophrenic angle be blunted?

Pleural effusion

15

What should you do if it is hard to determine costophrenic angle for obesity or large breasts?

Check the lateral image

16

What to check for in diaphragms

Are they blunted?
Are they at even heights?
Is one elevated? Why?
Is there free air?

17

What to check for in bony structures

Clavicles elevated?
Scapula out of lung fields?
Any fxs or other bony pathology?

18

Where are scapula on AP view?

Scapula medial border in lung field

19

What to look for in lung markings

Present?
Absent? What's filling the gap? Black or white?
Extra lines? (Kurley B)
Thickened lines? (Cephalization)

20

Who needs a CXR in the age range of 18-50 yrs?

Cough with fever for several days
SOB
Hx of pneumonia
Hemoptysis
Dyspnea
Trauma
Chest pain
Positive PPD
Smoker

21

Who needs a CXR >50 yo?

Cough with or without fever
SOB
Hx of pneumonia
Hemoptysis
Dyspnea
Trauma
Chest pain
Weakness
Dizziness
Positive PPD
Smoker

22

Other indications for a CXR

Sepsis
Tachycardia
Elevated WBC
Pleuritic pain
Coarse breath sounds and crackles
Wheezing- reactive air dz- usually reversible
Positive egophany
Tactile fremitus
Dull to percussion

23

What does an obscured right heart border indicate?

RML pneumonia

24

What are CXR findings in emphysema?

Flat diaphragm
Inflated lungs
Barrel chest

25

What are indications of CHF on a CXR?

Cephalization
Enlarged heart

26

What will an advanced CHF pt have on a CXR?

Pleural effusions and cardiomegaly

27

What can cardiomyopathy be in a young person?

HCM

28

What can be confused for CHF on a CXR?

Pneumocystis jiroveci pneumonia

29

In rib fxs, who should get a CT instead of a CXR?

Get one with contrast in a >50 yo pt

30

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

31

What is key to diagnosing pleural effusion?

Position of pt
Upright
Decubitus

32

When is pleural effusion seen?

Primarily with CHF and/or pneumonia
Also could be trauma, lung cancer, PE

33

Atelectasis

Decrease in lung volume
Incomplete expansion of the lung or "collapse"
Primary finding on CXR
Deviation towards dz
Unrealistic expectation of your interpreting this

34

Cavitations

A lucent area in the lung (that may or may not contain air/fluid levlels) is surrounded by walls
Necrotic process

35

What are the four types of cavitations, and what do they indicate?

Suppurative: lung abscess
Caseous: TB
Ischemic: infarction
Obstructive: cancer or PCP (pneumocystis pneumonia)

36

What does an abscess look like on a CXR?

Air fluid level with a straight line

37

What does an infarct look like on a CXR?

Wedge shape

38

Projection

Path of the central ray

39

What is a crucial principle in imaging?

Get imaging in 2 positions

40

When do you not need protective gear from shielding?

Within 6 feet away
Make sure to shield your thyroid

41

What are the advantages of u/s?

No radiation
Cheaper
Good for use in pregnant pts and children

42

What to take into consideration for radiation safety

Time
Distance
Shielding
Prior imaging, both recent and/or lifetime
Order exams AFTER you examine the pt

43

Penetration

Refers to strength of radiation vs the thickness of tissue being imaged

44

How can you tell a good inspiration?

Should see 8 or more ribs
Increased diaphragm with good inspiration: check liver

45

What is black on an X-ray?

Air

46

What is white and gray on an X-ray or CT?

Fluid-white
Organs- white or gray
Bone and teeth-white
Vessels-gray or white

47

What is black on an u/s?

Fluid
Vessels

48

What is gray on an u/s?

Organs/tissues

49

When could vessels be white on an X-ray?

Calcification

50

Left lateral CXR components

Decreases heart magnification
Arms above head
Standing or sitting upright only

51

What is a cross table lateral position used?

Primarily for extremities when injury is severe, pt unable to move from their current position
Cervical spines in children with trauma