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Radiology > Intro to Chest Imaging/Radiology > Flashcards

Intro to Chest Imaging/Radiology Flashcards

1
Q

What landmarks should you look for in a CXR?

A 
Trachea
Clavicles
Scapula
LV
Aortic arch
Costophrenic angles
Diaphragm
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2
Q

How wide should the aortic arch be?

A

Width of mediastinum

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3
Q

What other terms can be used when trachea is midline?

A

WNL
Nl
Unremarkable

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4
Q

When does tracheal deviation go towards the diseased side?

A

Atelectasis
Agenesis of lung
Pneumonectomy
Pleural fibrosis

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5
Q

When does tracheal deviation go away from the diseased side?

A

Pneumothorax
Pleural effusion
Large mass/tumor

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6
Q

What is included in the other causes of tracheal deviation?

A

Mediastinal masses
Tracheal masses
Kyphoscoliosis

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7
Q

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

A

Worrisome for dissection

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8
Q

What can a calcified aortic arch/knob indicate?

A

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

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9
Q

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

A

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

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10
Q

Wide mediastinum

A

Dissection until proven otherwise

Mass vs. sarcoid vs lymphadenopathy

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11
Q

Sinus inversus

A

All organ placement is reversed

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12
Q

Dextrocardium

A

Position of heart is reversed

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13
Q

What is the nl size of the heart

A

Should be 1/2 the size of the chest

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14
Q

When will the costophrenic angle be blunted?

A

Pleural effusion

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15
Q

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

A

Check the lateral image

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16
Q

What to check for in diaphragms

A

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

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17
Q

What to check for in bony structures

A

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

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18
Q

Where are scapula on AP view?

A

Scapula medial border in lung field

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19
Q

What to look for in lung markings

A

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

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20
Q

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

A 
Cough with fever for several days
SOB
Hx of pneumonia
Hemoptysis
Dyspnea
Trauma
Chest pain
Positive PPD
Smoker
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21
Q

Who needs a CXR >50 yo?

A 
Cough with or without fever
SOB
Hx of pneumonia
Hemoptysis
Dyspnea
Trauma
Chest pain
Weakness
Dizziness
Positive PPD
Smoker
22
Q

Other indications for a CXR

A 
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
Q

What does an obscured right heart border indicate?

A

RML pneumonia

24
Q

What are CXR findings in emphysema?

A

Flat diaphragm
Inflated lungs
Barrel chest

25
Q

What are indications of CHF on a CXR?

A

Cephalization

Enlarged heart

26
Q

What will an advanced CHF pt have on a CXR?

A

Pleural effusions and cardiomegaly

27
Q

What can cardiomyopathy be in a young person?

A

HCM

28
Q

What can be confused for CHF on a CXR?

A

Pneumocystis jiroveci pneumonia

29
Q

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

A

Get one with contrast in a >50 yo pt

30
Q

What are CXR findings in a tension pneumo?

A

Blunting on affected side
Tracheal deviation to opposite side
Increased haziness on opposite side d/t shift of heart and great vessels

31
Q

What is key to diagnosing pleural effusion?

A

Position of pt
Upright
Decubitus

32
Q

When is pleural effusion seen?

A

Primarily with CHF and/or pneumonia

Also could be trauma, lung cancer, PE

33
Q

Atelectasis

A

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
Q

Cavitations

A

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

35
Q

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

A

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

36
Q

What does an abscess look like on a CXR?

A

Air fluid level with a straight line

37
Q

What does an infarct look like on a CXR?

A

Wedge shape

38
Q

Projection

A

Path of the central ray

39
Q

What is a crucial principle in imaging?

A

Get imaging in 2 positions

40
Q

When do you not need protective gear from shielding?

A

Within 6 feet away

Make sure to shield your thyroid

41
Q

What are the advantages of u/s?

A

No radiation
Cheaper
Good for use in pregnant pts and children

42
Q

What to take into consideration for radiation safety

A 
Time
Distance
Shielding
Prior imaging, both recent and/or lifetime
Order exams AFTER you examine the pt
43
Q

Penetration

A

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

44
Q

How can you tell a good inspiration?

A

Should see 8 or more ribs

Increased diaphragm with good inspiration: check liver

45
Q

What is black on an X-ray?

A

Air

46
Q

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

A

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

47
Q

What is black on an u/s?

A

Fluid

Vessels

48
Q

What is gray on an u/s?

A

Organs/tissues

49
Q

When could vessels be white on an X-ray?

A

Calcification

50
Q

Left lateral CXR components

A

Decreases heart magnification
Arms above head
Standing or sitting upright only

51
Q

What is a cross table lateral position used?

A

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

Radiology (4 decks)

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