Introduction to Chest Radiology Flashcards
(114 cards)
1
Q
2 ways of looking at the chest?
A
- Chest radiograph (CXR)
- Chest CT
2
Q
Difference between X-ray and radiograph?
A
A radiograph is the resultant image after a patient or object is exposed to x rays
3
Q
Describe the detectors currently used in radiography.
A
All digital
4
Q
How to describe subject placement in radiography?
A
First the side receiving the rays first
Then the side next to the film
5
Q
Which frontal CXR is preferred?
A
PA
6
Q
Which lateral CXR is preferred?
A
Right
7
Q
How does one make a CT image of the chest?
A
- Patient passes in short increments through hole in scanner
- XR tube (in housing gantry) rotates around patient in a spiral
- X-rays pass through patient and strike detectors
- Computer generates the image
8
Q
Does a CT have multi-planar capability? What does this mean?
A
YES, meaning it can generate images in the axial, coronal, and sagittal planes
9
Q
What is an axial plane?
A
Horizontal plane cutting body in superior and inferior portions
10
Q
What is a coronal plane?
A
Plane cutting body in anterior and posterior portions
11
Q
What is a sagittal plane?
A
Plane cutting body in right and left portions
12
Q
Other word for axial plane?
A
Transverse plane
13
Q
Which CT plane would most closely simulate a lateral CXR?
A
Sagittal plane
14
Q
A
15
Q
Name the bones.
A
*coracoid process of the scapula
*spinous proccesses from the vertebrae
16
Q
Name the “moguls”. What to note?
A
Note: pulmonary trunk is more of a valley than a bump
17
Q
A
18
Q
In which position are patients passed through a CT scan?
A
Supine
19
Q
Other name for lung roots?
A
Hila
20
Q
Do the pulmonary arteries travel with the bronchi or the pulmonary veins?
A
Bronchi
21
Q
What are the pleural angles?
A
Junction of costal pleura and diaphragmatic pleura
22
Q
How to tell the difference between posterior and anterior ribs on a radiography?
A
The ribs most visible are posterior and horizontal
The faint ribs are anterior
TBD
23
Q
Are pulmonary arteries and veins parallel?
A
NOPE
24
Q
A
25
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28
Other name for bifurcation of the trachea?
Carina
29
30
Pectoralis muscle on left side and Poland syndrome on the right side = congenital absence of pectoralis muscle associated with hypoplasia of ipsilateral:
* pectoralis major muscle, and
* breast, and
* ribs, and
* upper extremity
31
Which 2 veins drain into the SVC?
R and L brachiocephalic veins
32
Is Poland's syndrome more common in men or women?
Men
33
What is pneumonia? Where does it originate?
Infection of the lung airspaces
Originates in the alveoli as organisms are inhaled and reproduce in the lungs
34
What are pores of Kohn?
Small holes connecting alveoli
35
Can pneumonia spread?
Yes, but only locally through the pores of Kohn
36
What is the distinguishing feature of pneumonia on a chest CXR?
Fluffy opacities in a focal site due to the inflammatory products replacing alveolar air
37
Right lung pneumonia
38
Left lung pneumonia
39
Right upper lobe pneumonia
40
What is a pulmonary edema?
Extravasation of fluid from pulmonary capillaries into alveoli replacing the alveolar air space
41
What is the distinguishing feature of pulmonary edema on a chest CXR?
Fluffy opacities bilaterally and symmetrically favored in mid and lower chest zones because of gravity =\> basilar dependent
42
2 possible causes of pulmonary edema? Fraction of cases for each?
1. Hydrostatic: due to the capillaries being subject to increased hydrostatic pressure, fluid seeps into the alveoli, usually due to heart failure (2/3rds of cases) or could be due to fluid overload or kidney failure
2. Permeability: noncardiogenic cause but increased permeability of pulmonary capillaries (1/3rd of cases)
43
Other than the distinguishing feature, how else is pulmonary edema visible on a chest CXR?
* Batwing pattern = specific central and symmetric cloudiness pattern
* Enlarged cardiac silhouette if the cause is cardiogenic
44
Pulmonary edema with enlarged cardiac silhouette
45
Pulmonary edema with enlarged cardiac silhouette
46
What is a primary lung carcinoma?
A cancer (tumor) that originates in the lungs or the cells lining the airways as normal lung cells become cancer cells and begin to uncontrollably divide
47
How to distinguish a malignant tumor from a benign one?
A malignant one is distinguished from a benign one in that it can spread (aka metastasize) to distant sites
48
Left lower lobe primary lung carcinoma
49
Left lower lobe primary lung carcinoma
50
Left lower lobe primary lung carcinoma
51
Left lower lobe primary lung carcinoma
52
Left lower lobe primary lung carcinoma on a PET scan showing the high mitotic rate of the cells that are taking up a lot of radioactive glucose, which is indicative of cancer
53
What is the distinguishing feature of secondary lung carcinoma on a chest CXR?
Multiple bilateral masses in the lungs
54
What is the distinguishing feature of primary lung carcinoma on a chest CXR?
Large, dense ball with smooth margins
55
Secondary lung carcinoma metastisized from a colon carcinoma
56
Secondary lung carcinoma metastisized from a colon carcinoma
57
2 layers of the pleura? What is in between?
1. Visceral pleura
2. Parietal pleura
In between = pleural cavity
58
What is a lung fissure?
A cleavage of the visceral pleura
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61
Other name for minor fissure? Where is it located?
Horizontal fissure on right lung
62
What does the left major fissure divide?
Left upper lobe and left lower lobe
63
Place the left major fissure.
64
What does the right minor fissure divide?
Rigght upper lobe from right medial lobe
65
What does the right major fissure divide?
The right upper and middle lobes from the lower lobe
66
Place the right lung fissures.
67
In what lobe do the schematic objects reside?
Cannot tell for sure
68
Are the schematic objects in the right or left lobes?
Cannot tell
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71
What is a pneumothorax?
Visceral and parietal pleural are separated by air in the pleural cavity
72
When pneumothorax occurs, which pleural layer becomes visible on CXR?
The visceral pleura
73
What is the distinguishing feature of a pneumothorax on a chest CXR?
Air in pleural space is hyper black or hyper luscent and the visceral pleural edge is visible
74
Right lung pneumothorax
75
Pneumothorax
76
Left lung pneumothorax
77
Left lung pneumothorax
78
What is a pleural effusion?
Visceral and parietal pleura are separated by fluid in the pleural space
79
4 types of pleural fluids?
1. Water
2. Pus
3. Blood
4. Lymphatic fluid
80
Other name for lymphatic fluid?
Chyle
81
What is the distinguishing feature of pleural effusion on a chest CXR?
Costophrenic angles are blunted with a meniscus sign
82
Normal
83
Normal
84
Right pleural effusion
85
Pleural effusion
86
Left pleural effusion
87
Pleural effusion with meniscus sign
88
Right pleural effusion
89
Right lung pleural effusion
90
Right lung pleural effusion
91
Right lung pleural effusion
92
Left pleural effusion in supine patient
93
Left lung pleural effusion in upright position
94
Is layering of fluid visible on chest CXR with pleural effusions?
YUP
95
How can you tell if the cardiac silhouette is enlarged?
If it is greater than half the transverse diameter of one hemithorax
96
If a chest CXR shows an enlarged cardiac silhouette, how can you differentiate between cardiomegaly and pericardial effusion?
You will need an echocardiogram or a CT, the CXR alone cannot distinguish them
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Normal
98
Enlarged cardiac silhouette
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Cardiomegaly
100
Normal
101
What is cardiomegaly? Main causes?
Enlargement of the cardiac chambers
Main causes: CAD or high BP
102
Cardiomegaly
103
Cardiomegaly
104
Which is the most inferior slide?
A
105
What is a pericardial effusion?
Visceral and parietal pericardial layers are separated by fluid in the pericardial sac
106
Pericardial effusion
107
What is the size of the heart?
Cannot tell for sure
108
What is the size of the heart?
Normal, because this is a pericardial effusion
109
Pericardial effusion
110
Cardiomegaly
111
Pericardial effusion
112
3 common causes of pericardial effusion?
1. Inflammation
2. Viral infection
3. Metastatic diseases
113
Large cardiac silhouette
114
What is a lung CT specifically used to assess?
The interstitium of the lungs
