Normal CXR

Question 1

What is the most common accessory fissure of the lung?

Answer 1

Azygous fissure containing the azygous vein

Question 2

In what condition would the costophrenic angle disappear on an CXR?

Answer 2

Pleural effusion

Question 3

The right hemi-diaphragm is usually slightly higher than the left. T/F?

Answer 3

True

Question 4

What is the maximum cardio-thoracic ratio that can be normal in an adult?

Answer 4

50%

Question 5

For what group of adults would it potentially be normal to have a slightly larger cardio-thoracic ratio of 55%?

Answer 5

African American adults

Question 6

In which bronchi is aspiration more likely to occur?

Answer 6

The right main bronchus as its more vertically oriented

Question 7

Pleura are visible on an CXR. T/F?

Answer 7

False

Question 8

Teenagers tend to have a small aortic knuckle. T/F?

Answer 8

True

Question 9

If the aorta-pulmonary window bulges out, this could be a sign of…?

Answer 9

Lymphadenopathy

Question 10

The left hilar point is general higher than the right hilarity point. T/F?

Answer 10

True

Question 11

The lymph nodes in the hilum are usually visible. T/F?

Answer 11

False - these are not usually visible unless enlarged

Question 12

The posterior ribs run horizontally. T/F?

Answer 12

True

Question 13

The anterior ribs run at an angle. T/F?

Answer 13

False

Question 14

Give examples of situations in which emergency CXRs may be performed.

Answer 14

Acute respiratory symptoms
Chest pain
Septic screen
Acute abdomen
Post central line/chest drain insertion

Question 15

Give examples of situations in which elective CXRs may be performed.

Answer 15

Persistent / chronic respiratory symptoms
Pre-operative work up
Metastatic screen
TB contacts

Question 16

What is the standard view used in a CXR?

Answer 16

PA

Question 17

Where would an AP CXR be used?

Answer 17

On a ward or in the ICU

Question 18

Why do you get a better sense of the size of the heart from a PA CXR view than an AP view?

Answer 18

Because in a PA view, the heart is closer to the film

Question 19

How can the degree of inspiration on a CXR be determined?

Answer 19

By counting the ribs

Question 20

How many anterior ribs should be visible on a CXR?

Answer 20

6 anterior ribs

Question 21

How many posterior ribs should be visible on a CXR?

Answer 21

9-10 posterior ribs

Question 22

How can rotation be assessed on a CXR?

Answer 22

Look for the ‘teardrop’ shape of the spinous processes and assess their distance from each of the clavicles

Question 23

How can you determine if there is good exposure in a CXR?

Answer 23

With good exposure you shouldn’t be able to see the vertebra through the heart shallow