Radiology of Chest and Pleura Flashcards Preview

ESA 3 - Respiratory System > Radiology of Chest and Pleura > Flashcards

Flashcards in Radiology of Chest and Pleura Deck (58):
1

Label this chest x-ray 

 

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  1. Trachea
  2. Hila 
  3. Lungs
  4. Diaphragm
  5. Heart
  6. Aortic knuckle
  7. Ribs
  8. Scapulae 
  9. Breasts
  10. Stomach

 

2

Label this diagram

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  • A - Right main bronchus 
  • B - Trachea
  • C - Aorta
  • D - Left main bronchus 
  • E - Carina 

 

3

What happens at the carina? 

The right and left main bronchus join 

4

Label this diagram

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  • A - Costophrenic recess
  • B - Costophrenic angle 

 

5

What is this radiograph showing? 

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A lobar collapse 

6

What is the radiological indicator of lobar collapse? 

Displacement of the horizontal fissure

7

When is the horizontal fissure displaced upwards? 

If there is volume loss of the right upper lobe (i.e. in a collapse)

8

When is the horizontal fissure displaced downwards? 

If there is volume loss of the right lower lobe (i.e. in a collapse)

9

What is this radiograph showing? 

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Consolidation 

10

How can consolidation be identified on a radiograph? 

Compare the middle zones 

11

When is the lung said to be consolidated? 

If the alveoli and small airways fill with dense material 

12

What may consolidation be due to? 

  • Infection 
  • Fluid
  • Blood
  • Cells 

 

13

What may cause consolidation in infection? 

Pus 

14

When may consolidation due to infection occur? 

In pneumonia 

15

When may consolidation due to fluid occur? 

Pulmonary oedema 

16

When may consolidation due to blood occur? 

Haemorrhage 

17

When may consolidation due to cells occur? 

Cancer 

18

What happens on an x-ray if an area of the lung is consolidated? 

It becomes dense and white 

19

How can you tell if larger airways have been spared in consolidation of the lung? 

They are of relatively low density, and therefore appear blacker on a x-ray

20

What is the phenomenon whereby the x-ray of a patient with consolidation appears dense and white known as? 

Air bronchogram 

21

What is being shown in this diagram? 

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A large, round, thick-walled lung cavity 

22

What has caused the cavity in this x-ray? 

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Squamous cell lung carcinoma 

23

What is being shown in this x-ray? 

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Pleural effusion

24

What is a pleural effusion? 

A collection of fluid in the pleural space 

25

Where does fluid gather in a pleural effusion? 

In the lowest part of the chest, depending on the patient's position 

26

What will be shown on an x-ray of a patient with pleural effusion if the x-ray is taken when the patient is standing? 

The pleural effusion will obscure the costophrenic angle/hemidiaphragm 

27

When is a pleural effusion difficult to see on a x-ray? 

When the patient is supine 

28

Why is a pleural effusion difficult to see on a x-ray when the patient is supine? 

Because the pleural effusion layers along the posterior aspect of the chest cavity 

29

How do pleural effusions appear on x-rays? 

Uniformly white, with the Meniscus sign 

30

What is the Meniscus sign? 

A concave area on the top of a pleural effusion, shown on x-ray 

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31

When does a pneumothorax form? 

When there is air trapped in the pleural space 

32

Why may a pneumothorax occur? 

  • May occur spontaneously 
  • May occur as a result of underlying lung disease 
  • Trauma 

 

33

How does trauma cause a pneumothorax?

Laceration of the visceral pleura by a fractured rib 

34

When is a pneumothorax a medical emergency? 

When it is a tension pneumothorax

35

What is a tension pneumothorax? 

If there is tracheal or mediastinal shift away from the pneumothorax, the pneumothorax is said to be under tension

36

What pushes the trachea in a tension pneumothorax? 

Air in the pleural cavity 

37

Why is the left hemithorax black in a x-ray of a tension pneumothorax? 

Because of air in the pleural cavity 

38

What are the signs of a tension pneumothorax on an x-ray? 

Illustrate these signs on an x-ray

  • The lung lung is completely depressed (arrowheads)
  • The trachea is pushed to the right (arrow)
  • The heart is shiften to the contralateral side, and the right heart border is pushed to the right (red line)
  • The left hemidiaphragm is depressed (yellow line)

 

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39

What should you do if you diagnose a pneumothorax clinically? 

Treat the patientdo not request an x-ray to confirm

40

What is shown in this x-ray? 

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Trachael displacement 

41

Label this x-ray

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  • A - Soft tissue mass
  • B - Tracheal shift 
  • C - Spinous process
  • D - Medial clavicles 

 

42

When may the trachea not genuinely be displaced to one side? 

If the patient is rotated 

43

What should you do if the trachea is displaced to one side?

Try to establish if it has been pushed or pulled by a disease process

44

What will push the trachea and mediastinum away from it? 

Anything that increases pressure or volume in one hemithorax 

45

Give 3 examples of things that may push the trachea and mediastinum away from it 

  • Tension pneumothorax
  • Pleural effusion 
  • Tumour 

 

46

What will pull the trachea towards it? 

Any disease that causes loss of volume in one hemithorax 

47

Give two examples of things that may pull the trachea towards it? 

  • Collaped lung 
  • Fibrosis 

 

48

What is this x-ray showing?

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Calcified asbestos related pleural plaques 

49

Are asbestos plaques malignant or benign?

Generally considered to be benign 

50

What is the characteristic apperance of asbestos plaques?

  • Irregular
  • Well-defined
  • Classically said to look like holly leaves

 

51

What does this x-ray show?

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Lung hyper-extension 

52

What can lead to hyperinflation of the lungs?

COPD

53

What does lung hyper-expansion lead to on an x-ray?

  • Blunting of both costophrenic angles 
  • Flattened hemidiaphragms 

 

54

What condition is shown in this x-ray? 

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Pneumoperitoneum 

55

What is seen on x-ray with a pneumoperitoneum?

Lungs are normal, but air is seen under the diaphragm 

56

What is pneumoperitoneum a sign of?

Bowl perforation 

57

What is measured when calculating the cardiac index (cardiothoracic ratio)?

The widest part of heart and ribcage 

58

When is the heart said to be enlarged?

If the heart is over 50% the width of the thorax