Session 10 - Lecture 1 - Radiology Flashcards

Question

26

Answer 1

A

Learning outcomes
You should be able to:-
 To understand the basic science of obtaining an image
 Describe and be able to recognise the key features of a plain film radiograph of the chest, in relation to
- Technical film factors
- Basic chest anatomy
 Understand the principles of an ABC approach to interpretation
 Describe the features of and recognise uncomplicated
- Pleural effusion
- Pneumothorax
- Consolidation
- Space occupying lesions within a lung
- Lobar collapse
- Estimate the cardiac index

Answer 2

A

Projection

PA projection
X-ray source
Direction of beam --> Posterior
Standing
Anterior
Viewed from front

AP projection
X-ray source
Viewed from front
Direction of beam --> Anterior
Sitting
Posterior

{Standard projection is PA, but pts unable to stand or doing well on ward - portable x-ray on wards, tends to be AP which alters what we see on img}

Answer 3

A

Projection - why is it important?

PA AP

{PA - lung fields nicely expanded; nice crisp heart border
AP - magnifies appearance of heart, don’t appear to have as good expansion of lung fields so can miss pathology}

Answer 4

A

Inclusion

 What do we need to see

 1st rib
 Lateral margin of ribs
 Costophrenic angle

{as long as we have all 3 of these things we have adequate coverage}

Answer 5

A

Rotation

 Alignment of:

 Spinous process
and
 Clavicles

Spinous processes
Medial clavicles

{Assess rotation by looking for nice crisp clavicles with spinous process in middle of clavicles – if pt is rotated it throws spinous process of projection to one side or other and makes one side of chest look bigger or smaller}

Answer 6

A

Lung volumes

 Inspiratory phase
 Normal
- 5th to 7th anterior ribs at MCL
 Problems with incomplete inspiration:
- Big heart
- Increased lung markings
 Exaggerated expansion
- Obstructive airways disease

Clavicle
Diaphragm
Midclavicular line
No consolidation
1 2 3 4 5 6

{If 5-7th anteiror ribs in MCL there is ADEQUATE INSPIRATORY FILM - to do this ask pts to take reasonable breath in.

May not be able to do that if unwell, or has other restrictive disease processes

OAD e.g. COPD, emphysema}

Answer 7

A

Lung volumes

Clavicle
Diaphragm
Midclavicular line
Ribs 1 2 3
Consolidation ? ?

{If not a good enough breath is taken in can’t assess the lung bases appropriately on a CXR – type of film you often get on sick pts on ward where ironically these are the ones most important to get a good CXR, but try as we might we can’t always get that.

Unable to tell if there is consolidation}

Answer 8

A

Penetration

 Degree to which the x-rays have passed through the body
 Adequate penetration
- Vertebrae just visible through heart
- Complete left hemidiaphragm is visible
 Digital manipulation often negates this

{Degree by which XR have gone through body and absorbed by XR detector/plate}