Soft Tissue Rad Exam 1 Flashcards
(115 cards)
1
Q
Column1
A
Column2
2
Q
Which type of radionuclide scanning injects radioactive particles into lungs that get trapped in the capillaries
A
Particle perfusion scintigraphy
3
Q
Which radionuclide scanning has a pt inhale the radioactive aerosol
A
Particle ventilation scintigraphy
4
Q
What’s the purpose of sonography/ultrasound & what are 3 common occurrences found w/this technique
A
To differentiate liquids vs solids Pleural effusion (MC), pleural thickening, pneumothorax
5
Q
What is an indication for bronchography
A
Bronchiectasis
6
Q
What is the most utilized imaging for the chest
A
CT
7
Q
With CT of the chest, within the mediastinum, what should you differentiate about masses
A
Cystic or solid
8
Q
When taking a CT of the lungs, what is something you should always look for
A
Primary neoplasms
9
Q
What is a downfall to MRI
A
Motion
10
Q
What is the primary purpose for an exam of sputum/specimens obtained by bronchial washings/brushing
A
Determine if there is a malignancy
11
Q
During the pathological exam, you take a needle aspiration of:
A
Pleural fluid
12
Q
What is the standard 2 view chest series in radiology
A
PA, lateral
13
Q
On a PA chest xray, how should the pt breath
A
Inhale & hold
14
Q
On a PA chest xray, what is the kVp
A
High (100-120)
15
Q
What happens to the apical vessels of lungs (bronchovascular markings) during an upright view w/inspiration
A
They have little blood flow & may collapse d/t hydrostatic pressure
16
Q
Pleura of the lungs is not normally visualized on xray, but often can be seen w/this disease
A
CHF (b/c extracardiac fluid)
17
Q
How do you know there has been adequate inspiration by the pt while taking an xray
A
You can clearly visualize the 10th post ribs w/out diaphragm interference
18
Q
MC benign tumor of diaphragm
A
Lipoma
19
Q
Where is the right hemi-diaphragm located in terms of boney landmarks
A
10 post rib, 7th ant
20
Q
Where is the left hemi-diaphragm located in terms of boney landmarks
A
11 post rib, 8th ant
21
Q
Aortic knob, costophrenic & cardiophrenic angles, diaphragm, & minor/horizontal fissure can be seen on this CXR
A
PA
22
Q
The minor/horizontal fissure is only seen on which chest view? Where is it located in terms of bony landmarks
A
PA chest T8 or 5th ant rib
23
Q
What are 2 reasons to take a PA chest view w/expiration
A
Obstruction & pneumothorax
24
Q
During a lateral chest xray, what is the breathing & kVp
A
Inspire & hold High kVp (100-120)
25
Which side is always to the film on a lateral chest xray
Left - to decrease magnification of the heart
26
What are 3 reasons to take a lateral chest xray
1 locate dz 2. Confirm presence of dz 3. See anything not seen on PA
27
The retrosternal & retrocardiac clear spaces, hilum, fissures & post sulcus can be seen on which chest view
Lateral
28
What are causes of an abnormal retrosternal clear space
Arms, anterior mediastinal tumor, aneurysm
29
What are causes of abnormal retrocardiac clear space
Cardiac enlargement/displacement, tumor, infiltrate
30
In the hilum, where are the pulmonary arteries in relation to each other
Right is in front, left is left behind
31
In the hilum, where are the upper bronchi in relation to each other
Right is higher, left is lower
32
What are 3 causes of increased hilum size
Aneurysm, tumor, lymph adenopathy
33
Where is the oblique/major fissure located in terms of bony landmarks? Which view can this NOT be seen on
Location: T5 diaphragm Not seen on PA
34
How must fissures be in relation to the xray beam in order to be seen
Parallel
35
Which fissure separates the middle & upper lobes of the right lung
Minor/horizontal fissure
36
Where is the diaphragm located on an xray in terms of bony landmarks
T12 VB
37
Which takes less fluid to fill: post costophrenic sulcus or costophrenic angles
Post costophrenic sulcus fills faster
38
Which view is best for pleural effusion? What does this view detect & which side do they lay on
Lateral decubitus - detects fluid movement, lay on side of interest
39
What is seen on the right ant oblique chest view
Right lung, retrocardiac clear space
40
What is the purpose of the Rigler Hoffman Sign
Detects enlarged LV
41
What is the MC accessory lobe seen on xray? Where is this lobe located & what causes it
Azygos, located (right MC) on top of lung & medial azygos vein doesn't migrate in utero so lobe forms
42
What sign on the diaphragm is considered a normal variant
Scalloping/eventration
43
In regards to the answer to the question above, what could be possible causes of this sign
Nerve deficiency, abnormal muscle development
44
Eventration/scalloping is MC on which hemidiaphragm
Right
45
Complete eventration is MC on which hemidiaphragm
Left
46
What is the cause of tenting of the pleura
Atelectasis (MC d/t pneumonia), inflammation occurs followed by fibrosis
47
How do you tell if there is rotation in an xray
The side person is rotated to will have increased space b/w clavicle & SP
48
Which view is used to see the lung apices & right middle lobe? How is this view taken
Apical lordotic view, taken AP
49
Air space = __________, whereas airway = _________
Alveoli; bronchi
50
What are the 2 patterns of parenchymal lung disease
Air space & interstitial
51
This parenchymal lung disease has fluid located in the alveoli
Air space
52
What does air space disease look like on xray? What are 2 signs associated w/this
Looks hazy, cloud-like, fluffy Air bronchogram sign & silhouette sign (only w/air space dz)
53
Which sign is only associated w/airspace disease & not w/interstitial
Silhouette sign
54
What are acute etiologies of air space disease
Pulmonary edema & pneumonia
55
What are chronic etiologies of airspace disease
Bronchoalveolar cell CA
56
What is the air bronchogram sign
There is air in bronchioles, which can be seen d/t surrounding airspace disease
57
What is the silhouette sign
Two tissues of the same density overlap, causing their margins not to be distinct
58
Air space disease can be in: whole lung, one segment, or a lobe?
All of the above
59
Right middle lobe causes a silhouette sign with:
Right heart border
60
Lingula (upper left lobe) causes a silhouette with:
Left heart border
61
Diaphragm causes a silhouette sign w/
Lower lung lobes
62
Right anterior upper lobe causes a silhouette sign with:
Ascending aorta
63
Apical segment of left upper lobe causes a silhouette sign with
Aortic arch
64
How does interstitial disease look on xray & where is it NOT located
Looks stringy/linear, it is NOT in alveoli
65
What are 3 patterns of interstitial disease
Reticular, nodular, reticulonodular
66
Reticular insterstitial pattern looks like:
Lines
67
Nodular insterstiail pattern looks like:
Dots/round density
68
Reticulonodular interstitial pattern looks like:
Lines & dots
69
Rheumatoid lung disease is associated w/which type of interstitial disease
Reticular
70
Nodular interstitial disease has what disease associated w/it
Bronchogenic CA, mets to lungs, miliary disease
71
What are the disease of reticulonodular interstitial disease:
Sarcoidosis, varicella zoster, lymphatic mets
72
Which gender MC has rheumatoid lung disease? What interstitial pattern is it
Males, reticular
73
Sarcoidosis stage 0
No radiographic findings
74
Sarcoidosis stage 1
Bilateral hilar "potato nodes" & paratracheal lymph adenopathy
75
Sarcoidosis stage 3
No hilar lymph adenopathy
76
Sarcoidosis stage 4
Pulmonary fibrosis (mostly of mid & upper lungs), can lead to cor pulmonale
77
What is an opacified hemithorax
One side of the thorax/chest is completely or almost completely radiopaque
78
What are 5 major causes of an opacified hemithorax
Atelectasis, pneumonectomy, massive pleural effusion, pneumonia, tumor tissue
79
What is atelectasis
Loss of volume in all or part of a lung
80
What are 2 direct signs of atelectasis on an xray
Displacement of fissures & increased density
81
What are 2 indirect signs of atelectasis on xray
Shifting on heart/mediastinum to the affected side & increased retrosternal clear space
82
What are the types of atelectasis (6)
Discoid/plate-like/segmental Compressive Obstructive Passive Adhesive Cicatrization
83
Platelike atelectasis is most likely d/t what? What is a common pt symptom?
Deactivation of surfactant Pt has splinting pain
84
Which type of atelectasis is a form of passive atelectasis
Compressive atelectasis
85
Which atelectasis is d/t SOL outside the lung
Passive
86
Which type of atelectasis is d/t scarring & contraction/fibrosis of tissue
Cicatrization
87
What is the MC type of atelectasis
Obstructive
88
Describe the S sign of golden. What does it go with
Mass in RUL bronchi + elevated minor fissure (AKA reverse S sign of golden), with atelectasis Massive pleural effusin: Fluid in pleural space acts like a mass
89
What are 3 common etiologies of massive pleural effusion? Which is MC
CHF (MC), bronchogenic CA, mesothelioma
90
What happens to mediastinal structures in massive pleural effusion
They get pushed away from the affected side
91
What are 3 causes of pleural effusion
Increased rate of fluid formation (CHF, Pneumonia) Decreased fluid resorption Peritoneal fluid moves thru diaphragm or via lymphatics
92
Which type of pleural effusion has fluid b/w the parietal & visceral pleural layers
Subpulmonic
93
The above type of effusion mimics what
Elevated hemi-diaphragm
94
What are 3 reasons the costophrenic angles may have blunting
Pleural effusion, tumor, fibrosis
95
Which costophrenic angle gets blunted first
Post costophrenic angle/sulcus
96
What sign on xray is strongly suggestive of pleural effusion? Describe
Meniscus sign - U shaped (goes up on ant & post)
97
Loculated pleural effusion has fluid located where & d/t what
Fluid in pleural space, d/t adhesions/fibrosis
98
What are vanishing/pseudotumors? What are they MC assoc w/
Collections of pleural fluid b/w layers of a fissure, assoc w/CHF
99
Where is the fluid located in laminar effusion
Band-like density across the lateral chest wall near the costophrenic angle
100
What is the MC infectious disease in the world
Pneumonia
101
What happen to mediastinal structures w/pneumonia of an entire lung
They don't shift
102
What is a complication of pneumonia that may be seen on xray
Empyema
103
What are the 5 patterns of pneumonia
Lobar, interstitial, bronchopneumonia, aspiration, cavitary
104
This pattern of pneumonia is MC assoc w/streptococcus pneumoniae
Lobar
105
This pneumonia is MC assoc w/staph aureaus
Bronchopneumonia
106
What are 2 etiologies of interstitial pneumonia? Which type of interstitial pattern does it have
Could be viral or from mycoplasma, pattern = reticular
107
Where is round pneumonia MC located
Post lungs & lower lobes
108
Which type of pneumonia is MC to occur w/post-primary (reactivation) TB
Cavitary pneumonia
109
What is a cavity
Air-filled space w/in consolidiation, mass or nodule produced by the exudate of a necrotic lesion
110
What size of cavity wall thickness indicates malignancy
>15 mm (1.5 cm)
111
What is seen on an xray of primary TB
None or ipsilateral lymphadenopathy
112
Where does post-primary (reinfective) TB have a predilection for in the lungs
Post & apical segments of upper lobes, or sup segments of upper lobes
113
Miliary TB is d/t what type of dissemination
Hematogenous (blood)
114
What does na xray look like of miliary TB
Nodular pattern - small nodules scattered throughout both lungs
115
On a pneumonectomy, how do the heart & mediastinal structures shift
Towards side lung has been removed
