Test #1 Flashcards
(117 cards)
0
Q
M/C disturbance of the diaphragm
A
Singultus (Hiccups)
1
Q
What ant/post rib level are each hemidiaphragm are located?
A
Right: 7th ant, 10th post
Left: 8th ant, 11th post
2
Q
M/C malignant tumor
A
Fibrosarcoma
3
Q
M/C benign tumor
A
Lipoma
4
Q
Where the diaphragm meets the ribs on the lat. side of the thorax
A
Costophrenic angles
5
Q
Where the left ventricle meets the diaphragm
A
Cardiophrenic angle
6
Q
What is air in the stomach called?
A
Magenblasse
7
Q
What is the SID for a lat chest xray?
A
72”
8
Q
What are the reasons to take a lat. view?
A
Locate ds
Confirm or negate presence of ds
May show ds not seen on P-A
9
Q
What are 5 key areas of a lateral chest xray?
A
Retrosternal/retrocardiac clear spaces Hilum Fissures T-spine Diaphragm & post. sulcus
10
Q
Shadows in the hilum are primarily made up of what?
A
Pulmonary Arts.
11
Q
If the hilum is increased in size what does it indicate?
A
Aneurysm
Tumor
Adenopathy
12
Q
What is the M/C reason for only 1 side of the hilum to be enlarged?
A
Bronchogenic carcinoma
13
Q
Drawing a line 2cm sup, 2cm post from diaphragm to inf. vena cava is what sign?
A
Rigler Hoffman Sign
14
Q
Which fissure located at T5, diaphragm a few cm behind the sternum?
A
Oblique/Major
15
Q
What fissure is located at the 4th ant. rib (T-8)?
A
Minor/Horizontal
16
Q
Which separates middle & upper lobes from the lower lobes?
A
Rt oblique/Major
17
Q
Which fissure separates the upper & lower lobes?
A
Rt. Minor/Horizontal
18
Q
How much fluid does it take to blunt the post. & lat. costophrenic angles?
A
75cc post.
250-300cc lats.
19
Q
What is the lat. decubitus view used for?
A
Looking for fluid/air movement (pleural effusion)
20
Q
What do you use a R ant. oblique to view?
A
Retrocardiac clear space
21
Q
What do you use a L ant. oblique view to see?
A
L lung, arch of aorta
22
Q
What are the segments of the R lung?
A
B-1: Apical B-6: Superior B-2: Anterior B-7: Med. basal B-3: Posterior B-8: Ant. basal B-4: Lateral B-9: Lat. basal B-5: Medial (R heart border) B-10: Pos. basal
23
Q
What are the segments of the L lung?
A
B-1: Apical-pos B-6: Superior B-2: Anterior B-7: Med. basal B-3: Apical-pos B-8: Ant. basal B-4: Sup. lingual B-9: Lat. basal B-5: Inf. lingual B-10: Pos. basal
24
What is the sagittal dimension of the thoracic cage from T8 to sternum in males? Females?
Males: 11-18cm
Females: 12-15cm
25
What is the M/C accessory lobe seen on x-ray?
Azygos lobe (anomalous development of azygos vein)
26
Which lung is an azygos lobe seen in?
R lung
27
Eventration/Scalloping of the diaphragm can be caused by what?
Abnormal muscle development
| Nerve deficiency
28
Eventration/Scalloping of the diaphragm is M/C on which side?
Right (if partial, complete on Left)
29
Peak-like pulling on the pleura d/t fibrosis is called what?
Tenting
30
What is the M/C cause of tenting?
Viral Pneumonia
31
What are the 5 technical factors for a Chest AP?
```
Penetration
Inspiration
Rotation
Magnification
Angulation
```
32
What are two indicators that an CXR is under exposed?
May not see L hemidiaphragm
| Blood vessels appear prominent
33
What are two indicators a CXR is overexposed?
Lung markings look decreased/absent
| Can hide subtle lesions
34
What can you see if a pt has proper inspiration on a CXR?
10th pos. ribs on both sides
35
Why is the standard upright view CXR taken P-A?
To decrease magnification of the heart
36
What is the preferred view to view lung apices?
Apical lordotic view
37
What t.t. is used for an apical lordotic view?
30deg cephalad
38
Lung zone above the clavicle is called what?
Apical zone
39
Lung zone b/w inf. margin of clavicle & above the hilum is called what?
Upper zone
40
Lung zone that contains the hilum is called what?
Middle zone
41
Lung zone that contains everything below the hilum is called what?
Lower zone
42
The cords b/w the alveoli are called what?
Kahn
43
Cords b/w the alveoli to bronchi/bronchioles are called what?
Canals of Lambart
44
What are the 2 primary patterns of parenchymal lung disease?
```
Air Space (alveolar)
Interstitial (infiltrative)
```
45
Air space/alveoli lung disease indicates what?
Fluid is in the alveoli
46
What are acute etiologies of airspace ds?
```
Penumonia (bacteria)
Pulmonary edema
Hemorrhage
Aspiration
Near-drowning
```
47
What are some chronic etiologies of airspace ds?
Bronchoalveolar cell CA
Alveolar cell proteinosis
Sarcoidosis (great imitator of lung ds)
Lymphoma
48
What is an air bronchogram sign?
Visualization of air in the bronchus (airways) b/c of surrounding airspace ds.
49
When two objects of the same radiographic density touch each other so that the edge or margin b/w them is not seen creates what sign?
Silhouette sign
50
The R heart border forms a silhouette sign w/ what?
R middle lobe
51
The L heart border forms a silhouette sign w/ what?
Lingulas of the L upper lobe
52
The diaphragm forms a silhouette sign w/ what?
Lower lobes (specifically costophrenic angles)
53
The ascending aorta forms a silhouette sign w/ what?
Ant. segment of the R upper lobe
54
The aortic arch forms a silhouette sign w/ what?
Apical segment of the L upper lobe
55
What are the 3 patterns of interstitial ds?
Reticular
Nodular
Reticulonodular
56
What are examples of interstitial ds w/ a reticular pattern?
Pulmonary Interstitial Edema
Idiopathic Pulmonary Fibrosis
Rheumatoid Lung ds
57
What are examples of interstitial ds w/ a nodular pattern?
Bronchogenic CA
Metastasis to the lung
Miliary ds
58
What are examples of interstitial ds have a reticulonodular pattern?
Sarcoidosis
| Rheumatoid lung ds
59
Atelectasis of the entire lung is usually d/t what?
Complete main stem bronchus obstruction
60
In atelectasis, do the heart & medial structures shift toward or away the affected side?
Shift toward (trachea is typically last structure to shift)
61
What are 2 direct indicators of atelectasis?
Displacement of fissures
| Increased density
62
What are 4 indirect indicators of atelectasis?
Shift of structures
Over inflation of unaffected lobes/lung
Increased retrosternal clear space
Depression of hemidiaphragm
63
Type of atelectasis most likely d/t deactivation of surfactant-collapse of airspaces in a nonsegmental or nonlobar pattern. Pt's have splinting pain. Mimics fibrosing.
Subsegmental/Discoid/Platelike
64
A form of passive atelectasis. D/t SOL w/i the lung & compresses the adjacent tissue
Compressive
65
What is the M/C type of atelectasis?
Obstructive
66
Atelectasis caused by space occupying mass or lesion outside of the lung
Passive
67
Type of atelectasis d/t decreased surfactant production
Adhesive
68
Type of atelectasis d/t scarring & contraction of tissue
Cicatrization
69
Type of atelectasis assoc. w/ the "S sign of Golden."
RUL atelectasis
70
In massive pleural effusion, do medial structures move towards or away from affected side?
Structures are moved away
71
What are causes of pleural effusion?
Increased rate of fluid formation (CHF, pneumonia)
Decreased rate of fluid resorption by lymphatics
Peritoneal fluid moves through diaphragm or via lymphatics
72
What is the view of choice for pleural effusion?
Lat. decubitus view
73
Type of effusion where the fluid is b/w the p. pleura along the diaphragm & v. pleura under the lower lobe. Mimics elevated hemidiaphragm. Misplaced Magenblase.
Subpulmonic Effusion
74
What is ddx for blunting of the costophrenic angle?
Pleural effusion
Tumor
Fibrosis
75
This sign is d/t the elastic recoil of the lungs, the fluid appears to rise higher along the lat. margin of the thorax than medially on the PA view.
Meniscus sign
76
Meniscus sign is strongly suggestive of what ds?
Pleural effusion
77
Type of pleural effusion where the fluid b/co trapped in the pleural space d/t adhesions/fibrosis. Doesn't change w/ pt. positioning.
Loculated pleural effusion
78
These are sharply marginated collections of pleural fluid b/w the layers of a fissure or in a subpleural location just beneath the fissure. M/C cause is CHF.
Vanishing/pseudo tumors
79
This is a band-like density along the lat. chest wall near the costophrenic angle. Lat. costophrenic angle tends to remain sharp. M/C d/t CHF or lymphatic metastasis.
Laminar effusion
80
What are indicators of pneumonia of an entire lung?
Positive air bronchogram sign
No shift of mediastinal structures
Symptoms related to pneumonia
81
What are indicators of a pneumonectomy?
Medial structures shift toward side of removal
| Evidence of surgery (ribs, staples)
82
What is the M/C infectious ds in the world?
Pneumonia
83
Outcome of pneumonia depends on what factors?
Causative organism
Pt age
Predisposing illness
84
What are the different patterns of pneumonia?
```
Lobar
Interstitial
Bronchopneumonia
Round
Cavity
```
85
What is the M/C cause of lobar pneumonia?
Strep pneumoniae
86
What is the M/C cause of bronchopneumonia?
Staph. aureus
87
Round pneumonia is M/C in what parts of the lungs?
Post. lungs
| Lower lobes
88
Round pneumonia is caused by what organisms?
H. influenza
Streptococcus
Pneumonococcus
89
What is the M/C cause of cavity pneumonia?
Mycobacterium tuberculosis
90
Cavity pneumonia is M/C in what condition?
Post-primary (reactivation) TB
91
Type of pneumonia that has an air filled space w/i consolidation, mass or a nodule produced by the expulsion of the necrotic part of the lesion via the bronchial tree.
Cavity pneumonia
92
This ds is 2nd only to HIV/AIDS as the greatest killer in the world d/t a single infectious agent
Tuberculosis
93
Type of TB that is M/C in children
Primary TB
94
Primary TB M/C'ly affects which lobes?
```
Upper lobes (M/C)
Sup. segments of lower lobes
```
95
In TB, hilar lymph node calcification combined w/ a Ghon tubercle creates what?
Ranke (Primary) Complex
96
Type of TB that is M/C in adults as a reactivation or continuation of the primary ds
Post Primary (Reinfective) TB
97
Post Primary TB has a predilection for which lobes?
Pos. & apical segments of the upper lobes
| Sup. segments of the upper lobes
98
Type of TB d/t hematogenous dissemination. Uncommon.
Miliary TB
99
What are causes of miliary TB?
Severe immunodepression during post-primary infection
| Impaired defenses during primary infection
101
Type of pneumonia that occurs in the most dependent portions of the lung; upright = lower lobes, recumbent = sup. segments of lower lobes or post. segments of upper lobes
Aspiration pneumonia
102
What are the 4 terrible T's assoc. w/ the ant. mediatstinum (M/C mediastinal lesions)?
Teratoma
Thyroid
Thymoma
T-cell Lymphoma
103
What is the M/C middle mediastinal lesion?
Bronchogenic cyst
104
What are common causes of bilateral depressed/low diaphragm?
COPD
Bilateral pneumothorax
Asthenic build (tall, slender people)
105
What is the M/C tumor of the pleura?
Mesothelioma
106
What is the M/C cause of pleural effusion?
CHF
107
Pleural thickening is M/C in what part of the lung?
Lung bases
108
What is the M/C cause of pleural fibrosis?
Asbestosis
109
What is the only benign tumor to originate in the pleura?
Pleural Fibroma
110
Platelike atelectasis is M/C where in the lung?
Lung base
111
What is the cause of platelike atelectasis?
Obstruction of small subsegmental bronchus
112
This is an anomalous budding of primitive foregut which b/co separated from the tracheo-bronchial tree
Congenital Bronchogenic Cysts
113
Chronic, irreversible dilation of airspaces distal to the terminal bronchiole w/ assoc. destruction of their walls
Emphysema
114
Parenchymal collections of air d/t advanced tissue destruction
Bullae
115
What is a complication assoc. w/ a bullae that ruptures?
Spontaneous pneumothorax
116
Collection of air w/i visceral pleura
Bleb
117
What are 3 types of bronchiectasis?
Cylindrical
Varicose
Saccular
