Test 4 Flashcards
(98 cards)
1
Q
What is the rule of 6 when it comes to estimating how far to tape the ETT?
A
Convert lbs to kg, then add 6
2
Q
How do you treat a pneumothorax of less than 25%?
A
100% Oxygen
3
Q
What is the minimum flow range for the OxyHood?
A
7 LPM
4
Q
What is the best flow range for the OxyHood?
A
10-12 LPM
5
Q
What causes PIE?
A
- The use of high PEEP and PIP
- Prolonged inspiratory times
6
Q
What is another name for bronchopulmonary dysplasia (BPD)?
A
Neonatal Chronic Lung Disease
7
Q
How long does long term exposure to high concentrations of O2 lead to BPD?
A
Causes edema and thickening of the alveolar membrane
8
Q
What is another name for pulmonary dysmaturity?
A
Wilson-Mikity Syndrome
9
Q
Pulmonary dysmaturity is similar to BPD with the exception of what?
A
The infant has NOT been ventilated
10
Q
If both parents are carriers of CF, what is the likelihood of the child being a carrier?
A
50%
11
Q
If both parents are carriers of CF, what is the likelihood of the child having CF?
A
25%
12
Q
If both parents are carriers of CF, what is the likelihood of the child being CF negative?
A
25%
13
Q
What are the four densities that are distinguished on CXR?
A
- Air (black)
- Bone (white)
- Fluid (gray)
- Tissue (grayer)
14
Q
What are the radiologic findings for the following disease?
Respiratory Distress Syndrome
A
- Fine reticulogranular patterns
- Ground glass or a frosted glass appearance
- Bilateral opaque white density or “white-out”
- Air bronchograms
- No pleural fluid
15
Q
What are the radiologic findings for the following disease?
Atelectasis
A
- Elevated diaphragm on affected side
- Mediastinal shift towards affected side
- Decreased intercostal spaces
- Possible hyperinflation of the adjacent lung lobes or of the opposite lung.
16
Q
What are the radiologic findings for the following disease?
Transient Tachypnea of Newborn
A
- Possible hyperaeration
- Small amount of pleural fluid
- Symmetrical, stringy infiltrates in the hilar region
17
Q
What are the radiologic findings for the following disease?
Neontal pneumonia
A
- Diffuse lung markings
- Excessive pleural fluid
- Consolidation
18
Q
What are the radiologic findings for the following disease?
Meconium Aspiration Syndrome
A
- Bilateral infiltrates
- Evidence of air trapping
- Atelectasis distal to the occlusion
- Pleural effusion
- Signs of edema and inflammation
19
Q
What is the purpose of X-rays?
A
- To confirm pathologic processes related in history or physical
- Evaluate placement of tubes and lines
- Observe progression of disease or effectiveness of therapy
20
Q
In order to fully visualize an abnormality in the chest of a patient what two views are required?
A
- Frontal (PA)
- Lateral view
21
Q
For patients who cannot leave the bed, what view is done?
A
AP view
22
Q
On patients who can stand and walk, what CXR view is taken?
A
PA view
23
Q
What is the preferred chest x-ray view on any newborn or intubated pediatric patient?
A
AP
24
Q
The heart lies more _______ in the chest, it will appear ________________ on an AP film than PA.
A
anterior ; larger
25
What does frontal views help identify?
Whether an abnormality is on the right or left side of the chest
26
What does lateral views help identify?
Abnormalities position (anterior or posterior)
27
A heart may appear to be enlarge if the distance is greater than ____ feet from the target.
6
28
In a neonate, where is the carina?
Near the level of the third vertebrae
29
By age 10, where is the carina typically at?
Near the level of the fifth vertebrae
30
The thymus is a gland located in the **mediastinum** extending from the lower edge of the thyroid gland in the neck near which rib?
Fourth
31
On an x-ray, the thymus appears what?
Less dense than the heart, but more dense than lung tissue.
32
The size of the thymus in relation to rest of body is largest at what age?
Two
33
The thymus is often triangular shaped and is called the "________________________."
Sail sign
34
The thymus is often confused with the heart border and can even appear as _______________.
Upper lobe atelectasis or pneumonia
35
The heart should be centered but slightly to the:
a. Left
b. Right
a. Left
36
If a stomach bubble is present, which side should it be on?
Your right as you look at the film
37
What does it mean when the spaces between the vertebrae are not visible?
Too little energy was used; underexposed film
37
Many normal infants have been misdiagnosed as having a __________________, when the only issue was an upside-down film.
Diaphragmatic hernia
37
What does it mean when the intervertebral spaces are excessively dark?
Too much energy was used; overexposed film
38
On an inspiratory x-ray, the diaphragm should be at or below which rib?
Ninth
39
What does it indicated if the diaphragm is near or below the tenth rib?
Overdistention or hyperaeration
40
On an expiratory x-ray, the diaphragm will be at the level of which rib?
Sixth or seventh
41
Hyperaeration will cause the ribs to appear __________________________ or the chest to be _______________.
Flattened; "bell" shaped
42
What is one common method used to evaluate the ribs?
Start the examination at the posterior portions of the ribs first, then proceed to anterior. The examination is finished by examining the lateral aspects of each rib.
43
The diaphragm should be ______-shaped on **both sides.**
Dome-shaped
44
Which side of the diaphragm is usually one rib higher than the other and why?
Right higher than the left. Liver pushing the diaphragm upward.
45
What may causes blunting of the costophrenic angles?
Fluid in the pleural spaces
46
What does it mean if the right diaphragm is not slightly higher than the left?
May be a water density in the lung adjacent to the diaphragm
47
A large air bubble in the stomach and excessive air in the bowel are indicative of what?
Gastric distention
48
What can excessive distention in the stomach do to ventilation?
Decrease ventilation of the neonate by pressing upward against the diaphragm
49
The liver should **not** be more than __________ cm below the rib cage.
1-1.5 cm
50
A liver that is **1-1.5 cm** below the rib cage is suggestive of what?
Blood engorgement resulting from right-sided heart failure.
51
The tip of the UAC should lie where?
Between the seventh or eighth thoracic vertebrae or between the third and fourth lumbar vertebrae
52
The UAC is positioned in the ________, just above the diaphragm.
Interior vena cava
53
The cardiac silhouette should be less than ____% of the thoracic width.
60%
54
What does a cardiac silhouette larger than 60% imply?
Enlarged heart
55
The area where the trachea splits and enters both lungs is called the ____.
Hilum
56
Excessive vascularity is seen in ___________.
CHF and certain congenital heart malformations.
57
Undervascularity is seen in what?
Right-to-left shunting, resulting in decreased pulmonary blood flow
58
The trachea often deviates slightly to the _____, but should always be located near the center.
Right
59
A trachea that is deviated significantly may indicate what?
- Atelectasis
- Pneumothorax
- Tension pneumothorax
60
In the presence of atelectasis, which way will the trachea deviate?
Toward affected side
61
In the presence of pneumothorax, which way will the trachea deviate?
Away from affected side
62
What is the most common lung disease found in infants?
RDS
63
TTN is thought to be partially caused by?
Retention of fetal lung fluids from nonvaginal births
64
Radiographically, if seen within the first few hours of life, TTN may closely resemble _____.
Hyaline membrane disease (RDS)
65
An important point in distinguishing TTN from other causes of respiratory distress is that ______.
Infiltrates clear rapidly, often within 24 hours.
66
Often, pneumonia is diagnosed in a normal _______ lobe.
Right-lower lobe, due to prominence of vessels and airways on the CXR at that location, giving the appearance of consolidation
67
What are the radiologic findings for the following disease?
**Diaphragmatic Hernia**
- Presence of stomach and bowel loops in the left thoracic cavity
- Severe deviation of the mediastinal structures and its contents away from the side of the hernia
68
Roughly **80-85%** of diaphragmatic hernias occur on which side?
Left
69
A **diaphragmatic hernia** is almost always accompanied by what?
Severe respiratory distress and a flat or sunken abdomen (scaphoid).
70
What are the radiologic findings for the following disease?
**Congenital Lobar Emphysema**
- Single lobe becomes overdistened and emphysematous
- Remaining lung is atelectatic
- Depression of diaphragm and displacement of mediastinum to opposite side
71
What are the radiologic findings for the following disease?
**Pneumothorax**
1. No lung markings
2. Border of the lung seen as a white line
72
Radiographically, a ____________ is identified when the lung is displaced away from the chest wall by a dark (black) band of air.
Pneumothorax
73
What are the radiologic findings for the following disease?
**Tension pneumothorax**
1. No lung markings
2. Border of the lung seen as a white line
3. Depressed diaphragm on affected side
4. Wide intercostal spaces
5. Mediastinal shift away from pneumothorax
74
What are the radiologic findings for the following disease?
**Pneumoperdicardium**
1. Air completely surrounds the heart
2. "Halo"
75
What are the radiologic findings for the following disease?
**Pneumomediastinum**
1. Air surrouds lateral sides of the heart
76
What are the radiologic findings for the following disease?
**Pulmonary Interstitial Emyphsema**
1 Atelectasis
2. Small dark streaks and cysts
3. Looks like black paint flicked onto white background
4. Sponge-like appearance
5. Ground hamburger with air in it
77
What is PIE caused by?
Air leaking from a lung rupture and migrating throughout the lung parenchyma
78
**What stage of BPD is this?**
Appearance similar to ARDS. Occurs 2-4 dayd following delivery.
Stage I
79
**What stage of BPD is this?**
RDS appearance changes to coarse, irreularly shaped densities.
Occurs. 4-10 following delivery.
Stage II
80
**What stage of BPD is this?**
Small cysts are now arranged in generalized patterns. Fibrotic areas show up as irrugular white streaks throughout the lungs. Occurs 10-20 days following delivery.
Stage III
81
**What stage of BPD is this?**
The lung field has a "bubbly" appearance caused by continued enlargement of the cysts. Signs of chronic air trapping with low set flattened diaphragms.
Stage IV
82
What are the radiologic findings for the following disease?
**Foreign Body Aspiration**
1. Air trapping and atelectasis distal t offending object
2. Diminished lung volume distal to the objet
3. Hyerlucency in areas distal to the object
83
What are the radiologic findings for the following disease?
**CF**
1. Consolidation
2. Cystic changes
3. Fibrosis
4. Thickening of peribronchial cells
84
What are the radiologic findings for the following disease?
**Asthma**
1. Hyperinflation
2. Depressed diaphragm
3. Hyperlucency of both lungs
4. Bulging at the intercostal margins
85
How does epiglottitis look on a chest x-ray?
Thumb sign
86
Is the epiglottitis supraglottic or subglottic?
Supraglottic
87
How does croup look on a chest x-ray?
Hour glass; steeple
88
Is croup supraglottic or subglottic?
Subglottic
89
What is the mortality rate of ARDS?
30%
90
True or false.
CPAP is a mode of oxygenation and ventilation.
True
91
What is the most effective CPAP delivery device?
Mask, good seal
92
How do you treat a mild case of croup?
Cool mist
93
Define liable hypoxemia.
Significant change in O2 saturation with no changes in ventilator settings or FiO2.
94
Where is PPHN most often seen?
Term or postterm infants
95
What test helps diagnose PPHN?
1. Hyperoxia test
2. Pre and post ductal measuring
3. Hyperoxia-hyperventilation test **is the most accurate.**
96
What is the most dangerous cause of asphyxia?
Bradycardia
