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800 > Week 9 (CXR) > Flashcards

Week 9 (CXR) Flashcards

1
Q

Air/gas appear

A

Black

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2
Q

Fat, soft tissues and water appear

A

Gray

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3
Q

Bone and metal appear

A

White

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4
Q

Patient and film details consists of

A

Labels (name, date, MRN)
Orientation
Projection (PA/AP)

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5
Q

Film quality consists of

A

Exposure
Inspiratory effort
Patient position

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6
Q

Extrathoracic/thoracic consists of

A 
Soft tissues
Thoracic cage (bones)
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7
Q

Intrathoracic consists of

A

Mediastinum (trachea, hila, heart)
Diaphragms (shape, angles, position)
Lung fields (boundaries, markings, fissures, zones)

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8
Q

Lines and attachments consist of

A

Drips, drains, tubes, foreign bodies

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9
Q

Patient and film details: PA projection

A

Rays pass from back to front
Patient usually standing
Ideal view

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10
Q

Patient and film details: AP projection

A

Rays pass from front to back
Patient usually sitting but can be supine
Less ideal view
Magnification of heart and widening of the mediastinum especially supine film

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11
Q

Exposure: correct penetration

A

Should just see IV discs behind the heart but can see them easily behind the trachea
All air filled structures should have appropriate amount of translucency

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12
Q

Exposure: over penetration

A

Can see IV discs behind the heart easily
Overall, film is more translucent
May miss problems that should show up as white/opaque

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13
Q

Exposure: under penetration

A

Can’t see IV discs behind the heart or trachea
Overall, film is more opaque
Might over-diagnose problems

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14
Q

Exposure: inspiratory effort

A

X-rays are taken at end of full inspiration and extent of inspiration can be measured by counting ant and post ribs. Deep inspiration:

  • 6th ant rib intersect diaphragm at mid-clavicular line
  • 9-10 post ribs about the diaphragm
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15
Q

Exposure: patient position

A

Good: medial ends of clavicles should be equidistant from spinous process
Bad position: some rotation of trunk probably evident when film was taken making normal CXR appear abnormal

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16
Q

Extra-thoracic/thoracic structures: soft tissue

A
  • Breast shadows

- Soft tissue: excess adipose, subcutaneous emphysema (air in soft tissues around thorax)

17
Q

Extra-thoracic/thoracic structures: thoracic cage

A

Bones of thoracic cavity should be checked for major abnormalities:

  • Vertebral column: scoliosis, kyphosis and rib orientation
  • Ribs: fractures and osteoporosis (appear more translucent)
18
Q

Intrathoracic: mediastinum

A
  • Trachea: translucent tube visible initially above clavicles
  • Hila: L hilum lies about 1cm higher and slightly smaller than R
  • Heart shadow: should not exceed 50% of the diameter of the thorax. 2/3 of the heart should sit L to midline, 1/2 to the R.
19
Q

Intrathoracic: lung fields

A
  • Lung markings: fine white lines should extend all the way out to the edge of the chest wall from hilar region to periphery
  • Horizontal fissure: visible in about 50-60% of normal adults. Seen as white hair like shadow at level of ant 4th rib running towards centre of R hilum
  • Rest of lung: upper zone; above 2nd ant rib, mid zone; between 2nd ant rib and 4th ant rib, lower zone; below 4th ant. rib
  • Increased translucency: lung fields appear darker
  • Increased opacity: lung fields appear whiter
20
Q

Intrathoracic: lines and attachment

A

Tracheostomy tube, oxygen tubing, central line, nasogastic tube, chest drains, surgery stables or wires, valve replacements, heart pacemaker box and pacemaker wires, swan ganz catheter, ECG electrodes and leads

21
Q

Symmetrical hila indicates

A

Pulmonary hypertension

22
Q

Shifted/rotated heart shadow indicates

A

Collapse of adjacent lung tissue

23
Q

Intrathoracic: diaphragm

A
  • Shape: dome
  • Position: L (stomach) lobe slightly lower than R (liver)
  • Angles: acute, clear and symmetrical
24
Q

Elevation of diaphragm indicates

A

Collapse on affected side, phrenic nerve damage, collection in abdomen, person didn’t/couldn’t take in deep breath

25
Q

Flattening of diaphragm indicates

A

Normally in singers, pathologically in hyperinflation e.g. emphysema

26
Q

Lung markings do not occur all way to periphery indicates

A

Pneumothorax

27
Q

Lung fields appear more translucent indicates

A

Emphysema/hyperinflation
Pneumothorax
Mastectomy

28
Q

Lung fields appear more opacity indicates

A

Consolidation, pleural effusion or masses, cavities

29
Q

Consolidation is

A

Fluid in the airspaces of the lungs

30
Q

Collapse is

A

Loss of air in the alveoli

31
Q

Pleural effusion is

A

Liquid in the pleural space

32
Q

Pneumothorax is

A

Air in the pleural space

33
Q

Tension pneumothorax is

A

Air enters pleural space during inspiration but cannot leave during expiration

34
Q

Emphysema is

A

Over-inflation of the alveoli causing SOB

35
Q

Signs of consolidation on CXR

A
  • Increased opacity
  • Air bronchogram
  • Silhouette sign
36
Q

Signs of collapse on CXR

A
  • Macro atelectasis

- Micro atelectasis

37
Q

Signs of pleural effusion on CXR

A
  • Increased opacity
  • Blunting of costophrenic angle
  • Meniscus sign
  • Distinct fluid line
38
Q

Signs of pneumothorax on CXR

A
  • Visible visceral pleural edge

- Lateral to this edge no vascular markings are visible

39
Q

Signs of emphysema on CXR

A
  • Hyperinflation

800 (12 decks)

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