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BSc Medical Imaging > X ray > Flashcards

X ray Flashcards

(43 cards)

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1
Q

What is the attenuation

A

absorption of Xray based on density

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2
Q

What does black mean in Xray

A

Air/Gas

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3
Q

What does dark grey mean in Xray

A

fat

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4
Q

What does light grey mean in Xray

A

soft tissues and fluid

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5
Q

What does white mean in Xray

A

bone and calcification

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6
Q

What does bright white mean in Xray

A

Metal

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7
Q

Why might the edges of tissue be sharp

A

Movement
Imaging equipment
structure does not have a sharp edge

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8
Q

What is the most commonly requested diagnostic xray

A

chest

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9
Q

First step to interpreting an xray

A

Correct patient,

Projection of image (PA/AP)

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10
Q

What happens to the scapula in PA and AP fields

A

PA

  • scapula retracted
  • clear view of lung fields

AP

  • medial border of scapula can be seen
  • obscures part of the lung field
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11
Q

How do you assess the technical quality of a chest xray

A

Field

  • entire thorax
  • apices and first ribs to costophrenic angles
  • humeral heads included

Rotation
-medial ends of the clavicles should be equidistant from spinous processes

Inspiration

  • Deep inspiration
  • Should be at least 8-10 posterior ribs
  • 5-7 anterior ribs
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12
Q

How do you assess the penetration of the image

A

outlines of vertebral bodies should be just visible behind the heart

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13
Q

Which lung has a middle lobe

A

Right

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14
Q

What are some terms used to describe obvious abnormalities

A

Focal/diffuse

Rounded/spiculated

Well/Poorly demarcated

Single/Multiple lesion

Remember to describe other features such as lines, tubes clips, fluid levels

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15
Q

What is the systemetic review step for CXR

A

Airway
-Trachea deviated?
(tension pneumothorax = away, lung collapse = towards)

Breathing

  • full expanded chest
  • fissures

Cardiac

  • Central mediastinum (positioned over thoracic vertebrae)
  • Cardiothoracic ratio
  • Clear borders

Diaphragm

  • both visible and convex
  • free air
  • costophrenic angles
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16
Q

Why is the right hemidiaphragm usually higher

A

Liver

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17
Q

List some commonly missed areas of the lung of CXR

A 
Apices
Costophrenics
Behind heart
Underneath diagphragm
Soft tissues
Bones -  lytic lesions
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18
Q

What is the whole process of assessing CXR

Study These Flashcards
A 
Patient details
Projection
Technical quality
Obvious abnormalities
Systematic review
19
Q

What shows up as air under the left lung

Study These Flashcards
A

Gastric bubble

Pneumoperitoneum

20
Q

What is characteristic of the small intestine

Study These Flashcards
A

Plicae circulares - full width of the lumen

21
Q

What is characteristic of the large intestine

Study These Flashcards
A

Haustra - partial width of lumen

22
Q

Are gallstones radio-opaque

Study These Flashcards
A

Not really

- approx 10% are radio-opaque

23
Q

Are kidney stones radio-opaque

24
Q

Where are the kidneys on AXR

Study These Flashcards
A

lateral to psoas major
t12-L3
Right lower than left due to liver

Adrenal glands not usually visible unless calcified

25
What are the structures visible on AXR
Stomach Intestines Kidneys Liver Spleen Psoas major Pancreas - not visible unless calcification Bladder Aorta - if calcified (>3cm diameter - possible aneurysm) Bones
26
What are the CXR features of pulmonary fibrosis
``` decreased lung volume due to scarring Mediastinal shift due to volume loss Ground glass appearance Honeycombing - advanced Blurring between mediastinum and diaphragm ```
27
What are the signs of pulmonary oedema on CXR
Alveolar shadowing - oedema in the alveoli Kerly B lines 0 oedema of interlobular septa Cardiomegaly Dilated pulmonary vessels Pleural effusions
28
How do you differentiate between small and large bowel
Small bowel -plicae circulares - cross entire diameter of bowel Large bowel -haustra - cross part of the diamter NB -longitudinal taenia coli muscles
29
What is the coffee bean sign
Sign of volvulus in left iliac fossa
30
What are the most common causes of bowel obstruction
Small bowel - Adhesions Long bowel -tumour or stirctures
31
What are some signs of volvulus
Grossly distended inverted loop RUQ pointing - sigmoid, LUQ pointing - caecal Loss of haustral folds
32
Which calculi are radiopaque
Urinary calculi - 80% - contain calcium - radiopaque Biliary calculi - Cholesterol - Radiolucent --> USS more sensitive
33
What are the AXR indications
Perforation Megacolon Obstruction Foreign bodies
34
What is expressed in the caudal embryo
brachyury
35
What does a double cardiac shadow mean
Lobe collapse
36
What spinal levels do the ligaments run between
Ant long - occipital bone to sacrum - resists hyperextension Post long - C2 to sacrum - prevents posterior herniation of IV disc Ligamentum flavum -binds lamina Intertransverse -binds transverse processes
37
How do elbow dislocations occur
50% sports injury Elbow one of the most stable joints Distal humerus displaced form trochlear notch of elecranon Humerus gets driven through weaker anterior capsule
38
What indicates a cavitating mass on CXR
Fluid level
39
What does an air bronchogram signify
Tram tracks | - consolidation around an airway
40
What are the signs of bronchiectasis on XR
Thickened bronchial walls Ring shadows (thickened airways seen end-on) Volume loss secondary to mucous plugging Air-fluid levels may be visible within dilated bronchi
41
When can ascites be detected on AXR
>500ml
42
What are the radiographic features of ascites on AXR
Diffusely increased density of the abdo Poor definition of the soft tissue shadows e.g. psoas mucsle, liver, spleen Medial dispalcement of viscera and bowel Bulging of the flanks Increased separation of small bowel loops
43
How do you distinguish between right upper, middle and lower lobe consolidation
lower - diaphragmatic border isn't visible middle - heart border isn't distinguishable upper - diaphragmatic and heart border will be visible

BSc Medical Imaging (5 decks)

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