Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 Clin Skills > X-Ray interpretation > Flashcards

X-Ray interpretation Flashcards

(72 cards)

Start Studying
1
Q

What anatomy can you see on a CXR?

A 
Trachea
Hila
Lungs
Diaphragm
Heart
Aortic knuckle
Ribs
Scapulae
Clavicles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the structure of interpreting CXR’s?

A 
Confirm details
Assess image quality
Obvious abnormalities
ABCDE approach
Review areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What pt details are important?

A

Projection
Name, DOB, ID no.
Date and time
Previous films

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you look for when assessing image quality?

A

Rotation
Inspiration
Projection
Exposure

‘Well inspired, non-rotated, well penetrated Xray with adequate exposure’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you assess rotation?

A

Medial aspect from each clavicle should be equidistant from spinous processes

Spinous processes should be vertically orientated against the vertebral bodies and lie halfway between the clavicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you asses inspiration?

A

5-6 anterior ribs
10 posterior ribs
Costophrenic angles and lateral rib edges should be visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do you check re projetion?

A

AP or PA

Should be labelled but if not labelled assume PA

AP - scapula within lung field and enlarged mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does projection matter?

A

Size of the heart will be different

Larger on AP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is important re exposure?

A

Left diaphragm should be visible to the spine
Vertebrae should be visible behind the heart
Make sure there is adequate penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How should you describe the obvious abnormalities?

A

Site? - which lung, which lung lobe/part?

Size?

Shape? - round, diffuse, well/poorly demarcated, focal, diffuse

Density? - more or less compared to surrounding tissue

Texture? - uniform or heterogenous

Number and distribution? - single/multiple or focal/widespread

Other features? - fluid levels, air bronchograms, bony changes, equipment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is A in the A-E approach?

A

Airway

Trachea? - central or deviating
Pushing or pulling

Carina

Lung hilar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes deviation away from the lesion?

A

Pleural effusion
Mass
Tension pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes deviation towards from the lesion?

A

Volume loss e.g. consolidation or collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the differences between the right and left bronchus?

A

Right bronchus is wider than left

Foreign objects usually go via the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is the carina significant?

A

Where left and right bronchi form

Landmark for NG tube placement

NG should bisect the carina, you know it is not in the airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What comprise the lung hilar?

A

Major bronchi
Pulmonary vessels
Lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What causes lung hilar enlargement?

A

malignancy (unilateral), sarcoidosis (bilateral_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is B in the A-E assessment?

A

Breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you assess breathing?

A

Lung fields

Start in apices, work down to costophrenic angles

Compare both lungs as you do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do marking indicate?

A

Increased air space shadowing - consolidation

Absence of markings - pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Give an example of how you would describe consolidation?

A

Large area of patchy air space shadowing near the right border of the heart

Suggestive of consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is C in the A-E assessment?

A

Cardiac
Heart size and borders
‘cardiothorocic ratio and cardiophrenic angle’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do we assess heart size?

A

heart should occupy no more than 50% of the thoracic width

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What conditions can cause cardiomegaly?

A

HF, valvular heart disease, cardiomyopathy, pulmonary hypertension and pericardial effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do we assess heart borders?
Well-defined The right atrium makes up most of the right heart border. The left ventricle makes up most of the left heart border.
26
What is reduced definition of the right heart border commonly associated with?
typically associated with right middle lobe consolidation
27
What is reduced definition of the left heart border commonly associated with?
Typically associated with lingular consolidation
28
What is D in the A-E assessment?
Diaphragm Height Under Costophrenic angles
29
What does a normal diaphragm look like?
Right normally higher | Curved
30
What does flattening of the diaphragm's mean?
Suggest lung hyper-expansion Air-trapping COPD
31
What should you check for under the diaphragm?
Free air under the diaphragm Pneumoperitoneum Can cause right hemidiaphragm to lift and visibly separate from the liver Air will look black under a thin white line which is the diaphragm
32
What commonly causes pneumoperitoneum?
Bowel perforation
33
What are you looking for in the costophrenic region?
Well defined acute angle Loss of this is known as costophrenic blunting
34
What can cause blunting of the costophrenic angles?
Fluid | Consolidation
35
What is E?
Everything else Bones - fractures, lesions Soft tissues - surgical emphysema, clips, masectomy Equipement - NGs, pacemakers
36
What is surgical emphysema?
Air in the soft tissue Usually resolves by itself
37
What can cause surgical emphysema?
After surgery, insertion of chest drain, NIV
38
What ares of interpretation are commonly missed?
Apices Hilar Behind the heart Under the diaphragm
39
What is the key difference between pneumothorax and tension pneumothorax
Tension you get entire shifting of mediastinum
40
What are the signs of lung collapse?
Loss of volume Raised hemidiaphragm ipsilaterally Tracheal and medistinal shift towards the collapsed side Narrowing of the space between the ribs compared to other side Homogenous opacity
41
What are the signs of pleural effusion of CXR?
Blunting of the costophernic angles Homogenous opacification Fluid level manifesting as a meniscus
42
What are the main features of tension pneumothorax
Significant mediastinal shift Depressed hemidiaphragm Lung collapse? Medical emergency Diagnosed clinically and treated immediately with needle thoracentesis Never diagnosed on CXR
43
What is the structure for interpreting AXR's?
``` Confirm details Assess image quality Obvi Bowels Bones Calcification (and artefact) ```
44
How do we assess quality on a AXR?
Projection: Most of them are AP with pt. lying flat Decubitas - used in paeds Exposure: Ensure whole abdomen is visible, from level of hemidiaphragm to bowel
45
If bowel perforation is suspected what is the best imaging?
Errect CXR must be done | Must sensitive at detecting the presences of free gas in abdomen
46
What are the typical characteristics of the large bowel?
``` Typically runs around outside of abdomen Follow along (rectum --> caecum) ``` May contains faeces which will appear as mottled due to gaseous content Diameter no wider than 6cm Caecum can be up to 9cm Haustra and haustral folds
47
What are haustra/haustral folds?
Haustral folds represent folds of the mucosa within the colon Hastra refer to the small segemented pouches of bowel separated by haustral folds
48
What are the typical characteristics of small bowle?
Lies centrally Diameter should be no wider than 3cm Valvulae conniventes - thin, circular folds of mucose
49
What are the features of small bowel obstruction on a AXR?
Dilation of the small bowel <3cm More prominent vavulae conniventes
50
What are the causes of small bowel obstruction?
Adhesions (75%) post surgery Hernias Malignancy
51
What are the features of large bowel obstruction?
Colonic distention > 6cm | May cause small bowel dilatation in prolonged obstruction or poor competence of the ileo-caecal valve
52
What are some causes of large bowel obstruction?
Colorectal cancer Diverticulitis Volvulus
53
What do you see on a AXR in sigmoid volvulus?
Coffee bean sign
54
What can you see when there is air in the abdomen?
Both sides of the bowel wall become visible Known as Rigler's sign
55
What are the causes of penumoperitoneum?
Perforated bowel Perforated duodenal ulcer Recent abdominal surgery
56
What are features of IBD on AXR?
Thumb-printing: mucosal thickening due to inflammation and oedema, appears like thumbprints projecting inwards Lead pipe: Loss of normal haustral markings Toxic megacolon: colonic dilatation
57
What other organs should you check on a AXR?
Lung - inspect bases Liver - evidence of hepatomegaly Gallbladder - gallstones, but most are radiolucent Kidneys - both should be visible Bladder - variable appearance depending on how full
58
What bones might you visualise on a AXR?
``` Ribs Lumbar vertebrae Sacrum Coccyx Pelvis Proximal femurs ```
59
What artefact may you see on a AXR?
Surgical clips Jewellery Indwelling lines Surgical lines
60
What calcification might be seen on a AXR?
``` Calcified gallstones in the right upper quadrant Renal stones/staghorn calculi Pancreatic calcification Vascular calcification Costochondral calcification ```
61
What are the 3 types of shadowing?
Alveolar 'fluffy' - pneumonia Homogenous - Pleural effusion Reticulonodular
62
How do you diagnose cause of pleural effusion?
Pleural tap | Exudate (high protein) vs Transudate
63
What do you see on CXR in pulmonary odema?
Bat's swing airspace shadowing
64
What external objects could be seen on CXR?
Metallic valves Sternotomy wires Pacemaker
65
What can cause pulmonary odeoma?
ARDS Pulmonary hypertension HF
66
When might you see batswing shadowing?
Pulmonary odema | ILD
67
What might cause coin lesions?
``` Malignancy TB Abscess Cyst Benign tumour e.g. schwannoma ```
68
What are causes of bihilar lymphadenopathy?
``` Sarcoidosis TB AIDS Recurrent Chest Infections Tumours e.g. lymphoma ```
69
What are causes of unilateral hilar lymphadenopathy?
TB AIDS Recurrent Chest Infections Tumours e.g. lymphoma
70
What is the difference between Sarcoidosis and TB?
TB - caseating granulomas Sarcoidosis - non-caseating
71
What are multiple coin lesions called?
Canonball mets seen in renal cancer can also be caused by prostate cancer
72
What can cause a widening of the mediastinum?
Aortic aneurysm/dissection Goitre Lymphoma

Year 3 Clin Skills (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions