Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Essentials of Acute Care > xray > Flashcards

xray Flashcards

1
Q

what can you evaluate with xray for a pacemaker

A

Evaluation of suspected pacemaker lead fracture

Pacemaker placement

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

the thicker the structure the _____ it will appear on x-ray film

A

brighter

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

what are the 3 factors that determine shadow brightness on an x ray

A

thickness
density
duration of exposure

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

pneumonic used in assessing xrays

A 
Airways
Bones (and soft tissue)
Cardiac silhouette (and mediastinum)
diaphragm (and gastric bubble)
Effusions
Fields (ie: lung fields)
Lines tubes devices surgeries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what x ray views can you see the vertebral bodies on

A

Lat is best

PA you can see but not as well

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

It is normal for the right hemidiaphragm to be slightly _____ than the left

A

higher

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

what lung fissures are seen on x ray and what view can you see in it

A

Horizonal

only on the PA

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

what view is the lung apex not visible above the clavicle?

A

Lordotic view

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

consequence of z-axis rotation

A

cardiac silhouette, mediastinum and/or hilum may all be distorted

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

How many posterior ribs can be seen with adequate inspiration and why is that important

A

10

better quality film

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

consequences of insufficient inspiration for a chest x ray

A

Lung volumes appear falsely low
lung markings appear falsely prominent
false appearance of pulmonary edema
cardiac silhouette and mediastinum may appear falsely large

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

what physical factors determine low exposure vs high exposure. What can the x ray tech do to control these

A

Duration of exposure - tech controls mAs
Energy of photons - tech controls kVp
Source to image distance - SID

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

what are you looking for on an x-ray in regards to airway

A

narrowing
deviation
foreign objects

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

what radiographic finding is seen in croup and tracheal stenosis

A

subglottic airway narrowing

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

what is the hallmark sign in airway narrowing on an xray called

A

Steeple sign

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

Tracheal deviation is usually cause by

A

unequal intrathoracic pressures between R and L sides

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

abnormalities that cause tracheal deviation away from the affected side

A

Pneumothorax
Pleural effusion
large mass

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

abnormalities that cause tracheal deviation towards the affected side

A

marked atelectasis/collapsed lung
lobectomy/pneumectomy
pleural fibrosis
pulmonary fibrosis (rarely unilateral)

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

carinal angle >90 degrees

A

splaying of R and L bronchi

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

Bone problems seen on x ray

A 
fractured
deformed
sclerosed
lytic
osteopenic (difficult to identify on x ray)
Notched (applies to ribs only)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

scoliosis is visualized in what views

A

PA and AP

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

Kyphosis is visual in what views

A

Lateral only

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

what radiographic finding is seen in advanced COPD

A

Kyphosis
increased AP diameter
“Barrel Chest”

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

increased density in bone

A

sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
etiologies of Sclerosis
``` osteoblastic metastasis primary bone tumor various benign tumor like lesions Paget's disease chronic osteomyelitis ```
26
decreased density in bone
lytic lesions
27
etiologies of lytic lesions
``` osteolytic metastasis multiple myeloma various benign cyst like bone lesions pagets disease acute osteomyelitis ```
28
focal deformation of one or more ribs
rib notching
29
notching of the superior surface (less common) etiologies
osteogenesis imperfecta connective tissue diseases local pressure hyperparathyroidism
30
notching of the inferior surface etiologies
coarctation of the aorta subclavian or SVC obstruction s/p Blalock Taussig shunt (only 2 upper ribs)
31
anatomic rib varient
cervical rib unilateral or bilateral usually incidental finding but can cause thoracic outlet syndrome
32
subcutaneous emphysema | etiologies from air introduced internally
Pneumothorax Pneumomediastinum Pulmonary interstitial emphysema
33
subcutaneous emphysema etiologies from air introduced externally
penetrating chest wall trauma post surgical complications from chest tube
34
subcutaneous emphysema etiologies from air introduced locally
necrotizing infection with gas producing organisms | gas gangrene
35
which chest x ray view will exaggerate the size of the heart
AP film
36
cardiomegaly is said to be present if
the cardiothoracic ratio is greater than 50% on the PA film
37
cardiothoracic ration =
maximum horizontal cardiac width divided by | maximum horizontal thoracic width (inner surface of the rib cage)
38
etiologies of cardiomegaly
any cause of L or R sided heart failure
39
_____ _______ can be mistaken for cardiomegaly
pericardial effusions
40
x ray findings for L atrial enlargement
splaying of the carinal angle >90% | Double density sign
41
etiologies for L atrial enlargement
``` L sided heart failure (any cause) mitral valve disease -mitral stenosis -mitral regurgitation -mitral valve prolapse ```
42
x ray findings that may indicate r ventricular enlargement
filling of the retrosternal space (seen on a lateral view)
43
etiologies for R ventricular enlargement
``` Pulmonary hypertension (any cause) Pulmonary valve disease (pulmonary stenosis, regurgitation) ```
44
Primary finding for a pericardial effusion is an
enlarged cardiac silhouette (not all are visible on x ray) other findings water bottle morphology of silhouette Oreo cookie sign
45
oreo cookie sign is seen on what x ray view
lat
46
what are the layers of the oreo cookie sign
posterior chocolate layer = pericardial fat middle cream layer = pericardial effusion anterior chocolate layer = epicardial fat
47
acute pericardial effusion etiologies
trauma viral pericarditis complication of MI (free wall rupture, Dressler syndrome) Iatrogenic (RV biopsy, EP procedures)
48
sub acute to chronic pericardial effusion etiologies
``` Malignancy renal failure collagen vascular disease hypothyroidism tuberculosis ```
49
widened mediastinum is defined as >
8 cm on PA
50
most cases of widened mediastinum are due to suboptimal technique such as
rotated pt poor inspiratory effort AP view
51
what anterior and superior mediastinal masses can be visualized on x ray
``` lymphoma thyroid thymus teratoma aortic aneurysm (superior only) ```
52
what middle mediastinal masses can be visualized on x ray
``` lymphadenopathy aortic aneurysm pericardial cysts dilated esophagus hiatal hernia ```
53
what posterior mediastinal masses can be visualized on x ray
neurogenic tumors | extension of spinal masses (tumors, infection)
54
anterior mediastinal masses are better seen on what view
lat
55
Hilar enlargement categories
``` malignancy infection other which includes - sarcoidosis silicosis pulmonary hypertension pulmonary artery aneurysm bronchogenic cyst ```
56
Small pneumothorax is
2 cm
57
large pneumothorax is >
2 cm
58
based on the thickness of the rim of air around the lung at the level of the hilum on a PA film
size of a pneumothorax
59
what type of film shows pneumothorax better
expiratory film
60
Deep sulcus sign is an indication of a
pneumothorax
61
etiologies of primary (spontaneous) pneumothorax
develops in the absence of lung disease or iatrogenic procedures
62
etiologies of secondary pneumothorax
iatrogenic (thoracentesis, lung biopsy, central line placement) COPD Cystic fibrosis pneumonia
63
which effusions seem to defy gravity? why is this important
Loculated instead of free flowing | difficult to drain
64
what other view other than PA to assess how free flowing the effusion is
Lat decub view with effusion side down.
65
fluid accumulation between the lung base and the diaphragm which does not track up the pleura, and does not blunt the costophrenic angle
subpulmonic effusion
66
fluid collection trapped within a fissure which can give the appearance of a lung mass
pseudotumor
67
transudative pleural effusion etiologies
heart failure hepatic hydrothorax (pleural effusion due to cirrhosis/ascites) hypoalbuminemia nephrotic syndrome
68
exudative pleural effusion etiologies
``` pneumonia/empyema malignancy pleural tuberculosis pancreatitis sarcoidosis various rheumatologic diseases -lupus, rheumatoid arthritis, ect ```
69
diffuse pleural thickening is seen in
``` prior infection prior hemothorax occupational exposure (asbestos) radiation malignancy ```
70
elevated hemidiaphragm caused by
diminished lung volume phrenic nerve paralysis eventration of the diaphragm
71
free air under diaphragm
pneumoperitoneum
72
Perforated viscus from PUD, appendicitis, diverticulitis, malignancy, bowel obstruction, complication of endoscopy post op complication trauma peritoneal dialysis
causes of pneumoperitoneum
73
``` trauma esophageal rupture vomiting asthma post neck or chest surgery barotrauma ```
causes of pneumomediastinum
74
trauma bacterial pericarditis secondary to gas producing organism post cardiac surgery pericardial drain fistula between pericardium and either lung, stomach or esophagus
causes of pneumopericardium
75
gas seen between liver and diaphragm
chilaiditi's sign
76
refers to condition of ab pain or other symptoms caused by the interposed colon
chilaiditi's syndrome
77
Hyperinflation is seen in
COPD | acute exacerbations in asthma
78
Kerley A lines represent
channels between peripheral and central lymphatics
79
Kerley B lines represent
interlobular septa (may have heart failure)
80
In cardiogenic pulmonary edema the cardiac size is typycally
enlarged | in non-cardiogenic it is typically normal
81
Regional distribution of opacities in non cardiogenic and cardiogenic pulmonary edema
Cardiogenic - relatively homogenous non-cardiogenic - opacities are relatively patchy
82
Air bronchograms are common in what type of pulmonary edema
non-cardiogenic
83
Peribronchial cuffing is more common in what kind of pulmonary edema
Cardiogenic
84
Kerley b lines are more common in what kind of Pulmonary edema
Cardiogenic
85
nodules <= 2mm
``` miliary tuberculosis fungal infection silicosis coal workers pneumoconiosis sarcoidosis ```
86
nodules > 2cm
``` metastatic cancer subacute hypersensitivity pneumonitis lymphoma sarcoidosis granulomatosis with polyangiitis rheumatoid nodules ```
87
relatively large, dense, homogenous opacification, frequently involving an entire lobe
consolidation
88
loss of the normally visible border of an intrathoracic structure caused by an adjacent pulmonary density
silhouette sign
89
an abnormal increase in opacification overlying the spine while moving superior to inferior on the lateral view, suggestive of lower lobe opacities/infiltrates
Spine sign
90
causes of focal opacities
``` Infections (pneumonia) Malignancy Pulmonary infarction Pulmonary hemorrhage vasculitis Eosinophilic pneumonia ```
91
Homogenous consolidation air bronchograms common sharp borders corresponding to fissures is consistent for what and caused by what?
Lobar pneumonia streptococcus pneumoniae Klebsiella pneumoniae Haemophilus influenzae
92
Patchy opacification Air bronchograms uncommon vague borders frequently bilat what is it what causes it
segmental pneumonia (Bronchopneumonia) Staphylococcus Aureus Pseudomonas aeruginosa Klebsiella pneumoniae Haemophilus influenzae
93
Reticular pattern no air bronchograms often develops into airspace disease
Interstitial Pneumonia Mycoplasma pneumoniae viral pneumonia pneumocystis pneumonia
94
Spherical opacification Easily mistaken for tumor or other lung mass Much more common in children than adults
Round Pneumonia H. Influenzae streptococcus pneumoniae
95
Distinguished by cavities | may or may not have air-fluid level
Cavitary Pneumonia Tuberculosis Staphylococcus aureus
96
a well circumscribed, generally round density, smaller than 3 cm in diameter
Solitary Pulmonary nodule
97
Causes of Solitary pulmonary nodules
Cancer Infectious/inflammatory (granuloma, pneumonia) Congenital anomalies - arteriovenous malformation or bronchogenic cyst
98
what 3 categories of etiologies cause multiple pulmonary nodules
Cancer - Pulmonary metastasis - Lymphoma Infectious/inflammatory - Fungal pneumonia - mycobacteria - nocardia - septic emboli - parasites - Rheumatoid Arthritis - Vasculitis Misc -Amyloidosis
99
Hampton's Hump indicates
pulmonary embolism cant always be detected on x ray dome shaped opacity due to lung infarction - takes months to resolve and can leave scarring
100
Westermark sign
pulmonary embolism cant always be detected on x ray focal reduction in appearance in lung markings due to embolis
101
Fleishner Sign
pulmonary embolism cant always be detected on x ray prominent central pulmonary artery caused by distension of the vessel caused by a PE
102
Typically arise within preexisting lung cavities and get colonized with Aspergillus. Pt asymptomatic, may have a chronic cough
Aspergilloma | "fungus ball"
103
loss of lung volume due to collapse of lung tissue
Atelectasis
104
Airway obstruction followed by gas resorption within non ventilated alveoli
Obstructive Resorptive atelectasis Tumor Mucus plug Foreign body aspiration External compression of airway
105
Disruption of normal contact between the visceral and parietal pleura allows the elastic recoil of the lung to pull itself inward
Non Obstructive Passive (relaxation) Atelectasis Pleural effusion Pneumothorax
106
Space occupying lesion in the thorax physically compresses adjacent lung
Non Obstructive Compressive Atelectasis Tumor Elevated diaphragm
107
Diminished surfactant results in higher surface tension in fluid lining alveoli with increased tendency for collapse
Non Obstructive Adhesive Atelectasis Infant Resp distress syndrome ARDS Radiation pneumonitis
108
Severe parenchymal scarring
Non obstructive Cicatricial Atelectasis TB Idiopathic pulmonary fibrosis
109
Elevation of the ipsilateral hemidiaphragm Mediastinal shift Juxtaphrenic peak sign
Lobar Atelectasis ``` Etiologies include Lung cancer Foreign body aspiration Mucus plugging External compression of an airway ```
110
Density in upper, medial right hemithorax Superior displacement of R hilum and horizontal fissure
Right upper lobe collapse
111
A thin shadow overlying the heart on the lateral view
RML collapse
112
Wedge shaped opacity behind R atrium
RLL collapse
113
Luftsichel sign
50% of pt will have a portion of the LLL interposed between the collapsed LUL and the aortic arch (Luftsichel sign) LUL collapse
114
Triangular opacity behind heart Inferior displacement of l hilum Obscuring the outline of the descending aorta
LLL collapse
115
optimal placement of a central line or PICC places the tip at the
junction of the SVC and R atrium
116
Optimal placement of a PA catheter (Swan-Ganz) will place the tip at the level of the
hilum, no more than 3 cm r of midline or 1 cm beyond the cardiac silhouette
117
Proper placement of an Endotracheal tube results in the tip being
approx 5 cm above the carina
118
Proper placement of NG tube is confirmed by
descends centrally crosses the diaphragm once below diaphragm, initially deviates to left optimally tip should be >10cm below the gastroesophageal junction
119
Complications seen on X-ray from Cardiac Devices
Pneumothorax Perforation Lead fracture Twiddlers syndrome - lead has been wrapped around device and displaced from person messing with it
120
in profile
suggests aortic prosthetic heart valve
121
en face
suggests mitral prosthetic heart valve
122
What are the 2 big differences when looking at pediatric x rays vs adults
Thymus enlargement - in children younger than 2 this is a normal finding Double atrium is a normal finding in kids. In adults this would indicate L atrial enlargement
123
the presence of posterior and lateral rib fractures in infant is highly suspicious for
non accidental trauma
124
Systematic approach mentioned in ped radiology video
``` Lung parenchyma Pulmonary vasculature airway/mediastinum Heart Bony abnormalities ```
125
meniscus sign points to
pleural effusion
126
7- shape ribs
pectus excavatum

Essentials of Acute Care (9 decks)

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