1 - Chest Imaging Flashcards

1
Q

What is the ideal orientation for chest x ray?

A

P-A

Heart closer to detector

Better lung image

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2
Q

Structure

A

Right Para-Tracheal Stripe

Thickening may indicate mass or enlarged lymph node

Left side not well defined dur to aortic arch

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3
Q
A

Window

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4
Q

How is heart sized assessed on radiographs?

What is the only orientation you’d use?

A

Ratio of widest diameters of heart to widest internal diameter of thoracic cage

Normal is < 50%

- - -

P-A

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5
Q
A

Pneumoperitoneum

Free Air at arrow

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6
Q

What condition is happening at the arrows?

A

The diaphragm is flattened, note the flattened costophrenic angles

Can be caused by emphysema

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7
Q

What’s going on at the arrow you jackass?

A

Effusion, costophrenic recess

Look for blunted angles

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8
Q

What is going on in this image?

A
  1. Heart and mediastinum shifted left
  2. Absent lung markings at upper arrows
  3. Collapsed right lung

= Tension Pneumothorax

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9
Q
A

Upper - Retrosternal Space

Lucent area b/t the sternum and ascending aorta/hear

Lower - Retrocardiac Space

Posterior to posterior heart border; can decrease with enlargement of posterior of the heart

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10
Q

Which of these is bad?

A

Left - Anterior Mediastinal Adenopathy

Right is just a f*cking arm.

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11
Q

What view do you need to assess the hila?

A

Lateral

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12
Q

What’s going on here buster?

A

Lower left lobe pneumonia is superimposed on the lower spine at the white arrow

Called “Spine Sign”

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13
Q
A

Fluid blunting the posterior costophrenic sulcus (white arrow)

Pleural effusion is on the right

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14
Q

On a lung window CT, what color will the lungs be?

What would indicate a mass in the lungs?

A

Black

large areas of white may indicate lesion or mass

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15
Q

Five Vessel Level

A

Trachea - T - Black from air, circular

Esophagus - not labeled - Posterior to trachea, usually collapsed

Great vessels:

R Brachiocephalic V - RBV

L Brachiocephalic V - LBV

Brachiocephalic Trunk - BT

Common Carotid - C

Left Subclavian - S

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16
Q

Aortic Arch Level

A

Aortic Arch - aa

Superior Vena Cava - S

Azygous Vein - A

17
Q

Aortopulmonary Window Level

A

Ascending Aorta - AA

Descending Aorta - DA

Superior Vena Cava - S

uppermost aspect of left pulmonary - P

Arrow = Aortopulmonary Window

18
Q

Main Pulmonary Artery Level

A

Superior Vena Cava - S

Ascending Aorta - AA

Right and Left Pulmonary Arteries - RPA, LPA

Pulmonary Trunk - PT

Right and Left Main Bronchi - RB, LB (black from air, circular)

Descending Aorta - DA

19
Q

High Cardiac Level

A

Left Atrium - LA (posterior heart, note pulmonary veins entering)

Right Atrium - RA (right border)

Ascending Aorta - AA

Right Ventricle - RV (anterior border)

Left Ventricle - LV

Descending Aorta - DA

20
Q

Low Cardiac Level

A

Right Atrium - RA

Left Atrium - LA

Right Ventricle - RV

Left Ventricle - LV

Pericardium - White arrow, usually 2mm thick

Interventricular Septum - IVS black arrow

Descending Aorta - DA

21
Q
A