19 - Radiology 2 Flashcards
What do you need for a chest x-ray to be adequate?
- 1st rib
- Lateral margin of ribs
- Costophrenic angle
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/866/460/a_image_thumb.png?1575018078)
What indicates cardiomegaly on a chest x ray?
- Over 50% cardiac thoracic ratio
- Only on PA film
- Think about situs invertus
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What are the A and B of the ABCDE approach of looking at a CXR?
A: airway for central trachea and hila
B: lungs, pleural spaces, lung interfaces (silhouette sign)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/392/a_image_thumb.jpeg?1575018174)
What are the C and D of the ABCD approach of looking at a CXR?
C: mediastinum, aortic arch, pulmonary vessels, borders of the heart
D: free gas under diaphragm, nodules, fractures, mass
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/472/a_image_thumb.jpeg?1575018259)
Where are some of the important review areas on a CXR?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/514/a_image_thumb.jpeg?1575018310)
What is the silhouette sign?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/526/q_image_thumb.jpeg?1575018518)
Structures of differing density form a crisp silhouette so when this is lost there is pathology in an area
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/526/a_image_thumb.jpeg?1575018494)
How can you tell on a CXR if there is mediastinal shift?
- Check the trachea and the cardiac shadow
- Pushed if there is an increase in volume or pressure (pleural effusion) pulled if decrease (consolidation with lung collapse)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/572/a_image_thumb.png?1575018626)
What are some causes of costophrenic blunting on a CXR?
- Consolidation
- Fluid
- Hyperinflation of lung
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/594/a_image_thumb.jpeg?1575018866)
How do you identify a pneumothorax on a CXR?
- Most commonly due to laceration of visceral pleura or fractured rib
- Lung edge more than 2cm from chest wall it is large
- Tracheal or mediastinal shift away from pneumothorax is tension
- Visible pleural edge and no lung markings beyond this point. Side effected is blacker
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/685/a_image_thumb.png?1575019133)
How do you identify a pleural effusion on a CXR?
- Collection of fluid so uniform white area
- Loss of costophrenic angle
- Hemidiaphragm obscured
- Meniscus at upper border (not when supine)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/780/a_image_thumb.jpeg?1575019214)
How does a lobar lung collapse look on a CXR?
- Elevation of ipsilateral hemidiaphragm
- Crowding of ipsilateral ribs
- Shift of mediastinum towards atelectasis
- Crowding of pulmonary vessels
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/827/a_image_thumb.jpeg?1575019417)
What are some things that can cause consolidation on a CXR?
Always reassess in 6 weeks to think about cancer
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/905/a_image_thumb.jpeg?1575019487)
How do you spot consolidation on a CXR?
- Increased opacity
- Air bronchograms
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/936/915/a_image_thumb.jpeg?1575019610)
What is being shown on this CXR?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/938/193/q_image_thumb.png?1575019739)
Cavitation which could be due to infarction, abscess, TB, malignancy, septic microthrombi
What are some causes of a space occupying lesion on a CXR?
Vertebral body height is about 3cm
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/938/343/a_image_thumb.jpeg?1575020004)