ACCS Chest Xrays

Question 1

What are the white stringy-things that you see in the lungs?

Answer 1

Vascular markings. (They’re normal.)

Question 2

The trachea should be (smaller than/same size/larger than) the vertebral column.

Answer 2

Same size.

Question 3

A greater A-P diameter could mean ____.

Answer 3

COPD.

Question 4

If the costophrenic angles are not sharp, this could mean ____.

Answer 4

Pulmonary effusion.

Question 5

The diaphragm is normally dome shaped. If it’s flat, this may indicate ____.

Answer 5

COPD.

Question 6

If the left or right side of the diaphragm is flattened, this may indicate ____.

Answer 6

Pneumothorax

Question 7

Hyperlucency may indicate ____.

Answer 7

Subcutaneous empysema

Question 8

The most common type of CXR is ___. However, the most clear type of CXR is ___.

Answer 8

Most common is AP.

Most clear is PA.

Question 9

On a CXR, you see fluid in the lungs. You can tell if it’s pleural effusion by placing them in the ___ position. If the fluid moves, it’s a pleural effusion, If it doesn’t, it’s pneumonia.

Answer 9

Lateral decubitus position

Question 10

This CXR position is useful for localizing lesions.

Answer 10

Oblique position

Question 11

What angle is the oblique CXR taken from?

Answer 11

Slanting or diagnal

Question 12

To take a CXR of the lung apices, use this CXR position.

Answer 12

Apical lordotic

Question 13

This CXR position is taken after the patient exhales. It’s useful for detecting a ____.

Answer 13

End-exhalation.

Small pneumothorax.

Question 14

How far should ET tubes be positioned above the vocal cords?

This is at the same level as what cardiovascular landmark?

Answer 14

2 cm or 1 inch

Aortic arch. (Clavicles are too high)

Question 15

You should inspect the ET tube/Tracheostomy tube for what problem? (Not tube placement)
How can you tell that this problem exists?

Answer 15

Cuff hyperinflation. (The cuff should not extend over the end of the tube)

Question 16

Pacemakers are normally positioned in the ___.

Answer 16

R ventricle

Question 17

Pulmonary artery catheters are usually seen in the ___.

Answer 17

Right lower lung

Question 18

Central venous catheters are placed in one of these three places. It should rest in the ___ or the ___.

Answer 18

Placed in the right or left subclavian or jugular vein.

Should rest in the vena cava or right atrium

Question 19

Nasogastric tubes should be placed in the stomach, approximately ___ below the diaphragm

Answer 19

2-5 cm

Question 20

Cardiac silhouette (shadow) size should be about ____ the chest diameter. If it’s greater, that indicates ___.

Answer 20

Should be about half the chest diameter. If it’s greater, that indicates cardiomegaly (CHF).

Question 21

When would you get a spinal radiograph?

Answer 21

Evaluate for trauma (clearing Cspine)
Vertebral problems or trauma
Cancer metastasis

Question 22

What should you do if you want to look inside the heart? (Two answers)

Answer 22

Echocardiogram or heart sonography

Question 23

When you do a ___, CO2 is injected into a vein and then that CO2 is followed throughout the body, tracked by ___. It indirectly measures the ___ and to identify ___.

Answer 23

Bubble Echocardiogram / Bubble Contrast
Tracked by ultrasound
Measures pulmonary arterial pressure.

Question 24

A ventilation/perfusion scan detects ___.
Mismatch indicates ___.
Matching indicates ___.

Answer 24

Blood flow defects.
Mismatch = pulmonary embolism
Matching = parenchymal disease

Question 25

The first thing you do when you assess a CXR is:

Answer 25

Look at the clavicles. Are they straight?

Question 26

A bubble echocardiogram indirectly measures ___.

Answer 26

Pulmonary artery pressure (PAP)