anatomy demonstration Flashcards
how can one tell if a CXR is rotated
the spinous processes of the vertebrae shoudl be equidistant from the clavicles if correctly orientated.
cut off cardiothoracic ratio for enlarged heart
should be less than 0.5 to be normal.
what is upper lobe diversion in a CXR
blood vessels to upper lobe become distended relative to the lower lobe ones which are normally more distended than the upper ones. this occurs when oxygen tension drops in the lower lobes eg oedema or pneumonia.
what is perihilar haze
when the borders of the hilar vessels become harder to define due to interstitial oedema around them. also occurs around the bronchi = peribronchal cuffing. and around the acini = kerli B lines
what is consolidation in a CXR
opacity due to stuff in the alveoli eg pus/fluid.
what does an AP view do to a CXR vs a PA view
widens the shadow of the mediastinum. the scapulae also wont be retracted so you will see a vertical line across the lung at their medial border.
where does pain from retroperitoneal structures TEND to refer?
the back.
systematic way to interpret a CXR
EABCD
E - exposure and technical feature of the film. not too black or white. look at the spinous processes and the vertebra and the intervertebral discs. if you can differentiate all of these then it is correctly exposed. check rotation. assess inspiratory effort of the individual= should be able to see 8-10 posterior (horizontal) ribs, or should be able to see 6-8 anterior (angled) ribs. AP vs PA.
A = airway and airspaces. trachea should be central, straight and not deviated. airspaces should be equal, the same colour and homogenous (no masses or consolidation).
B= bones. dislocations and fractures. soft tissues. subcutaneous/surgical emphysema.
C= circulation - heart, blood vessels, mediastinum, hila. hilar vessels, lymphatics and airways.
D = diaphragm - look at them, above and below. right side should be sligthly higher due to the liver pushing up and the heart pushing down on the left. costophrenic recess, cardiophrenic recess.
as a general rule, compare like for like.
The classical divisions of COPD
emphysema and chronic bronchitis
at what spinal level does the trachea split
T4
what does loss of hemidiaphragm silhouette suggest
obscuration of the hemidiaphragm suggests lower lobe pathology.
cause of lung crackles
fluid
cause of wheeze
airway narrowing.
what is bronchial breathing
breathing sounds throughout inspiration and expiration. normal (vesicular) sounds are hear throughout inspiration but only at the start of expiration.
