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pulmonary > basic radiographic diagnostics > Flashcards

basic radiographic diagnostics Flashcards

1
Q

consolidation

A

region of compressible lung tissue filled with liquid

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2
Q

atelectasis

A

collapse or incomplete expansion of the lung or part of the lung (snapping sound when opening)

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3
Q

complications for atelectasis

A 
cystic fibrosis
inhaled foreign objects
lung tumors
fluid in the lung 
respiratory weakness 
chest injuries
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4
Q

AP view

A

x-ray picture beam pass from front to back (anteroposterior)

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5
Q

PA view

A

standard chest x-ray (posterioranterior) and lateral chest x-ray

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6
Q

PA scapula and clavicles

A

scapula seen in periphery of thorax

clavicles project over lung fields

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7
Q

AP scapula and clavicles

A

scapula seen over lung fields

clavicles above the apex of lung fields

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8
Q

why get the lateral view

A

PA view
The triangular shape below the left ventricle will hide a lot of “bad things” and a lateral view is the only way to see it. It is blocked by the heart

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9
Q

chest x-ray for decubitus

A

helpful in assessing the volume of pleural effusion and demonstrate whether a pleural effusion is mobile or loculated

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10
Q

kerley lines

A

thin linear pulmonary opacities caused by fluid or cellular infiltration into the interstitium of the lungs

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11
Q

sarcoid

A

sarcoidosis - disease involving abnormal collections of inflammatory cells forming granulomas aka: nodules

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12
Q

labs that aid in sarcoid dx

A

elevated serum Ca
normal parathyroid hormone
elevated serum ACE level
DX: should be one of exclusion

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13
Q

lofgren syndrome

A

type of acute sarcoidosis

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14
Q

lofgren syndrome s/sx

A

fever, large lymph nodes, arthritis and rash (erythema nodosum)
additionally patients may present with wheezing, cough, SOB and chest pain
so if patient comes in for flu and you see erythema nodosum - get a picture

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15
Q

erythema nodosum

A

inflammatorycondition
aka: sub-acute migratory panniculitis of vilanova and pinol

characterized by inflammation of the fat cells under the skin, resulting in tender red nodules or lumps.

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16
Q

causes of erythema nodosum

A

It can be caused by a variety of conditions such as IBD, Strep, TB, Cat Scratch Fever, and Sarcoid

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17
Q

air bronchogram

A

refers to the phenomenon of air filled bronchi (dark) being made visible by the opacification of the surrounding alveoli

basically large airway becomes more visible

18
Q

causes of air bronchogram

A 
lung consolidation
pulmonary edema
nonobstructive pulmonary atelectasis
severe interstitial disease
neoplasm
normal expiration
19
Q

interstitial

A

anatomy relating to or situated in the small narrow spaces between tissues or parts of an organ
interstitial cells
interstitial fluid

20
Q

pleural or pulmonary effusion

A

buildup of fluid in pleural space

-area between the layers of tissue that line the lungs of the chest cavity

21
Q

two types of pleural effusions

A

transudative

exudative

22
Q

transudative pleural effusion

A

fluid leaking into the pleural space from increased pressure in the blood vessels or a low blood protein count.
Think in terms of fluid overload

23
Q

exudative pleural effusion

A

blocked blood vessels or lymph vessels
Inflammation
lung injury
tumors.

24
Q

pneumothorax

A

air in the cavity between the lungs and chest wall causing a collapse of the lung

25
Q

closed pneumothorax

A

air in the pleural space

can be spontaneous

26
Q

open pneumothorax

A

guns knife ect

27
Q

tension pneumothorax

A

air in pleural cavity and is trapped during expiration
air pressure within the thorax mounts higher atmospheric pressure and compressing the lung
displace the mediastinum and its structures towards the opposite

28
Q

hemothorax

A

blood in the pleural space

29
Q

solitary pulmonary nodule

A

SPN aka coin lesion
mass in lung usually smaller than 3 cm in diameter
10-20% of patients with granulomas are diagnosed with lung cancer

30
Q

color of images

A

black-air
gray- muscle, fat, fluid
white- bone, metal, contrast media

31
Q

limitations of chest x -ray

A
  • show only conditions that change the side of tissue in the chest or how the tissue absorbs radiation
  • limited to two dimension pictures
  • very small areas of cancer and blood clots in the lungs usually not visible
32
Q

many reasons to get a chest x-ray but dr hatch specifically mentioned

A

post tube and line insertions

33
Q

approach to imaging steps 1-4

A
  • check patient details (name DOB)
  • check film orientation (L&R is view AP or PA)
  • check additional info (enough inspiration expansion or expiration compression)
  • check rotation (measure distance from medial end of each clavicle to the spinous process of the vertebra at the same level- SHOULD BE THE SAME)
34
Q

approach to imaging steps 5-7

A
  • check for adequacy of inspiration (9 pairs of ribs)
  • check penetration (thoracic vertebra should be visible behind heart)
  • check exposure (ID both costophrenic angles and lung apices)
35
Q

ABCDEFGHI of chest x -ray

A 
Assessment of quality
Bones and soft tissues
Cardiac
Diaphragm
Effusions
Fields and Fissures
Great Vessels
Hilum / mediastinum
Impression
36
Q

cardiac on chest x-ray

A

heart should be 50% of the chest diameter on PA films

37
Q

diaphragm on chest x-ray

A

check hemi-diaphragms for position and shape (right is slightly higher than left) (may be flat in asthma and COPD)
-look below the diaphragm for free air (gastro perforation)

38
Q

pleural effusions on chest x-ray

A
  • Pleural effusions may be large and obvious or small and subtle.
  • Always check the costophrenic angles for sharpness (blunted angles may indicate small effusions).
  • Check a lateral film for small posterior effusions
39
Q

epidural

A

pt fine for a few minutes then progressively worse
above the dura
looks like a lemon

40
Q

subdural

A

under the dura
progressive unconscious
looks like a banana

41
Q

kids suspect pneumonia but CXR is negative

A

admit and hydrate and then re-film in the morning

pulmonary (6 decks)

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