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smp - cardiopulmonary lab practical > CC 2 - Thoracic Anatomy (Radiologic Review of the Chest) > Flashcards

CC 2 - Thoracic Anatomy (Radiologic Review of the Chest) Flashcards

1
Q

Indicate what portions of the heart appear on the X-ray.

A
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3
Q

What color does soft tissue (e.g. fat, muscle) appear like on an X-ray?

A

Grey

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4
Q

What appears black on an X-ray?

A

Air

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5
Q

Mark the structures that can be seen on the X-ray.

A
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6
Q

What do the white lines in the lungs correspond to?

A

Blood vessels

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7
Q

What are the sharp angles on either side of the chest inferiorly on the X-ray? What does it mean when these angles are blunted?

A

Where the diaphragm meets the chest wall

Blunted angles could be indicative of pleural effusion or other fluids in the thorax

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8
Q

Can tissues of the same density be distinguished on an X-ray? Example?

A

NOPE

Liver and spleen

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12
Q

What does the gastric bubble correspond to on a chest X-ray?

A

Pocket of air in the stomach just underneath the diaphragm

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13
Q

Mark the structures that can be seen on the X-ray.

A
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14
Q

On the RL chest X-ray, why is the area toward top of spine white and then it gets darker?

A

Latissimus dorsi are responsible for the white and then there is less and less muscle

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15
Q

Why are PA X-rays preferred to AP? Issue though?

A
  1. With the patient holding the plate in front of them, they roll their shoulders forward, getting the scapulae out of the way of the X-ray
  2. Puts heart closest to the plate so that it does NOT appear larger because the X-rays diverge as they come out (you want a better representation of the organ)

Issue: a lot of patients are bed ridden, so we need to use AP shot by putting a plate below the bed

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16
Q

How to describe subject placement in radiography?

A

First the side receiving the rays first
Then the side next to the film

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17
Q

What are the 2 types of X-ray positioning?

A
  1. AP = anterior posterior
  2. PA = posterior anterior
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18
Q

What is the preferred lateral chest X-ray? Why?

A

Right lateral chest X-ray so the heart is closest to the plate

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21
Q

How to tell which is the right and left diaphragm on a RL chest X-ray? Which one is higher more often than not?

A
  • Right diaphragm will extend from the back all the way to the front of the chest
  • Left diaphragm will extend from the back and will disappear before reaching the front of the chest because the soft tissue heart above it makes the outline dissipate

Right diaphragm is OFTEN higher because the heart pushes down on the left (according to radiologists) or because the liver pushes up on the right (according to anatomists)

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22
Q

What is the carina of the trachea?

A

Ridge of cartilage in the trachea that occurs between the division of the two main bronchi

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23
Q

What’s the issue here?

A

Pneumothorax causing compressive atelactasis

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24
Q

What’s the issue here?

A

Pneumothorax due to tube inserted into bronchi instead of esophagus

25
Q

What’s the issue here?

A

Right pneumothorax

26
Q

What is the aortic knob formed by on an X-ray?

A

Aortic arch

27
Q

What’s the issue here?

A

Left tension pneumothorax with right tracheal and mediastinum deviation and left diaphragm is completed pushed into the pelvis

28
Q

What’s the issue here?

A

Pleural effusion with white meniscus

29
Q

How to find the carina on a chest X-ray?

A

Right under pulmonary artery and hilum there should be a darker column coming superiorly from left chest and meeting the trachea

30
Q

What’s the issue here?

A

Complete white out of the hemi-thorax caused by pleural effusion

31
Q

What are the 6 main veins used to insert tubes inside the chest?

A
  • R/L subclavian veins
  • R/L jugular veins
  • R/L femoral veins
32
Q

What is a pneumothorax?

A

Presence of air in pleural space

33
Q

What’s the issue here?

A

Obstructive atelectasis with right tracheal deviation

34
Q

What’s the issue here?

A

Obstructive atelectasis of left lung due to right main stem intubation (left lung is not receiving any air)

35
Q

What’s the issue here?

A

Cannot see the left heart border => lingula which is in contact with it has pneumonia => left upper lobe pneumonia => left upper lobe atalectasis

36
Q

What is a tension pneumothorax?

A

Air in pleural space due to pneumothorax restricts inflation of the lungs => progressive build-up of pressure in the pleural space causes compressive atelectasis and pushes the mediastinum to the opposite hemithorax => mediastinum obstructs venous return to the heart => may result in traumatic arrest

37
Q

What is atelectasis? 2 types? Treatment for each?

A

Alveolar collapse

  1. Obstructive = something obstructs the lung and the air that remains in the alveoli is absorbed into the capillaries so the lung collapses (with tracheal deviation toward side of atelectasis due to negative pressure and due to other lung taking up more volume) => bronchoscope
  2. Compressive = positive pressure outside the lung (e.g. tension pneumothorax) causes the alveoli to collapse (with tracheal deviation away from side of atelectasis) => chest tube
38
Q

What’s the issue here?

A

Left upper lobe lung pneumonia

39
Q

What’s the issue here?

A

Right heart border is obscured => right middle lobe pneumonia

40
Q

What’s the issue here?

A

Obscured diaphragm and right border of the heart + shifting of heart to the right => right lung middle and inferior lobes obstructive atalectasis

41
Q

What’s the issue here?

A

Abnormal lymphadenopathy of sarcoid

45
Q

What is a buffalo chest?

A

2 lungs in only 1 pleura

48
Q

How can a pleural effusion be confirmed by X-ray?

A

Make patient lie down during X-ray and see the fluid spread out

50
Q

What is pneumonia?

A

Fluid inside the lungs without any shifting of structures

51
Q

3 potential causes of white out?

A
  • Pleural effusion with shifting of mediastinum away from effusion
  • Pneumonia
  • Obstructive atelectasis with shifting of mediastinum towards obstruction
55
Q

What does it mean for a pneumothorax to be spontaneous?

A

They occur in the absence of known pathology

56
Q

Symptoms of pneumothorax?

A
  1. Pain
  2. Shortness of breath
  3. Cardiorespiratory collapse
57
Q

Are most pneumothoraces spontaneous?

A

YUP

58
Q

What is an endobronchial lesion?

A

Lesion within a bronchus

59
Q

What’s the issue here?

A

Patient had heart bypass surgery during which the sternum was opened and the surgeons inserted graft markers so that the new coronary artery could be later catheterized to check if it is still patent

smp - cardiopulmonary lab practical (11 decks)

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