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Fundamentals of Radiology > Chapter 12: Methods of examination; Normal Anatomy, and Radiographic findings of Chest Disease > Flashcards

Chapter 12: Methods of examination; Normal Anatomy, and Radiographic findings of Chest Disease Flashcards

1
Q

Four basic features of proper radiographic technique:

A

Penetration
Inspiration
Rotation
Motion

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2
Q

How is rotation assessed?

A

relationship between a vertical line drawn midway between the medial cortical margins of the clavicular heads and one drawn vertically through the spinous processes of the thoracic vertebrae

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3
Q

How is appropriate inspiration assessed?

A

present when the apex of the right hemidiaphragm is visible below the tenth posterior rib.

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4
Q

How is proper penetration of xray assessed?

A

when there is faint visualization of the intervertebral disk spaces of the thoracic spine and discrete branching vessels can be identified through the cardiac shadow

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5
Q

the focus to film distance in AP technique

A

40 inches: results in magnification of intrathoracic structures

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6
Q

The apparent cardiac diameter in AP techniques increases by?

A

15 to 20% bringing the upper limit of normal CT ratio from 50% to 57% in AP

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7
Q

normal CT ration in AP xray?

A

57%

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8
Q

Result of AP projection on chest xray?

A
  1. Elevates the diaphragm-> compressing the lower lobes and decreasing lung volumes
  2. Gravitational effect evens the blood flow between upper and lower zones in supine patients- difficult to assess Pulmo HPN
  3. Widening of the upper mediastinum or “vascular pedicle”
  4. gravitational layering hides small effusions and pneumothorax
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9
Q

what is Dual energy subtraction?

A

a form of computed radiography that utilizes low-energy (60 keV) and high energy (120 keV) photons to produce selective bone and soft tissue images

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10
Q

position that that detects small effusions, characterize free flowing effusions on decubitus side and small pneumothorax on contralateral side

A

Lateral decubitus

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11
Q

Can detect focal or diffuse air trapping and eases detection of a small pneumothorax

A

Expiratory radiograph

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12
Q

Improves visualization of the apiceswhich are obscured on routine PA xray by the clavicles and first costochondral junctions

A

Apical lordotic view

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13
Q

used to mainly assess chest dynamics on patients with suspected diaphragmatic paralysis now replaced by CT

A

chest flouroscopy

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14
Q

the major advantages of MRI?

A
  1. superior contrast resolution between tumor and fat
  2. ability to characterize tissues on the basis of T1 and T2 relaxation times
  3. the ability to scan in direct sagittal and coronal planes
  4. the lack of need for IV iodinated contrast
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15
Q

the major disadvantage of MRI?

A

unable to distinguish benign masses from malignant masses or lymph node

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16
Q

is an imaging modality based on he metabolic activity of neoplastic and inflammatory tissues

A

PET: Flourodeoxyglucose (FDG) PET

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17
Q

flat band of muscle and connective tissue of the cartilage

A

posterior tracheal membrane

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18
Q

lining epithelium of tracheal mucosa

A

Pseudostratified, ciliated columnar epithelium which contains scattered neuroendocrine cells (APUD)

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19
Q

The trachea is approximately __ cm long in adults

A

12 cm

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20
Q

the coronal tracheal diameter is __mm in men and __mm in women?

A

25 mm in men and 21 mm in women

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21
Q

in cross section the trachea is oval or horseshoe shaped with a coronal to sagittal diameter ratio of __?

A

0.6:1.0

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22
Q

A narrowing of the coronal diameter of the trachea with coronal-sagittal ratio of

A

saber sheath trachea seen in patients with COPD

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23
Q

A slight tracheal deviation to the right after entering the thorax can be a normal radiographic finding?

A

YES

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24
Q

the interface of the RUL with the right lateral tracheal wall is called ?

A

the right paratracheal stripe

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25
Q

the right paratracheal stripe should be uniformly smooth and should not exceed __mm in width

A

4mm in width

26
Q

the left lateral tracheal wall is surrounded by mediastinal vessels and fat and is not normally visible in xray?

A

YES

27
Q

the presence of air in the esophagus produces the ? represents the combined thickness of the tracheal and esophageal wall and intervening fat.. t

A

tracheoesophageal stripe

28
Q

tracheoesophageal stripe thickness?

A
29
Q

the ___ main bronchus is shorter than the ___ main bronchus (mean length of 2.2 and 5 cm respectively)

A

Right

Left

30
Q

bronchioles bearing alveoli in their walls are termed?

A

respiratory bronchioles dividing into alveolar ducts and sacs

31
Q

the airway just before the first repiratory bronchiole is the

A

terminal bronchiole= the smallest bronchiole without respiratory exchange structures

32
Q

the lungs are divided by these invaginations of the visceral pleura?

A

interlobar fissures

33
Q

Branches of the RUL

A

branches into 3 segmental branches: anterior, apical, posterior

34
Q

Branches of the RML; arises from the intermediate bronchus

A

divided into medial and lateral branches. Blood supply by a branch of the right interlobar pulmonary artery

35
Q

The RLL is supplied by the RLL bronchus and pulmonary artery. it is subdivided into .. segments

A

superior segment and 4 basal segments: anterior, lateral, posterior, and medial basal segments.

36
Q

the LEFT lung is divided into upper and lower lobes by the what?

A

left major fissure

37
Q

The LUL is analogous to the combined ___ lobes

A

RUL and RML

38
Q

The LUL is subdivided into __ segments: namely?

A

4 segments namely: anterior, apicoposterior and the superior and inferior lingular segments

39
Q

Blood supply of LUL?

A

anterior and apicoposterior segments= left main pulmonary artery.
Superior and inferior= superior and inferior lingular arteries are proximal branches of the left interlobar pulmonary artery analogous to the middle lobes blood supply.

40
Q

The LLL segments?

A

superior segment and 3 basal segments: anteromedial, lateral, and posterior

41
Q

gas exchanging units of the lungs?

A

alveolar ducts and sacs

42
Q

pneumocytes that are flattened squamous cells covering 95% of alveolar surface

A

type 1

43
Q

this pneumocytes are cuboidal cells capable of mitosis; source of new type of pneumocytes and provide mechanism for repair following alveolar damage. source of surfactant

A

type 2

44
Q

the left major fissure begins more superiorly and has a slightly more vertical course than the right major fissure

A

YES

45
Q

The minor fissure projects at the level of the right __th rib and is seen as a thin undulating line on frontal xray.

A

right 4th rib

46
Q

the ___fissure is the most common accessory fissure and is found in 10 to 20% of individuals

A

inferior accessory fissure

47
Q

the ___ fissure has been misidentified as the inferior pulmonary ligament and is responsible fro the juxtaphrenic peak(tenting) described in upper lobe volume loss.

A

inferior accessory fissure

48
Q

the __ fissure is seen in 0,5% of individuals, represents the invagination of the right apical pleura by the azygos vein.

A

Azygos fissure

49
Q

The __ fissure separates the superior segment from the basal segments of the lower lobe. On lateral it extends xray it extends posteriorly from the major fissure to the chest wall.

A

superior accessory fissure

50
Q

The __ fissure is rarely seen normal variant that separates the lingula from the remaining portions of the upper lobe.

A

left main fissure

51
Q

is a sheet of connective tissue that extends from the hilum superiorly to a level at or just above the hemidiaphragm, on CT it is a small laterally directed beak of mediastinal pleura adjacent to the esophagus

A

inferior pulmonary ligament

52
Q

the inferior pulmonary ligament contains this vein superiorly

A

inferior pulmonary vein

53
Q

This septum has been mistaken for the inferior pulmonary ligament. seen on CT near the inferior pulmonary ligament

A

sublobar septum

54
Q

this ligament is a triangular density extending toward the lung that is seen along the posterior aspect of the right heart border on lung windows on chest CT

A

periocardiophrenic ligament

55
Q

is an elastic artery that arises from the right ventricle at approximately 1 oclock position relative to the ascending aorta.

A

pulmonary arteries

56
Q

are the primary nutrient vessels of the lung. They supply blood to the bronchial walls to the level of the terminal bronchiole

A

bronchial arteries

57
Q

the two major lymphatic pathways in the lung and pleura

A
  1. The visceral pleural lymphatics

2. the parenchymal lymphatics

58
Q

Is the scaffolding of the lung an as such provides support for the airways and pulmonary vessels

A

pulmonary interstitium

59
Q

Edema involving this interstitium is recognized radiographically as peribronchial cuffing

A

axial interstium

60
Q

Edema of this interstitium accounts for Kerley B Lines

A

peripheral and subpleural interstitium

61
Q

is seen as a thin vertical line that overlies the thoracic spine

A

anterior junction line

62
Q

a radio-lucent region regpresenting contact of the posterosuperior portions of the upper lobes

A

retrotracheal triangle

Fundamentals of Radiology (1 decks)

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