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CLASP 2 - Anatomy & Radiology > Chest > Flashcards

Chest Flashcards

1
Q

Is the heart larger on an AP or PA CXR?

A

AP CXR

This is due to the heart lying more anteriorly within the chest.

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2
Q

What width of a PA CXR should be taken up by the heart?

A

Less than, or equal to 50%.

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3
Q

Can inspiration/expiration affect a CXR?

A

Yes, can mimic pathology.

Counter this by asking patient to take a deep breath and hold.

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4
Q

What are the hila?

A

The junctions found between the lungs and the heart.

The left hilum is slightly higher.

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5
Q

Which diaphragm is higher?

A

The right diaphragm lies slightly higher than the left.

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6
Q

What areas should be given special attention when reviewing a CXR?

A

Lung apices
Above/Behind the clavicles
Behind the heart
Below the diaphragms

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7
Q

How many lobes are there in the right lung?

A

3

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8
Q

How many lobes are there in the left lung?

A

2

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9
Q

What causes lobar collapse?

A

Bronchial obstruction

Can be a foreign body, compacted mucus or tumour.

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10
Q

How does a left lower lobe collapse appear on CXR?

A

White triangle muffles the left heart border.

Hilum not visible on this side.

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11
Q

How does left upper lobe collapse appear on CXR?

A

Tricky to see, left heart border appears to have disappeared.

Described as a veil-like opacity.

Left diaphragm may become higher than the right.

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12
Q

How does right upper lobe collapse present?

A

Clearly visible horizontal fissure - white tissue will border black tissue below the fissure.

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13
Q

Does the right middle lobe collapse alone?

A

Very rarely seen without a right lower lobe collapse too - this is because both lobes share a bronchus intermedius.

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14
Q

If only a right middle lobe collapse is seen, how does this present?

A

Lost right heart border only.

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15
Q

If only a right lower lobe collapse is seen, how does this present?

A

Lost diaphragm contour only.

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16
Q

If both right middle and right lower lobes collapse, how does this present?

A

Loss of the right heart border AND diaphragmatic contour.

Right lung will be clearly smaller.

17
Q

Which lung has a lingula?

A

The left lung.

18
Q

How does infection of the lingula affect a CXR?

A

Obscures the left heart border.

19
Q

How does the presence of fluid in the pleural space initially present?

A

Blunting of the costophrenic angles.

20
Q

How is a small pneumothorax seen on a CXR?

A

A dark crescent sign without lung markers, often seen at the lung apices.

Can be subtle.

21
Q

How is a large pneumothorax seen on CXR?

A

There will be no lung markings.

22
Q

What is the ‘ABCDE’ of heart failure?

A 
Alveolar oedema
Kerley B lines
Cardiomegaly
Dilated upper lobe vessels
Pleural effusion
23
Q

Where are Kerley B lines seen?

A

In the lower zones at the edges.

24
Q

What is ‘batwing’ oedema characteristic of?

A

Heart failure

25
Q

Where should an endotracheal tube be observed on CXR?

A

5cm above the carina.

26
Q

What is the carina of the lungs?

A

The point at which the bronchus splits.

27
Q

Where are CVC lines most commonly inserted?

A

The right internal jugular vein

28
Q

Where are PICC lines inserted?

A

Usually in the cephalic vein, basilic vein or brachial vein.

29
Q

A line placed too high risks what?

A

Thrombosis

30
Q

A line placed too low risks what?

A

Arrhythmia (can enter the right atrium)

31
Q

Where should be checked for metastasis in lung cancer?

A

Brain
Liver
Adrenal glands
Bones

32
Q

What are sites of perforation associated with pneumoperitoneum?

A

Stomach
Diaphragm
Small bowel
Large bowel

33
Q

Can pneumoperitoneum be diagnosed on a supine CXR?

A

No, as the air will not rise to the top of the abdominal cavity - will need to be a erect CXR.

34
Q

What is gold standard for diagnosis of a pulmonary embolism?

A

CT-pa

CLASP 2 - Anatomy & Radiology (4 decks)

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