Chest Flashcards
what 8 views are used to view the chest
- PA
- AP
- lateral
- inspiratory
- expiratory
- lordotic
- decubitus
- oblique
what is the gold standard view?
why
PA
it gives maximum visabilty of the heart
what view is this?
give three indicators
PA chest
- clavicles are low
- heart is well defined
- diaphragm is more flat
aortic arch
diaphragm
left ventricle
liver
pulmonary artery
right atrium
right mainstem bronchus
stomach
trachea
why is an AP view usually taken supine
they are taken on the portable when the patient cant make it to radiology
what view is this?
three indentifiers
- diaphragm is more lifted
- clavicle is higher
- heart is less defined
how far is the xray source from the plate in an AP? PA? Lateral?
AP is 3 feet
PA is 6 feet
lateral is 6 feet
what lateral view would you get for a left sided lesion
a left lateral view
three rules of a lateral chest x ray
- diaphragm shadows should be clear
- show of the upper vertebrae is whiter than the lower
- retrosternal and retrocardiac spaces should both be the same color and are both normally dark
diaphragm shadow
retrosternal space
retrocardiac space
lateral chest
what is this? when would you take this?
expiratory AP
looking for pneumothorax
aortic arch
pulmonary artery
right ventricle
left ventricle
what is the difference between these two radiographs
the left is inspiratory, right is inspiratory
why is a lordotic view done
to see the apices of the lungs
lordotic
what is this view? why is it done
decubitus
looking for an air fluid level
what is this view? why is it done
oblique
to look around the heart at the trachea, esophagus, or vertebrae
five boney structure of the thorax
- ribs
- clavicles
- shoulder articulation
- spine
- scapula
what are the individual sides of the diaphragm called
left and right hemidiaphragm
hilum
the origin of the lungs
list the lobes of the left and right lungs
left: upper and lingual, lower
right: upper, middle, lower
two fissures of the lungs visable on chest xray
major and minor
mediastinum
the extrapleural space between the lungs
two pleural layers visable on chest xray
parietal and visceral
what are the three costophrenic angles
anterior, posterior, lateral
deep recesses formed by the diaphragm and the ribs on PA and lateral views
lateral costophrenic angles
Ap costophrenic angles
hilum of the lungs
where the pulmonary arteries enter the lung and branch off
where are the pulmonary arteries found on radiograph
superior to the atria on both sides
the left pulmonary artery is inferior to the aortic arch
lung markings
A Left upper
B Right Upper
C Right middle lobe
D Lingula
E Right lower lobe
Left Lower Lobe
left and right hilar points
when can you see lung fissures on a chest xray
when the beam is parallel to the fissure
describe the orientation of the lung fissures with respect to the lobes
the left oblique fissure separates the upper and lower lobe
the right oblique fissures separates the middle and lower lobe
the horizontal fissure separates the upper and middle lobe
horizontal fissure
horizontal and oblique fissure
what 6 structures are found in the mediastinum
- heart
- great vessels
- trachea
- mainstem bronchi
- esophagus
- lymph nodes
name the three parts of the bronchial tree
define the first part
carina, bronchi, bronchioles
carina: the bifurcation of the trachea into bronchi
anterior/middle/posterior mediastinum
vascular structures
A Right Pulmonary artery
B Knob of the aortic arch
C Right pulmonary artery
D Left pulmonary artery
E Right pulmonary artery (lower lobe)
F RIght border fo the heart
G inferior vena cava
A Left brachial vein
B Superior vena cava
C Ascending aorta
D Aorta
E Pulmonary artery
F Left Pulmonary artery
A Pulmonary vein
B Right atria
C aortic valve
D mitral valve
E tricuspid valve
F Right ventricle
G Lefr ventricle
A Superior vena cava
B azygoesphageal recess
C right main pulmonary artery
D right descending pulmonary artery
E Right atrium
F cardio phrenic angle
G Liver
H Breast Shadow
A aortic arch
B aortopulmonary window
C descending pulmonary artery
D left atrium
E left ventricle
F gastric bubble
G splenic flexure of the colon
H descending aorta
what does the parietal pleura cover?
visceral pleura?
what is the space between them?
the interior of the chest wall
the lungs
a potential space that can fill with air or fluid
what are the structures of the lungs that should be noted in alphabetical order
(D, E, and H have two things)
A- airway
B- bones
C- cardiac
D- densities and diaphragms
E- effusions and equal lung fields
F- foreign bodies
G- gastric bubble
H- hilum and mediastinum
I- inspiration
define the mnemonic Are There Many Lung Lesions
Abdomen
Thorax
Mediastinum
Lungs individually
Lungs comparitively
what structures should be examined in a systematic review of a chest xray (9)
- general
- bony structures
- soft tissues
- lungs
- pleura
- hila
- fissures
- mediastinum
- artificial changes
during a systematic review of CXR, what are the features examined on general overiew (6)
- contrast
- projection
- orientation L.R
- correct patient
- correct films
- inspiration
what four bony structures should be examined on a systematic review of a CXR
- shoulder joint
- ribs
- spine
- scapula
when examining soft tissue (lung, breast, diaphragm) on CXR what four qualities should be noted
- thickness
- contour
- foreign body
- densities
what three features of the lungs should be reviewed on CXR
- pulmonary vessels
- airspace
- interstitial pattern
when examining the lung air space, what would be four features you might note
- nodules
- masses
- atelectasis
- COPD
two examples of diseases would cause pleural abnormalities on CXR
- pleural effusion
- pneumothorax
what three abnormalities might you see in the fissures of the lung on CXR
- presence
- shift in location
- abnormalities
what changes in the mediastinum should be noted on a systematic review of a CXR
- cardiothoracic ratio
- widening
- shifts or abnormalities
what are three examples of artificial changes to note on CXR
- surgical clips
- foreign bodies
- pacemakers
define the mnemonic I Quit And Wanna Be Free
Identify the patient
Quality of the film
Air
Water (fluid)
Bone
Funny looking things (foreign bodies)
should a CXR be symmetrical?
if not, why?
mostly symmetrical
- right hemidiaphragm should be a little higher
- left heart shadow more prominent
- aortic knob projects right
why is it important to find lung markings and follow them to the edge of the chest
because they determine the size and contour of the lung
what is wrong with this CXR
underpenetrated
what is wrong with this CXR
over penetrated
what is wrong with this CXR? how can you tell?
it is rotated
the clavicles are not equidistant from the spinous processes
