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Image interpretation theory > chest and abdomen > Flashcards

chest and abdomen Flashcards

1
Q

how does artificial heart valves appear on xray

A

typically appear as ring-shaped structure

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2
Q

how does pacemaker appear on xray

A

radio-opaque disc or oval in infraclavicular region

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3
Q

common tubes / lines

A

nasogastric tube (NGT)
endotracheal tube (ETT)
central venous lines
chest drainage tubes

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4
Q

how should NGT placement be

A

CXR should include upper esophagus to below diaphragm

NGT should
- remain in the midline down to the level of the diaphragm
- bisect the carina

tip of NGT should be
- clearly visible and below the left hemidiaphragm
- approx 10cm beyond the gastro-esophageal junction

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5
Q

correct placement of ETT

A

tip should be in the trachea, 5cm above the carina

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6
Q

what is the CVC for

A

monitoring of central venous pressure
fluid administration
hemodialysis

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7
Q

correct placement of CVC

A

SVC or just above the level of carina

cavo-atrial junction
- long term chemotherapy - hemodialysis

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8
Q

common conditions and injuries of the chest

A

pulmonary consolidation
pneumomediastinum
pneumoperitoneum
flail chest
aortic dissection
pleural effusion
pneumothorax
atelectasis

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9
Q

what is pulmonary consolidation

A

loss of alveolar air by fluid, cells, pus or other materials

pneumonia is the most common cause of consolidation

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10
Q

radiological appearance of pulmonary consolidation

A
  • patchy shadowing
  • lobar density
  • absent / ill-defined heart borders and hemidiaphragm
  • air bronchogram
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11
Q

absent / ill-defined border of which region indicates pulmonary consolidation of which lobe

A

ill-defined —> location

right heart boarder —> middle lobe
left heart border —> left upper lobe
right hemidiaphragm —> right lower lobe
left hemidiaphragm —> left lower lobe

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12
Q

what is pneumomediastinum

A
  • free air within the mediastium
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13
Q

causes and risk factor of pneumomediastinum

A
  • forceful coughing
  • excessive vomiting
  • neck/chest injury
  • rupture of trachea
  • rupture of esophagus
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14
Q

radiological appearance of pneumomediastinum

A
  • lucency surrounding mediastinal structures
  • subcutaneous emphysema
  • continuous diaphragm sign
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15
Q

causes of pneumoperitoneum

A

perforation of
- peptic ulcer
- bowel
- stomach

trauma

post surgery

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16
Q

what is flail chest

A
  • 2 or more adjacent ribs fractured in more than one area (2 or more breaks in 1 or 2 ribs can present as flail chest)
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17
Q

what does flail segment affect

A

breathing mechanism

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18
Q

what is aortic dissection

A
  • tear in the inner layer of the aorta
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19
Q

causes or risk factor of aortic dissection

A
  • chronic hypertension
  • trauma
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20
Q

how are aortic dissection classified

A

Stanford A (involving ascending aorta)
- DeBakey I
- DeBakey II

Stanford B (involving only descending aorta)
- DeBakey III

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21
Q

4 quadrants of an abdomen

A

RUQ
LUQ
RLQ
LLQ

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22
Q

9 regions of an abdomen

A

right hypochondrium
epigastic
left hypochondrium
right lumbar
umbilical
left lumbar
right iliac
suprapubic
left iliac

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23
Q

systematic approach in checking abdomen

A

ABDOX
Assessment of Air
Bowels
Density
Organs
External objects and artefacts

ABBDO
Air
Bowels
Bones
Densities
Organs

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24
Q

common pathological conditions of the abdomen

A

ascites
pneumoperitoneum
bowel dilation
sigmoid volvulus
inflammatory bowel disease
kidney calculi
gallbladder & bladder calculi

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25
Q

what is ascites

A

accumulation of fluid in the peritoneal cavity

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26
Q

radiological appearance of ascites

A

ground glass appearance
absent/ill-defined organs and soft tissue shadows
laterally displaced properitoneal fat stripe
centralised bowels
paucity of bowel gas

require >500ml of fluid to be detected on plain radiograph

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27
Q

what is pneumoperitoneum

A

free air in the peritoneal cavity

28
Q

radiological appearance of pneumoperitoneum

A

chest xray:
rim of lucency under diaphragm
continuous diaphragm sign

abdomen xray:
rigler/double wall sign
football sign
falciform ligament sign

29
Q

describe bowel dilation

A

3-6-9 rule: small bowel, large bowel, caecum

measured on supine abdomen radiograph

indicates bowel obstruction

30
Q

position of dilated small bowels

A

central

31
Q

wall pattern of dilated large bowels

A

haustral folds

32
Q

position of dilated large bowels

A

circumferential

33
Q

wall pattern of dilated small bowels

A

valvulae conniventes

34
Q

what is sigmoid volvulus

A

twisting of the bowel on its mesentery, the sigmoid mesocolon

can cause partial or complete bowel obstruction

35
Q

radiological appearance of sigmoid volvulus

A

coffee bean sign
loss of haustra pattern
possible distention of the proximal portion of the colon

36
Q

what is inflammatory bowel disease

A

unknown cause; could be due to bacteria, virus or an autoimmune response

37
Q

what are some types of IBD

A

Crohn’s disease
Ulcerative colitis

38
Q

describe Crohn’s disease

A
  • can occur anywhere along the GIT
  • common sites are terminal ileum and proximal colon
39
Q

describe Ulcerative colitis

A
  • usually occur in the colon and rectum
40
Q

radiological appearance of IBD

A

mucosal thickening of the bowel resulted in
- increased distance between the bowel loops
- thick haustral folds which form the thumbprinting sign

41
Q

what is the lead pipe sign in IBD

A

a lack of haustral markings in the descending colon has resulted in a smooth cylindrical appearance termed the lead pipe sign

42
Q

how does gallbladder calculi appear to be

A

different shapes and sizes:
- polygonal shaped, radiopaque outline with lucent center or concentric rings
- often rounded and cluster together

43
Q

common sites for CVC insertion

A
  • subclavian vein
  • internal jugular vein
  • peripherally inserted central catheter
44
Q

what happens if CVC is inserted into the brachiocephalic veins

A

increased risk of line infection and thrombosis

45
Q

when does lobar and segmental bronchi become visible

A
  • asthma (thick walled)
  • bronchiectasis (dilated)
  • distorted (lung fibrosis)
46
Q

systematic approach for chest

A

Airway
Breathing
Circulation
Diaphragm
Everything else

47
Q

what to look out for when checking for airway

A

trachea
carina
bronchi
hilar structures

48
Q

what to look out for when checking for circulation

A

cardiac size
mediastinal contours
great vessels
hilar assessment

49
Q

which pathology affects the anatomic outlook of the diaphragm

A

pleural effusion
pneumoperitoneum
phrenic nerve palsy

50
Q

zones of the lung

A

upper
mid
lower (including behind the diaphragm)

do not correspond to the lobes

51
Q

lobes of the right lung

A

upper
middle
lower

52
Q

lobes of the left lung

A

upper lower

53
Q

fissures of the right lung

A

oblique
horizontal

54
Q

fissures of the left lung

A

oblique

55
Q

where can azygos lobr be found

A

medial right upper lung

56
Q

how are fissures seen in radiographs

A

right oblique - partly visible on the lateral CXR
horizontal - visible as a thin white line in the right midzone on the frontal CXR

57
Q

right upper lobe can be further divide into

A

3 segments:
anterior
posterior
apical

58
Q

right middle lobe can be further divided into

A

2 segments:
medial
lateral

59
Q

right lower lobe can be further divided into

A

5 segments:
superior
posterobasal
laterobasal
antero basal
medial basal

60
Q

left upper lobe can be further divided into

A

4 segments:
superior and inferior lingular segments
anterior and apicoposterior

61
Q

left lower lobe can be further divided into

A

4 segments
superior
posterior
lateral
anteromedial

62
Q

how is cardiothoracic ratio calculated

A

horizontal diameter of the heart divided by widest internal diameter of thoracic cage

63
Q

what is a normal CTR

A

<50%

64
Q

what is the degree of cardiomegaly

A

mild 50-55%
moderate 55-60%
severe >60%

65
Q

what structure is checked to confirm a situs inversus

A

aortic knuckle on the right and
liver density below the left diaphragm

66
Q

examples of radiolucent kidney stones

A
  • uric stones
  • pure matrix stones

Image interpretation theory (5 decks)

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