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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
what is ascites
accumulation of fluid in the peritoneal cavity
26
radiological appearance of ascites
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
27
what is pneumoperitoneum
free air in the peritoneal cavity
28
radiological appearance of pneumoperitoneum
chest xray: rim of lucency under diaphragm continuous diaphragm sign abdomen xray: rigler/double wall sign football sign falciform ligament sign
29
describe bowel dilation
3-6-9 rule: small bowel, large bowel, caecum measured on supine abdomen radiograph indicates bowel obstruction
30
position of dilated small bowels
central
31
wall pattern of dilated large bowels
haustral folds
32
position of dilated large bowels
circumferential
33
wall pattern of dilated small bowels
valvulae conniventes
34
what is sigmoid volvulus
twisting of the bowel on its mesentery, the sigmoid mesocolon can cause partial or complete bowel obstruction
35
radiological appearance of sigmoid volvulus
coffee bean sign loss of haustra pattern possible distention of the proximal portion of the colon
36
what is inflammatory bowel disease
unknown cause; could be due to bacteria, virus or an autoimmune response
37
what are some types of IBD
Crohn's disease Ulcerative colitis
38
describe Crohn's disease
- can occur anywhere along the GIT - common sites are terminal ileum and proximal colon
39
describe Ulcerative colitis
- usually occur in the colon and rectum
40
radiological appearance of IBD
mucosal thickening of the bowel resulted in - increased distance between the bowel loops - thick haustral folds which form the thumbprinting sign
41
what is the lead pipe sign in IBD
a lack of haustral markings in the descending colon has resulted in a smooth cylindrical appearance termed the lead pipe sign
42
how does gallbladder calculi appear to be
different shapes and sizes: - polygonal shaped, radiopaque outline with lucent center or concentric rings - often rounded and cluster together
43
common sites for CVC insertion
- subclavian vein - internal jugular vein - peripherally inserted central catheter
44
what happens if CVC is inserted into the brachiocephalic veins
increased risk of line infection and thrombosis
45
when does lobar and segmental bronchi become visible
- asthma (thick walled) - bronchiectasis (dilated) - distorted (lung fibrosis)
46
systematic approach for chest
Airway Breathing Circulation Diaphragm Everything else
47
what to look out for when checking for airway
trachea carina bronchi hilar structures
48
what to look out for when checking for circulation
cardiac size mediastinal contours great vessels hilar assessment
49
which pathology affects the anatomic outlook of the diaphragm
pleural effusion pneumoperitoneum phrenic nerve palsy
50
zones of the lung
upper mid lower (including behind the diaphragm) do not correspond to the lobes
51
lobes of the right lung
upper middle lower
52
lobes of the left lung
upper lower
53
fissures of the right lung
oblique horizontal
54
fissures of the left lung
oblique
55
where can azygos lobr be found
medial right upper lung
56
how are fissures seen in radiographs
right oblique - partly visible on the lateral CXR horizontal - visible as a thin white line in the right midzone on the frontal CXR
57
right upper lobe can be further divide into
3 segments: anterior posterior apical
58
right middle lobe can be further divided into
2 segments: medial lateral
59
right lower lobe can be further divided into
5 segments: superior posterobasal laterobasal antero basal medial basal
60
left upper lobe can be further divided into
4 segments: superior and inferior lingular segments anterior and apicoposterior
61
left lower lobe can be further divided into
4 segments superior posterior lateral anteromedial
62
how is cardiothoracic ratio calculated
horizontal diameter of the heart divided by widest internal diameter of thoracic cage
63
what is a normal CTR
<50%
64
what is the degree of cardiomegaly
mild 50-55% moderate 55-60% severe >60%
65
what structure is checked to confirm a situs inversus
aortic knuckle on the right and liver density below the left diaphragm
66
examples of radiolucent kidney stones
- uric stones - pure matrix stones

Image interpretation theory (5 decks)

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