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CLASP: Radiology and Anatomy > Chest Imaging > Flashcards

Chest Imaging Flashcards

1
Q

what colour is air on CXR?

A

black

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2
Q

what colour is fat on CXR?

A

grey

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3
Q

what colour is soft tissue/ muscle on CXR?

A

grey/ white

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4
Q

what colour is bone on CXR?

A

white

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5
Q

what colour is metal on CXR?

A

bright white

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6
Q

what to check when looking at a CXR?

A

patients name
CHI
side marker
adequate projection

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7
Q

how do you tell if there is adequate projection on CXR?

A

PA
ratio of cardiac diameter to horizontal thoracic diameter is <50%
assess scapula

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8
Q

how do you tell if a CXR is adequate inspired?

A

anterior ends of at least 6 ribs are visible (remember the ribs you can see are posterior)

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9
Q

how do you tell if a CXR if adequately rotated?

A

medial ends of clavicles equidistant from spinous processes of upper thoracic vertebra

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10
Q

which hila is higher?

A

left due to the heart

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11
Q

which side of the diaphragm is higher?

A

right due to the liver

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12
Q

what should the hila look like on CXR?

A

chevrons ><

if not= bilateral hilar lymphadenopathy

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13
Q

review areas on CXR

A
  1. lung apices
  2. behind the heart
  3. below the diaphragm
  4. bone and soft tissues
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14
Q

why do you need to look at the lung apices on CXR?

A

masses (Pancoast tumour)

pneumothroax

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15
Q

what to look for behind the heart on CXR?

A

consolidation
masses
hiatus hernia

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16
Q

what to look for below the diaphragm on CXR?

A 
free gas
lines
tube e.g. NG
gastric distension
bowel obstruction
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17
Q

what to look for in bones and tissues on a CXR?

A 
fractures
masses
mastectomy
subcutaneous emphysema
evidence of previous surgery e.g. axillary clips
18
Q

how many lobes does each lung have?

A 
left= 2 lobes
right= 3 lobes
19
Q

fissure in the right lung

A

oblique

horizontal

20
Q

what causes a lobar collapse?

A

obstruction of a lobar bronchus

21
Q

causes of lobar collapse

A

tumours
aspirated foodstuffs
mucus impacted

22
Q

why does the lobe collaspe?

A

air is resorbed, loses volume and collapses

23
Q

pleural space abnormalities

A
  1. pleural effusion

2. pneumothorax

24
Q

how does a pleural effusion appear on an erect CXR?

A

pleural fluid collects at lung bases and forms the curved appearance of a meniscus at lung edges blunting the costophrenic angles

25
Q

what causes a pneumothorax?

A

rupture of the visceral pleura allows air to rush in from the lungs every time the patient inspires
air accumulates impairing respiratory function

26
Q

why is tension pneumothorax an emergency?

A

displaces heart and diaphragm

27
Q

signs of pulmonary oedema

A 
A (alveolar oedema- batwing opacities)
B (kerley B lines)
C (cardiomegaly)
D (dilated upper lobe vessels)
E (pleural effusion)
28
Q

what is CXR used to confirm the placement of?

A 
endotracheal tubes (ET)
nasogastric tubes (NG)
central venous lines
29
Q

where should an endotracheal tube sit?

A

5cm above carina

30
Q

malposition of endotracheal tube

A

past carina
right main bronchus (more vertical at carina)
oesophagus

31
Q

where should NG tubes sit?

A

subdiaphragmatic position in the stomach (overlying stomach bubble)
10cm beyond gastro-oesphageal junction

32
Q

malpositioning of NG tube

A

remaining in oesophagus
traversing bronchus
intracranial insertion (possible in skull base trauma/ surgery)

33
Q

where should central venous catheters be placed?

A

central lines can be inserted via right and left internal jugular or subclavian veins

tip should be at cavoatrial junction

34
Q

how are peripherally inserted central catheters done?

A

via cephalic, basilic or brachial veins

35
Q

malpositioning of central venous catheters

A

tip to high in proximal SVC (thrombus risk)
tip too low in distal right atrium or ventricle (arrhythmias)
coiled/displaced in vein (IJV/azygous vein)

36
Q

when is contrast enhanced CT used for pulmonary masses?

A

assessing tumour size
showing metastases
guided biopsy of peripheral lesion

37
Q

what is FDG-PET CT used for pulmonary masses?

A

nodal and distant mets (not brain)

38
Q

what is a pneumoperitoneum?

A

perforation of a hollow viscus that results in air in peritoneal cavity

39
Q

diagnosis of pneumoperitoneum?

A

erect allowing gas to rise up under the diaphragm(black thin line between diaphragm and subdiaphragmatic structures)

40
Q

diagnosis of PE

A

XR
V/Q scan
CTPA

CLASP: Radiology and Anatomy (4 decks)

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