Chest Radiography

Question 1

What are the standard views for chest radiography?

Answer 1

posteroanterior (PA) & lateral

Question 2

What are additional views for chest radiography?

Answer 2

anteroposterior

Question 3

What is the preferred view for chest radiography? Why?

Answer 3

posteroanterior (PA) because AP view will over-magnify the heart

Question 4

What is the ABCDEF checklist for reading a chest radiograph?

Answer 4

Airways
Bones
Cardiac
Diaphragm
Effusion
Fields of lungs

Question 5

At what spinal level does the trachea bifurcate?

Answer 5

T4-5

Question 6

Pneumothorax

Answer 6

abnormal presence of air or gas in the pleural cavity which impairs oxygenation & ventilation

Question 7

If there is a L pneumothorax, which way will the trachea deviate?

Answer 7

deviates contralaterally to the right

Question 8

If there is a R pneumothorax, which way will the trachea deviate?

Answer 8

deviates contralaterally to the left

Question 9

Atelectasis

Answer 9

partial or complete collapse of the lung due to loss alveolar air volume

Question 10

If there is R atelectasis, which way will the trachea deviate?

Answer 10

deviates ipsilaterally to the right

Question 11

If there is L atelectasis, which way will the trachea deviate?

Answer 11

deviates ipsilaterally to the left

Question 12

Cardiothoracic Ratio

Answer 12

cardiac width should measure less then half the thoracic width at level of diaphragm (only applies to PA view)

Question 13

What is a normal diaphragm shape?

Answer 13

• curved
• right side higher than left side
• level w/10th posterior rib or intercostal space

Question 14

Where are costophrenic angles?

Answer 14

intersection of each hemidiaphragm & lateral chest wall

Question 15

How do normal costophrenic angles appear?

Answer 15

clearly visible as well-defined, sharp angles

Question 16

How do abnormal costophrenic angles appear?

Answer 16

loss of acute angle

Question 17

What view is the loss of acute costophrenic angle seen earliest?

Answer 17

lateral view

Question 18

Pleural Effusion

Answer 18

excess fluid in the pleural cavity produced by an underlying condition

Question 19

What are the four types of fluid accumulation?

Answer 19

1. hydrothorax
2. hemothorax
3. chylothorax
4. pyothorax

Question 20

Hydrothorax

Answer 20

collection of serous fluid in the pleural cavity

Question 21

Hemothorax

Answer 21

collection of blood in the pleural cavity

Question 22

Chylothorax

Answer 22

collection of lymph fluid in the pleural cavity

Question 23

Pyothorax

Answer 23

collection of pus in the pleural cavity

Question 24

With a pleural effusion, how does the fluid move within the lung?

Answer 24

moves down w/gravity to the base of the lung

Question 25

Radiographically, what does a pleural effusion cause?

Answer 25

loss of acute costophrenic angles or visible concave surface

Question 26

How far do the pulmonary vascular markings extend?

Answer 26

extend to the edges of the lungs

Question 27

If the lung field appears too white, what might this indicate?

Answer 27

atelectasis & pleural effusion

Question 28

If the lung appears too black, what might this indicate?

Answer 28

pneumothorax & COPD

Question 29

Duplex Ultrasound

Answer 29

non-invasive form of ultrasounds using high frequency sound waves to identify gross circulation anomalies

Question 30

Duplex ultrasound is the modality of choice for evaluation of what conditions?

Answer 30

- deep vein thrombosis - venous insufficiency - cerebrovascular disease - renal disease - aortoiliac disease

Question 31

Deep Vein Thrombosis (DVT)

Answer 31

formation of a blood clot within a deep vein

Question 32

What are signs and symptoms of DVT?

Answer 32

erythema, warmth, swelling in extremities, pitting edema, extremity tenderness, prominent superficial veins

Question 33

If you suspect DVT, do you continue treatment?

Answer 33

NO!

Question 34

What are the two modes of ultrasound used?

Answer 34

b-mode & doppler

Question 35

What kind of image does b-mode ultrasound obtain?

Answer 35

two-dimensional, greyscale image of the vessel being studied

Question 36

What does b-mode ultrasound allow us to visualize?

Answer 36

vascular compression vs. non compression

Question 37

Arteries are _________ compressible, whereas veins are __________ compressible.

Answer 37

minimally, normally

Question 38

What does doppler ultrasound evaluate?

Answer 38

velocity & direction of blood flow in a vessel

Question 39

If the blood cells are moving away from the transducer, reflected waves return at a ____________ rate/frequency.

Answer 39

lower

Question 40

If the blood cells are moving toward the transducer, reflected waves return at a __________ rate/frequency.

Answer 40

higher

Question 41

Doppler Effect

Answer 41

blood flowing within a vein changes the sound waves

Question 42

What confirms the diagnosis of DVT?

Answer 42

absence of blood flow