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CLASP Applied Anatomy & Radiology (Y3) > Chest Radiology > Flashcards

Chest Radiology Flashcards

1
Q

What are the initial steps to assessing a chest radiograph?

A
  • Check name & CHI no. - Establish side/view - Is it technically adequate - projection, inspiration, rotation, penetration?
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2
Q

What is meant by the projection?

A

AP or PA

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3
Q

Is a PA or AP chest radiograph preferable and why?

A

PA as doesn’t over-magnify the heart

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4
Q

Cardio-thoracic ratio should only be done on…

A

PA radiograph

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5
Q

What is the correct inspiration for a chest radiograph?

A

At least 6 ribs should be visible

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6
Q

What is a normal cardiothoracic ratio?

A

< 0.5

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7
Q

How can you establish if the rotation of a chest radiograph is correct?

A

medial ends of the clavicles should be equidistant from the spinous processes of the upper thoracic vertebrae

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8
Q

Which structure does 1 correspond to?

A

Aorta

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9
Q

Which structure does 2 correspond to?

A

Pulmonary artery

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10
Q

Which structure does 6 correspond to?

A

Trachea

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11
Q

Which structure does 9 correspond to?

A

Horizontal fissure

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12
Q

Which structures are contained in the hila?

A

Pulmonary artery, vein, bronchi & nodes

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13
Q

Are the hila at the same level?

A

No, left hilum usually lies higher

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14
Q

Where does the diaphragm lie on each side?

A

Right around 1.5cm higher than left

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15
Q

When reporting chest radiographs, how can you describe the area of a lung field defect?

A

Upper, mid or lower zones

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16
Q

Where roughly is referred to as the upper zone?

A

Apex to rib 2

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17
Q

Where roughly is referred to as the mid zone?

A

Rib 2 to 5

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18
Q

Where roughly is referred to as the lower zone?

A

Rib 5 to base

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19
Q

What is meant by ‘review areas’?

A

Areas which are commonly missed

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20
Q

What are the review areas on a chest radiograph?

A

Lung apices

Below the diaphragm

Behind the heart

Bones & soft tissues

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21
Q

Which lobes are seen from the front of the patient?

A

Right upper & middle lobes

Left upper lobe (including lingula)

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22
Q

Which lobes are seen from the back of the patient?

A

Right lower lobe

Left lower lobe

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23
Q

When does lobar collapse occur?

A

Obstruction of a bronchus

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24
Q

What pathology is shown here?

A

Left lower lobe collapse - sail sign

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25
Q

What is the classic sign of left lower lobe collapse?

A

Sail sign

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26
Q

What is the classic sign of right upper lobe collapse?

A

Veil-like opacity

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27
Q

What pathology is shown here?

A

Left upper lobe collapse

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28
Q

Which pathology is shown?

A

Right upper lobe collapse

29
Q

Which classical sign is seen in right middle lobe collapse?

A

Obscures right heart border

30
Q

Which pathology is seen?

A

Right middle lobe collapse

31
Q

Which pathology is seen?

A

Right lower lobe collapse

32
Q

Which lobes tend to collapse together?

A

Right lower & middle lobes

33
Q

Which pathology is shown?

A

Right middle & lower lobe collapse

34
Q

Why do the right middle and lower lobes tend to collapse together?

A

Have same bronchus of origin - bronchus intermedius

35
Q

Which pathology is shown?

A

Right middle lobe consolidation

36
Q

Which pathology is shown?

A

Right upper lobe consolidation

37
Q

Which pathology is shown?

A

Right lower lobe consolidation

38
Q

Which pathology is seen here?

A

Lingular consolidation

39
Q

Which pathology is seen here?

A

Left upper lobe consolidation

40
Q

The lingula is part of the…

A

Left upper lobe

41
Q

Where is the pleural space?

A

between visceral & parietal pleura

42
Q

Which radiological feature suggests pleural effusion?

A

Meniscus sign - blunting of the costophrenic angle on erect CXR

43
Q

A pneumothorax occurs due to rupture of…

A

Visceral pleura

44
Q

What is the sign of a pneumothorax on CXR?

A

dark crescent without lung markings bounded medially by the lung edge

45
Q

Which pathology is seen here?

A

Left sided pleural effusion

46
Q

Which pathology is seen here?

A

Small left-sided pneumothorax

47
Q

Which pathology is shown here?

A

Right-sided tension pneumothorax

48
Q

What is usually the first sign of pulmonary oedema?

A

Dilation of upper lobe vessels/cardiomegaly

49
Q

What are the radiological signs of heart failure?

A

ABCDE

A - alveolar oedema (bat wing opacities)

B - Kerley B lines

C - cardiomegaly

D - dilated upper lobe vessels

E - pleural effusion

50
Q

Chest x-rays are used to ensure that which tubes are correctly placed?

A

Endotracheal (ET) tubes

Nasogastric tubes

Central venous lines

51
Q

Where is the normal placement of an endotracheal tube?

A

tip 5 cm above carina

width 2/3 tracheal diameter

cuff should not expand the trachea

52
Q

Where is an endotracheal tube commonly misplaced?

A

Inserted into right main bronchus - should not extend past carina

53
Q

What is the correct positioning of a nasogastric tube?

A

Inserted in the mid-line beyond the carina, below the diaphragm and ideally, 10cm beyond the gastro-oesophageal junction

54
Q

Where should central venous catheters be inserted?

A

right and left internal jugular or subclavian veins

55
Q

Where should Peripherally inserted central catheters (PICC) be inserted?

A

via cephalic, basilic or brachial veins

56
Q

Where should the tip of a CVC be seen radiologically?

A

2nd intercostal space

57
Q

How big is a pulmonary mass?

A

> 30mm

58
Q

What density masses are most suspicious of malignancy on CXR?

A

Soft tissue density masses

59
Q

Where do metastases in the lungs tend to be found?

A

At the bases

60
Q

Where do primary lung cancers tend to be?

A

Apical

61
Q

Which imaging would be preferred in suspected lung cancer?

A

Contrast-enhanced CT

62
Q

What is pneumoperitoneum?

A

Perforation of stomach, duodenum, small or large bowel resulting in gas in the peritoneum

63
Q

How would pneumoperitoneum be visualised?

A

Erect x-ray - seen as a thin black line between the diaphragm and subdiaphragmatic structures

64
Q

Which pathology is seen here?

A

Pneumoperitoneum

65
Q

When should D-dimers be used in work up of PE?

A

Only in low risk groups to exclude diagnosis

66
Q

What kinds of imaging may be used in PE?

A

CXR

CTPA

V/Q scan

67
Q

What finding on V/Q scanning suggests PE?

A

Mismatch perfusion defect

68
Q

What is shown on the CT?

A

Pulmonary fibrosis

69
Q

What is shown on the CT?

A

Bronchiectasis

CLASP Applied Anatomy & Radiology (Y3) (9 decks)

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