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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
What is the classic sign of left lower lobe collapse?
Sail sign
26
What is the classic sign of right upper lobe collapse?
Veil-like opacity
27
What pathology is shown here?
Left upper lobe collapse
28
Which pathology is shown?
Right upper lobe collapse
29
Which classical sign is seen in right middle lobe collapse?
Obscures right heart border
30
Which pathology is seen?
Right middle lobe collapse
31
Which pathology is seen?
Right lower lobe collapse
32
Which lobes tend to collapse together?
Right lower & middle lobes
33
Which pathology is shown?
Right middle & lower lobe collapse
34
Why do the right middle and lower lobes tend to collapse together?
Have same bronchus of origin - bronchus intermedius
35
Which pathology is shown?
Right middle lobe consolidation
36
Which pathology is shown?
Right upper lobe consolidation
37
Which pathology is shown?
Right lower lobe consolidation
38
Which pathology is seen here?
Lingular consolidation
39
Which pathology is seen here?
Left upper lobe consolidation
40
The lingula is part of the...
Left upper lobe
41
Where is the pleural space?
between visceral & parietal pleura
42
Which radiological feature suggests pleural effusion?
Meniscus sign - blunting of the costophrenic angle on erect CXR
43
A pneumothorax occurs due to rupture of...
Visceral pleura
44
What is the sign of a pneumothorax on CXR?
dark crescent without lung markings bounded medially by the lung edge
45
Which pathology is seen here?
Left sided pleural effusion
46
Which pathology is seen here?
Small left-sided pneumothorax
47
Which pathology is shown here?
Right-sided tension pneumothorax
48
What is usually the first sign of pulmonary oedema?
Dilation of upper lobe vessels/cardiomegaly
49
What are the radiological signs of heart failure?
ABCDE A - alveolar oedema (bat wing opacities) B - Kerley B lines C - cardiomegaly D - dilated upper lobe vessels E - pleural effusion
50
Chest x-rays are used to ensure that which tubes are correctly placed?
Endotracheal (ET) tubes Nasogastric tubes Central venous lines
51
Where is the normal placement of an endotracheal tube?
tip 5 cm above carina width 2/3 tracheal diameter cuff should not expand the trachea
52
Where is an endotracheal tube commonly misplaced?
Inserted into right main bronchus - should not extend past carina
53
What is the correct positioning of a nasogastric tube?
Inserted in the mid-line beyond the carina, below the diaphragm and ideally, 10cm beyond the gastro-oesophageal junction
54
Where should central venous catheters be inserted?
right and left internal jugular or subclavian veins
55
Where should Peripherally inserted central catheters (PICC) be inserted?
via cephalic, basilic or brachial veins
56
Where should the tip of a CVC be seen radiologically?
2nd intercostal space
57
How big is a pulmonary mass?
\> 30mm
58
What density masses are most suspicious of malignancy on CXR?
Soft tissue density masses
59
Where do metastases in the lungs tend to be found?
At the bases
60
Where do primary lung cancers tend to be?
Apical
61
Which imaging would be preferred in suspected lung cancer?
Contrast-enhanced CT
62
What is pneumoperitoneum?
Perforation of stomach, duodenum, small or large bowel resulting in gas in the peritoneum
63
How would pneumoperitoneum be visualised?
Erect x-ray - seen as a thin black line between the diaphragm and subdiaphragmatic structures
64
Which pathology is seen here?
Pneumoperitoneum
65
When should D-dimers be used in work up of PE?
Only in low risk groups to exclude diagnosis
66
What kinds of imaging may be used in PE?
CXR CTPA V/Q scan
67
What finding on V/Q scanning suggests PE?
Mismatch perfusion defect
68
What is shown on the CT?
Pulmonary fibrosis
69
What is shown on the CT?
Bronchiectasis

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

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