Chest X-ray Flashcards
What are the 4 stages when checking the quality of the chest X-ray?
RIPE
Rotation
Inspiration
Projection
Exposure
What are you looking for when looking at the rotation of the chest x-ray?
The medial aspect of each clavicle should be an equal distance from the spine. Also the spinous processes should be in vertically orientated against the vertebral bodies
What are you looking for when looking at the inspiration of the chest x-ray?
The 5-6 ribs, lung apices, both costophrenic angles and the lateral rib edges should be visible
What projection should the chest x-ray be?
AP
What are you looking for when looking at the exposure of the chest x-ray?
The left hemidiaphragm should be visible to the spine and the vertebrae should be visible behind the heart
What is the stepwise acronym for interpretation of a chest x-ray?
A - airways
B - breathing
C - cardiac
D - diaphragm
E - everything else
What could cause pushing cuasing tracheal deviation in a CXR?
Large pleural effusion or tension pneumothorax
What could cause pulling to cause tracheal deviation in a CXR?
Lobar collapse
What is the carina?
The cartilage situated at which the trachea divides into the left and right main bronchus
How does the right bronchus appearon a CXR compared to the left?
wider, shorter and more verticle
What is aspiration pneumonia?
When inhaled foreign objects become lodged - more common in right bronchus
What does the hilar consist of?
Pulmonary vasculature and major bronchi - same size so if this changes then it indicates pathology.
What pathology causes symmetrical changes in the lung fields?
pulmonary oedema
What pathology does increased airspace shadowing indicate?
Consolidation/malignant lesion
What pathology does the complete absence of lung markings indicate?
Pneumothorax
When looking at the lungs and comparing each zone what should you been looking for?
Asymmetry
What does the presence of pleural thickening indicate?
Mesothelioma
What does an area of increased opacity on a CXR suggest?
Hydrothorax or haemothorax in the pleural space
What is cardiomegaly?
When the heart occupies more than 50% of the thoracic width on a PA chest x-ray
What does a reduced definition of the right heart border typically associate with?
right middle lobe consolidation
What does a reduced definition of the left heart border typically associate with?
lingular consolidation
Is the right hemidiaphragm higher or lower than the left and why?
higher due to the presence of the liver
What happens in bowel perforation on a CXR?
Air accumulates under the diaphragm causing it to lift and become visibly separate from the liver
What conditions can result in false impression of free gas under the diaphragm?
pseudo-pneumoperitoneum, including chilaiditi syndrome
What does costophrenic blunting indicate?
Presence of fluid or consolidation in that area. COPD
what does the reduced definition of the aortic knuckle contours indicate?
can occur in the context of an aneurysm
What can the loss of the aortopulmonary window result from?
The mediastinal lymphadenopathy
Where are the review areas?
The lung apices, the reterocardiac region, behind the diaphragm, the peripheral region of the lungs, the hilar regions
