chest X-ray Flashcards by Alyssa J

What does the acronym PET means ?

Positron Emission Tomography

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What is a PET scan?

An imaging test that can be used to reveal biochemical or metabolic functions of the patients’ tissues and organs.

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What is the name of the radioactive drug used in PET scan ?

Tracer

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How is tracer given ?

It is injected into the patients veins

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How is the tracer used in PET scan?

It is injected into the patients vein. It then circulates to various organs, The Scanner detects the activity and converts it into an image that is then read by a radiologist.

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How long does a PET scan last approximately?

About 2 hours

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Cancer cells shows up as what, on a PET Scan image?

They show up as bright spots because they have abnormal metabolic activity

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PET are done to do what?

Detect cancer
Determine of the treatment is working
Determine if the cancer spread
finding a cancer recurrence

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What are Gamma rays used For?

used in medicine for killing cancer cells.

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What are xrays used for?

To view inside of bodies and objects

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what is ultraviolet used in?

Absorbed by the skin, used in Fluorescent tubes

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What does visible light used for?

used to make things able to
be seen

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Infrared does what?

Transmits heat from sun, fire, and radiators

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What are 2 physical properties of x-rays that make them useful?

Penetrates matter
Photographic effect

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With emphysema patients, what will you see in a lateral CXR’s view?

An increased retrosternal airspace

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What disease might you identify that is found more in the Apex?

Tuberculosis

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If the patient has fluid only in the left lungs, what position would most benefit this patient?

right lateral decubitus

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Can a patient be examined in a lateral decubitus position?

Yes

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A patient can be examined in a lateral decubitus position for what purpose ?

To assess the volume of pleural effusion
Demonstrate whether a pleural effusion is mobile or loculated.

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What occurs if the patient is further away from the film/ detector?

The image magnification will increase, and the sharpness will decrease 1

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What occurs to the image When the patient is close to the film/ detector ?

The image decrease in magnification and increase in sharpness

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What does the PA view refer to?

The direction of the x-ray

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What does the patient have to do to avoid the scapula from being present in the lung field?

Place hand on machine or place hand on hips

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In order to get a clear image of the lungs the technologist instructs the patient to do what?

Take a deep breath and hold it

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A Supine View x-ray equipment is how far from the patient?

40 inches

An x-ray taken in supine view would yeild what type of image ?

A magnification of anterior structures such as the heart with decrease in sharpness of image.

What type of structure is the heart in respect to position?

Anterior structure

Why is the PA viewed preferred?

It's preferred because the PA view decreased the magnification Of the anterior structures and the sharpness of the image would be increased

What are the type CXR's?

A-P x-ray PA x-ray

Would the AP CXR's magnify pulmonary vasculature?

Yes

from what distance is PA X-ray taken?

6ft (1.83 m)

From what distance is an AP x-ray taken?

40 in ( 101 cm)

When an individual is standing up right, where does most of the blood flow occur?

At the base of the lungs

When standing in a upright position most of the ventilation goes where?

At the base of the lungs

What is the most common type of Chest X-ray done in hospitals?

Posterior Anterior X-rays

In a lateral view X-ray, where do we expect to see the heart projecting?

out to the left

What makes the anterior oblique position used in x-ray?

It frees lesions from overlying structures. In other words, it allows us to get a better view of the lesion.

Apical Lordotic X-ray is most commonly done to diagnose which disease?

Tuberculosis

Apical lordotic view is use to view what specifically?

The apex of the lung

Which of the following are/is false about PA film ? A. It is the gold standard for chest x-rays B. Heart shadow is larger because the heart is anterior and closer to the film/ detector in PA x-ray C. Anterior ribs are prominent D. Superior to AP because the diaphragm is down and we can view more of the lungs.

Which of the following is /are false about AP films? A. AP views are more useful and should be reserved for very ill patients who can not stand erectly. B. All X-rays in the ICU are portable and are AP view C. Heart shadows are larger because the heart is anterior and further away from the film/ detector. D. less sharp and greater magnification E. Vertebral column and posterior ribs are prominent

What should we expect on chest x-ray with adequate exposure?

Ribs through the heart. Pulmonary vasculature on the edges of the lungs Barely seeing the spine

What should We expect to see on an overpenetrated film?

1. Lung fields is darker than normal 2. See spine well beyond diaphragm 3. Inadequate lung detail

What should we expect to see in an underpentrated film?

1. Hemidiaphragm is obscured 2. Pulmonary markings are more prominent than they actually are

At full inspiration,at what level should the diaphragm be? A. 5-6 rib B. 8-10 rib C. 9-12 rib D. 7-8 rib

When assessing film technique full inspiration allows us to see what?

Intrapulmonary structures

Define penetration?

The amount of radiation required for a quality image

With adequate penetration in a PA film, we should barely see ?

The thoracic spine disc spaces

With adequate penetration laterally, We should see?

Spine should appear darker as it move gradually

Clavicle shoulders lay on which rib?

The 3rd rib

Where should the spine be in respect to the clavicles?

The spine should be centered on the clavicles

If the spinous process appears closer to the right clavicle. Which side is the patient rotated to?

The patient is rotated to their left.

If the spinous process appears closer to the right clavicle, which side is the patient rotated to?

Patient rotated on their left side

How do we observe rotation?

By comparing the location of the clavicular heads

Where should the clavicular heads be located?

Equidistant from the spinous process

With soft tissue and bony structures, what are we checking for?

1. Symmetry 2. Deformities 3. fractures 4. masses 5. Calcification 6. Lytic lesions

When pertaining to the mediastinum, what do we check for?

1. Cardiomegaly 2. Mediastinal and Hilar contours

The trachea is located where in relation to the mediastinum?

The trachea is located in upper Stinum

The apex of the heart is located where in respect to the mediastinum?

Apex is located in the lower mediastinum

On the lateral view, where is the heart projected?

It is projected to the left

What should we expect to see on a chest x-ray concerning an Emphysema patient?

Increase retrosternal air space Increase A-P diameter

What position will assist us in localizing lesions, and what is this position's role in respect to other organs?

Right or left anterior oblique view This view move other organs out of the way making it easier to view lesions

What position type is useful in assessing the apex of the lungs?

Apical Lordotic

What disease might you identify that is found more in the apex ?

Tuberculosis

Is tuberculosis an anaerobic or aerobic organism?

Aerobic

When standing upright, where does most of the ventilation and perfusion go?

To the base of the lungs

What position can we utilize to assess pleural effusion?

Lateral decubitus

What do you know about PA Films?

Gold standard in hospitals Decreases the size of the heart shadow and increases the sharpness of the image Anterior ribs are prominent Superior to AP because the diaphragm is downward creating .a better view of the lung fields

What do you know about AP Film?

It is reserve for patients in the ICU It increases the size of the heart shadow and decreases the sharpness of the image

What should We expect to see in an adequately exposed film?

Barely see the spine should see the ribs through the heart should see pulmonary vessels nearly to the edges of the lungs

What should we expect to see in an overexposed film?

lung fields are darker than usual Spine goes beyond the diaphragm Inadequate lung details

What should we expect to see in an underexposed film?

obscured Hemidiaphragm Pulmonary markings are more prominent than usual

What is the characteristic of sputum For pulmonary edema?

Pink and frothy

When would We see a fungal infection of the lung?

In patients receiving inhaled corticosteroids

What do we expect to see on a chest x-ray for Emphysema patients?

hyperluncency vertical heart shadow Flattened diaphragm

Why would you do a left lateral X-ray on a patient with emphysema?

To assess retrosternal airspace

How many lobes on the right lung?

3 lobes

How many lobes on the left lung?

2 lobes

How many segments in the right lung?

10 segments

How many segments are in the left lung?

8 segments

What procedure is utilized to get further down in the lungs

BAL

What drugs are used for tuberculosis?

Isoniazid Rifampin Ethambutol Pyrazinamide

Examples of Tuberculosis

Consolidation Cavitation Fibrosis adenopathy Pleural effusion

Examples of pneumothorax

Air in the thoracic cavity But outside the lungs

Examples of COPD and Emphysema

hyperinflation Flattened diaphragm Bullae Increase retrosternal airspace

Define Flail chest

fracture of adjacent ribs in 2 or more places

What are some differential diagnoses for emphysema?

Pneumothorax Large multiple Bullae overexposed film Asthma

What are some differential diagnoses for pulmonary tuberculosis?

Resolving bacterial pneumonia Pulmonary edema lung carcinoma Fungal infection in the lungs

Define atelectasis?

Partial or complete collapse of the lungs

What are the cause of atelectasis?

Extrinsic compression Peripheral Compression Endobronchial lesions

What are the results of atelectasis?

Elevated hemidiaphragm Tracheal shift to the affect side unaffected side may appear more radiolucent (compensatory emphysemal ) Widened intercostal spaces