Chest X ray

Question 1

What chest x ray direction is unsuitable for looking at the heart?

Answer 1

AP

Question 2

When are AP chest x-rays used?

Answer 2

used when patient are too unwell to stand and therefore have to do it lying or standing

Question 3

What do look out for when looking at a chest x-ray

Answer 3

• inspiration- diaphragm at 6th rib level
• penetration - seee the lower thoracic vertebral bodies at the bottom
• patient rotated - spinous process mid way between the clavicles

Question 4

What do you say first when looking at a chest x ray?

Answer 4

this is a Pa chest radiograph of a young female patient. the patient has takena good inspiration and is not rotated , the film is well penetrated

Question 5

How big should the heart be on chest x ray?

Answer 5

less than 50% of the chest

Question 6

if there is a normal chest x ray what do you say?

Answer 6

the trachea is central, the mediastinum is not displaced. the mediastinal contour and hila appear normal. The lung appear clear with no pneumothorax. There is no free air under the diaphragm . The bones and soft tissue appear normal.

Question 7

What is the checklist for chestr x rays?

Answer 7

Airway: trachea? and hilum
Bone and breast
Cardiac shadow (size and shape)
Diaphragm- (sharpness and costophrenic angle)
Everything else- soft tissue
Fileds - lung infiltrates and vascularity

Question 8

What are the 5 causes of pneumothorax due to?

Answer 8

1. obstructive lung disease (asthma and COPD)
2. infection (pneumonia and TB)
3. Cystic fibrosis
4. connective tissue disease(Marfan and Ehler danlos)
5. iatragenic and trauma

Question 9

How does a pneumothorax look like on an X ray

Answer 9

BLACK

Question 10

How does a consolidation look like on an X ray

Answer 10

whiteness with not well defined borders

Question 11

What does a mass lesion look like on a scan?

Answer 11

discrete area of whiteness
could be
tumour, infection

Question 12

What does a bihilar lymphadenopathy look like?

Answer 12

cloudy hilium

-

Question 13

what are causes of bihilar lymphadenopathy?

Answer 13

neoplastic causes (bronchial carcinoma or primary lymphoma)
infective: TB
sarcoidosis - bilateral

Question 14

How does hyperinflated lungs persent in an x ray?

Answer 14

count ribs
seven or more are hyperinflated

diaphragm often flat instead of concave

Question 15

What is cardiomegaly seen on an x ray likely be due to ?

Answer 15

left ventricular failure