Chest X ray interpretation Flashcards
how are most x rays done
PA view
how is technical quality assessed on a chest x-ray
RIPE
no Rotation
full Inspiration
Penetration
Enough coverage
what approach should be taken to assessing the chest x ray
Dr 0 ABCD2E
D
details of patient and radiograph
name, dob and ID
view,date,marker
R
radiograph quality
RIPE
How is rotation assessed
medial aspect of each clavicle should be equidistant from spinous processes
how is inspiration assessed
5-6 anterior ribs, lung apexes, costophrenic angles and lateral rib edges visible
how is penetration assessed
left hemidiaphragm should be visible to spine and vertebrae should be visible
o
obvious abnormality
A
Airway
trachea deviation?
carina
right main bronchus wider,shorter more vertical
B
breathing
symmetrical lungs
lung zones - apices,hila,bases
pleura
compare like zones between lungs note any asymmetry
pleura not usually visible inspect borders of each lung ensure markings extend all the way down to edges no thickening no changes in opacity
what does no lung markings indicate
pneumothorax
C
cardiomediastinum
heart size (no more than 50%) of thoracic width cardiothoracic ratio <0.5 no cardiomegaly
mediastinal borders - well defined?
right atrium = right heart border
left ventricle = left heart border
aortic knuckle definition
aorto pulmonary window (between arch of aorta and pul arteries)
d
diaphragm
right hemidiaphragm higher than left
gastric bubble in stomach underlying left hemidiaphragm
costophrenic angles -visiblity?acute angle?no blunting
disability
bones in tact?
soft tissues normal ?
Everything else
no lines, tubes or artefacts
