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Respiratory - Week 3 > Chest X Ray Introduction - Tutorial 1 > Flashcards

Chest X Ray Introduction - Tutorial 1 Flashcards

1
Q

How do X rays produce an image?

A

High energy photon produced by x-ray tube X-rays pass through the body and are absorbed/attenuated in proportion to the density of the body part, - this appears as white X rays that have not been absorbed pass through the patient and hit an image receptor - this appears as black

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2
Q

What are the basic densities seen on an X ray?

A

Air - shows as black Fat - shows as dark grey Soft Tissue - Shows as light grey Bone - shows as White

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3
Q

What is a contrast study?

A

Injecting iodine based intravenous contrast or introducing barium suspensions into hollow viscera -Make is possible to see disease anatomy that would not be seen

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4
Q

For a thoracic x-ray what must the patient do?

A

Breath in and hold their breath.

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5
Q

What way do the X-rays pass through the patient?

A

Posterior to Anterior (PA radiograph)

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6
Q

Where does the heart lie in the thorax?

A

Anteriorly - PA radiogrpahy reduces shadowing

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7
Q

How are X rays carried out for those who cannot stand?

A

AP radiograph

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8
Q

How can you tell if the CXR is adequately inspired?

A

The anterior ends of 6 ribs should be present.

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9
Q

What are the pulmonary hila?

A

hila (lung roots) are complicated structures mainly consisting of the major bronchi and the pulmonary veins and arteries

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10
Q

What are the great vessels of the heart?

A

Superior vena cava
Inferior vena cava
Pulmonary arteries
Pulmonary veins
Aorta

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11
Q

What normal structures can we see on a CXR

A
  • Heart
  • Great vessels
  • Pulmonary hila
  • Trachea and bronchi
  • Lungs
  • Pleura & pulmonary fissures
  • Diaphragms
  • Bones
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12
Q

What cancer is associated with te Hila?

A

•common place for bronchial carcinoma to arise and because lymph nodes located there may become visibly enlarged due to disease.

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13
Q

When might the minor bronchi or the major bronchi be visible?

A

May be visible if they are calcified

  • This occurs in older patients.
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14
Q

Describe what parts of the Right and Left anterior lung surface ?

A

Right

Right Upper Lobe

Right Middle Lobe

Left

Left upper lobe

Lingula

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15
Q

Describe what parts can be seen on the Right and Left lung posterior surface?

A

Right Lower Lobe

Left lower Lobe

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16
Q

What is seen inthis X ray?

A
17
Q

In a healthy lung what colour is the Retrosternal space and the retrocardiac space?

A

The retrosternal and retrocardiac spaces should be dark on a lateral CXR.

If they are not, disease is present

18
Q

What are the common disease that can be deteced on a CXR?

A
  • Pneumonia
  • Lobar Collapse
  • Features of cardiac failure
  • Pneumothorax
  • Pneumomediastinum
  • Thoracic malignancy
19
Q

What is the Silhouette sign?

A

If a border of a viscera is silhouetted, it means that there is pathology present.

20
Q

What is disease is shown in the CXR?

A

Right Middle Lobe Pneumonia

In pneumonia, airspaces are filled by inflammatory exudate and affected lung becomes of soft tissue density.

Using the silhouette sign the right heart border opposite can no longer be discerned, so we can predict that the right middle lobe is involved.

Note that the right diaphragm remains visible.

21
Q

What disease is shown in this CXR?

A

Lingular Pneumonia

The lingular segments of the left upper lobe abut the left heart border, so can be thought of as anatomically equivalent to the middle lobe in the right lung.

Infection of the lingula causes the left heart border to become obscured, as shown opposite.

22
Q

Describe how a lobar collapse occurs?

A

•This happens when there is obstruction of a lobar bronchus.

23
Q

What causes a Lobar collapse?

A

bronchial obstruction

tumours,

aspirated foodstuffs,

mucus impaction

24
Q

What does this CXR show?

A

Left Lobar Collpase

25
Q
A
26
Q

What does this CXR show?

A

Right Upper lobe collapse

27
Q

How do you find Bronchial Malignancy on a CXR?

A
  • Look for enlarged lymph nodes and areas of focal bone destruction indicating skeletal metastases.
  • Primary tumours may present with lobar collapse or as a discrete mass, as shown adjacent to the left hilum opposite.
28
Q

What can cause pleural effusion?

A

Heart Disease

29
Q

What are the signs of Pleural effusions?

A

Basal density

Obscured diaphragms

Meniscus signs

Fluid tracking into right oblique fissure

30
Q

Wha causes a Pneumothoax?

A

A pneumothorax usually follows spontaneous rupture of the visceral pleura, allowing air to rush in from the lungs every time the patient inspires.

A small pneumothorax is subtle – look for a dark crescent without lung markings bounded medially by the lung edge. It is often at the lung apex.

31
Q

What is present on this CXR?

A

Pneumothorax

32
Q
A
33
Q

What is present in this CXR?

A
34
Q

What does Iatrogenic mean?

A

Relating to a medical procedure that has resulted in a complication.

e.g. iatrogenic pneumothorax

35
Q

What is present in this CXR?

A

Tension Pneumothorax

If the pneumothorax accumulates large amounts of air, it will squash the lungs so that the patient cannot ventilate them.

Opposite, note the large air filled right pleural space. This displaces the mediastinum to the left and depresses the right diaphragm. The collapsed right lung is squashed against the heart.

36
Q

What are hte common signs on a CXR for Cardiac failure?

A
  • Enlarged heart (cardiomegaly)
  • Pleural effusions
  • Interstitial pulmonary oedema (septal lines)
  • Airspace pulmonary oedema
37
Q

What is CTR?

A
  • The cardiothoracic ratio (CTR) is the ratio of the maximum diameter of the heart divided by the maximum diameter of the thorax.
  • The normal ratio should be less than or equal to 50%,
38
Q

What is shown in this CXR?

A

Cardiomegally

Cardiomegaly is a medical condition wherein the heart is enlarged.

Respiratory - Week 3 (10 decks)

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