Chest X-ray's Flashcards
Why does the right hemidiaphragm tend to be higher than the left?
The liver pushes it up slightly
What is the acronym for film technical factors of a good x-ray and what do each mean? (4 answers)
Rotation (Angle of body)
Inspiration (How many ribs can you see?)
Projection (AP or PA?)
Exposure/penetrance (can you see the structures well?)
How many anterior ribs should you see on an chest x-ray?
6-8
How many posterior ribs should you see on an chest x-ray?
8-10
What do we check inspiration (RIPE)? (2 answers)
Checking the number of ribs is a good indication of how well a patient can take for a deep breath (normal anatomy)
What is meant by the “cardiothoracic ratio?
This is the size of the heart from R to left boarders
What size is considered abnormal for the heart?
50% of the chest from one wall to another
What does an enlarged heart suggest?
Heart conditions such as HF, high BP, CHD
What approach would you use to assess a chest x-ray?
Airways
Breathing
Cardiac
Diaphragm
Everything else
What do you look for in the approach for A (airway) on a chest x-ray?
Positioning of the trachea
What do you look for in the approach for B (breathing) on a chest x-ray?
Compare right to left zones of the lungs for differences
What do you look for in the approach for C (cardiac) on a chest x-ray?
Are the boarders of the heart smooth?
How large is the heart?
What would blunt angles of both costophrenic angles suggest on a chest x-ray?
Systemic pathology like HF/Pleural effusion
What would block white marking suggest on a chest x-ray?
Pleural effusion
What would grey markings on a chest x-ray suggest?
Infection/pneumonia
What is pleuritic chest pain?
Pain on inspiration due to pleura rubbing over each other
Can you explain what the silhouette sign is?
It is where the R or L boarder of the heart is obscured by markings
What is the diagnosis of a silhouette sign of the R side?
R middle lobe consolidation
What is the diagnosis of a silhouette sign of the L side?
L Lower zone consolidation
How would you determine between a simple and a tension pneumothorax on an x-ray?
‘Simple’ has no tracheal deviation
‘Tension’ has deviation which can cause stress on organs such as the heart
How would a transudate pleural effusion present on a chest x-ray?
Bilateral angle or lobe white out
What would cause a transudate pleural effusion?
Some form of organ failure
How would a exudate pleural effusion present on a chest x-ray?
Singular angle/lobe white out
What would cause a exudate pleural effusion? (2 answers)
Infection
Cancer
What would ‘batwinging’, Kerley B lines’, Cephilization of vessels’ and increased cardiothoracic ratio/silhouette indicate on a chest x-ray and what is this caused by?
Pulmonary oedema caused by heart failure
What would sail sign suggest? (Diaphragm) unable to be seen by heart)
Left lower lobe collapse
