Chest X Ray Things

Question 1

What are the 2 projections you get?

Answer 1

1. Anteroposterior (AP)

2. Posteroanterior (PA)

Question 2

Why are AP projections crAP?

Answer 2

you cant comment on cardiac size

Question 3

When looking at the technical quality of a CXR what do you comment on?

Answer 3

1. Rotation

2. Inspiration

Question 4

Should X rays be taken on deep inspiration or expiration?

Answer 4

on deep inspiartion

Question 5

Where should the heads of the clavicles be on a good X ray?

Answer 5

they should be equidistant from spinous processes of vertebrae

Question 6

What should you check for with the trachea?

Answer 6

Central or deviated

Question 7

if there is a tension pneumothorax, which way will the trachea deviate?

Answer 7

away from the pneumothorax

Question 8

If there is a collapsed lung, which way will the trachea deviate?

Answer 8

towards the lesion

Question 9

When looking at the mediastinum what 3 things are visible on the left border?

Answer 9

1. aortic knuckle
2. pulmonary outflow tract
3. left ventricle

Question 10

Which way will the mediastinum shift if

a) there is a collapsed lung
b) pleural effusion

Answer 10

a) towards the collapsed lung

b) away from the pleural effusion

Question 11

What do you check for when looking at the hila?

Answer 11

1. symmetrical-size and density

2. calcification

Question 12

Describe the position and size of the heart within the thorax?

Answer 12

1. it should be half the width of the thorax

2. one third lies to the right and two thirds to the left

Question 13

When observing the diaphragm what do you look for?

Answer 13

1. right side should be higher than the left

2. costophrenic angles

Question 14

What are the typical findings on a CXR for pneumonia?

Answer 14

1. consolidation

2. shadowing, heart border can be obscured

Question 15

What do you tend to see in pleural effusions?

Answer 15

1. unilateral pleural thickening
2. hemidiaphragm- concave surface
3. blunted costophrenic angles

Question 16

What can you see in a pneumothorax?

Answer 16

visible pleural edge

in a tension the trachea would be deviated

Question 17

In what diseases might you see bilateral hilar enlargement?

Answer 17

sarcoidosis
TB
Lymphoma
Metastatic cancer
pulmonary arterial hypertension

Question 18

In what disease might you see ring shadows?

Answer 18

Bronchiectasis

Question 19

What will you see in pulmonary oedema?

Answer 19

consolidation

Question 20

What will you see in lung cancer?

Answer 20

consolidation
blunting of costophrenic angles
mediastinal shift

Question 21

What would you see in asbestosis?

Answer 21

pleural plaques- calcified

Question 22

In what disease would you see lung hyperexpansion?

Answer 22

COPD

Question 23

What are the 5 things you can see for heart failure?

Answer 23

A-Alveolar oedema (bats wings)
B- Kerley B lines
C- Cardiomegaly
D- dilated prominent upper lobe vessels
E- effusion

Question 24

When would you see a D sign on a CXR?

Answer 24

empyema