Chest X-Rays Flashcards
How does gas show up on X-ray?
Black
How does fat show up on X-ray?
Grey
How does soft tissue show up on X-ray?
Grey
How does bone or metal show up on X-ray?
White
What to check before looking at the x-ray?
Name and date Projection (AP? PA?) Exposure Position Inspiration
What are some questions to ask?
Who? What? When? Why? How?
What is the system to follow when looking at a x-ray?
A - alignment B - bones C - cardiac D - diaphragms E - expansion F - lung fields G - gadgets
What do you look at for alignment?
Look at the proximal ends of the clavicles in relation to the spinous process
What to look at when looking at bones on a x-ray?
Are they all there, in tact and in a normal position?
Don’t just look at the ribs
What to look at when looking at the heart on an x-ray?
Is there a clear heart border?
Is it a normal size?
Is there any evidence of shifting structures?
What to look for when looking at a diaphragm on an x-ray
Are both hemidiaphragms clearly visible
What to look for in terms of expansion on a x-ray
How well expanded is the chest
The 10th rib posteriorly should bisect the right hemidiaphragms at mid clavicular line and it’s 6th rib anteriorly
What to look for when looking at fields of the lung on a x-ray
Are the lung fields clear
Are there any areas where the density either increases or decreases
Can you see a lung edge
Can you see a fluid level
With a consolidation you will see increased opacity but with collapse you can see shifting of structures or crowding of lung markings
What gadgets to look for on a x-ray
Drips Drains Tubes Lines Are they in or around the patient
What are common abnormalities on an x-ray?
Consolidation Collapse Pneumothorax Pulmonary oedema Fracture
What is a lung consolidation?
Lung tissue becomes firm and solid because it has accumulated fluids and tissue debris
What are the clinical features on x-ray of consolidation?
White/grey shadow, no loss of volume
What does consolidation sound like on auscultation?
Increased breath sounds / bronchial breathing
Or
Decreased breath sounds with or without crackles or wheezes
What are the main causes of consolidation?
Pneumonia
Chest infection
Lung contusion following trauma
What is a collapsed lung?
Airless state of the lung tissue which may involve all or part of the lung
What are the features of a collapsed lung on x-ray?
white/grey shadow with loss of volume and shifting of structures
What does a collapsed lung sound like on auscultation?
Quiet breath sounds
Crackles
What are the main causes of a collapsed lung?
Shallow breathing Bronchial obstruction Absorption of trapped gas Surfactant depletion Compression from external pressure such as pleural disorder Abdominal or cardiac surgery
What is a pleural effusion?
Excess fluid in the pleural cavity
What does a pleural effusion look like on a x-ray?
White
Fluid line
What does pleural effusion sound like on auscultation?
Quiet breath sounds over the pleural effusion with bronchial breathing above the fluid level
What are the causes of a pleural effusion?
T.B. Pneumonia Abdominal or cardio thoracic surgery Heart, kidney or liver failure Malignancy Changes in membrane permeability
What is a pneumothorax?
Air in the pleural space secondary to a rupture in either pleural layer
What does a pneumothorax sound like auscultate?
Quiet over area of pneumothorax
What are causes of a pneumothorax?
Fast growth
‘Blebs’
Trauma
Barotrauma with a high pressure positive pressure devices
What is a pulmonary oedema?
Extra vascular water in the lungs
What does a pulmonary oedema look like on a x-ray?
Bilateral fleecy opacities from the hila
What are the causes of pulmonary oedemas?
Fluid overload
Back pressure from a failing left heart
Increased capillary permeability
