Chest X Rays Flashcards
3 parts of the sternum
Manubrium
Body
Xiphisternum
How many lobes in each lung
Left 2
Right 3
Which fissure is in both lungs
Oblique
Which fissures are in the right lung
Oblique
Horizontal
structures in the lung hilum
Bronchi
Pulmonary arteries
Pulmonary veins
What determines the amount of x rays absorbed by an object
Density and structural composition
Do high or low density structures appear white on x rays
High
What patient details should be confirmed on an x ray
Name
DOB
unique identification number
Date x ray performed
Time x ray performed
How is image quality assessed - mnemonic
R rotation
I Inspiration
P projection
E Exposure
What is RIPE used to assess
Image quality
How is XR rotation checked
Spinous processes half way between clavicles
How many ribs should be seen on X-ray with adequate inspiration
7 anterior or 9 posterior
Which projection cannot be used to assess heart size
AP
Is PA or AP the standard X-RAY projection
PA
X ray exposure
Whether X-ray beams have adequately penetrated tissues
How is correct X-ray exposure checked
Vertebrae just visible behind heart
Left hemidiaphragm visible to edge of spine
How do lung markings appear in over penetrated X-rays
Decreased or absent
What does ABCDE stand for in X-ray interpretation
Airway
Breathing
Circulation
Diaphragm
Everything else
What airway features should be checked while interpreting X-ray
Tracheal deviation
Inhaled foreign bodies
Hilum abnormalities
How is tension pneumothorax treated
Chest drain
What causes tracheal deviation
Change in volume of 1 hemithorax
What is a pneumonectomy
Removal of lung
Which bronchus is an inhaled object more likely to lodge in
Right
What hilum abnormalities may be seen on an X-ray
Asymmetry
Enlargement
Should the pleura be visible in a healthy X-ray
No
How does consolidation appear on an X-ray
Patchy opacification
What conditions can cause lung consolidation
Pneumonia
Malignancy
Pulmonary embolism
What is lung consolidation
Alveolar tissue infiltrated by cells, liquid, or pus
What can cause a lung mass
Cancer
Access
Infectiom
How do lung masses usually appear on X-ray
Pale
Well defined
Pulmonary oedema
Fluid in alveolar and interstitial spaces
What X-ray sign shows alveolar oedema
Batwing opacities
What X-ray sign shows interstitial oedema
Kerley b lines
What do batwing opacities show
Alveolar oedema
What do Kerley b lines show
Interstitial oedema
Pleural effusion
Fluid in pleural space
How can pleural effusion be seen on X-ray
Mensicus
Blunt costophrenic angles
Blunt cardiophrenic angles
Pneumothorax
Air in pleural space
How can a tension pneumothorax be identified on X-ray
Tracheal deviation
How can pneumothorax be identified on X-ray
Lung markings don’t extend to edge of lung field
What heart characteristics should be checked in X-ray
Size
Borders
Mediastinal contours
What is a normal cardio thoracic ratio
</= 0.5
What can cause heart borders to be undefined
Pathology in overlying lung tissue
Which hemidiaphragm should be higher
Right
Pneumoperitoneum
Air underneath diaphragm
What is the most common cause of pneumoperitoneum
Bowel perforation
How do hyperinflated lungs appear on a X-ray
Marked hyperinflation
Flattened diapragm
10 anterior ribs visible
What can push the diapragm up
Phrenic nerve palsy
Loss of lung volume
Mass in abdomen
What features can come under the ‘everything else’ section of X-ray interpretation
Bones
Soft tissues
NG tubes
Pacemakers
Lines
Artificial heart valves
How should a correctly placed NG tube appear on an X-ray
In midline to level of diapragm
Bisects carina
Tip seen clearly below left hemidiaphragm
What complications can broken ribs cause
Flail chest
Pneumothorax from punctured lung
What causes reciprocal breathing
Flail chest
Cannonball metastasis
Metastatic deposits from primary tumour spread over both lungs
