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Respiratory System > Chest X Rays > Flashcards

Chest X Rays Flashcards

1
Q

What mnemonic is used for assess the image quality of a chest X ray

A

RIPE
Rotation
Inspiration
Projection
Exposure

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2
Q

How do you assess the image quality of a chest X ray?

A

RIPE
- Rotation: medial aspect of clavicle should be equidistant from spinous processes (which should be vertically orientated)
- Inspiration: posterior ribs 8-10 lung apices, both costophernic angles + lateral rib edges should be visible
- Projection: AP or PA? (If scapulae is not projected within the chest it’s PA)
- Exposure: left hemidiaphragm should be visible to the spine + vertebra should be visible behind the heart

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3
Q

What is the ABCDEF approach on a chest X ray?

A

Airways
Bones
Cardiac contour
Diaphragm
Effusion
Fields

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4
Q

Normal position of the trachea on a chest X ray

A

Centrally or very slightly to the right

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5
Q

What could a deviated trachea be due to?

A
  • large pleural effusion or tension pneumothorax if pushed
  • lobar collapse if pulled
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6
Q

What is a true vs apparent tracheal deviation on a chest X ray?

A
  • True means the trachea is actually deviated
  • Apparent is when there is the appearance of deviation due to the rotation of the patient (inspect clavicles to see if rotated)
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7
Q

Which main bronchus are inhales forgein objects are more likely to be lodge in and why?

A
  • right
  • right main bronchus is wider, shorter + more vertical
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8
Q

Normal cardiothoracic ratio

A

0.4 - 0.55

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9
Q

Why should you not draw any conclusion about heart size from a AP film?

A

AP films exaggerate heart size

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10
Q

Reasons for doing a chest X-ray

A

Evaluating:
- symptoms
- signs
- lines, tube + pacemakers
- effects of treatment

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11
Q

What must be seen for the inspiration of a chest x ray to be adequate?

A

Must be able to count 8-10 posterior ribs
(More horizontal)

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12
Q

Differentiate between anterior and posterior ribs on a chest x ray

A

Posterior are more horizontal
Anterior angled down

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13
Q

What is the cardiac contour made from?

A

The borders of the heart:
Right atrium
Left ventricle

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14
Q

What is the lung hilum formed from?
What shape is it?

A

Superior pulmonary vein
Inferior pulmonary artery
Concave

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15
Q

What is the aorto-pulmonary window?

A

A space between the arch of the aorta + pulmonary arteries

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16
Q

What is the paratracheal stripe?

A

There should be nothing next to the trachea on the right side

17
Q

What is looked for under the diaphragm on a chest x ray?

A
  • Gastric air bubble (normal) under the left hemidiaphragm (location of the stomach)
  • the diaphragm should be indistinguishable from the underling liver
  • accumulation of free gases (from bowel perforation) under the diaphragm causes it to lift + visibly separate from the liver
  • If air is in incorrect place, indicative of pathology
18
Q

What are the fissures of the lungs?

A

Oblique (both)
Horizontal (right)

19
Q

Why must lung markings be seen until the edge in a chest x ray?

A

Lost in pleural effusion + pneumothorax

20
Q

What is seen on a chest x ray in a lower lobe collapse?

A

Obscured hemidiaphragm on affected side

21
Q

What is seen on a chest x ray in a upper lobe collapse?

A

Both hemidiaphragm seen
Affect lung is more hazy + smaller
Affected side of heart border is gone

e.g. left ULC: left lung smaller +hazy with left heart border gone

22
Q

What is seen on a chest x ray in a right middle lobe consolidation?

A
  • both hemidiaphragms seen
  • right heart border obscured
23
Q

What is seen on a chest x ray with military nodules + paraspinal mass?

A
  • multiple small dots
  • FINISH CHECK ***
24
Q

What is seen in a chest x ray of a patient with bilateral hilar lymphadenopathy?

A

Hilar angle is obliterate (not concave)

25
Q

What is seen on a chest x ray of a patient with a pleural effusion?

A
  • blunting of costophernic angle
  • dense opacities (higher on lateral sign)
  • meniscus sign (concave line)
26
Q

What is the bats wing appearance on a chest x ray?

A

Bilateral fluffy appearance around hilum
Due to pulmonary oedema
>\???

27
Q

What is seen on a chest x ray in a patient with pneumothorax?

A

Lung markings don’t go to the edge of the lungs

28
Q

What is the unfolding of the aorta?

A

Not pathological - age related
Aorta looks larger
Compare with previous x rays to see if the same

29
Q

What makes up the right heart border?

A

Right atrium

30
Q

What makes up the left heart border?

A

Left ventricle

31
Q

What is reduced definition of the right heart border typically associated with?

A

Right middle lobe consolidation

32
Q

Normal position of the right and left hemidiaphragm

A

The right hemidiaphragm is normally higher than the left due to the presence of the liver

33
Q

How can air accumulate under the diaphragm?

A

From a bowel perforation

34
Q

What are the costophernic angles formed from?

A

Dome of each hemidiaphragm + lateral chest wall

35
Q

What is blunting of the costophrenic angles indicative of?

A

Presence of fluid or consolidation

36
Q

What is dextrocardia?

A

Heart is positioned on right side of chest instead of left
Aortic arch on right ride instead of left

Respiratory System (25 decks)

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