Chest X-Rays Flashcards
What is the basic approach used to interpet CXRs?
A-airways (tracheal deviation, bronchi, carina and hilum)
B-breathing (lung lobes- upper middle, lower lobes)-consolidation or lobar collapse?
C-circulation-size heart, alveolar oedema or kerley b lines
D-diaphragm- pneumoperitneum (dolphins sign?)
E-everything else
What components are assessed in ‘airways’
-tracheal deviation- tension pneumthorax
-carina. bronchi and hilum
What components are assessed in ‘breathing’
-lungs (upper, middle and lower lobes)
-lung outlines (tension pneumothorax)
e.g
-sail sign- lobar collapse
-kerley b lines and batwings- alveolar oedema and HF
-meniscus-pleural effusion
-tracheal deviation– tension pneumothorax
What components are assessed in ‘cardiac’
-heart size (if more >50% of mediastinum- cardiomegaly)
-alveolar oedema + kerley b lines = HF
What components are assessed in ‘diaphragm’
-diaphragm size, level and shape
-pneumoperitoneum (dolphin sign)
What do these buzzwords indicate in a CXR?
a) sail sign
b) kerley b lines and batwing sign
c) meniscus
d) tracheal deviation
e) dolphin sign
f) conslidation of lobe
e.g
-sail sign- lobar collapse
-kerley b lines and batwings- alveolar oedema and HF
-meniscus-pleural effusion
-tracheal deviation– tension pneumothorax
-dolphin sign-pneumoperitoneum
-consolidation-pneumonia (mucus filling airspaces)
What junction is NG tube inserted at?
-Gastro-osophageal junction
Where is an Endotracheal Tube inserted
-5cm above carina
-2/3rds tracheal diameter taking
What vessels are venous catheters inserted into?
-IJV
-subclavian veins
How many ribs must be evident for a CXR o have been taken properly?
6 ribs must be evident for x ray to be accuarte
What side is diaphragm lower?
left is lower
