Chest x-rays

Question 1

Trachea and main bronchi

Answer 1

trachea may be deviated to the right - and even kinked sometimes
angle of normal carina < 90 degrees

Question 2

TB presentation in children

Answer 2

only have lymph nodes - hilar and mediastinal
often only thing see is narrow airway due lymph nodes
prominent right perihilar shadow = lymphadenopathy
lateral view confirms lymphadenopathy superimposed on mediastinal vessels = DOUGHNUT SIGN

Question 3

Thymys gland

Answer 3

wavy margins - impression on ribs
can be very large - might need differentiated from a mass and consolidation
disappear 2-8 years

Question 4

Heart

Answer 4

LA and RV only seen on lateral CXR
LV and LA seen on AP CXR
TOF - boot shaped - RVH - oligaemic lung fields - de

Question 5

Vascular pattern

Answer 5

tapers towards periphery
vessels in upper lobe smaller lower lobe
peripheral arteries are approximately size adjacent bronchi

Question 6

Increased translucency

Answer 6

too much black 
air leak/ pneumothorax 
hyperinflation > 9 posterior ribs 
- bilaterally increased translucency 
- flattened diaphragm 
- small airway disease - asthma and bronchiolitis 

increased translucency of hemithorax = consider TB

Question 7

Increased pulmonary opacification

Answer 7

pulmonary infiltrates 
pulmonary collapse 
pulmonary hypoplasia/ agenesis 
pleural fluid 
tumour infiltration/mass/ thickening chest wall

Question 8

Volume gain

Answer 8

trachea deviates away

Question 9

Volume loss

Answer 9

trachea deviates towards