Chest XR

Question 1

what is the standard chest XR

Answer 1

PA CXR

Question 2

when are AP CXR done

Answer 2

used when pt is debilitated, immobilized or unable to cooperate with PA procedure

Question 3

what is “DRIP to ABCDEFGHI

Answer 3

Details
Rotation
inspiration vs expiration
Penetration

Airway
Bones
Cardiac silhouette
Diaphragm
Edges/external soft tissues
Fields
Gastric bubbles
Hilum
Insertions/artefacts

Question 4

are CXR obtained during inspiration or expiration

Answer 4

FULL - inspiration

Question 5

what level is the diaphragm located on CXR

Answer 5

8th to 10th rib posteriorly
or
5th to 6th rib anterior at mid clavicular line

Question 6

what is a aortic knuckle

Answer 6

represents the lateral edge of the aorta as it arches backward over left main bronchus and pulmonary vessels
contour of descending throacic aorta can be seen in continuation from the aortic knuckle

Question 7

where is the aorto-pulmonary window

Answer 7

lies between arch of the aorta and the pulmonary arteries. potential space in the mediastinum where abnormal enlargement of lymph nodes can be seen on CXR

Question 8

what can a widened-mediastinum be indicative of

Answer 8

aortic aneurysm
aortic dissection
enlarged lymphoid mass

Question 9

what view is required to confidently diagnosed cardiac enlargement

Answer 9

PA view

Question 10

what is pneumopericardium/pneumomediastinum

Answer 10

air in the wrong places
look in soft tissues of the neck
consider hx of surgery/procedure

Question 11

what is the costophrenic recesses/ angles

Answer 11

on PA view, costophrenic recesses are seen on each side of the costophrneic angles
costophrenic angles are formed by the lateral chest wall and the dome of each hemidiaphragm

Question 12

where can abnormal fluid be seen in the chest

Answer 12

alveolus +/- bronchioles
Interstitium
Pleura

Question 13

what type of effusion is seen with patient position changes the location of the fluid

Answer 13

pleural effusion

Question 14

what is the most common cause of consolidation

Answer 14

Pneumonia

Question 15

what are key findings of consoludation

Answer 15

silhouetting (loss of lung/soft tissue interface)
air-bronchograms
no volume loss

Question 16

what is atelectasis

Answer 16

loss of air in a portion of the lung with subsequent volume loss
can be secondary to decreased inspiratory effort, compression by pleural fluid, pneumothorax, bronchial obstruction

Question 17

what are the key findings of atelectasis

Answer 17

no air bronchograms
usually sharply-defined
volume loss (displacement of normal structures)

Question 18

what are patterns of the intertital

Answer 18

reticular (too many lines)
nodular (too many dots)
reticulonodular (too many lines and dots)

Question 19

what is Fleischner criteria used for

Answer 19

size of pulmonary nodules

Question 20

what is a pneumothorax

Answer 20

air in the pleural space

Question 21

what is seen on x-ray with tension PTX

Answer 21

mediastinal shift

Question 22

what is penumoperitoneum

Answer 22

air in the abdominal cavity
on upright xr - continuous diaphragm sign may be seen
think about recent procedure vs peritoneal dialysis

Question 23

what side of the hilum is commonly higher

Answer 23

Left higher than Right