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1Fall24 PoA II > Chest XR pt2 Exam1 > Flashcards

Chest XR pt2 Exam1 Flashcards

1
Q

Label 1

A
  • Oblique Fissure
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2
Q

Label 2

A
  • Horizontal Fissure
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3
Q

Label 3

A
  • Thoracic spine/ Retrocardial space
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4
Q

Label 4

A
  • Retrosternal space
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5
Q

What will cause a Silhouette Sign on a CXR?

A
  • Lungs making contact with the heart or any structure (tumor, mass, lesion) that may obscure the border of a CXR.
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6
Q

Visualization of air in the intrapulmonary bronchi on a CXR is called a ________ sign.

A
  • Bronchogram
  • Bronchogram sign indicates an abnormal lung (consolidation).
  • With consolidation, pulmonary vessels are no longer visualized b/c they are surrounded by other soft tissue density material.
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7
Q

1/3rd of the heart sides on ______ side
2/3rd of the heart sides on the ______ side.

A
  • right side
  • left side
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8
Q

Lung injury or pathological states can be either a ________ or _______ process.

A
  • generalized
  • localized
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9
Q

What can cause generalized liquid density in a lung? (3)

A
  • Diffused alveolar
  • Diffused interstitial
  • Mixed/Vascular
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10
Q

What can cause localized liquid density in a lung? (6)

A
  • Infiltrate
  • Consolidation
  • Cavitation
  • Mass
  • Congestion
  • Atelectasis
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11
Q

What can cause increased air density in the lungs? (4)

A
  • Localized airway obstruction
  • Diffuse airway obstruction
  • Emphysema
  • Bulla
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12
Q

What is consolidation on a CXR?

A
  • Alveolar space filled with inflammatory exudate (bacteria/WBC/plasma/debris).
  • With consolidation, architecture remains the same and the airway is patent
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13
Q

What is obstructive atelectasis on a CXR?

A
  • No ventilation to the lobe beyond the obstruction (ie: mucous plug, right main stem intubation)
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14
Q

What are the stages of evaluating a CXR abnormality?

A
  • ID abnormal shadows
  • Anatomically localize lesion
  • ID pathological process
  • ID etiology
  • Confirm clinical suspicion (contrast, CT, MRI)
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15
Q

What are the two arrows pointing at?
What does the “^” indicate?

A
  • ETT
  • Carina

central line passing by

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16
Q

What does this CXR show?

A
  • Right mainstem intubation

radiopaque line in ETT directed down right mainstem

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17
Q

Is this a proper placement of a central line?

A
  • No, the tip (smaller red arrow) is within the right ventricle. Pt will probably experience PVCs.
  • The catheter tip should lie between the most proximal venous valves of the subclavian or jugular veins and the right atrium.
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18
Q

What is this CXR showing?

A
  • Right pleural effusion
  • Notice the loss of the costophrenic angle and leveling of fluid
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19
Q

What is this CXR showing?

A
  • RML pneumonia
  • You can rule out RLL pneumonia because there is no accumulation at the base of the lung.
  • A lateral CXR will have the best view for confirmation.
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20
Q

What is this CXR showing?

A
  • RUL pneumonia
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21
Q

What is this CXR showing?

A
  • RLL pneumonia
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22
Q

What is this CXR showing?

A
  • Free air under the diaphragm
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23
Q

What are the four arrows pointing at?

A
  • Cavitary Infiltrate
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24
Q

A lesion seen in the lung that is caused by tuberculosis.

A
  • Ghon’s Complex
  • The lesions consist of a calcified focus of infection and an associated lymph node.
  • Very hard to detect.
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25
Q

What are the arrows pointing to in this CXR?

A
  • Anterior Mediastinal Mass
  • Need lateral CXR to confirm. It’s hard to see the mass in AP view.
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26
Q

What are the arrows pointing to in this CXR?

A
  • LUL Mass
27
Q

What is this CXR showing?

A
  • Pulmonary Metastasis (Cancer)
  • The white circular object on the patient’s right lung is a medication port.
28
Q

What are the two arrows on this CXR indicating?

A
  • Pneumomediastinum
  • There should never be that much air between the heart and lungs.
  • This can be caused by airway trauma, tracheal or esophageal rupture
29
Q

What is this CXR showing?

A
  • Left Pneumothorax
  • Notice the air trapping on the patient’s left lung
30
Q

What is this CXR showing?

A
  • Subcutaneous Emphysema
  • Notice the intermittent areas of radiolucency, often representing a fluffy appearance on the exterior borders of the thorax.
31
Q

What is the red arrow indicating?

A
  • Deep Sulcus Sign
  • This is an indirect indicator of a pneumothorax.
32
Q

If a child swallows a large coin, is it more likely to go down the esophagus or trachea?

A
  • Esophagus
33
Q

What is this CXR showing?

A
  • Pulmonary Fibrosis
34
Q

What is this CXR showing?

A
  • Diffuse Pulmonary Edema
35
Q

What is the classic sign on a CXR of pulmonary edema secondary to CHF?

A
  • Bat Wing Pattern
  • Enlarged Heart
36
Q

What is this CXR showing?

A
  • Post-op Left Pneumonectomy
  • There is no left lung
37
Q

What is this CXR showing?

A
  • Transverse Aortic Arch Aneurysm
38
Q

What is this CXR showing?

A
  • Cardiomegaly
39
Q

What is this CXR showing?

A
  • Aortic Dissection
  • Notice the wide mediastinum and deviation of the heart to the patient’s left side
40
Q

What sign is present when a large loop of the intestine gets shoved between the diaphragm and the liver?

A
  • Chilaiditi Sign
41
Q

What is this CXR showing?

A
  • Esophageal Rupture (Boerhaave’s Syndrome)
  • Notice small bilateral lung field and infiltrates
  • Wide mediastinum pattern
  • Air visible on bilateral sides of the heart
42
Q

What is hilar adenopathy?

A
  • Hilar adenopathy is the enlargement of lymph nodes in the hilum.
  • It can be caused by conditions such as tuberculosis, sarcoidosis, drug reactions, infections, or cancer.
43
Q

What is this CXR showing?

A
  • Bilateral Hilar Adenopathy
44
Q

Case Study: 35 y/o male with dyspnea, unplanned weight loss over 3 months.

A
  • Pulmonary lesion on patient’s left lung
  • Thin-walled cavity is noted in the left midlung. Most likely cancerous.
  • This finding is most typical of squamous cell carcinoma (SCC).
45
Q

Case Study: 65y/o with a month worth of dyspnea, occasional productive cough, and fever

A
  • LUL Atelectasis: Loss of heart borders/silhouetting.
  • Notice over inflation on unaffected lung
  • Inflammatory process or pneumonia in the LUL
46
Q

Case Study: 30yo female with 1 week of fever and cough

A
  • Right Middle Lobe Pneumonia
  • Left Upper Lobe Pneumonia
47
Q

Case Study: 28y/o inmate for CT-guided drainage

A
  • Cavitation: cystic changes in the area of consolidation due to the bacterial destruction of lung tissue.
  • Pleural Effusion in RML
  • Notice air-fluid level.
48
Q

What are the two arrows indicating in this CXR?

A
  • Tuberculosis (stretched out cotton ball appearance)
49
Q

What is this CXR showing?

A
  • COPD: increase in heart diameter, flattening of the diaphragm, and increase in the size of the retrosternal air space.
  • In addition, the upper lobes will become hyperlucent due to the destruction of the lung tissue.
50
Q

What is this CXR showing?

A
  • Pseudotumor: fluid has filled the minor fissure creating a density that resembles a tumor (arrow). Recall that fluid and soft tissue are indistinguishable on plain film.
  • Further analysis, however, reveals a classic pleural effusion in the right pleura.
  • Note the right lateral gutter is blunted and the right diaphram is obscurred.
51
Q

What is this CXR showing?

A
  • Pneumonia: a large pneumonia consolidation in the right lower lobe.
  • Knowledge of lobar and segmental anatomy is important in identifying the location of the infection.
52
Q

What is this CXR showing?

A
  • Pulmonary Edema secondary to CHF
  • A great deal of accentuated interstitial markings, curly lines, and an enlarged heart.
  • Normally indistinct upper lobe vessels are prominent but are also masked by interstitial edema.
53
Q

What is the CXR showing?

A
  • Chest wall lesion: arising off the chest wall and not the lung
54
Q

What is the CXR showing?

A
  • Pleural effusion: Note loss of left hemidiaphragm.
  • Fluid drained via thoracentesis
55
Q

What is the CXR showing?

A
  • Lung Mass
56
Q

What is the CXR showing?

A
  • Small Pneumothorax: LUL
  • Notice that thin white line, that is the lung being shoved down by the pneumothorax
57
Q

What is the CXR showing?

A
  • Right Middle Lobe Pneumothorax: complete lobar collapse and deep sulcus
58
Q

What is the CXR showing?

A
  • Metastatic Lung Cancer: Multiple nodules seen
59
Q

What is the CXR showing?

A
  • RUL pulmonary nodule
60
Q

What is the CXR showing?

A
  • TB
61
Q

What is the CXR showing?

A
  • Perihilar mass
  • Hodgkin’s disease
62
Q

What is the CXR showing?

A
  • Widened Mediastinum
  • Aortic Dissection
63
Q

What is the CXR showing?

A
  • Pulmonary artery stenosis with cardiomegaly likely secondary to stenosis.

1Fall24 PoA II (28 decks)

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