Chest Xray Flashcards
what dz causes airpsace dz
pneumonia pulmonary alveolar edema hemorrhage aspiration near-drowning
What dz cause interstitial dz
pulmonary interstitial edema
interstitial pneumonia
scleroderma
sarcoid
describe characteristics of airspace dz
- opacites?
- margins?
- signs that can be present too
- fluffy, cloudlike or hazy opacities
- Margins: indistinct–difficult to identify a clear demarcation b/w dz and normal lung
- confluent opacities: blend into one another with imperceptible margins
*localized as in segmental or lobar pneumonia
OR
*distributed thorughought the lung–pulmonary edema
- air bronchograms
- silhouette sign
air bronchograms are assoc with which type of dz
airspace
**pneumonia
define air bronchograms
visibility of air in bronchus bc of surrounding airspace dz
- *bronchi normally not visible bc walls are very thin and contain air and surrounded by air
- when somehting other than air fills the space around the bronchus—fluid or soft tissue–inside of the bronchus becomes visible—looks like black branching tubular structures
what can fill in airspaces besides air?
- fluid: pulm edema
- blood
- gastric juices (aspiration)
- inflammatory exudate (pnma)
- water (near drownings)
Silhouette sign can be seen with?
airspace dz
patchy, segmental or lobar airspace dz
pneumonia
bilateral, perihilar airspace dz
pulmonary alveolar edeam
bat-wing sign or angel wing confirmation
pulm alveolar edema (airspace)
do you see air bronchograms with pulm alveolar edema?
no because the fluids fill airspacs and the bronchi
for bedridden patients, where does aspiration usully occur
lower lobes or posterior portions of upper lobes
reasons why trachea would not be midline
- deviated towards dz side
- -lung collapse aka atelectasis
- -pneumonectomy or lobectomy - deviated away from side of dz
- -tension pneumo
- -massive effusion
if u cannot see the right heart border– where is the opacification?
RML
if u cannot see the left heart border– where is the opacification?
Lingula of LUL
if u cannot see the right hemidiaphgram border– where is the opacification?
RLL
if u cannot see the left hemidiaphgram border– where is the opacification?
LLL
MCC of kerley B lines
interstitial pulmonary edema (like from HF or PHTN)
where do u see kerley B lines
periphery of the lungs—extend inwards from pleural surface
*become visible when thickened with fluid tumor or fibrosis
how do Kerley B lines (aka??) develop
septal lines caused by engorgement of pulmonary interlobular septal lymphatics by fluid, tumor or fibrosis
define cardiomegaly on CXR
when the width of heart is more than half the total width of thorax
which view can u measure heart
PA
NOT AP or supine
which hemi-dia is usually higher?
right is higher
BC of the heart’s position
lungs interstitium consists of?
CT lymphatics BVs bronchi ***these surround and support airspaces
characteristics of interstitial lung dz
- Reticular Interstitial dz—-network of lines
- Nodular–assortment of dots
- Reticulonodular–both lines and dots
**packets or particles of interstitial dz are separated from each other by visible areas of normal aerated lung–inhomogenous
**margins are sharper
homogenous vs inhomogenous (what goes with which type of lung dz)
homogenous–airspace/alveolar
inhomogenous–interstitial/infiltrative
list the predominantly reticular interstitial lung dz
pulmonary interstitial edema
list the four radiologic findings for interstitial pulmonary edema
- fluid in fissures (major and minor)
- peribronchial cuffing (fluid in the walls of bronchioles)
- pleural effusions
- Kerley B lines
how many posterior ribs visible for a good inspiration XRay
10
in hospitizd pt, how many post ribs makes adequate inspiration
8-9
what is a downfall to severe roation
pulmonary arteries appear larger on the side father from the film
in a ___ film, the heart is closer to the film and appears less magnified
PA
in an ____ film, the heart is farther from the film and is more magnified
AP
list causes that would lack full inspiration on CXR
- Obesity
- Acute abdomen or recent surgery (voluntary restriction)
- CHF
- Chronic restrictive lung disease
- Scarring and loss of compliance in the lung tissues
- Referred to as
- “shallow lung volumes” and “poor inspiratory film”
- Good inspiratory effort
- Low lung volumes
why would we get an expiratory film (5)
- Suspected foreign body in a bronchus
- Suspected pneumothorax.
- If the patient cannot cooperate
- Toddler or a sedated patient
- Decubitus views
what is dressler’s syndrome
also called Post pericardiotomy/Postmyocardial infarction syndrome
+pleural effusion with compressive atelectasis
+patient is usally s/p recent cardiac surgery with a pacemaker placed in
