Clin Lab: Pulmonology Flashcards
PwrPts: Pulmonology imaging
Initial imaging modality
Chest x-ray
Pulm indications for chest x-ray
- SOB
- Dyspnea on exertion
- Chest pain
- Hemolysis
- Increased sputum production
Why get a CT chest or CTA chest?
better resolution than Chest x-ray
Indicated use for US.
to evaluate
- pneumothorax: collapsed lung
- consolidation: thick pocket of pus-like material & show up as a dense area; seen w/ bacterial pneumonia
- effusion: pleural effusion
Use for ventilation/perfusion scan (V/Q scan)
to look for pulmonary embolism when CTA can’t be done (contrast allergy or kidney dz)
Perfusion
looks at blood flow
Ventilation
looks at air flow
What does IQ: ABCDE stand for?
Identification, Quality, Airways, Bones, Cardiovascular/Circulation, Diaphragms, Everything
Views of chest x-ray
- PA vs AP (heart is bigger on AP)
- Lateral
Which view on do we get in the hospital?
AP view b/c most people are bedridden
Orientation on lateral chest x-ray
heart is towards the front & spine is towards the back
Chest x-ray anatomy
- trachea & L/R bronchi
- L/R hemidiaphragms & costophrenic angles
- heart areas & heart borders
- aortic knob, aorta, aortopulmonary window
- L/T pulmonary arteries/hila
- vertebrae, spinous processes
- ID & count ribs
- clavicles & scapulae
- ID liver & stomach
Based on surface anatomy, where to the lungs end?
Somewhere along the nipple line
Where are the apices of the lungs located.
above the clavicles.
When following the trachea down on a chest x-ray, which bronchi will you reach first?
right
What does the trachea look like on a lateral view?
slight shadow that’s angled from front to back coming down just behind the heart
Name the lung fields
- left upper & lower
- right upper, middle, & lower
Which diaphragm tends to be elevated?
right
Which organ sits under the right lung?
the liver
Describe orientation of the diaphragms on the lateral view.
right hemidiaphragm - higher under the heart (sits anterior)
left hemidiaphragm - high at the spine (sits posterior)
Based on the heart anatomy, where should structures be on the x-ray? (PA/AP view)
RA - falls on right side of the spine
LV - falls on left side of the spine
RV - in the middle, edges aren’t clearly seen
LA - hidden behind
What should be seen of the heart from the AP/PA view?
RA & RV
What BVs can be seen on the AP/PA view?
AO, PA, & SVC
On the lateral view, what can be seen of the heart & describe?
RV - sits up against the sternum
LA & LV - more towards the spine
PA - seen a little
Describe heart size on a PA view.
heart diameter should be less than 1/2 of the chest diameter
What is the ductus arteriosus?
structure that connects the bottom of the aortic arch & the pulm trunk. (lives in the aortopulmonary window)
