Clin Lab: Pulmonology

Question 1

Initial imaging modality

Answer 1

Chest x-ray

Question 2

Pulm indications for chest x-ray

Answer 2

• SOB
• Dyspnea on exertion
• Chest pain
• Hemolysis
• Increased sputum production

Question 3

Why get a CT chest or CTA chest?

Answer 3

better resolution than Chest x-ray

Question 4

Indicated use for US.

Answer 4

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

Question 5

Use for ventilation/perfusion scan (V/Q scan)

Answer 5

to look for pulmonary embolism when CTA can’t be done (contrast allergy or kidney dz)

Question 6

Perfusion

Answer 6

looks at blood flow

Question 7

Ventilation

Answer 7

looks at air flow

Question 8

What does IQ: ABCDE stand for?

Answer 8

Identification, Quality, Airways, Bones, Cardiovascular/Circulation, Diaphragms, Everything

Question 9

Views of chest x-ray

Answer 9

• PA vs AP (heart is bigger on AP)
• Lateral

Question 10

Which view on do we get in the hospital?

Answer 10

AP view b/c most people are bedridden

Question 11

Orientation on lateral chest x-ray

Answer 11

heart is towards the front & spine is towards the back

Question 12

Chest x-ray anatomy

Answer 12

• 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

Question 13

Based on surface anatomy, where to the lungs end?

Answer 13

Somewhere along the nipple line

Question 14

Where are the apices of the lungs located.

Answer 14

above the clavicles.

Question 15

When following the trachea down on a chest x-ray, which bronchi will you reach first?

Answer 15

right

Question 16

What does the trachea look like on a lateral view?

Answer 16

slight shadow that’s angled from front to back coming down just behind the heart

Question 17

Name the lung fields

Answer 17

• left upper & lower
• right upper, middle, & lower

Question 18

Which diaphragm tends to be elevated?

Answer 18

right

Question 19

Which organ sits under the right lung?

Answer 19

the liver

Question 20

Describe orientation of the diaphragms on the lateral view.

Answer 20

right hemidiaphragm - higher under the heart (sits anterior)

left hemidiaphragm - high at the spine (sits posterior)

Question 21

Based on the heart anatomy, where should structures be on the x-ray? (PA/AP view)

Answer 21

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

Question 22

What should be seen of the heart from the AP/PA view?

Answer 22

RA & RV

Question 23

What BVs can be seen on the AP/PA view?

Answer 23

AO, PA, & SVC

Question 24

On the lateral view, what can be seen of the heart & describe?

Answer 24

RV - sits up against the sternum
LA & LV - more towards the spine
PA - seen a little

Question 25

Describe heart size on a PA view.

Answer 25

heart diameter should be less than 1/2 of the chest diameter

Question 26

What is the ductus arteriosus?

Answer 26

structure that connects the bottom of the aortic arch & the pulm trunk. (lives in the aortopulmonary window)