common normal and abnormal findings seen on a chest film Flashcards
Assessing technical adequacy
What is the RIP technique
Rotation
Inspiration
Penetration
What part of the RIP
(a) Look at the clavicles relative to the vertebral column
(b) They should be equally spaced
(c) If not properly aligned, structures will change in appearance which may mean abnormal.
Rotation
What part of the RIP
(a) Look at the ribs
1) Should be able to count 9-10 ribs
2) Posterior ribs are easier to see (more horizontal and project from the spine)
Inspiration
What Part of the RIP
(a) Should see the ribs through the heart
(b) Should barely see the spine through the heart
(c) Should see pulmonary vessel near the edges of the lungs (lungs should not be
completely black).
1) Over-penetrated film
a) Lung fields almost completely black
b) Suggests pneumothorax
2) Under-penetrated film
a) Soft tissue structures are obscured
b) Image appears bright suggesting consolidation (like a pneumonia).
Penetration
OVER or UNERPENETRATED?
a) Lung fields almost completely black
b) Suggests pneumothorax
Over-penetrated
OVER or UNERPENETRATED?
a) Soft tissue structures are obscured
b) Image appears bright suggesting consolidation (like a pneumonia).
Under-penetrated film
Conduct a systematic method
What does (ABCDE) stand for?
A- Airways/Airspaces
B- Bones/Soft Tissue
C- Cardiac Shadow
D- Diaphragm
E- Everything else
The transverse diameter of the silhouette should NOT exceed ______ of the transverse diameter of the thoracic cage, called cardiothoracic ratio (only applies to PA film).
50%
What is considered for
A- Airway/Airspace
(a) Follow the trachea down
1) Is it midline?
2) Is it patent?
(b) Look at the airspaces
1) Do the blood vessels go all the way to the edges?
2) Are there any patches of white suggesting infection, fluid, or foreign objects?
What is considered for
B-Bones
(a) Look at the clavicles, ribs, pectoral girdle, spine
1) For alignment, lack of symmetry, fracture lines
what is considered for
D- Diaphragm
(a) Should be dome-shaped
(b) Right hemidiaphragm is always higher than or same level as left.
(c) Check the costophrenic angles (sulcus) which should be dark and have sharp points
(like upside down cat ears).
What is considered for
E- Everything else
(a) Look for gastric bubble (left side)
(b) Check for EKG leads, lines, tubings, and other missed items (four corners of the film).
What part of the RIP
(a) Look at the clavicles relative to the vertebral column
(b) They should be equally spaced
(c) If not properly aligned, structures will change in appearance which may mean abnormal.
Rotation
