CXR Flashcards
which test is best used to discover a pulmonary embolism
V/Q scan with CT
what structure on CXR is most radiopaque
bone
what structure on CXR is most radiolucent
air in the lungs, stomach, and intestines
what causes right side of heart to be unseen in CXR
AP film can cast a shadow over the right side of heart
indications for CXR outpatient
unexplained dyspnea severe persistent cough hemoptysis fever and sputum production acute severe chest pain positive TB skin and blood test
indications for CXR inpatient
placement of ETT
placement of pulmonary artery catheter
placement of central venous pressure catheter
sudden onset of dyspnea or chest pain
elevated or changing pressure during mech vent
sudden decline in oxygenation
Lag Behind
CXR may lag behind the patients clinical condition
people with pneumonia may not show air infiltrates for 12-24 hours
what is the best position for CXR film
standing
PA
considerations for AP exposure
heart may appear enlarged
things might appear closer
rotation and CXR
projecting midline structure to the right or left
mediastinum unusually wide
obscures pulmonary arteries as they emerge from the mediastinum and parenchyma
overexposed film
leaves lung parenchyma black
difficult to visualize peripheral blood vessels and abnormalities
clinical indication for CT
lung nodules masses great vessels mediastinum pleural diseases lung volumes pulmonary embolism
diseases evaluated with HRCT
interstitial lung disease
emphysema
bronchiectasis
limitations of MRI
it is magnetic
patients with pacemakers
metal objects like gas cylinders and ICU ventilators
structures evaluated with MRI
mediastinum
hilar regions
large vessels in lungs
which two areas in chest do ultrasound evaluate
small and large pleural effusions pleural fluid from solid tissue differentiates blood vessels and arteries placement of catheters thoracentesis heart volumes and volume status
blunt costophrenic angles mean
pleural effusion
lateral decubitus XRAY
detecting small amounts of pleural fluid
taken from frontal view as the patient is lying on effected side
5mL of fluid can be detected
identifying spontaneous pneumothorax
observing a think pleural line along the periphery of the lung with absence of lung markings between the lung margin and inner aspect of chest wall
identifying tension pneumothorax
inferior displacement of the hemidiaphragm on the side of the pneumothorax or mediastinal shift away from the pneumothorax (midline)
what are infiltrates
airspace opacities
which cardiac complications are associated with pulmonary edema
left heart failure
interstitial lung disease on CXR
diffuse, bilateral opacities scattered and poorly defines nodules and lines
honeycombing = scarring (end stage)
volume loss
what is sarcoidosis and how common
one of two of the most common interstitial lung diseases
HRCT establishes
volume loss
idiopathic
