CXR Flashcards
What structures are visible on a CXR
Trachea
Clavicles
Scapula
Ribs
Hila
Aortic Knuckle
Lungs
Heart
Diaphragm
Breast
Bowel gas
What are the fissures and lobes in the left lung
Oblique fissure- superior and inferior lobe
What are the fissures and lobes in the right lung
Horizontal Fissure- Superior lobe
Oblique fissure - Middle and inferior lobe
What are the hila?
Connects bronchi and pulmonary vessels
Left higher than right
What is hila lymphadenopathy?
Hila lymph nodes visivle during abnormality
What is seen in primary TB
upper zone consolidation
What does consolidation look like on CXR
white hazy areas- cotton wool appearance
what does mass or metastases look like?
white spherical structures- more dense than consolidation
What do pleural plaques look like?
Hazy defined areas
Layers of the pleural outside-> inside?
PArietal pleura
pleural CAvity
VIsceral pleura
what is CTR
Cardiothoracic ratio- ratio between heart and thoracic size
>50% is abnormal
What is seen in pneumothorax?
no lung markings
may see visible pleural edge
tracheal deviation away from affected area
Causes or pleural plaques?
ASBESTOSIS
haemothorax
TB
Empyema
Pleurisy
What separates the thorax from the abdomen?
Hemidiaphragm
Name the 4 angles seen in a CXR
2 costophrenic angle
2 cardiophrenic angle
What does stomach gas look like and where is it found?
Below the left hemidiaphragm
seen as a black bubble
Define perforation
A hole
define pneumoperitoneum
Air in the peritoneal cavity due to perforation
what does pneumoperitoneum look like?
black space between lung and diaphragm- has a defined white line
Differentiate between the left and right hemidiaphragm
right higher than left due to liver
How are CXR interpreted?
DRS ABCDE
Details
RIPE
Soft tissues and bones
Airway
Breathing
Circulation
Diaphragm
Extras
What is RIPE?
Rotation
Inspiration
Projection
Exposure
How do you check rotation?
medial clavicle must be equidistant from spinous processes
What is observed during inspiration?
5-7 ribs anterior ribs intersecting diaphragm
What is projection
May be AP or PA
How to differentiate between AP or PA film
AP: CTR = 50%, edge of scapula in midclavicular line
PA: CTR < 50%, edge of scapula near the edges of pleura
Carina?
where the trachea splits into left and right bronchi
when does tracheal deviate towards affected area?
lung consolidation- collapsed lung?
What is E in DRS ABCDE
Everything else:
NG tube
Endotracheal Tube
ECG lines
Chest tubes
Permanent Pacemaker
Metal heart valves (appear white)
What causes tracheal deviation away from affected area?
tension pneumothorax and large pleural effusion
