CXR

Question 1

What structures are visible on a CXR

Answer 1

Trachea
Clavicles
Scapula
Ribs
Hila
Aortic Knuckle
Lungs
Heart
Diaphragm
Breast
Bowel gas

Question 2

What are the fissures and lobes in the left lung

Answer 2

Oblique fissure- superior and inferior lobe

Question 3

What are the fissures and lobes in the right lung

Answer 3

Horizontal Fissure- Superior lobe
Oblique fissure - Middle and inferior lobe

Question 4

What are the hila?

Answer 4

Connects bronchi and pulmonary vessels
Left higher than right

Question 5

What is hila lymphadenopathy?

Answer 5

Hila lymph nodes visivle during abnormality

Question 6

What is seen in primary TB

Answer 6

upper zone consolidation

Question 7

What does consolidation look like on CXR

Answer 7

white hazy areas- cotton wool appearance

Question 8

what does mass or metastases look like?

Answer 8

white spherical structures- more dense than consolidation

Question 9

What do pleural plaques look like?

Answer 9

Hazy defined areas

Question 10

Layers of the pleural outside-> inside?

Answer 10

PArietal pleura
pleural CAvity
VIsceral pleura

Question 11

what is CTR

Answer 11

Cardiothoracic ratio- ratio between heart and thoracic size
>50% is abnormal

Question 12

What is seen in pneumothorax?

Answer 12

no lung markings
may see visible pleural edge
tracheal deviation away from affected area

Question 13

Causes or pleural plaques?

Answer 13

ASBESTOSIS
haemothorax
TB
Empyema
Pleurisy

Question 14

What separates the thorax from the abdomen?

Answer 14

Hemidiaphragm

Question 15

Name the 4 angles seen in a CXR

Answer 15

2 costophrenic angle
2 cardiophrenic angle

Question 16

What does stomach gas look like and where is it found?

Answer 16

Below the left hemidiaphragm
seen as a black bubble

Question 17

Define perforation

Answer 17

A hole

Question 18

define pneumoperitoneum

Answer 18

Air in the peritoneal cavity due to perforation

Question 19

what does pneumoperitoneum look like?

Answer 19

black space between lung and diaphragm- has a defined white line

Question 20

Differentiate between the left and right hemidiaphragm

Answer 20

right higher than left due to liver

Question 21

How are CXR interpreted?

Answer 21

DRS ABCDE
Details
RIPE
Soft tissues and bones
Airway
Breathing
Circulation
Diaphragm
Extras

Question 22

What is RIPE?

Answer 22

Rotation
Inspiration
Projection
Exposure

Question 23

How do you check rotation?

Answer 23

medial clavicle must be equidistant from spinous processes

Question 24

What is observed during inspiration?

Answer 24

5-7 ribs anterior ribs intersecting diaphragm

Question 25

What is projection

Answer 25

May be AP or PA

Question 26

How to differentiate between AP or PA film

Answer 26

AP: CTR = 50%, edge of scapula in midclavicular line
PA: CTR < 50%, edge of scapula near the edges of pleura

Question 27

Carina?

Answer 27

where the trachea splits into left and right bronchi

Question 28

when does tracheal deviate towards affected area?

Answer 28

lung consolidation- collapsed lung?

Question 29

What is E in DRS ABCDE

Answer 29

Everything else:
NG tube
Endotracheal Tube
ECG lines
Chest tubes
Permanent Pacemaker
Metal heart valves (appear white)

Question 30

What causes tracheal deviation away from affected area?

Answer 30

tension pneumothorax and large pleural effusion