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Clin Lab Med > CXR > Flashcards

CXR Flashcards

1
Q

What is shown on the following cxr?

A

Pleural effusion (w loss of cardiac silhouette sign)

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2
Q

What is shown on the following cxr?

A

Infiltrate in R middle lobe (w loss of cardiac silhouette sign)

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3
Q

What is shown on the following cxr?

A

Normal bowel gas in LUQ

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4
Q

What lung lobes are shown?

A

Right upper lobes

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5
Q

What lung lobes are shown?

A

Right lower lobes

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6
Q

What lung lobes are shown?

A

Right middle lobes

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7
Q

What lung lobes are shown?

A

Left upper lobes

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8
Q

What lung segments are shown?

A

Superior lingular segments of LUL

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9
Q

What lung segments are shown?

A

Inferior lingular segments of LUL

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10
Q

What lung lobes are shown?

A

Left lower lobes

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11
Q

Pleural markings should extend all the way to where?

A

Chest wall (more prominent lower and centrally within the lung fields)

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12
Q

What makes up the left and right heart contour?

A

Left heart contour = left lateral border of left ventricle and left atrium

Right heart contour = right lateral border of right atrium

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13
Q

What is shown in the following cxr?

A

Aortic knob

(represents left lateral edge of the aorta as it arches backwards over the left main bronchus and pulmonary vessels)

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14
Q

The following cxr is consistent with what condition?

A

COPD

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15
Q

The following cxr is consistent with what condition?

A

Bullous emphysema and fibrosis (large bullae)

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16
Q

What does the following cxr show?

A

Pneumothorax

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17
Q

What does the following cxr show?

A

Left upper pneumothorax

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18
Q

What does the following cxr show?

A

Left tension pneumothorax

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19
Q

What does the following cxr show?

A

Subcutaneous emphysema

(air leak from lung into subcutaneous tissue, dark lines following muscle and tissue planes)

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20
Q

What does the following cxr show?

A

Pneumoperitoneum

(radiolucent area noted below the diaphragm across the abdomen)

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21
Q

What does the following cxr show?

A

Right pleural effusion

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22
Q

What does the following cxr show?

A

RUL pneumonia with minor fissure outline

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23
Q

What does the following cxr show?

A

RLL infiltrate

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24
Q

What does the following cxr show?

A

Kerley B lines (suggestive of CHF)

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25
Q

What does the following cxr show?

A

Air bronchograms

(seen with pneumonia or CHF but NOT effusion)

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26
Q

What does the following cxr show?

A

Butterfly or bat-wing sign (CHF)

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27
Q

What does the following cxr show?

A

Bilateral lower lobe atelectasis

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28
Q

What does the following cxr show?

A

Pulmonary malignancy

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29
Q

What does the following cxr show?

A

Pulmonary metastases

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30
Q

What does the following cxr show?

A

Pulmonary abscess

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31
Q

What does the following cxr show?

A

Mediastinal mass consistent with lymphoma

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32
Q

What does the following cxr show?

A

Mediastinal mass

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33
Q

What does the following cxr show?

A

Thoracic aortic aneurysm

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34
Q

What does the following cxr show?

A

Anterior mediastinal mass (thymoma)

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35
Q

What does the following cxr show?

A

Chest trauma- rib fractures

36
Q

What is the following cxr concerning for?

A

Child abuse (chest trauma/ acute clavicle fracture/ healed rib fractures)

37
Q

What does the following cxr show?

A

NG tube

38
Q

Is an AP or PA view preferred and why?

A

PA, projection of the mass of the heart is more accurate (heart and mediastinum project a larger “shadow” with AP)

39
Q

What does a silhouette sign indicated?

A

Where materials of the same radiographic density meet there is no border

40
Q

What does a border, inerface, or line indicate?

A

Meeting point of materials of different radiographic densities

41
Q

Marked differences in densities lead to what kind of borders?

A

Sharp

42
Q

Minor differences in densities lead to what kind of borders?

A

Fuzzy

43
Q

Visualiziation of 8-10 ribs posteriorly and 5-7 ribs anteriorly indicates what?

A

Good inspiration

44
Q

In a non-rotated pt, the clavicles will to be located where w/ respect to the spinous processes?

A

Equidistant

45
Q

If CXR is captured while pt is sitting, what bone structure will you be able to visualize?

A

Scapula

46
Q

What side of the diaphragm will naturally sit higher? Why?

A

Right side b/c of liver

47
Q

What should you be concerned about if you notice blunting of the diagphragm?

A

Scarring or fluid

48
Q

What should you check for below the diaphragm?

A

Gas pattern and free air

49
Q

Paralysis from nerve damage, trauma, or loss of lung volume on 1 side due to atelectasis pr pneumothorax will be evident via what on cxr?

A

Unilateral high diaphragm

50
Q

What might a low, flat diaphrgam suggest?

A

COPD

51
Q

What is the ABCDEFGHI systematic approach?

A

A= assessment of quality/ airway | B = bones | C= cardiac | D= diaphragm | E= effusions/ extrathoracid soft tissue | F= fields, fissues, foreign bodies | G= great vessels/ gastric bubble | H= hila and mediastinum | I= impression

52
Q

Which hilum is typically higher, left or right?

A

Left

53
Q

What makes up the hila?

A

Main pulmonary arteries and major bronchi

54
Q

What are the potential spaces around the mediastinum? (3)

A

In front of the heart (anterior mediastinum), being the heart (posterior mediastinum), above the heart (superior mediastinum)

55
Q

A cardio throracic ratio > 1:2 (50%) is normal or abnormal?

A

Abnormal

56
Q

Under what conditions might underlying structures such as the lung markings be obscured?

A

Thick soft tissue due to obesity

57
Q

On a CXR what shouyld you look for to indicate adequate penetration?

A

Able to see disk spaces, but not bony details of spine

58
Q

On CXR of COPD pt, what would you expect to see? (3)

A

hyperlucency, flattened diaphragms, hyperinflation/”barrel chest” (increased rib sapce and rib angle)

59
Q

What is defined as a shift of intrathoracic structures and tracheal deviation?

A

Tension pneumothorax

60
Q

A tall pt in his 20s presents w acute dyspnea and chest pain. You suspect pneumothorax due to what?

A

Primary cause (bleb)

61
Q

An older pt presents with acute dyspnea and chest pain. You suspect pneumothorax due to what?

A

Secondary cause (underlying lung disease)

62
Q

Why is an expiratory CXR used in pt’s with a suspected small pneumothorax?

A

B/c volume of the PTX will remain the same, but lung volume shrinks, making the PTX more obvious

63
Q

What additional imaging study can you order for definitive dx of PTX?

A

CT

64
Q

What is the gold standard for DX penumomediastinum?

A

CT

65
Q

Leakage of air into mediastinum primarily seen in the young adult male population that presents with acute chest pain that can radiate anterior, posterior and/or superior to the jaw is concerning for what?

A

Pneumomediastinum

66
Q

If pneumomediastinum is noted on cxr, what condition is it important to r/o?

A

Esophageal perforation

67
Q

Crackly, “rice-crispy” sound (like popping bubble wrap) with palpation is concerning for what?

A

Subcutaneous emphysema (air from pneumo-mediastinum that dissected up to the neck)

68
Q

The following history/ signs/ sxs are associated w what? Recent abd/ pelvic surgery, trauma, PUD/ duodenal ulcer, malignancy (bowel cancer), IBD, and acute onset abd pain that may radiate to shoulders will likely show what on cxr?

A

Subdiaphragmatic air

69
Q

What is the most common cause of pneumoperitoneum?

A

Disruption of the wall of a hollow viscus

70
Q

On LLD CXR for pt w/ suspected pleural effusion, what would you expect to see?

A

Layering of pleural fluid

71
Q

What is defined as pulmonary parenchymal process due to presence of blood, pus, protein, interstitial fluid within the lung tissue (not pleural space)?

A

Infiltrate (infectious process)

72
Q

Fluid in the pleural space is what?

A

Pleural effusion

73
Q

Air in the pleural space is what?

A

Pneumothorax

74
Q

Fluid in the lungs is what?

A

Infiltrate

75
Q

Can infiltrate and effusion occur together?

A

Yes

76
Q

Kerley-B lines and “butteryfly”/”bat wing” patten on CXR is suggestive of what disease process?

A

CHF (fluid filled alveoli)

77
Q

What is defined as collapse or incomplete expansion of pulmonary parenchyma?

A

Atelectasis

78
Q

Increased lung density, displacement of interlobal fissures, crowding of pulmonary vessels, shift of mobile structures of the thorax, overinflatioin of the unaffected ipsilateral lobes or the contralateral lung, +/- air bronchograms and elevated hemidiaphragm are all signs of what?

A

Atelectasis

79
Q

Structural shifts (fissues, trachea, heart, diaphragm elevation) are suggestive of infiltrate or atelectasis?

A

Atelectasis

80
Q

What typically appear as peripheral, rounded nodules of variable size, scattered throughout both lungs?

A

Pulmonary metastases

81
Q

What is the most common etiology of atelectasis?

A

Bronchial obstruction (neoplasm, mucus plugging, FB aspiration)

82
Q

Breast, head and neck SCC, colorectal, renal cell, and uterine CAs are the most common primary cancers to result in what?

A

Pulmonary metastases

83
Q

What are the characteristics of malignant lesions? (4)

A

Large nodule size (>15mm), irregular, homogeneous density, spiculated margins

84
Q

What are the characteristics of a benign lesion? (4)

A

Smooth, well-defined margins, homogeneous density, calficifcations

85
Q

Traumatic aortic injury, vascular anomalies, pulmonary masses, mediastinal lymphadenopathy, enlarged pulmonary arteries, mediastinal mass, or thymus can all be causes of what?

A

Mediastinal widening

Clin Lab Med (4 decks)

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