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Chest Reporting > CXR and ITU setting RCR > Flashcards

CXR and ITU setting RCR Flashcards

1
Q

Cantral lines should not be placed near the brachiocephalic valves because …

A

accurate CVP estimate

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2
Q

report and consequences 2m

A

potential breach of visceral pleura and once removed cause a pneumothorax

NG in the rt costophrenic angle via the right main bronchus

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3
Q

What are the possible risks of right sided central lines? 3 m

A
  1. Arrythmias
  2. Cardiac perforation
  3. Cardiac temponadeCardiac tamponade is a serious medical condition in which blood or fluids fill the space between the sac that encases the heart and the heart muscle. This places extreme pressure on your heart. The pressure prevents the heart’s ventricles from expanding fully and keeps your heart from functioning properly.
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4
Q

describe the effected segment of lung

A

flail segment - needs cardiothoracic assistence - multiple rib fractures and re- expansion problems

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5
Q

report

A

lamella pleural eff - fluid trapped between lung ans visceral pleura

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6
Q

ETT is ideally placed at?

A

4cm

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7
Q

how can pmneumoperitoneum be seen on a axr

A

riglers sign 2nd image triangle of gas in the upper right quadrant

The Rigler sign, also known as the double-wall sign, is a sign of pneumoperitoneum seen on an abdominal radiograph when gas is outlining both sides of the bowel wall, i.e. gas within the bowel’s lumen and gas within the peritoneal cavity.

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8
Q

ETT can be effected by patients head position. True or false

A

True

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9
Q

what defines a tension pneumothorax? 3m

A
  1. Mediastinal shift
  2. flattened/ eversion/ depression diaphragm
  3. hypeexpanded hemithorax
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10
Q

Tracheostomy purpose?

A

Prolonged need for ventilation

prevent tracheal stenosis

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11
Q

Tracheal diameter should be

A

2/3 tracheal diameter

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12
Q

How do you know the Subclavian vein has had correct cannulation?

A

Beneath or behind the clavicle

if above clavicle arterial puncture of extravascular placement

Remember to look for pneumothorax

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13
Q

report rta 3m

A
  1. widened mediastinum hx trauma - in other patients can be a nonspecific finding. No aortic knuckle - mediastinal haematoma
  2. pulmonary contusion
  3. fractured left clavicle.
  4. extra pleural cap - blood tracked into the superior sulcus
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14
Q

The most common infective causative agents are :

Other uncommon agents are:

Legionella pneumophila 3

Mycobacterium tuberculosis

A
  1. Streptococcus pneumoniae: pneumococcal pneumonia- floxicillin
  2. Klebsiella pneumoniae: Klebsiella pneumonia
  3. Pseudomonas aeruginosa: pseudomonas pulmonary infection
  4. Staphylococcus aureus

https://radiopaedia.org/articles/bulging-fissure-sign-lobar-consolidation?lang=gb#:~:text=The%20bulging%20fissure%20sign%20refers,bulging%20(sagging)%20fissure%20sign.

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15
Q

Carina is located at which level?

A

T4-5

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16
Q

type of pneumonia

A

covid19

peripheral consolidation

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17
Q

report - ventilated desaturating

A

contonous diaphragm sign

surgical emphysema

positive pressure ventilation - barrier trauma - pneumomediastinum

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18
Q

report

A

pneumoperitoneum

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19
Q

Most common cause of cavitating pnaumonia 1m

A

bacterial pneumonia

staphylococcas pneumonia

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20
Q

state the most likely cause of pneumopericardium and differentiating appearence from pneumomediastinum. 2m

A
  1. trauma
  2. no continous diaphragm sign.
  3. positive pressure ventilation

thoracic surgery/pericardial fluid drainage

penetrating trauma

blunt trauma (rare)

infectious pericarditis with gas-producing organisms

fistula

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21
Q

typical clinical and radiographic appearence of aspiration pneumonia 2m

A

episode of reduced consciousness

patchy consolidation not necessarily at the bases

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22
Q

report 2m

A

Drain in the lung not pleural space

large pneumothorax

haemorrhage around the drain

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23
Q

report - trauma 3m

A

aortic lasceration

widened mediastinum

loss of aorta contour

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24
Q

report

A

pneumopericardium

note no continous diaphragm sign

25
Q

type of pneumonia

A

atypical pneumonia

26
Q

staphylococcal pneumonia radiographic appearence? 2m

A
  1. patchy segmental consolidation
  2. cavitation in area of pneumonic change
  3. developement of pneumatocoele - gas filled space near aread of consolidation - round lucent area
27
Q

Lobar pneumonia with lobe expansion 2

A

Klebsiella or streptococcus pneumoniae

28
Q

Central line tip position in proximal 1/3 of SVC are likely to ….

A

Thrombose

byt upto 10X

29
Q

report

trauma assult

A

tension haemothorax

breach in the parietal pleura + intercostal artery bleed

30
Q

id the radiological sign to pneumoperitoneum

A

cupler sign football sign

31
Q

name the radiographic sign 1m

A

bulging fissure sign

33
Q

Case: Patient desaturating in resus?

A

ETT in the oesophagus - stomach dilated - gaseous distension

34
Q

report!

A

left sided normal variant SVC - travels behind the heart and into the right atrium

35
Q

report!

A

RLL consolidation

right hemidiaphragm effaced but right heart border is visible

lobar pneumonia - likely pneumococcal pneumonia

36
Q

report 2m

A
  1. Bilateral batwing pulmonary oedema
  2. ng in the right maing bronchus
  3. remove immediately
37
Q

type of pneumonia

A

PCP

ground glass

perihilar distribution

38
Q

define the cause of the pulmonary oedema

A

re-expansion pulmonary oedema

39
Q

state the type of pneumothorax

A

​tension haemopneumothorax

  1. Mediastinal shift
  2. flattened diaphragm
  3. hypeexpanded hemithorax
40
Q

Tracheal tip position

A

1/2 - 1/3 distance from stoma to carina

41
Q

Treatment for CAP

A

Amoxicillin

42
Q

Tracheostomy can be effected by patients head position. True or false

43
Q

report

A

Line in extra pleural space + haemorrhage

44
Q

Most likely cause of lobar pneumonia? 1 m

A

streptococcus pneumoniae

45
Q

report

A

ruptured left hemidiaphragm

46
Q

Which line induces an increrased chance of pneumothorax?

A

Subclavian

also look for mediastinal widening for insertion injury causing haematoma

47
Q

Misplaced ETT in the bronchus will have two reactions

A
  1. Collapse of opposite lung
  2. Consolidation
48
Q

report - trauma 3m

A

mediastinal haematoma

right apical cap

c6-c7 hyperextension facet injury

49
Q

Interstitial pul oedema developes into ..

A

alveolar pul oedema or bats wing

50
Q

treatment for for staphylococcal pneumonia

A

fluxicillin

51
Q

What is the safe rang for ETT placement?

52
Q

report

A

fb dental bridge

53
Q

Report!

A

ETT in the right main bronchus left lung collapse

54
Q

report

A

rt art puncture

55
Q

Contraindication of central line in the right atrium 2m

A
  1. Ventricular Arrythmia
  2. Cardiac perforation
56
Q

report - cp endoscopy 1m

A

pneumomediastinum

57
Q

report

A

ruptured left hemidiaphragm

58
Q

What are the consequences of a tension haemothorax or pneumothorax for the heart? 1m

A

Impead venous return to the heart

note: must be discussed with ir radiologist or thoracic team - not to put in chest drain

59
Q

Cause of atypical pneumonia?

A

mycoplasma

legionella

Chest Reporting (3 decks)

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