CXR knowledge Flashcards
What is a pneumothorax? What causes it?
Total lung collapse. Caused by air entering the pleural cavity which causes positive pressure on the outside of the lung resulting in lung collapse. (Thanks, Pete!)
What is atelectasis? What causes it?
Partial lung collapse and loss of lung volume. When alveoli deflate/collapse and there is a partial lung collapse. Can be in just one segment or lobe. Lung bronchiole(s) becomes blocked or there is loss of elasticity in the smooth muscle of the bronchi resulting in the alveoli becoming deflated. (Thanks, Pete!)
Overpenetrated is when you can see ____ too ____?
See the intervertebral discs too clearly
Underpenetrated is when you can’t see what?
You do not see the intervertebral discs at all
Normal penetration is when you can barely see the ____ through the ____
Barely see the intervertebral discs through the heart
The Diaphragm is higher on which side because of what organ?
Higher on right due to the liver pushing up on it
Heart is supposed to be what size of the chest?
Heart size is supposed to be half the size of the chest
What does cancer do to tissue?
Pulls and distorts tissue. “Crab”
What is normal cardiac diameter in men and women?
Males= less than 15.5cm; Females= less than 14.5
A change of heart size of how many cm between two xrays is significant?
Change in diameter of greater than 1.5 cm between two
X-rays is significant
What is the Cardiothoracic Ratio formula?
Cardiothoracic Ratio (A+B) less than C
Which view can the Cardiothoracic Ratio only be assessed on?
PA view
If heart is more than 66% of the chest then the patient’s age is likely…?
Neonatal
A heart’s percentage of the chest greater than _____ is abnormal?
Greater than 50%
Three possible causes of a ratio greater than 50% include
Cardiac failure, pericardial effusion, left or right ventricular hypertrophy
An AP view makes the heart look larger or smaller than it really is?
Larger, by about 10%
The clavicle should be at which intercostal space on a normal CXR?
Clavicle placement at 2-3 intercostal space
A normal looking diaphragm should look like what at the angles?
Rounded with sharp pointed costophrenic and costocardiac angles
The right diaphragm is usually how many cm higher than left?
Right diaphragm is usually 1-2 cm higher
Lung parenchyma becomes lighter or darker as you go down the lung?
Lighter
If lung parenchyma does not become lighter as it goes down what might it mean?
Lower lobe infiltrate or pleural effusion
What is the difference between an effusion and infiltrate?
Infiltrate=In Lung; Effusion= between lung and chest wall
Define Infiltrate
A collection of something (usually liquid) within tissue or within a space
Define Effusion
a collection of something (usually liquid) outside a tissue or within a potential space
Define Mass
something solid that is generally well marginated and doesn’t belong there
Define Lesion
something poorly marginated that doesn’t belong
Mass vs Lesion
Mass is well marginated, Lesion is poorly marginated
What color does Radiolucency show up as? What does it mean for density?
Blackness, decreased density
What color does Radiopacity show up as? What does it mean for density?
Whiteness, increased density
What does an Alveolar Pattern looks like?
Fluffy, soft, poorly demarcated opacifications,
What are four possible causes of an Alveolar Pattern?
Pulmonary edema, Viral pneumonia, Pneumocystis, Alveolar cell carcinoma
What does an Interstitial Pattern look like?
Looks like branching lines radiating toward the periphery of the lung. Like “lace”.
What are two possible causes of an Interstitial Pattern?
Interstitial pneumonitis, Pulmonary fibrosis
What does a Vascular Pattern look like?
Fat pulmonary arteries, small/no pulmonary artery, lack of vascular markings
What are three possible causes of a Vascular Pattern?
Fat pulm arteries=pulmonary hypertension, small/no pulm arteries=embolus, lack of vascular marking=pneumothorax
Can you see the heart border on a lingular infiltrate?
Nope. Cannot see heart border then likely lingular infiltrate.
Can you see the heart border on a LLL infiltrate?
Usually yes. Lower lobe infiltrate usually lets you see the heart
An obstruction in a lobe causing no ventilation past that spot is called…?
Obstructive atelectasis
What happens to the trapped air in atelectasis?
Absorbed by pulmonary circulation
What happens to the unaffected lung in atelectasis?
Compensatory hyperinflation of normal lungs.
Underpenetration makes atelectasis look more prominent or less prominent?
Makes the atelectasis more prominent
What does Congestive Heart Failure looks like?
Increased heart size. Large hila with indistinct markings, Fluid in interlobar fissures, Pleural effusions, and alveolar edema
What do Kerley B lines represent?
Interstitial edema (fluid collection at minor fissures of lungs), look like little dashes near CFAs. Heart failure.
Little dashes near the CFAs are called what?
Kerley B Lines, represent fluid collection at minor fissures in lungs. Heart failure.
What is Pathoneumonic for heart failure?
Kerley B Lines (dashes near CFAs), represent interstitial edema
Where do you decompress a Tension Pneumothorax?
5th intercostal space mid clavicle line
If you see a Thin-Walled Cavity with a density similar to bone what do you consider?
Possibly TB
What is the Cardiothoracic Ratio formula?
(A+B) less than C
