EXAM #1: INTRO TO CHEST RADIOLOGY Flashcards

1
Q

What are the four different densities on a CXR?

A

1) Soft tissue (water)
2) Fat
3) Air
4) Bone (calcium)

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2
Q

How do high density objects appear on CXR?

A

White

*Note that these are absorbing more photons

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3
Q

How do low density objects appear on CXR?

A

Black

*Note that these are absorbing fewer photons

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4
Q

What are the three things to look for to determine of a CXR is adequate for interpretation?

A

1) Full inspiration
2) Apex of the right hemidiaphragm should be at the level of the posterior 9th or 10th ribs
3) Non-rotated film

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5
Q

How much “penetration” should there be on a PA CXR?

A

T-spine should be just visible, but no detail

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6
Q

How much “penetration” should there be on a lateral CXR?

A

Spine should darken as you move caudally

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7
Q

Where do you look for rotation on a CXR?

A

Clavicles–should be equal distance from the spinous process of the vertebral body

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8
Q

How do you tell the difference between a posterior and anterior rib?

A
Posterior= horizontal
Anterior= vertical
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9
Q

What is the significance of the right paratracheal stripe?

A

Should be less than 5mm

*Enlargement can be lymphadenopathy most commonly associated with lung cancer

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10
Q

What forms the right heart border?

A

Right atrium

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11
Q

What is the AP window?

A

Space between the aorta and the pulmonary artery

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12
Q

What do you need to have to visualize structures on a CXR?

A

Different densities

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13
Q

What forms the left heart border?

A

Left ventricle

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14
Q

What is a fissure?

A

Adjacent viseral pleura

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15
Q

What is the difference between the fissures in the right and left lung?

A

Right= 2x

  • Horizontal= superior
  • Oblique= inferior

Left= 1x major fissure

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16
Q

What fissure separates the upper and lower lobes of the lungs?

A

Oblique/major fissure

17
Q

What does the horizontal fissure separate?

A

Right upper lobe from right middle lobe

18
Q

On the lateral CXR, what do you need to look for to tell the difference between the right and left hemi-diaphragms?

A

Which ribs the hemi-diaphragm abuts:

  • Left= smaller/ non-magnified
  • Right= larger/magnified
19
Q

What structure prevents the anterior left hemi-diaphragm from touching the anterior thorax?

20
Q

What is the retrosternal clear space?

A

Space between the chest wall and heart i.e. anterior mediastinum

21
Q

What are the 5 T’s that can fill the retrosternal space?

A

1) Terrible lymphoma
2) Thymoma
3) Teratoma
4) Thyroid
5) Throacic aortic aneurysm

22
Q

What is the retrotracheal clear space?

A

Space between the trachea and the T-spine

23
Q

What diseases can fill the retrotracheal clear space?

A

1) Vascular abnormalities
2) Esophageal disease
3) Lung cancer

24
Q

What is the retrocardiac space?

A

This is the normal clear “space” that is posterior to the heart on lateral CXR

25
What diseases can fill the retrocardiac space?
1) Hiatal hernia 2) Esophageal disease 3) LV enlargement 4) Pneumonia
26
What are the contents of the anterior mediastinum?
- Thymus - Lymph nodes - Fat - Inframammary vessels
27
What should you remember about a mass that crosses the midline on a CXR?
Likely NOT part of the lung b/c the lungs don't communicate
28
What shape should the AP window be on PA CXR?
Concave
29
What is the cardiothoracic ratio?
Max diameter of heart vs. thorax *Should be less than 0.5 on PA CXR*
30
What should the relationship between the right and left hilar structures be?
Left is typically higher than right
31
What should the relationship between the hemidiaphragms be?
Right is higher than left (b/c of liver)
32
What is the sequence for reviewing a CXR?
1) Admin 2) Quality 3) Initial survey 4) Soft tissue 5) Bones 6) Mediastinum 7) Pleura spaces 8) Lungs