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ANE 8510 - Principles of Anesthesia II > Exam 1 - X Ray > Flashcards

Exam 1 - X Ray Flashcards

1
Q

T/F: a normal chest x-ray does not rule out pulmonary problems.

A

True; for example, asthmatics can have normal chest x-rays…

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2
Q

Overexposure causes a film to be too dark. What structures in the lung cannot be seen because of this? Select 2.
A. small nodules
B. mediastinal structures
C. fine structures
D. thoracic spine

A

A. small nodules
C. fine structures

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3
Q

What type of exposure can cause small pulm blood vessels appear prominent and could lead you to think there are generalized infiltrates when really none are present?
A. overexposure
B. underexposure
C. upright position
D. minimal inspiration

A

B. Underexposure - it causes the film to be quite white!

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4
Q

What are some image differences between male and female regarding amount of breast tissue? select 2.
A. problematic if the inferior aspect of breast is above the hemidiaphragms
B. breast tissue absorbs some of the xray beam
C. breast tissue causes overexposure of the tissues in the path
D. not problematic if the inferior aspect of breast is above the hemidiaphragms

A

B. breast tissue absorbs some of the xray beam; causing underexposure
D. not problematic if the inferior aspect of breast is above the hemidiaphragms

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5
Q

For interpretive purposes, what is the main difference between AP and PA projection?
A. lungs will be magnified on a PA projection
B. lungs will be magnified on an AP projection
C. heart will be magnified on an AP projection
D. heart will be magnified on a PA projection

A

C. heart will be magnified on an AP projection

b/c in AP, the heart is farther from the film and the xray beam diverges as it goes farther from the tube

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6
Q

Where will a pneumothorax accumulate if patient is upright?

A

up at the top (apex) of the lungs

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7
Q

The amount of inspiration is greater in ____ film, which allows for spreading of pulm vessels and allows clearer visualization.
A. supine
B. upright
C. lateral
D. PA

A

B. upright

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8
Q

If the patient is supine, a hemothorax may cause an entire CXR to be:
A. underexposed
B. overexposed
C. obscured

A

C. obscured

also, the standard AP projection + cephalic push of abd contents can make a normal heart appear large

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9
Q

When taking an inspiration while standing, the domes of the hemidiaphragms come down to what rib level?
A. ninth anterior ribs
B. ninth posterior ribs
C. tenth anterior ribs
D. tenth posterior ribs

A

D. tenth posterior ribs

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10
Q

When inspiring while sitting down, the domes of the hemidiaphragms come down between what ribs?
A. eighth and tenth
B. ninth and eleventh
C. seventh and ninth
D. sixth and eighth

A

A. eighth and tenth

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11
Q

What 5 bony fragments should we be able to point out in a CXR?

A

ribs, sternum, spine, shoulder girdle, clavicles

r,s,s,s,c

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12
Q

What 4 soft tissues might we see on a normal CXR?

A

breast shadows, supraclavicular areas, axillae, tissues alongside of breasts

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13
Q

What is most important to note about breast shadows seen on CXR?
A. may obscure costophrenic angles
B. shadows should be equal on both sides
C. may cause overexposure of image
D. breast tissue is unable to absorb the xray beam

A

A. may obscure costophrenic angles

breast tissue does absorb the xray beam which essentially causes underexposure (not overexposure) of the tissues in the path

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14
Q

What pulmonary markings should be visible in a normal CXR?

A
  • hilum (pulm arteries and pulm veins)
  • lungs (linear and fine nodular shadows of pulm vessels)
  • blood vessels
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15
Q

About what percentage of the lung fields are obscured by other tissue?

A

40%

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16
Q

If you don’t see one or either costophrenic angles, what should you suspect? select 2.
A. aspiration pneumonia
B. ruptured diaphragm
C. atelectasis
D. pleural effusion
E. tension pneumothorax

A

B. ruptured diaphragm
D. pleural effusion

based on cornelius’ lecture

17
Q

T/F: Normal pleura is not visible on a normal CXR, but you should be able to see interlobar fissures.

A

True

this pic was on this slide but can’t see the fissures if u ask me lol…

18
Q

What 4 structures are seen on the right side of patient’s mediastinum/heart on CXR?

A

SVC, IVC, right atrium, ascending aorta

19
Q

What structures are seen on the left side of patient’s mediastinum/heart on CXR?

A

left ventricle, left atrium, pulmonary artery, aortic arch, subclavian artery and vein

20
Q

Should you measure heart size on AP or PA projection? why?

A

PA projection - because heart will be magnified on an AP projection… which could result in an inaccurate diagnosis of cardiomegaly

21
Q

What should be noted about the abdomen on a normal CXR?

A

the gastric bubble on pt’s left side

  • breast tissue may obscure this gas bubble and also air under the diaphragm so be mindful of that
22
Q

Some pitfalls to CXR interpretation include:
A. poor inspiration
B. under/overpenetration
C. rotation
D. forgetting the path of the xray beam
E. all of the above

A

E. all of the above

23
Q

Poor inspiration results in: select 2.
A. flattened diaphragm
B. stretched out lung markings
C. high diaphragms
D. crowding of normal lung markings

A

C. high diaphragms
D. crowding of normal lung markings

24
Q

How can you tell if the PA chest XR is properly penetrated?

A

one can just make out the thoracic vertebrae overlying the image of the heart

25
Q

review lung anatomy

A
26
Q

Name the lobes of the R lung?
L lung?

A

R (3): superior, middle, inferior
L (2): superior and inferior

27
Q

Which lobe is the largest of all three lobes, seperated from the others by the major fissure?

A

RLL - extends as far superiorly to T6 and inferiorly to the diaphragm

28
Q

Describe the anatomical position of the RUL: select 2.
A. posteriorly, adjacent to the first 4-6 ribs
B. occupies upper 1/4 of right lung
C. posteriorly, adjacent to the first 3-5 ribs
D. anteriorly, extends inferiorly as far as the 4th right anterior rib
E. anteriorly, extends inferiorly as far as the 3rd right anterior rib

A

C. posteriorly, adjacent to the first 3-5 ribs
D. anteriorly, extends inferiorly as far as the 4th right anterior rib

and occupies upper 1/3 of right lung!

29
Q

Near what structure is the right middle lobe the most narrow?

A

near the hilum

30
Q

What 2 fissures and 2 spaces should be seen on a lateral view of a CXR?

A
  1. Oblique fissure
  2. Horizontal fissure
  3. Thoracic spine and retrocardiac space
  4. Retrosternal space

ANE 8510 - Principles of Anesthesia II (17 decks)

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