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Neuroanatomy > Frontal Chest Radiography Interpretation > Flashcards

Frontal Chest Radiography Interpretation Flashcards

1
Q

What is the order for tissue absorption of X-ray from least to most

A 
Air or gas 
Fat 
Soft tissue 
Bone or calcium 
Metal
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2
Q

how does air appear on a radiograph

A

black

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3
Q

What are the 11 steps to reading a frontal radiograph

A
  1. Is it PA or AP?
  2. Is it over or under exposed??
  3. Is it satisfactory inspiration
  4. Is the patient rotated
  5. Is the heart enlarged?
  6. SIlhouette signs
  7. What is the position of the mediastinum
  8. Can you se the landmarks in the mediastinum
  9. Are the hilla/fissures normal
  10. Are the bones normal?
  11. Remember your clinical reasoning skills
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4
Q

the most standard beam goes from ___ to _____

A

posterior to anterior

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5
Q

What are 3 disadvantages to AP x-rays

A
  1. Mediastinum is magnified
  2. sometimes difficult for patients to take full inspiration
  3. Patient position compromised
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6
Q

50 shades of grey is an indication of a

A

pathology

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7
Q

uniform grey is an indication of

A

healthy individual

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8
Q

How many ribs do you need to see for it to be adequate inspiratory level

A
  • 9 ribs posteriorly

- 6 ribs anteriorly

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9
Q

What is different between the right and left hemi diaphragm

A

right side is typically 1-2 ribs higher than left

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10
Q

How do you determine if an xray is rotated

A

make a vertical line from T1-T5, measure from this line to medial end of the clavicles

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11
Q

When determining rotation if left side is rotated what does this mean

A

posterior rotation on the left

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12
Q

What might you also see with a posterior leftward rotation

A

increased heart size

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13
Q

How do you determine appropriate heart size

A

draw two lines
1. spanning each lateral heart border
2. spanning from each lateral thoracic border
heart line should be <50% of thorax line

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14
Q

When you have a positive silhouette sign you ____ see the silhouette

A

do not

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15
Q

What are some silhouette signs you look for

A

arch of aorta
Costocardiac angles
Costophrenic angles
Heart borders

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16
Q

Loss of silhouette gives you positive silhouette sign and from whatever structure is missing you can correlate that to

A

a pathology in this lobe of the lungs

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17
Q

How do you determine mediastinum shift

A

draw a horizontal line from one edge of the heart border to one edge of the thorax. The ratio between right and left should be 2:1

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18
Q

how do you determine tracheal shift

A
  • Draw a vertical line down the spinous processes of T1-T5, SP should be midline inside the silhouette of the trachea
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19
Q

a volume increase causes a tracheal or mediastinal shift in which direction

A

away from the volume increase

20
Q

What are two mediastinum landmarks

A
  1. pulmonary artery

2. general vascularity

21
Q

where do you see the pulmonary artery

A

1-2 rib counts below arch of aorta

should be bent

22
Q

Where do you find the hila

A
  • 1-2 rib counts below the inferior aspect of the arch of the aorta
  • same level as pulmonary artery
23
Q

Where do you find the transverse fissure

A

at the level of the right hila

24
Q

What other 2 things should you look at when looking for rib fractures

A
  1. shape/contour of the ribs

2. shape/contour of the hemi diaphragms

25
Q

What is one thing that causes a volume decrease int he lungs

A

collapse/atelectasis

26
Q

What are 4 things that cause a volume increase in the lungs

A
  1. consolidation
  2. pleural effusion
  3. pneumothorax
  4. COPD
27
Q

What is a lung collapse

A

when air enters the pleural space

28
Q

What is a total lung collapse called

A

a pneumothorax

29
Q

What is atelectasis

A

start of collapse/partial collapse

Condition where the alveoli are deflated down to little or no volume

30
Q

What are some general features on a radiograph of a lung collapse/atelectasis

A
  • Shift of landmarks: fissures, mediastinum, trachea, & diaphragm towards volume decrease
  • Elevation of hemi diaphragm
  • Decrease in spacing between the ribs and/or rib count
  • Silhouette signs
31
Q

Why may a lobar collapse appear white

A
  • Affected lung tissue occupies a smaller volume
  • It has no air in it
  • Mucus secretions back up and collect in alveoli
32
Q

What is consolidation

A

any pathological process which fills the alveolar

33
Q

How do consolidated areas of lung appear

A

as areas of opacification which may conform to the outline of the lobe or segment

34
Q

What is pleural effusion

A

fluid in the pleural space

35
Q

how do pleural effusions appear? (large and small)

A
  • Small: a blunted costophrenic angle

- Larger: increased opacification up the chest wall and there may be a mediastinal shift to the opposite side

36
Q

What are the general features of consolidation/pleural effusion on a radiograph

A
  • opacification
  • often a variable amount of atelectasis with consolidation
  • Silhouette signs
  • Shift away from volume increase
  • Small PE: blunting of costophrenic angle
37
Q

What is a pneumothorax

A

total lung collapse

38
Q

What is a hemothorax

A

blood gathering in pleural space

39
Q

What is a tension pneumothorax

A

results from a wound in the chest wall, which allows air to enter the pleural cavity, but prevents its escapse

40
Q

What is a spontaneous pneumothorax

A

spontaneous rupture of the lung occurs internally with no external trauma

41
Q

What are 3 causes of pneumothorax

A
  • trauma
  • lung disease
  • mechanical ventilation
42
Q

What are 3 signs and symptoms of pneumothorax

A
  • Chest pain
  • SOB
  • Respiratory distress
43
Q

What are the general features of a pneumothorax on a radiograph

A
  • Air in the pleural space will cause a dark area, usually begins at apex
  • Absence of lung marking
  • A fine line indicating the outline of the collapsed lung is usually seen
44
Q

What is emphysema + it’s signs on a radiograph

A
  • The lungs are hyperinflated with the ribs more horizontal and flattened diaphragms
  • Hyperlucency of the lung fields with the development of bullae and loss of vascular marking
  • The heart is more pear shaped as it rests on lower, flattened diaphragm
45
Q

What is chronic bronchitis and what are the physiological changes seen with it

A
  • Over inflation
  • Thickened bronchial walls
  • Decreased width of pulmonary vessels

Neuroanatomy (23 decks)

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