Imaging Of Heart And Lungs Flashcards
Chest x ray technical factors to make sure on interpretation
Name Sex Patient ID Date Side marker PA AP Erect or semi erect Need to make sure patient is correct And the basics are established
Why is PA or AP important to determine
AP heart look enlarged
As it is further away from the film only used in patient who are too unwell to stand
Imp to determine supine erect or semi erect
Supine enlarges the heart, pleural effusions and pneumothoraces
Difficult to detect poorer inspiration semi erect or supine
Why it it important to inspire during CXR
Imp 5 anterior ribs if under inspired can’t see as many ribs
If underinspired causes apparent congestion and may miss lesions at the lung bases
Why is the rotation important to determine in a CXR
Spinous process in relation so the distance in either side of the spine to the clavicles should be equal if it is not the patient is rotated to the medial clavicles can be used to see if there is any rotation
Alter the transradiancy of the lungs and make the mediastinum seem abnormal
How to asses the penetration of the x ray
Underpenetrated cannot make out the lung bases and the spine cannot be seen behind the heart
Over penetrated the lungs seem as too black and the spine too white
Needs to be dark enough to see T6 but not too dark that you cannot assess the lungs
Terminology to talk about the density of different structures
Soft tissue - grey Fat - grey Air - black Calcific - white Metallic/contrast - very white
Words to use when describing abnormalities
Soft tissue nodule if under 3cm/ mass of over 3cm
Air space opacity - consolidation
Reticular opacity - network of opacity
Nodules
What principle is used to identify where an abnormality is
Use the normal borders of structures and see if they are present or not or have moved in the case of the lung borders
How to assess the size of the heart
Called the cardiothoracic ratio
Heart width/thorax width
Eyeball assessment is reasonable
Heart should be 50% of the thorax width
What are the supporting signs of LV failure
Pulmonary/interstitial oedema
Pleural effusion
Cardiac surgery/ biventricular pacing
Upper vessels larger than lower vessels
What does the hilar consist of
Bronchi
Pulmonary arteries
Pulmonary veins
Lymph nodes
CT scanning
Main image form of the thorax and shows the heart well too
Types of CT
HRCT is tailored to look at the lung and is for discuss parenchymal disease
CECT includes the whole of the chest and is for cancer mediastinal nodes
Low does CT is for follow up of small lung nodules
Basics of echocardiography
No ionising radiation Easily available and quick Non invasive Is a functional assessment of the heart It is limited by an acoustic window
