Imaging of the Chest Flashcards
What is the most common CXR?
PA (posterior to anterior) Chest, Detector located in front of patient and X-ray sent through from back.
What is in the far left and right bottom corners of a CXR?
Costophrenic Angle
Is it over or under penetrated?
Is the film overexposed so you’re missing something in the photo?
Is it an adequate breath?
- Inadequate breathe will “crowd” the lung structures and make them look pathologic
- Should have 10-11 ribs visible to be considered adequate
What bone fractures are extremely common in CXR? What fracture is MOST common?
- Clavicle fractures - often we see healing clavicle fractures
- Rib fractures are MOST common
What could cause a rib lesion?
- Most common = callous due to a healing fracture
- Metastatic lesion most common in older age group
- Benign lesions exist but most require additional imaging to better characterize
What does a metastatic rib lesion look like?
It looks expanded and bubbly!
What components make up the mediastinum?
Heart, aorta, pulmonary vessels, trachea, esophagus
What two conditions will make a heart look larger on film?
- Supine pictures (ER or ICU) accentuates heart size
2. AP films will as well
What things can cause an enlarged heart?
- Hypertrophy due to overuse
- Cardiomyopathy (CV disease, Drugs, Infectious)
- Fluid around the heart
What abnormal aorta problems can be picked up on CXR?
- Aneurysm (focal dilation of caliber of aorta) - seen in upper middle chest = aortic knob
- Aortic Dissection
- Post traumatic Injury with Hematoma
What is the diaphragm?
Thin muscular band that separates the abdominal cavity from the peritoneal cavity
How do you evaluate a diaphragm paralysis?
- Inspiration and Expiration films
- Fluoroscopic evaluation
- Sniff test (fluroscopic test)
