Imaging of the chest Flashcards
imaging of the chest
CXR - chest x-ray
CT
MRI
nuclear medicine - PET
AP
Anterior to posterior - magnifies mediastinal structures
PA
posterior to anterior
male vs female chest x-ray
denser in females due to breast tissue
parts of left lung
upper and lower lobe
lingula which is part of the upper left lobe
oblique fissure
T4/5 to bottom of lung
horizontal fissue
6th rib
what is a CTPA?
CT pulmonary angiogram - looks for pulmonary emboli by looking at pulmonary arteries
trachea
16-20 incomplete C or U shaped cartilage
down
cricoid cartilage level
C6
level of the carina
T4-6
carina
divides into right and left main bronchus
right upper lobe
3 segments
what are the segments of the right upper lobe?
apical
posterior and anterior
bronchus intermedius
right middle and lower lobe
right middle lobe
2 segments
medial and lateral
right lower lobe
5 segments
what are the segments of the right lower lobe?
apical anterior posterior lateral medial
left upper lobe
superior and inferior divisions
superior divisions of left upper lobe
2 segments, anterior and apico-posterior
inferior divisions of left upper lobe
lingular - 2 segments superior and inferior
left lower lobe
4 segments
what are the segments of the left lower lobe?
apical
anteromedial
posterior
lateral
what is the bronchus intermedius?
one of the 2 bronchi which the right main bronchus bifurcates into, the other is the right upper lobe bronchus
insertions of the diaphragm
vertebral
costal
sternal
openings of the diaphragm
aortic
oesophageal
caval
vertebral insertions
right and left crus
L1-3
costal insertions
lower 6 ribs and costal cartilages
sternal insertions
posterior aspect of xiphisternum
aortic openings
T12
thoracic duct, azygos and heimazygos veins
T12
oesophageal openings
vagus nerve
oesophageal arteries
T10
caval openings
right phrenic nerve
T8
what is the pulmonary trunk?
major vessel of the heart that originates from the right ventricle. It branches into the right and left pulmonary arteries which leads to the lungs
V/Q scan
ventilation-perfusion scan
what is V/Q scanning
looking for perfusion abnormality and pulmonary emboli
why do V/Q in pregnant women
dose of radiation same as CT but less concentrated on developing breast tissue as in CT there is increased risk of tumour
how to do V/Q scanning?
gases inhaled
scan for ventilation.
inject technitium for perfusion, which is picked up by gamma camera
Normal Ventilation scan
radioactive compounds that are inhaled are distributed evenly
normal perfusion scan
technitium should reach all of lung, where it doesn’t there is lack of perfusion, usually due to pulmonary embolism
what are the differences between normal and abnormal V/Q scans?
evenly greyish black normally but patchy when abnormal or area of white
what is the diagnosis when ventilation is normal but perfusion is . abnormal?
pulmonary embolism
diagnosis when perfusion is normal and ventilation is abnormal?
lung pathology where something is taking up lung tissue that shouldn’t be
mismatching
when perfusion and ventilation scans are not both normal
