Imaging the thorax Flashcards

1
Q

Which review areas should you pay special attention to on a chest x-ray?

A

–Apices

–Costo-phrenic angle

–Behind the heart

–Hila

–Peripheries

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2
Q

Where is -

  • Aortic arch
  • Left and right heart borders
A
  • Aortic arch - M1
  • Left heart border - M3

Right heart border - M4

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3
Q

How can you ensure there is no rotation on a chest x-ray?

A

Align: spinous processes of thoracic vertebrae (posterior) with medial ends of both clavicles

Distance should be equal

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4
Q

What are the causes of cardiomegaly on chest x-ray

A

Left ventricular failure (CCF)

Pericardial effusion - heart normal size

Dilated cardiomyopathy

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5
Q

What chambers are these?

A
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6
Q

What anatomical structures makes up the left and right heart borders?

A

Right - right atrium

Left - left ventricle

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7
Q

Where is the hilar point?

A

Hilar point:

‘v’ shaped point where the lower lobe pulmonary arteries cross the upper lobe pulmonary veins

-Should be symmetrical

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8
Q

Where is the pulmonary artery and pulmonary vein?

A

V - pulmonary artery

* - pulmonary vein

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9
Q

What does a raised hilum indicate?

A
  • upper lobe collapse / fibrosis
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10
Q

What does an obscured hilum indicate?

A

?Lymphadenopathy / tumour / mediastinal mass

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11
Q

Complete the diagram of pulmonary arteries and hila

A

MPA - Main pulmonary artery

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12
Q

Complete the diagram of pulmonary arteries and hila

A
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13
Q

Where is the trachea and what is abnormal about this trachea?

A

A

Veers slightly to the right

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14
Q

What is hyperexpansion?

A

Hyperexpansion: if greater than 6 anterior ribs above dome of hemidiaphragm.

  • normal in young
  • Asthma
  • COPD / emphysema
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15
Q

How can you look for hyperexpansion on a chest x-ray?

A

6th anterior rib should clip the middle of the diaphragm (blue line)

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16
Q

What soft tissues can you see on a chest x-ray?

A

Breast shadow - S

Axillary tail - AT

Gastric fundus and bowel gas below diaphragm - GF

17
Q

What does this image show?

A

Air under diaphragm - caused by bowel perforation

18
Q

What does this chest x-ray show?

A

Tension pneumothorax

Heart shifted to right from tension caused by valve effect

19
Q

What does this chest x-ray show?

A

Non-tension pneumothorax

20
Q

What does this show?

A

Cardiomegaly

21
Q

How can you tell if a chest x-ray has cardiomegaly?

A
22
Q

Which lobe is the lung shadowing in?

A

Lower lobe

23
Q

Complete the diagram

A
24
Q

Which lobe is the mass in?

A

Upper lobe

25
Q

Complete the diagram

Assess myocardial thickness

A

X - tricuspid valve

V - descending/thoracic aorta

D - left atrium

Y - mitral valve

Left wall thicker

26
Q

What is A and B?

What scan is this?

What is the diagnosis?

A

A - RV

B - LV

Myocardial perfusion scan

Bad MI - damaged left ventricle wall

27
Q

Where does the interventricular septum recieve most of its blood supply from?

A

Interventricular septum recieves majority of blood supply from the circumflex branch.

Also some from right coronary artery.

28
Q

What is the diagnosis?

A

75% narrowing.

Likely occlusion of left anterior descending artery (LAD)

29
Q

What is the purpose of red cell scans and white cell scans?

A

Red cell scan - for patients who are slowly losing blood but don’t know where

White cell scan - for patients who have a hidden infection

30
Q

Which organs are showing on this red cell scan?

A

Heart, liver and kidneys

31
Q

What structures are showing on this white cell scan?

A

Spleen, bone marrow

32
Q

Which organ do you ignore on red and white cell scanning?

A

Bladder - how contrast is excreted

33
Q

What is A and B?

A

A - left subclavian artery

B - internal thoracic / mammary artery

34
Q

What type of image is this?

Label the diagram

A

Venegram