Imaging the Thorax

Question 1

What views can
1. X ray
2. CT
give you?

Answer 1

1. Frontal, lateral

2. Coronal, Sagittal, Axial

Question 2

AP or PA for CXR? Why?

Answer 2

PA is standard

Because in AP, the heart will be magnified and distort the image

Question 3

How far do you want the patient to breath in for an X-ray

Answer 3

So the diaphragm is below ribs 8-10

You can see ribs 9-10 posteriorly

Question 4

How to tell between posterior and anterior ribs

Answer 4

Posterior ribs: more horizontally and extend all the way medially
Anterior: obliquely angled towards the heart

Question 5

Costodiaphragmatic recess

Answer 5

Pleural space at the bottom of the lungs
Fluid can collect here because of gravity
Should be sharp

Question 6

Thoracocentesis

Answer 6

Under ultrasound guidance

Needle is inserted into the fluid and the fluid is sampled and sent to the lab for analysis

Question 7

Pneumothorax

Answer 7

Air collected in the pleural space
Surgical emergency
May interfere with normal breathing

Question 8

Fissures in the right lung

Answer 8

Major (oblique) and minor (horizontal)

Question 9

Left lung fissure

Answer 9

Major (oblique)

Question 10

Consolidation

Answer 10

When the air in the alveoli has been replaced by blood, pus, water, protein, or cell debris

Question 11

Septal thickening

Answer 11

Interstitial disease
The scaffolding surrounding the alveoli is abnormal
Can be due to edema, inflammation, or fibrotic thickening

Question 12

Silhouettes

Answer 12

Clean, well defined margins of the heart and dome of diaphragm

Question 13

Silhouette sign

Answer 13

Loss of the silhouette indicates there is consolidation in the adjacent parenchyma