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Radiology > Interpretation of Chest Radiographs > Flashcards

Interpretation of Chest Radiographs Flashcards

1
Q

What is the most opaque (white) thing you will see in an x-ray?

A

metal

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2
Q

What appears large in a pediatric chest c-ray, becomes smaller by age 2 and disappears from imaging by age 8?

A

thymus

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3
Q

What should you make sure of when you order a chest x-ray?

A
  • make sure you ordered the right test/c-ray
  • make sure you have the patient’s x-rays in your hand or on the computer
  • make sure that the correct date and time are on your films
  • compare to old x-rays when possible
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4
Q

Where can you find the gastric bubble?

A

on the left side of the plain film (patients left side)

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5
Q

What is the term for the condition with completely mirror positioning of abdominal organs and heart?

A

situs inversus

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6
Q

The mirrored silhouette of the heart in situs inversus is called what?

A

dextocardia

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7
Q

What should you remember when looking at chest x-rays?

A
  • Position
  • Inspiration
  • Penetration
  • Rotation
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8
Q

Which view is always the best for chest x-rays?

A

PA

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9
Q

What type of film will slightly magnify the heart?

A

AP

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10
Q

What is better if the patient is standing upright as opposed to supine?

A

chest x-ray

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11
Q

What do you want your patient to do when taking a chest x-ray and how many ribs do you want to see?

A

inspiration
- want to see at least 8-10 ribs

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12
Q

What does PIPR stand for?

A
  • position
  • inspiration
  • penetration
  • rotation/angulation
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13
Q

What view is preferred unless patient is unable to stand or is acutely ill, in which case another view can be used at bedside?

A

PA

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14
Q

Which view can be used at bedside?

A

AP

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15
Q

In which view may there be diminished quality of the CXR since a patient who is supine is less likely to be able to take a full inspiratory breath, reducing the quality of the film?

A

AP view

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16
Q

What should you not compare when looking for progression of disease, especially cardiac disease/heart size?

A

AP and PA films

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17
Q

What is this describing:
- taken in standing or sitting position
- scapulae not overlapping lung fields
- clavicle is not foreshortened
- no cardiac magnification
- fundic air bubble seen

A

PA view

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18
Q

What is this describing:
- taken in supine position
- scapulae overlapping lung fields
- clavicle is foreshortened
- cardiac magnification
- fundic air bubble not seen

A

AP view

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19
Q

What word describes when an object is shown closer than it really is?

A

foreshortened

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20
Q

Portable chest x-rays usually give you what type of view?

A

AP view

21
Q

How can you assess the quality of inspiration in a chest film?

A

counting the ribs visible within the lung field

22
Q

How many ribs do you want to see in the lung field in a chest x-ray?

A
  • 6 anterior
  • 8-10 posterior
23
Q

Ideally, the diaphragm should be intersected by which ribs in the mid-clavicular line?

A

ribs 5-7

24
Q

What should be visualized in a well-penetrated chest x-ray?

A
  • vertebrae behind heart
  • left hemidiaphragm to edge of spine
25
Q

What should lie equidistant from the medial aspect of each clavicle?

A

the spinous processes

26
Q

If you have a patient that is rotated in chest x-rays, what can happen?

A

it can obscure important findings within the chest

27
Q

What happens if a patient is rotated left in a CXR?

A

heart is exaggerated

28
Q

What happens if a patient is rotated right in a CXR?

A

the true size of heart may be underestimated

29
Q

After PIPR, what do you look at?

A

ABCDEs

30
Q

What do the ABCDEs stand for?

A
  • airway
  • bones (clavicle, ribs)
  • cardiomediastinal silhouette
  • diaphragms
  • everything else (lung field, soft tissue, tubes, etc)
31
Q

When looking at the airway in a CXR, what are you looking at?

A

position of the trachea

32
Q

What should be at the midline over the thoracic vertebrae and is air-filled?

A

trachea

33
Q

What signs should you look for when looking at the trachea in a CXR?

A
  • deviation
  • foreign body or ET tube
34
Q

What should you look for/do when looking at the bony structures in a CXR?

A
  • count ribs
  • clavicle placement at 2-3 intercostal space (may be rotated if not)
  • evaluate for trauma or fracture of ribs or clavicles if suspected
  • find a bone pattern and stick to it (shoulders, scapula, ribs, spine)
35
Q

When looking at the cardiomediastinal silhouette, what are you comparing?

A

the size of the diaphragm to size of the heart (cardio-thoracic ratio)

36
Q

Cardio-thoracic ratio is only looked at in what view?

A

PA

37
Q

If the cardio-thoracic ratio is over 50%, what does this mean?

A

considered abnormal in an adult

38
Q

What are possible causes of a cardio-thoracic ratio >50%?

A
  • heart failure
  • left or right ventricular hypertrophy
39
Q

What symptoms might a person have with a cardio-thoracic ratio >50%?

A
  • SOB
  • fatigue
  • edema
40
Q

When looking at diaphragms in a CXR, which diaphragm is usually slightly higher?

A

the right diaphragm

41
Q

What is eventration of the diaphragm mean?

A

one diaphragm is elevated abnormally

42
Q

When looking at “expanded lungs,” what should you evaluate?

A
  • hilar region of the lungs
  • the lung fields from top to bottom and right to left
43
Q

When looking at the hilar region of the lungs, what should you look for?

A

enlarged hilum (TB, lymphoma, cancer, sarcoidosis)

44
Q

When evaluating lung fields from top to bottom and right to left, what should you look for?

A
  • follow bilaterally top to bottom and compare both sides
  • lung parenchyma usually becomes lighter as you go down the lung
  • varying shades of grey in lung fields
  • look for areas of altered density in areas it would not be suspected
45
Q

When looking at “everything else,” what should you evaluate?

A
  • soft tissue structures
  • tubes, lines, and wires
  • presence of any devices, such as pacemaker
46
Q

What should you follow in evaluating CXRs from beginning to end?

A

PIPR
- position
- inspiration
- penetration
- rotation
ABCDEs
- airway
- bones
- cardiomediastinal silhouette
- diaphragm
- expanded lungs and everything else

47
Q

When a PA view is obtained, what other type of view is usually also obtained?

A

lateral view

48
Q

What can be helpful in identifying some pneumonias especially and afford a view into the retrocardiac space?

A

lateral views

49
Q

When evaluating lateral CXR, what should you do?

A
  • look for abnormalities present in airway/hilar structures
  • look for distinct border of left ventricle and normal cardiac position and size
  • pay attention to retrosternal and retrocardiac spaces as they should be clear
  • evaluate each vertebrae and ribs for abnormalities or trauma

Radiology (6 decks)

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