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MD3001 Cardiology > Interpretation of Normal Chest X-Rays > Flashcards

Interpretation of Normal Chest X-Rays Flashcards

1
Q

What are important things to remember to fill out in an imaging request form?

A
  • clinical history

- findings

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2
Q

What are the indications for a chest x-ray?

A
  • acute deterioration in SOB
  • acute chest pain
  • suspected malignancy
  • pneumonia
  • pleural disease
  • peritonitis
  • chronic lung disease
  • following invasive procedures (to check it was done right)
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3
Q

What are the important things to check when viewing an x-ray?

A
  • right patient (2 point ID: CHI and specific radiological number)
  • correct date
  • PA/AP
  • correct orientation
  • exposure
  • rotation
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4
Q

What can the radiographer ask the patient to do to improve the view for a PA x-ray?

A

Ask the patient to raise their arms to rotate the scapula off the thorax

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5
Q

Why can you only comment on the heart with PA chest x-rays?

A
  • heart is an anterior organ so there is less magnification as it is closer to the x-ray plate
  • in AP films, the x-rays diverge more
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6
Q

How do you know the x-ray image is well-exposed?

A

you can see the intervertebral discs

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7
Q

How can you tell there is no rotation in the x-ray image?

A

look at the spinous process and look at the clavicle, the distance should be equal, assess any asymmetry

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8
Q

What term is used for areas in a radiograph that are too black?

A

increased translucency

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9
Q

What are reasons for increased translucency in a radiograph?

A
  • air/gas

- loss of tissue density

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10
Q

What term is used for areas in a radiograph that are too white?

A

opacification

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11
Q

What are reasons for opacification in a radiograph?

A
  • fluid

- increased tissue

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12
Q

What are reasons for areas in a radiograph being really white?

A
  • presence of man-made structure:
  • pacemaker
  • NG tube
  • ETT
  • sternal wiring
  • prosthetic heart valves
  • chest drains
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13
Q

What does ABCDEFGH stand for in the systematic approach to searching a chest x-ray?

A 
A - airway
B - breathing
C - cardiac
D - diaphragm
E - external structures and equipment
F - fat and soft tissue
G - great vessels
H - hidden areas
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14
Q

What is a common mistake made when looking at radiographs?

A
  • search satisfaction
  • abnormality found and doesn’t look further
  • always do systematic search
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15
Q

A- airway

A
  • check if trachea is straight

- look for carina (T4)

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16
Q

Where are you most likely to find abnormality when looking at the lungs on a chest x-ray?

A
  • right bronchus

- more wider and shorter than the left bronchus so more likely to be obstructed

17
Q

B- breathing

A
  • check expansion of lungs: anterior (curves downwards) 6th rib should cross dome of right hemi-diaphragm
  • lung markings, compare zones
18
Q

What would you find at the level of the horizontal fissure of the right lung in a radiograph? (end of right upper lobe)

A
  • 4th CC

- 5th intercostal space

19
Q

What type of film would you be able to see the oblique fissure of the right lung in a radiograph ( end of right middle lobe)

A

lateral film

20
Q

Where would you find the the end of the right lower lobe of the right lung in a radiograph?

A

behind the anterior part of the diaphragm

21
Q

When describing abnormalities on a radiograph related to the lungs, what should you use to describe instead of lobes?

A

zones (upper/middle/lower)

22
Q

Lung markings

A
  • opacity increases from top to bottom
  • left hilum higher than right
  • right diaphragm higher than left
23
Q

C- cardiac

A
  • measure heart
  • should be less than 50% diameter of chest
  • 1/3 should be visible right side of sternum
24
Q

D- diaphragm

A
  • right hemi-diaphragm is one rib higher than left
  • look for gastric bubble in left hemi-diaphragm
  • look for free air
25
Q

E- external structures

A
  • bones

- medical devices

26
Q

F- fat and soft tissues

A
  • look for breast shadows

- look at subcutaneous fat for signs of surgical emphysema

27
Q

G- great vessels

A
  • look for aortic arch (normally concave), pulmonary arteries, and veins in mediastinum
  • look for calcium deposits in elderly
28
Q

H- hidden areas

A

commonly missed areas:

  • neck
  • apices
  • mediastinum
  • behind heart
  • costophrenic angle
  • behind/below diaphragm
  • soft tissue
  • bones

MD3001 Cardiology (56 decks)

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