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Chest Radiology > Introduction and Normal Variants > Flashcards

Introduction and Normal Variants Flashcards

1
Q

The standard chest examination consists of ___ xray views

A

PA and lateral chest views

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2
Q

Perform a __ view of the chest to reduce magnification of the heart

A

left lateral view

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3
Q

what is the right border of the heart

A

right atrium

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4
Q

what is the left border of the heart

A

left ventricle

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5
Q

what do you COUNT to evaluate a chest film

how many should be seen

what would cause a decrease or increase number seen

A

ribs (dont miss the 2nd rib - commonly missed)

9-10.5

decrease in ribs - not full inspiration when taking film or phrenic nerve issues

increase in ribs - COPD - air trapping

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6
Q

when you see see a left or right on the lateral chest film, what does this mean

A

if it was a left lateral chest view, the left side of the patient is closest to the FILM (not the tube)

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7
Q

when examining a patients chest films you should set them up after imaging and look at them how

A

PA on left

lateral on right

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8
Q

which bronchus is more vertical

A

right bronchus - more likely for something inhaled to land here

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9
Q

PA film is obtained when patient is facing the cassette (away from tube) and the tube is how far away from the patients back

A

6 ft

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10
Q

AP supine chest view the xray tube is how far away

A

40 inches

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11
Q

what are the differences between AP and PA views

what is preferred

A

AP - magnifies the heart and widens mediastinum

PA with inspiration is preferred

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12
Q

what is lateral decubitus position or cross table lateral position used for

A

assess volume of pleural effusion

determine if mobile or loculated based on if effusion travels to the side of the lung which the patient is laying on

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13
Q

what are the indications of inspiration an expiration views

A

pneumothorax accentuated on expiration

diaphramatic paradoxical motion

obstruction

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14
Q

what are the indications of lordotic views

A

apical lung disease

right middle lobe disease

lingular lobe disease

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15
Q

what are the indications of oblique chest views

A

small peripheral lesions

rib fractures

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16
Q

on PA chest view, the diaphragm should be seen at the level of the right __

A

right 10th posterior rib

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17
Q

how can you determine if the patient is rotated on a PA film

A

trachea may be shifted

clavicular heads should be equal distance from the spinous processes

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18
Q

how many secondary bronchi to left and right lung

A

left - 2

right - 3

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19
Q

how many alveoli in a pair of human lungs

A

300 million alveoli

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20
Q

what is inflammation of these membranes that causes them to secrete fluid that collects in the thoracic cavity

how do you treat

A

pleurisy

steroids

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21
Q

what divides the right middle and right upper lobe

A

minor horizontal fissure

22
Q

right and left major oblique fissures are seen on what view

A

best seen on lateral view

also seen on PA but not as well

23
Q

what does the fissure appear as if there is fluid in the fissure

A

increase in density

24
Q

what is the slice thickness of a HRCT scan

A

.625 mm to 1.5 mm

25
Q

left minor fissure is present in what percent of people

A

8-18%

26
Q

what does the left minor fissure separate

A

left upper lobe from the lingula

27
Q

the azygos fissure consists of what

A

2 layers of parietal pleura and 2 layers of visceral pleura

28
Q

where is the azygos fissure located

A

upper medial region of the right upper lobe

29
Q

where is the inferior accessory fissure located

A

lower medial region of the right lower lobe

30
Q

where is the superior accessory fissure located

A

divides right lower lobe into superior segment and 4 basal segments

31
Q

where is the rhomboid ligament located

A

aka costoclavicular ligament

between 1st rib and clavicle

normal variant that looks like lytic lesions under the medial surface of the clavicles

32
Q

how do you know if a breast implant is leaking

A

rim of calcification

33
Q

what are companion shadows

A

shadows of clavicle

seen above clavicle

34
Q

what are findings of pectus excavatum on xray

what is treatment

A

obliteration of lower right heart border

sternum protruding inwards

flattening of the heart

verticality of the anterior ribs

tx - pectus bar

35
Q

what are clinical findings of pectus carinatum and excavatum

A

mitral valve prolapse

36
Q

what are the xray findings of straight back syndrome

A

xray ratio < 1/3

distance between T8 and posterior sternum on lateral view
/
distance of trasnverse diameter of thorax at the level of diaphraphm on PA view

loss of normal kyphosis on xray

leftward shift of the heart

prominent pulmonary artery

37
Q

what are symptoms of straight back syndrome

A

most are asymptomatic

systolic ejection murmur - made louder with chest compression

1/2 the cases involve mitral valve prolapse

palpitations

chest pain

38
Q

in straight back syndrome, the AP diamete of the chest is what

A

10-11 cm or less

39
Q

what do you do when you suspect a mitral valve prolapse

A

echocardiogram

40
Q

children with pectus carinatum have what

A

scoliosis

41
Q

pectus carinatum treatment

A

external bracing technique

42
Q

what are the xray findings of pectus carinatum

A

marked protrusion of the upper third of sternum

chicken or pigeon breast deformity

43
Q

the L pulmonary artery arches over what

the R pulmonary artery passes posterior to what

A

L - left upper lobe bronchus

R - ascending aorta

44
Q

what is normal thorax:heart width

A

2:1

45
Q

how do you evaluate for rib fractures

A

examine posterior ribs first and then anterior ribs and then lateral aspects of ribs

46
Q

fracture of the upper 3 ribs is associated with what

A

aortic injury

47
Q

fracture of the lower 3 ribs is associated wtih what

A

liver or spleen injury

48
Q

multiple bilateral rib fractures in various stages of healing suggest what

A

child abuse in children
or
alcohol abuse

49
Q

what is a term for multiple rib fractures that can cause paradoxical movement of the thoracic cage

A

flail chest

50
Q

majority of CT scans of the chest are what type

A

intravenous contrast spiral CT studies

best assess the pulmonary, pleural, and mediastinal structures

51
Q

what are the applications of spiral CT

A

pulmonary nodules

hilar and mediastinal masses

lung cancer

pulmonary emboli

aortic diseaes - aneurysm and dissection

pleural diseases

52
Q

what are the applications of HRCT

A

bronchiectasis

interstitial disease

alveolar diseases

emphysema

Chest Radiology (2 decks)

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