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SMP - Cardiopulmonary Lab Practical > Introduction to Chest Radiology > Flashcards

Introduction to Chest Radiology Flashcards

1
Q

2 ways of looking at the chest?

A
  1. Chest radiograph (CXR)
  2. Chest CT
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2
Q

Difference between X-ray and radiograph?

A

A radiograph is the resultant image after a patient or object is exposed to x rays

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3
Q

Describe the detectors currently used in radiography.

A

All digital

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4
Q

How to describe subject placement in radiography?

A

First the side receiving the rays first

Then the side next to the film

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5
Q

Which frontal CXR is preferred?

A

PA

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6
Q

Which lateral CXR is preferred?

A

Right

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7
Q

How does one make a CT image of the chest?

A
  1. Patient passes in short increments through hole in scanner
  2. XR tube (in housing gantry) rotates around patient in a spiral
  3. X-rays pass through patient and strike detectors
  4. Computer generates the image
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8
Q

Does a CT have multi-planar capability? What does this mean?

A

YES, meaning it can generate images in the axial, coronal, and sagittal planes

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9
Q

What is an axial plane?

A

Horizontal plane cutting body in superior and inferior portions

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10
Q

What is a coronal plane?

A

Plane cutting body in anterior and posterior portions

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11
Q

What is a sagittal plane?

A

Plane cutting body in right and left portions

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12
Q

Other word for axial plane?

A

Transverse plane

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13
Q

Which CT plane would most closely simulate a lateral CXR?

A

Sagittal plane

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14
Q
A
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15
Q

Name the bones.

A

*coracoid process of the scapula

*spinous proccesses from the vertebrae

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16
Q

Name the “moguls”. What to note?

A

Note: pulmonary trunk is more of a valley than a bump

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17
Q
A
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18
Q

In which position are patients passed through a CT scan?

A

Supine

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19
Q

Other name for lung roots?

A

Hila

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20
Q

Do the pulmonary arteries travel with the bronchi or the pulmonary veins?

A

Bronchi

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21
Q

What are the pleural angles?

A

Junction of costal pleura and diaphragmatic pleura

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22
Q

How to tell the difference between posterior and anterior ribs on a radiography?

A

The ribs most visible are posterior and horizontal

The faint ribs are anterior

TBD

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23
Q

Are pulmonary arteries and veins parallel?

A

NOPE

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24
Q
A
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25
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26
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27
Q
A
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28
Q

Other name for bifurcation of the trachea?

A

Carina

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29
Q
A
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30
Q
A

Pectoralis muscle on left side and Poland syndrome on the right side = congenital absence of pectoralis muscle associated with hypoplasia of ipsilateral:

  • pectoralis major muscle, and
  • breast, and
  • ribs, and
  • upper extremity
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31
Q

Which 2 veins drain into the SVC?

A

R and L brachiocephalic veins

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32
Q

Is Poland’s syndrome more common in men or women?

A

Men

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33
Q

What is pneumonia? Where does it originate?

A

Infection of the lung airspaces

Originates in the alveoli as organisms are inhaled and reproduce in the lungs

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34
Q

What are pores of Kohn?

A

Small holes connecting alveoli

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35
Q

Can pneumonia spread?

A

Yes, but only locally through the pores of Kohn

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36
Q

What is the distinguishing feature of pneumonia on a chest CXR?

A

Fluffy opacities in a focal site due to the inflammatory products replacing alveolar air

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37
Q
A

Right lung pneumonia

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38
Q
A

Left lung pneumonia

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39
Q
A

Right upper lobe pneumonia

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40
Q

What is a pulmonary edema?

A

Extravasation of fluid from pulmonary capillaries into alveoli replacing the alveolar air space

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41
Q

What is the distinguishing feature of pulmonary edema on a chest CXR?

A

Fluffy opacities bilaterally and symmetrically favored in mid and lower chest zones because of gravity => basilar dependent

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42
Q

2 possible causes of pulmonary edema? Fraction of cases for each?

A
  1. Hydrostatic: due to the capillaries being subject to increased hydrostatic pressure, fluid seeps into the alveoli, usually due to heart failure (2/3rds of cases) or could be due to fluid overload or kidney failure
  2. Permeability: noncardiogenic cause but increased permeability of pulmonary capillaries (1/3rd of cases)
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43
Q

Other than the distinguishing feature, how else is pulmonary edema visible on a chest CXR?

A
  • Batwing pattern = specific central and symmetric cloudiness pattern
  • Enlarged cardiac silhouette if the cause is cardiogenic
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44
Q
A

Pulmonary edema with enlarged cardiac silhouette

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45
Q
A

Pulmonary edema with enlarged cardiac silhouette

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46
Q

What is a primary lung carcinoma?

A

A cancer (tumor) that originates in the lungs or the cells lining the airways as normal lung cells become cancer cells and begin to uncontrollably divide

47
Q

How to distinguish a malignant tumor from a benign one?

A

A malignant one is distinguished from a benign one in that it can spread (aka metastasize) to distant sites

48
Q
A

Left lower lobe primary lung carcinoma

49
Q
A

Left lower lobe primary lung carcinoma

50
Q
A

Left lower lobe primary lung carcinoma

51
Q
A

Left lower lobe primary lung carcinoma

52
Q
A

Left lower lobe primary lung carcinoma on a PET scan showing the high mitotic rate of the cells that are taking up a lot of radioactive glucose, which is indicative of cancer

53
Q

What is the distinguishing feature of secondary lung carcinoma on a chest CXR?

A

Multiple bilateral masses in the lungs

54
Q

What is the distinguishing feature of primary lung carcinoma on a chest CXR?

A

Large, dense ball with smooth margins

55
Q
A

Secondary lung carcinoma metastisized from a colon carcinoma

56
Q
A

Secondary lung carcinoma metastisized from a colon carcinoma

57
Q

2 layers of the pleura? What is in between?

A
  1. Visceral pleura
  2. Parietal pleura

In between = pleural cavity

58
Q

What is a lung fissure?

A

A cleavage of the visceral pleura

59
Q
A
60
Q
A
61
Q

Other name for minor fissure? Where is it located?

A

Horizontal fissure on right lung

62
Q

What does the left major fissure divide?

A

Left upper lobe and left lower lobe

63
Q

Place the left major fissure.

A
64
Q

What does the right minor fissure divide?

A

Rigght upper lobe from right medial lobe

65
Q

What does the right major fissure divide?

A

The right upper and middle lobes from the lower lobe

66
Q

Place the right lung fissures.

A
67
Q

In what lobe do the schematic objects reside?

A

Cannot tell for sure

68
Q

Are the schematic objects in the right or left lobes?

A

Cannot tell

69
Q
A
70
Q
A
71
Q

What is a pneumothorax?

A

Visceral and parietal pleural are separated by air in the pleural cavity

72
Q

When pneumothorax occurs, which pleural layer becomes visible on CXR?

A

The visceral pleura

73
Q

What is the distinguishing feature of a pneumothorax on a chest CXR?

A

Air in pleural space is hyper black or hyper luscent and the visceral pleural edge is visible

74
Q
A

Right lung pneumothorax

75
Q
A

Pneumothorax

76
Q
A

Left lung pneumothorax

77
Q
A

Left lung pneumothorax

78
Q

What is a pleural effusion?

A

Visceral and parietal pleura are separated by fluid in the pleural space

79
Q

4 types of pleural fluids?

A
  1. Water
  2. Pus
  3. Blood
  4. Lymphatic fluid
80
Q

Other name for lymphatic fluid?

A

Chyle

81
Q

What is the distinguishing feature of pleural effusion on a chest CXR?

A

Costophrenic angles are blunted with a meniscus sign

82
Q
A

Normal

83
Q
A

Normal

84
Q
A

Right pleural effusion

85
Q
A

Pleural effusion

86
Q
A

Left pleural effusion

87
Q
A

Pleural effusion with meniscus sign

88
Q
A

Right pleural effusion

89
Q
A

Right lung pleural effusion

90
Q
A

Right lung pleural effusion

91
Q
A

Right lung pleural effusion

92
Q
A

Left pleural effusion in supine patient

93
Q
A

Left lung pleural effusion in upright position

94
Q

Is layering of fluid visible on chest CXR with pleural effusions?

A

YUP

95
Q

How can you tell if the cardiac silhouette is enlarged?

A

If it is greater than half the transverse diameter of one hemithorax

96
Q

If a chest CXR shows an enlarged cardiac silhouette, how can you differentiate between cardiomegaly and pericardial effusion?

A

You will need an echocardiogram or a CT, the CXR alone cannot distinguish them

97
Q
A

Normal

98
Q
A

Enlarged cardiac silhouette

99
Q
A

Cardiomegaly

100
Q
A

Normal

101
Q

What is cardiomegaly? Main causes?

A

Enlargement of the cardiac chambers

Main causes: CAD or high BP

102
Q
A

Cardiomegaly

103
Q
A

Cardiomegaly

104
Q

Which is the most inferior slide?

A

A

105
Q

What is a pericardial effusion?

A

Visceral and parietal pericardial layers are separated by fluid in the pericardial sac

106
Q
A

Pericardial effusion

107
Q

What is the size of the heart?

A

Cannot tell for sure

108
Q

What is the size of the heart?

A

Normal, because this is a pericardial effusion

109
Q
A

Pericardial effusion

110
Q
A

Cardiomegaly

111
Q
A

Pericardial effusion

112
Q

3 common causes of pericardial effusion?

A
  1. Inflammation
  2. Viral infection
  3. Metastatic diseases
113
Q
A

Large cardiac silhouette

114
Q

What is a lung CT specifically used to assess?

A

The interstitium of the lungs

SMP - Cardiopulmonary Lab Practical (11 decks)

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