Introduction to radiology of neck and thorax

Question 1

Pros and cons of radiography

Answer 1

+ quick, cheap, easy

• 2D, artefact, radiation

Question 2

Pros and cons of computed tomography

Answer 2

+ quick, good spatial detail

-Poor tissue contrast, high dose

Question 3

Pros and cons of Magnetic resonance

Answer 3

+versatile, good tissue detail, structure and function

-Limited availability, slow, artefacts, patient tolerance

Question 4

Pros and cons of fluoroscopy

Answer 4

+Versatile, some functional info

-High dose

Question 5

Pros and cons of ultrasound

Answer 5

+quick, cheap and safe

-User dependent, artefact

Question 6

Pros and cons of nuclear medicine

Answer 6

+ functional, systemic

-Poor resolution, needs targeting

Question 7

What is used to image bones

Answer 7

Plain film and CT

Question 8

What is used to image spinal cord and nerves

Answer 8

MRI

Question 9

What is used to image soft tissue

Answer 9

Ultrasound, CT and MRI

Question 10

What is used to image vessels

Answer 10

Ultrasound, CT and MRI

Question 11

What does the articulation of C1 and C2 allow

Answer 11

Pivoting of the neck

Question 12

What are the steps of checking the neck

Answer 12

Check alignment of the neck using the anterior, posterior and spinolaminar line

Question 13

Which part of the neck does the soft tissue bulge out

Answer 13

C4

Question 14

What could a change in soft tissue be an indication of

Answer 14

Fracture

Question 15

How do you overcome the things blocking your view of C2

Answer 15

Patient opens mouth and an X-ray of inside the mouth is taken

Question 16

What happens if something doesn’t look right in a CT scan

Answer 16

Do an MRI

Question 17

What can’t you see behind in an ultrasound

Answer 17

Can’t see behind structures filled with air ie trachea

Question 18

Which orientation are x-rays taken from and why

Answer 18

Posteriorly

IN an anterior projection, you get a larger projection of the heart and mediastinum so therefore it will be harder to see if the heart is larger than normal

Question 19

What hilum is higher

Answer 19

Left

Question 20

When would you know if a heart is enlarged when looking at the chest X-ray

Answer 20

If the heart size is more than 50% of the thoracic size (cardiac-thoracic ratio is more than 50%)

Question 21

what could black areas in a CT of the lungs indicate

Answer 21

Emphysema/COPD

Question 22

How should you approach interpretation of imaging

Answer 22

Airway
Breathing
Circulation 
Disability
Everything else

Question 23

What should you check for when assessing airway

Answer 23

1) Trace trachea and continue to the right main bronchus

2) Trace carina and left main bronchus

Question 24

What should you check for when assessing breathing

Answer 24

1) In inspiratory effort, the anterior 5-7 ribs should be visible above the diaphragm
2) Are both lungs of similar volume?
3) Look for collapse
4) Trace around entire pleural edge for pleural anomalies ie pleural thickening, pneumothorax, effusion

Question 25

How should you check circulation

Answer 25

Check cardio-thoracic ratio (ratio should be below 50%)