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Respiratory: Radiology > Introduction to Respiratory Radiology > Flashcards

Introduction to Respiratory Radiology Flashcards

1
Q

What colour (density) is air on a CXR?

A

Black - least dense

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2
Q

What colour (density) is fat on a CXR?

A

Grey

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3
Q

What colour (density) is soft tissue/muscle on a CXR?

A

Grey/white

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4
Q

What colour (density) is bone on a CXR?

A

White - very dense

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5
Q

What colour (density) is metal on a CXR?

A

Bright white - densest

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6
Q

(pic)

A

Label the different densities from least dense to densest

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7
Q

Why is intra-thoracic air not as dense as extra-thoracic air?

A

Chest wall and blood vessels impair x-ray beams

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8
Q

What is the CT density of air?

A

-1000

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9
Q

What is the CT density of lungs?

A

-500

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10
Q

What is the CT density of fat?

A

-100

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11
Q

What is the CT density of water?

A

0 (all CT densities are given relative to water - anything less dense than water will be negative and anything denser than water will be positive)

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12
Q

What is the CT density of muscle?

A

+50

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13
Q

What is the CT density of bone?

A

+200

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14
Q

What is the CT density of metal?

A

+1000

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15
Q

(pic)

What does the tiny nodule on the CXR indicate?

A

Shade of white-grey denser than adjacent ribs - nodule composed of calcium (granuloma)

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16
Q

Are calciferous granulomas worrying?

A

No, likely to be chronic

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17
Q

What modality other than CXR and CT scans can be used for lung imaging?

A

Ultrasound

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18
Q

What is ultrasound?

A

Uses passage of sound waves which bounce off of structures to create image based on speed of return of sound wave

19
Q

What effect does fluid have on the passage of sound waves?

A

Allows passage of sound waves - appears black

20
Q

What effect does soft tissue have on the passage of sound waves?

A

Allows passage of sound waves - appears bright

21
Q

What effect does air have on the passage of sound waves?

A

Blocks passage of sound waves

22
Q

What complications can fluid in the chest lead to?

A

Haemothorax - can lead to lung collapse

Fluid - haemothorax
Air - pneumothorax

23
Q

What is the standard CXR technique?

A
  • Patient stands 2m from the x-ray apparatus, facing the digital cassette
    *The shoulders are braced forward so that the scapulae do not obscure the lungs
    *The radiograph is taken at full inspiration.
    “Breathe in and hold your breath”
    *The x-rays pass from Posterior to Anterior producing a ‘PA radiograph’
24
Q

When is ‘AP’ view taken in CXR?

A
  • When patient cannot stand
25
Q

What are 3 reasons that AP x-rays are technically inferior to PA views?

A
  • The heart shadow is magnified so heart size cannot be assessed accurately
  • The scapulae overlie and partly obscure the lungs
  • It can be difficult for the patient to take an adequate inspiration
26
Q

What are other CXR techniques, aside from AP and PA view?

A

Lateral view

27
Q

What are the advantages of lateral view CXR?

A

Gives additional information - shows structures behind the heart i.e. lung cancer in regions behind heart

28
Q

What are 3 factors that determine whether a CXR is technically adequate?

A

The 3 ‘-ations’

  • Inspiration
  • Rotation
  • Penetration (is there enough radiation?)
29
Q

What is the importance of inspiration and rotation in CXR?

A

A poorly inspired or rotated CXR can simulate pathology when none is there

30
Q

How can you tell if a CXR is adequately inspired?

A

The anterior ends of at least 6 ribs should be visible

31
Q

How can you tell if a CXR is correctly centred?

A

The medial ends of the clavicles should be equidistant from the spinous processes of the upper thoracic vertebrae

32
Q

Why would cardiothoracic ratio change in different images of the same patient’s chest?

A

Due to inspiration and expiration

33
Q

What is situs inversus?

A

Congenital anomaly - large organs are swapped from left to right

34
Q

Name the mediastinal borders labelled 1-9

pic

A

1) Aorta
2) Pulmonary artery
3) Left auricle
4) Left ventricle - left heart border
5) Right atrium - right heart border
6) Trachea
7) Hemidiaphragm
8) Horizontal fissure

35
Q

Why is left hemidiaphragm lower than right hemidiaphragm?

A

Right hemidiaphragm pushed up by liver

36
Q

Are lymph nodes visible on CXR?

A

Only visible when enlarged

37
Q

What do visible lymph nodes on CXR indicate?

A

Pathology of the lymph nodes

38
Q

What are ‘red flags’?

A
  • Weight loss

* Haemoptysis

39
Q

Label the lateral radiograph of the right lung

pic

A

1) Oblique fissure
2) Horizontal fissure
3) Posterior costophrenic recess
4) Retrosternal space

40
Q

How can you tell if an abnormality is if left lower lobe or left upper lobe?

A

Behind oblique fissure - lef blower lobe

In front of fissure - left upper lobe

41
Q

What is the only part of the right lung that touches the right heart border?

A

The right middle lobe

42
Q

What is the part of the left lung that touches the left heart border?

A

The lingula

43
Q

Why is patient history important with regards to CXR?

A

A tumour would look identical to pneumonia - history of fever (infection) would indicate pneumonia, whereas afebrile may indicate cancer

44
Q

What are red flags for lung cancer?

A
  • Weight loss
  • Loss of appetite
  • Haemoptysis
  • Dyspnoea
  • Cough

Respiratory: Radiology (4 decks)

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