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Unit 3 Clin Lab Med > L8: CXR > Flashcards

L8: CXR Flashcards

1
Q

Standard views

A

PA + lateral

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2
Q

View which magnifies the heart

A

AP view

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3
Q

Most radiopaque (white)

A

metal/bone

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4
Q

Least radiopaque (black)

A

air

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5
Q

Lower lung lobes appear

A

inferior to the diaphragm, you should see bilateral lung markings below the diaphragm

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6
Q

Where are most abnormalities seen?

A

Chest wall

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7
Q

What may obscure lung markings?

A

Obesity

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8
Q

RIP for image quality

A

Rotation
Inspiration
Penetration

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9
Q

Assess rotation

A

clavicles are equidistant from the spinous processes

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10
Q

Assess inspiration

A

diaphragm below ribs 8-10 posteriorly and 5-7 anteriorly

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11
Q

Adequate penetration

A

disc spaces are seen but bony details of spine cannot be seen

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12
Q

Overexposed CXR

A

lungs appear too black (radiolucent)

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13
Q

Underexposed CXR

A

lungs appear whitish, cloudy, lower lobes not seen

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14
Q

Are there many lung lesions? Acronym

A 
A: Abdomen
T: thoracic wall: soft tissues and bones
M: Mediastinum
L: Lung fields (assess individually)
L: Lungs comparison
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15
Q

Normal pleural/vascular markings

A

Extend all the way to the chest wall, all the way to the periphery of the ribcage
More prominent in the central/lower lung fields (bases)

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16
Q

Right vs left hemidiaphragm

A

Right is 3 cm higher

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17
Q

Gastric bubble

A

seen below the left diaphragm

normal

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18
Q

Middle Mediastinum

A

heart and great vessels

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19
Q

Anterior Mediastinum

A

potential space in front of the heart

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20
Q

Posterior Mediastinum

A

potential space behind the heart

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21
Q

Superior Mediastinum

A

potential space above the heart

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22
Q

Normal Cardio:Thoracic Ratio (CTR)

A

1:2 or less

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23
Q

Cardiomegaly

A

CTR >1:2

24
Q

Left cardiac contour

A

left lateral border of the left ventricle

25
Q

Right cardiac contour

A

right lateral border of the right atrium

26
Q

Aortic knob

A

Represents the left lateral edge of the aorta as it arches backwards over the left main bronchus and pulmonary vessels
Can be calcified→ more radioopaque

27
Q

soft tissue/fat vs muscle

A

soft tissue is less dense than muscle and therefore darker

28
Q

Which bone is the only bone seen in its entirety?

A

The clavicle

29
Q

Where might bone metastasis be visible?

A

clavicle, scapula, humorus

30
Q

What should the spinous process of the vertebrae look like?

A

should lie midway between the medial ends of the clavicles

if not, patient is rotated (positioned oblique to the x-ray beam)

31
Q

Lung hyperexpansion (hyperinflation) appears

A

> 7 posterior ribs seen or flattened diaphragm

32
Q

How is the sternum best seen?

A

Lateral view

33
Q

Child bones appear

A

Immature bones which have not completely ossified

34
Q

Sail sign

A

A huge thymus seen in children (do not confuse with spinnaker sign)

35
Q

Shaken baby syndrome

A

clavicle fracture + multiple rib fractures

36
Q

Child abuse

A

Bone remodeling due to healing rib fractures

37
Q

Water bottle sign

A

Pericardial effusion: shape of cardiac silhouette is expanded

38
Q

Kerley B lines

A

CHF: vascular markings all the way at the periphery

39
Q

CHF

A

Cardiomegaly + increased lung markings +/- Kerley B lines

40
Q

Unilaterally high diaphragm could indicate

A

Paralysis of the phrenic nerve (3/4/5)
eventration
atelectasis
pneumothorax

41
Q

Pulmonary edema appears

A

Increased vascular markings, “fluffy”

42
Q

COPD

A

Low, flat diaphragm

Barrel chest= Kyphosis+Increased AP diameter

43
Q

Can cause cavitary lesions

A

TB

Valley fever

44
Q

Pneumoperitoneum definition

A

air trapping below diaphragm.

Caused by surgical incision or CO2, ruptured ulcer

45
Q

Pneumoperitoneum appearance

A

Crescent shaped bubble of air below the thin membrane of the diaphragm when an erect PA view is taken

46
Q

Spine sign

A

lower lobe pneumonia: lower dorsal bodies become more radiodense (whiter)

47
Q

Infiltrates vs consolidation

A

Infiltrate: patchy
Consolidation: more solid appearing

48
Q

Pleural effusion is often secondary to

A

rib fractures

49
Q

blunting of the costophrenic angle

A

pleural effusion

50
Q

Flail chest

A

paradoxical breathing caused by multiple rib fractures

51
Q

Aortic aneurism

A

widened mediastinum

52
Q

Feels like rice krispies

A

subcutaneous emphysema

53
Q

Widened mediastinum (>8 cm) could be caused by

A

aortic aneurysm
Hilar adenopathy
mass
metastasis

54
Q

Subcutaneous emphysema

A

Air at periphery of CXR, outside of the lung fields

55
Q

Spinnaker sign

A

sign of pneumomediastinum

56
Q

Hemopneumothorax

A

fluid below the diaphragm

Unit 3 Clin Lab Med (5 decks)

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