Lecture 2 - Interpretation of Chest Radiographs

Question 1

In which X-ray film, Anterior to Posterior (AP) or Posterior to Anterior (PA), will the heart appear larger, despite being the same size in reality?

Answer 1

In the AP view, because the X-ray beams image the heart sooner before they spread and eventually hit the plate at the patient’s back.

Question 2

To determine if an X-ray film is under or over-penetrated (to bright or too dark, respectively) what should you look for? Remember, they should be only barely visible.

Answer 2

Look to see if the intervertebral discs are barely visible.

Question 3

In X-rays, the whiteness of things in the image depends on their ______. More ____ = Whiter.

Answer 3

Density

Dense

Question 4

Should patients inspire or expire during X-ray imaging of the lungs?

Remember the diaphragm should be around the ___th to ___th posterior rib or ___th to ___th anterior rib.

Answer 4

Patients should inspire (depress the diaphragm)

8th to 10th posterior

5th to 6th anterior

Question 5

A lateral X-ray film helps to appreciate the lung tissue that lays behind the ____.

Answer 5

Heart

Question 6

Mnemonic for Interpretation of Lung X-ray:

A - \_\_\_\_
B - \_\_\_\_
C - \_\_\_\_\_\_
D - \_\_\_\_\_\_
E - Everything else

Answer 6

A - Airways
B - Bones
C - Cardiovascular
D - Diaphragm
E - Everything else

Question 7

Patients with ______ tend to have prominent lymph nodes in the Hilar region of the lungs.

Answer 7

Sarcoidosis

Question 8

Air _______ will show bronchi as being accentuated dark passages, seemingly outlined by whiter alveolar areas. This signifies the alveoli are filled with something more dense than air.

Answer 8

Air Bronchogram

Question 9

Lung cavities in the upper lobes of the lungs should make you suspicious of which disease?

Lung cavities with balls inside are indicative of which disease?

Answer 9

TB

Mycetoma (mass from fungal growth/infection)

Question 10

A Meniscus sign is highly indicative of pleural _______.

Answer 10

Pleural Effusion

Question 11

Which direction would the heart and trachea deviate in a patient with a “white out” due to Atelactesis vs Pleural Effusion?

Answer 11

Atelactesis –> deviation TOWARD the affected side.

Pleural Effusion –> deviation AWAY from the affected side.