Making sense of Chest X-rays

Question 1

can you see airways in the lungs on CXR normally?

Answer 1

Nope. Vessels only

Question 2

how to measure heart size?

Answer 2

PA-heart width should be <50% of full thorax diameter

Question 3

AP or supine heart looks bigger?

Answer 3

supine

Question 4

normal lung volumes in terms of ribs?

Answer 4

5-6.5 anterior ribs

Question 5

COPD has increased lucency where?

Answer 5

retrosternal

flattening of diaphragms`

Question 6

fluid in lungs can collect?

Answer 6

1. airpaces

2. interstitiuem

Question 7

what is atelectasis?

Answer 7

partial collapse of lung/alveoli

Question 8

silhouette sign?

Answer 8

air/tissue interface vs. fluid/tissue interface

Question 9

common causes of increased lucency? 2

Answer 9

pneumothorax

bullous emphysema

Question 10

tension pneumo, how to take the x-ray?

Answer 10

expiratory film to see which lung is retaining air

Question 11

What does Kerly B lines indicate?

Answer 11

interstitial oedema

Question 12

how to tell if airspace or interstitial consolidation?

Answer 12

airspace is fluffy and you can see the ‘bronchogram’, silouetting the branches

Question 13

bilateral opacities in lungs post-op, reasons?

Answer 13

• Fluid overload from transfusion

- aspiration pneumonia

Question 14

Mitral Valve disease on lateral projection would show?

Answer 14

esophageal compression via left atrium

Question 15

enlarged pulmonary artery cause?

Answer 15

pulmonary hypertension

post pulmonary stenosis dilation

Question 16

3 reasons for marked cardiomegaly

Answer 16

1. cardiomyopathy
2. pericardial effusion
3. mixed valvular disease