Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Diagnostic Imaging III > Midterm > Flashcards

Midterm Flashcards

1
Q

Which lobes does the right oblique fissure (major) divide?

A

superior & middle lobes are above fissure and inferior lobe is below fissure

*begins at T5 and extends down & fwd to end at anterior pleural gutter of diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

On what type of view is oblique fissure seen?

A

only on lateral film

not seen on PA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which lobes does the right horizontal fissure (minor) divide?

A

anterior portion of superior lobe is above fissure and middle lobes is below fissure

*begins at the oblique fissure at mid-axillary line and runs horizontally to the sternal end of 4th costal cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

On what type of view is right horizontal fissure seen?

A

lateral film

seen in 54% of PA

(absent or incomplete in 25% of individuals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What lobes does the left oblique fissure (major) separate?

A

left upper lobe from left lower lobe

*begins at T5 and extends obliquely down and fwd to end at anterior plural gutter of diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In lungs, LUL is analogous to _________

A

RUL & RML combined

LLL = LRL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the lingula?

A

there are two lingular bronchopulmonary segments of the left upper lobe (inferior & superior lingular segment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the radiographic significance of lingula?

A

the abut the left heart border causing a silhouette sign when there is lingular collapse or consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What anatomical parts are responsible for the cardiac contours on the PA film?

A

right atrium (R heart border), left atrium & ventricle (L heart border), ascending aorta, aortic arch, pulmonary trunk, brachiocephalic vessels, SVC, IVC

(all of these are retrosternal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What anatomical parts are responsible for the cardiac contours on a lateral film?

A

Right ventricle, ascending aorta, aortic arch, descending aorta, left atrium & ventricle, IVC

(all of these are in the posterior mediastinum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which views are included in a routine plain film examination of the chest?

A

Minimum = PA and left lateral done during full inspiration

put area of interest closest to the film

apical/lordodic view to look at apices in addition to PA (gets clavicle out of the way)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does positioning of chest study differ from thoracic spine plain film?

A

chest study - PA chest and left lateral chest

thoracic study - AP thoracic & either lateral view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the technique for chest study plain film?

A

72” FFD, high kVp, low mA and short time, full inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does collimation differ on chest vs. thoracic plain film study?

A

chest films must include all air spaces of the lungs vs. tightly collimated thoracic spine films

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What condition or anatomical region is best demonstrated by the apical lordotic view?

A

see apices of lung, can dx a pancoast tumor (or anything in the apices of the lung)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is routine chest xray taken with inspiration or expiration?

A

Full inspiration so there is no crowding and you can see all the vessels

breath held in inspiration expands the lung fields, depresses diaphragm, and provides contrast (air vs. tissue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the difference in appearance between inspiration and expiration

A

during a good inspiration you should see the first 10 ribs posteriorly, lowers diaphragm

diaphragm crosses T12 vertebral body on lateral film during full inspiration & is at level of posterior R10-11 on PA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What condition is better demonstrated upon expiration than inspiration?

A

pneumothorax - upper right expiration is more sensitive; look for mediastinum displacement

on expiration consolidation appears more bright

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the appearance of interstitial dz?

A

thickened alveolar septa, alveolar walls; interstitial lymph, veins, cells

usu. a diffuse pattern, mb combined with consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What dz has the pattern of reticular, nodular, honeycomb, or any combo

A

interstitial disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do you see with a combination of air space dz and interstitial dz (both types of lung opacification)?

A

acinar shadow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the appearance air space disease?

A

silhouette sign, air bronchogram, atelectasisi

pattern = diffuse, lobar/localized, solitary nodule/masses, multiple nodule or masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What dz has pattern of diffuse, lobar/localized, solitary nodule/masses, multiple nodule or masses?

A

air space disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

air-bronchograms

A

lucent tubular and branching structures representing aerated bronchi surrounded by opaque acini

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the four patterns of “white lung” disease?

A

Diffuse - consolidation
Localized/Lobar
Solitary mass/Nodule
Multiple masses/Nodule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

DDx for diffuse-consolidation pattern of “white lung” disease

A

pulmonary edema (MC) d/t CHF, stroke, trauma, drugs; systemic/widespread dz such as sarcoidosis, histoplasmosis, TB; unusual infx (pneumocysitis carnii, opportunistic, immune compromised); bronchioalveolar carcinoma; idopathic hemorrhage

usu. see bilateral sx; implies involvement of all lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

DDx for localized/lobar pattern of “white lung” disease

A

bacterial infx or pneumonia (MC); pancoast tumor; pulmonary TB; pulmonary infarct; bronchopulmonary sequestration; atypical pneumonia (viral, mycoplasma)

MC presentation for infx

usu. only a portion of one lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

primary TB is usu. seen with consolidation in _______, while secondary TB is usu. seen with patchy consolidation in ________

A 
1' = lower lobe
2' = upper lobe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

DDx for solitary mass/nodule pattern of “white lung” disease

A

primary neoplasm (bronchogenic carcinoma - is most alarming); hematogenous metastasis; hamartoma; tuberculoma; lung abscess; hydatid cyst; hematoma; bronchopulmonary sequestration

smaller, well-defined area

Is there calcification? usu. a good finding, but depends on the pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

DDx for multiple masses/nodules pattern of “white lung” disease

A

MC indicates pulmonary metastesis; lymphoma; granulomatous infx (TB, histoplasmosis, coccidioidomycosis); Rheumatoid nodules; Wegener’s granulomatosis

usu. bilateral, see multiple well-defined areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the silhouette sign?

A

obliteration/burring of an anatomical shadow d/t a water density (structure or lesion) in anatomic contact with that structure (can’t see structure any longer)

*indicates water density materia in air spaces; can localize by structure silhouetted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Examples of water densities that may cause a silhouette sign

A

pneumonia, tumors, pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Structures that may show a silhouette sign

A

1) Mediastinal structure - heart, aorta
2) Diaphragms d/t effusion/fluid
3) Chest wall - tumors, etc.
4) Posterior heart structures - descending aorta, aortic knob

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where do you normally see a silhouette sign?

A

heart on left of hemidiaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

If most of the right heart border is obliterated, it indicates involvement of

A

right middle lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

If uppermost portion of the right heart border is obliterated, it indicates involvement of

A

anterior segment of the right upper lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If most of the left hear border is obliterated, it indicates involvement of

A

lingular portion of the left upper lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

If uppermost portion of the left heart border is obliterated, it indicates involvement of

A

anterior segment of the left upper lobe

39
Q

If the aortic knob is obliterated, it indicates involvement of

A

apical segment of the left upper lobe

40
Q

If the diaphragm is obliterated, it indicates involvement of

A

appropriate basal segment (determine anterior or posterior)

41
Q

Two water densities ________________ will dim the borders of each but will NOT obliterate them

A

superimposed but not in contact

42
Q

Water densities that may cause a silhouette sign include

A

pneumonia, tumors, pleural effusion, etc.

43
Q

With pneumothorax, you see mediastinal push ______ from the area of air/concern

A

away

44
Q

What main types of atelectasis?

A

1) Resorptive (obstructive)

2) Passive (compressive)

45
Q

Causes of central resorptive (obstructive) atelectasis

A

bronchogenic carcinoma, bronchial adenoma, foreign body, bronchial TB, lymphadenopathy, mediastinal mass, aneurysm

46
Q

Causes of peripheral resorptive (obstructive) atelectasis

A

pneumonia, mucous plugging, POST-OPERATIVE

47
Q

Causes of passive (compressive) atelectasis

A

interthoracic space occupying process - pneumothorax (MC), hemothorax, hydrothorax, any mass essentially

few actually show signs of atelectasis

48
Q

What is the MC cause of atelectasis?

A

resorptive (obstructive) - think tumor

49
Q

Signs of resorptive atelectasis

A

displaced fissures, elevated hemidiaphram, displace hilus, mediastinal shift (everything shifts twd it)

Also see increased density, approximation of the ribs, vascular bronchial crowing, compensatory emphysema (other lung shifts twd that side), lung herniation

50
Q

Signs of passive atelectasis

A

collapsed lung –> look for lack of lung margins and b.v. in periphery & edge of visceral pleura on outer margin of lung

51
Q

What is direction of collapse if different types of atelectasis?

A

Resorptive = toward collapsed lung

Passive = away from collapsed lung

52
Q

What is the air bronchogram sign?

A

when air spaces are filled with water density –> air filled bronchi are visible

*bronchi/bronchioles are normally not visible on chest xray

53
Q

What does air bronchogram indicate?

A

pneumonia

*this sign is likely with diffuse consolidation and possible w/ lobar/localized consolidation; it is unlikely with masses

54
Q

Which condition commonly demonstrates as a mass in the pulmonary apex or hilar area and may cavitate?

A

bronchogenic carcinoma

(2’ TB can also show up in pulmonary apex and cavitates in 40%, but it is usu. bilateral, whereas bronchogenic carcinoma is usu. unilateral)

55
Q

Which condition commonly demonstrates pleural plaques in the lung bases (calcified)?

A

this is the MC change in asbestos related dz

15% visible on chest x-ray

56
Q

What is pathognomonic for asbestos exposure?

A

calcified pleural plaques - this may take up to 20 yrs after exposure

57
Q

Radiographic signs of pulmonary emphysema?

A

flattened, depressed hemidiaphragms; hyperlucency; increased retrosternal clear space; increased AP chest diameter; decreased peripheral vascular markings; > 10 ribs visible (hyperinflated); may present with pneumothroax

58
Q

What is an air filled bulla?

A

abn air filled spaces within lung - mb d/t confluent destruction of alveolar walls 2’ to emphysema

59
Q

radiographic image of focal round or oval radiolucencies surrounded by a thin wall

A

air filled bulla

indicates emphysema

60
Q

radiographic findings of meniscus sign, blunted costophrenic angle, effusion (transudate/exudate), blood, pus, lymph (chylothorax)

A

pleural effusion

61
Q

causes of pleural effusion

A

CHF, pneumonia, neoplasm, infection (empyema), trauma, embolism, CT dz, TB, abdominal dz (pancreas, cirrhosis)

62
Q

Types of pneumothorax

A

Spontaneous, traumatic/iatrogenic, tension

63
Q

_________ pneumothorax is seen in tall, thin males and ____________ pneumothorax is seen with underlying lung dz, bullae, blebs, air trapping

A

primary spontaneous

secondary spontaneous

64
Q

valve effect with progressive accumulation of air, shift of mediastinum away from collapsed lung, leads to vascular compromise (MEDICAL EMERGENCY)

A

tension pneumothorax

need a chest tube

65
Q

what is the appearance of pneumothorax with pleural effusion?

A

shrunken lung, pleural space larger, no b.v. seen where they should be, heart shifted away from lung, may see meniscus sign from pleural effusion

66
Q

What is the difference btwn tension and spontaneous pneumothorax?

A 
Tension = extreme collapse
Spontaneous = small amount of collapse
67
Q

What is a pancoast tumor?

A

superior sulcus tumor; apical; extension into adjacent chest wall; usu. squamous cell (can also be adenocarcinoma)

68
Q

clinical presentation of pancoast tumor

A

Horner syndrome - ptosis, anhydrosis, myosis

Pain radiating to arm, apical mass (look for rib or vertebral dysfn), pleural extension

69
Q

What are multiple pulmonary masses of varying sizes suggestive of?

A

metastatic cancer

bronchogenic is solitary

70
Q

Is calcification common in a malignant pulmonary mass?

A

NO - most calcifications are benign

MC calcification is granuloma (TB, histoplasmosis, cocsidiomycosis)

71
Q

Conditions that demonstrate unilateral elevation of hemidiaphragm

A 
atelectasis 
phrenic nerve palsy 
splinting
eventration 
subphrenic inflammation
72
Q

Conditions that demonstrate bilateral elevation of hemidiaphragm

A 
poor inspiration 
obesity 
pregnancy 
ascites 
hepato-splenomegally
73
Q

Normal relation btwn transverse diameter of heart and thoracic cage on PA chest fil,?

A

located in middle mediastinum, 1/3 to right of midline & 2/3 to left of midline

74
Q

cardiothoracic ratio on PA upright w/ full inspiration

A

widest coronal diameter of heart is less than or equal to thoracic cavity (no minimum)

**not the best evaluation for cardiomyopathy

75
Q

Causes of left ventricle hypertrophy

A

aortic stenosis, chronic HTN

76
Q

Causes of right atrium enlargement

A

CHF

77
Q

In lateral view of chest x-ray, heart should be _______ the width of the heart cavity

A

less than half

78
Q

anterior mediastinum from lateral view

A

sternum to anterior cardiac silhouette = anterior (retrosternal) clear space

79
Q

middle mediastinum from lateral view

A

anterior to posterior cardiac silhouette

80
Q

posterior mediastinum from lateral view

A

posterior cardiac silhouette to posterior border of lung field

81
Q

Contents of anterior mediastinum

A

thymus gland & lymph nodes

82
Q

Pathologies of anterior mediastinum

A

3T’s and an H

Thyroid retrosternal goiter (MC)
Hodgkin’s Lymphoma
Thymic mass - thymoma
Teratoma - germ cell tumor

83
Q

contents of middle mediastinum

A

pericardium, heart, great and pulmonary vessels, phrenic nerve, upper vagus nerves, trachea - primary bronchi, lymph nodes

84
Q

masses above clavicle are in ____________ and masses below clavicle are in ____________

A

anterior mediastinum

middle mediastinum

85
Q

pathologies of middle mediastinum

A

lymphadenopathy (enlarge LN), bronchogenic carcinoma (in primary bronchi), aortic aneurysm, bronchogenic cyst, CHF, CVD (hardening of aa)

86
Q

contents of posterior mediastinum

A

descending thoracic aorta, esophagus, thoracic duct, azygous vv., hemizygous vv., sympathetic ganglia, lower vagus nn., lymph nodes

87
Q

pathologies of posterior mediastinum

A

Hiatal hernia (MC), neurogenic tumors, paravertebral masses, meningocele, esophageal masses, aneurysm

88
Q

increased retrosternal clear space

A

emphysema

89
Q

what is the MC retrocardiac mass?

A

hiatal hernia

90
Q

apical lordotic view

A

pt. learning back and looks like xray beam angled on pt. - fuzzier film
* used to view pancoast tumor, reactivated TB

91
Q

loss of costophrenic angle

A

water from pleural effusion

92
Q

accessory fissure in lungs on upper R side

A

azygous fissure

93
Q

extrapleural sign

A

xs bone seen in lung xray –> usu. d/t rib bone metastasis or rib fx with hematoma

94
Q

Black lung dz

A

pneumothorax, emphysema, cystic dz, trapped air - obstruction

Diagnostic Imaging III (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions