MT SUMMER/2014 Flashcards
With chest CT, structures are best seen when perpendicular to the transverse beam rather than parallel. Which fissure would not be visible on axial chest CT imaging due to it being parallel to the beam rather than perpendicular?
A. Major
B. Azygous
C. Minor
D. Inferior Accessory
C- Minor
The only fissures visible on the frontal and lateral views are ______ and _____. PICK TWO
A. Minor
B. Major
C. Inferior accessory
D. Superior accessory
A. Minor
D. Superior accessory
Some chest imaging procedures are no longer utilized, due to replacement with newer and better imaging. Which imaging procedure utilized a contrast agent to better visualize a structure not normally seen on a plain chest x-ray?
A. Bronchography B. Tomography C. Decubitus view D. CT Scanning E. Oblique views
A. Bronchography
Which are required for legal film demographic identification? PICK ALL THAT APPLY.
A. Producing institution
B. Patient name and age
C. Production date
D. Film #
A. Producing institution
B. Patient name and age
C. Production date
Left hilar masses may impact which of the following nerves. PICK ALL THAT APPLY.
A. Recurrent laryngeal
B. Sympathetic chain
C. Phrenic
D. Vagus
A. Recurrent laryngeal
C. Phrenic
D. Vagus
Stand chest plain film x-rays
A. Front view done AP
B. Always use a grid
C. Done upright in ambulatory patient
D. Performed with expiration breathing termination
C. Done upright in ambulatory patient
Suspected small pneumothorax (air in pleural space) on a full inspiration PA chest view could be confirmed most cost effectively by:
A. AP supine chest
B. Chest oblique views
C. Lateral decubitus with involved side down
D. Lateral decubitus with involved side up
D. Lateral decubitus with involved side up
The silhouette sign:
A. Localizes at the chest wall
B. Works only with chest technical factors
C. Occurs with RML #4 touching the diaphragm
D. Localizes at diaphragm
Localizes at diaphragm
Upper left heart border “silhouette sign” may be produced by:
A. LUL atelectasis
B. LUL #1-3 atelectasis
C. LLL #7,8 pneumonia
D. LUL #4 pneumonia
D. LUL #4 pneumonia
Pulmonary consolidation in this segment could cause a silhouette sign with posterior chest wall.
A. RUL #2 B. RLL #7 C. RML #5 D. RLL #6 E. RML #4
D. RLL #6
The superior accessory fissure:
A. Splits RUL segment 2 from 3
B. Splits LLL segment 6 from segments 2 & 3
C. Splits RUL segment 1 from 2 & 3
D. Splits LLL segment 6 from segments 9&10
D. Splits LLL segment 6 from segments 9 & 10
Which two fissures are horizontally oriented? PICK TWO
A. Inferior accessory fissure
B. Superior accessory fissure
C. Accessory left minor fissure
D. Azygous fissure
B. Superior accessory fissure
C. Accessory left minor fissure
Which of the following is not characteristic of the chest series?
A. 72 inch or > FFD
B. Full inspiration
C. Frontal view AP or PA
D. 100 or > KVP
C. Frontal view AP or PA
Which one of the following imaging procedures is non-ionizing (no radiation)?
A. MRI
B. Nuclear med. ventilation/ perfusion scan
C. Cardiac ultrasound
D. Decubitus view
A. MRI
or
C. Cardiac ultrasound
The simplified form of patient positioning (for x-rays) that we discussed in class includes all except:
A. Visualize the anatomy
B. Place the anatomy in the centre of the film
C. Place the central ray to the cassette centre
D. Align the central ray to fixed anatomical point
D. Align the central ray to fixed anatomical point
In class we discussed an alternate, more standardized method of laterality labelling of oblique x-rays (chest, cervical or lumbar does not matter) different from what you were taught in positioning class:
A. Always use the RAO marker
B. Label laterality of the patient
C. Always use an R marker
D. Always use an L marker
B. Label the laterality of the patient
If there was no easy access to chest CT, which plain film view would show the right lung to better visualize a questionable density:
A. PA chest
B. Apical lordotic
C. LAO
D. RAO
C. RAO
The chest series is always performed ____ in conscious patients:
A. In the upright or recumbent position
B. With a grid
C. With suspended breathing @ full inspiration
D. At 60 or 72 inch FFD
C. With suspended breathing @ full inspiration
Nuclear medicine scan of the heart:
A. Cardiac ultrasound
B. Thallium scan
C. Coronary arteriography
D. Retrograde aortography
B. Thallium scan
Nuclear med scan for air and blood movement in the lungs:
A. Thallium
B. Chest MRI
C. Decubitus series
D. Ventilation and perfusion scans
D. Ventilation and perfusion scans
The dividing line between the anterior and middle mediastinum radiographically:
A. Anterior pericardium only
B. Posterior trachea posterior pericardium
C. Posterior pericardium only
D. Anterior trachea posterior pericardium
D. Anterior trachea posterior pericardium
Regarding the trachea, which is an incorrect statement?
A. Deviates slightly to the right at the aortic knob
B. Can never deviate from midline normally
C. Carina division at T4 in the infant
D. Is in intimate contact with the esophagus
B. Can never deviate from midline normally
Which structures at the pulmonary hills are not visible as individual structures? PICK ALL THAT APPLY
A. Lymph nodes
B. Nerves
C. Pulmonary arteries
D. Pulmonary veins
A. Lymph nodes
B. Nerves
D. Pulmonary veins
Understanding lymphatic drainage of the lung helps to explain all of the following except:
A. How pulmonary edema behaves
B. How infections spread to hills
C. How bronchiogenic cancer may spread to hilus
D. How consolidation spreads within a lobe
D. How consolidation spreads within a lobe
Segments of the left upper lobe include all of the following except:
A. Apical/posterior #1-3
B. Inferior #5
C. Anterior #2
D. Lateral #4
D. Lateral #4
RML and lingual have the same named segments
A. True
B. False
B. False
Segments #1 and #3 are the same in both the right and left lung.
A. True
B. False
B. False
Segments #9 and #10 are combined segments in the left lung
A. True
B. False
B. False
All authors consider segments #7 and #8 to be the same in the right and left lung
A. True
B. False
B. False
The inferior accessory fissure
A. Splits RUL segment 1 from 3
B. Splits RLL segment 7 from 8-10
C. Visible only on lateral view
D. Splits LLL segment 6 from 7-10
B. Splits LLL segment 6 from 7-10
MATCHING
Primary lobule __
A. Bronchi to bronchi connection B. 3-5 acini C. Ducts, sacs, alveoli D. Foundation of airspace consolidation E. Interalveolar infectious exudate spread AB. Related to Fleischner's lines AC. Bronchi to alveoli air perfusion AD. 3-5 respiratory bronchioles
C. Ducts, sacs, alveoli
MATCHING
Secondary lobule __
A. Bronchi to bronchi connection B. 3-5 acini C. Ducts, sacs, alveoli D. Foundation of airspace consolidation E. Interalveolar infectious exudate spread AB. Related to Fleischner's lines AC. Bronchi to alveoli air perfusion AD. 3-5 respiratory bronchioles
B. 3-5 acini
MATCHING
Acinus __
A. Bronchi to bronchi connection B. 3-5 acini C. Ducts, sacs, alveoli D. Foundation of airspace consolidation E. Interalveolar infectious exudate spread AB. Related to Fleischner's lines AC. Bronchi to alveoli air perfusion AD. 3-5 respiratory bronchioles
D. Foundation of airspace consolidation
MATCHING
Pores of Kohn __
A. Bronchi to bronchi connection B. 3-5 acini C. Ducts, sacs, alveoli D. Foundation of airspace consolidation E. Interalveolar infectious exudate spread AB. Related to Fleischner's lines AC. Bronchi to alveoli air perfusion AD. 3-5 respiratory bronchioles
E. Interalveolar infectious exudate spread
MATCHING
Channels of Martin __
A. Bronchi to bronchi connection B. 3-5 acini C. Ducts, sacs, alveoli D. Foundation of airspace consolidation E. Interalveolar infectious exudate spread AB. Related to Fleischner's lines AC. Bronchi to alveoli air perfusion AD. 3-5 respiratory bronchioles
A. Bronchi to bronchi connection
Extremely rare fissure in left lung:
A. Inferior accessory fissure
B. Superior accessory fissure
C. Accessory left minor fissure
D. Azygous fissure
C. Accessory left minor fissure
What is the foundational building block for the pathological process of air space consolidation?
A. Acinus
B. Primary lobule
C. Secondary lobule
D. Pores of Kohn
A. Acinus
Which of the following anatomical structures does not contribute to the lateral view cardiovascular
A. Right atrium
B. Ascending aorta
C. Pulmonary artery
D. Right ventricle
A. Right atrium
Two causes for unilateral hyper lucent lung/hemithorax: PICK TWO
A. Absence of chest wall tissue
B. Pneumothorax
C. Empysema
D. Large pleural effusion
A. Absence of chest wall tissue
B. Pneumothorax
The normal relationship of the pulmonary blood vessels in the recumbent position:
A. Vessel should extend to the chest wall
B. Upper and lower lung blood vessels of equal size
C. Vessel size constant throughout lung medial to lateral
D. 1:2 ratio upper to lower lung vessels
B. Upper and lower lung blood vessels of equal size
Silhouette sign with the aortic knob created by:
A. RUL #2
B. LUL #1-3
C. LUL #2
D. LLL #6
B. LUL #1-3
Silhouette sign with the upper descending thoracic aorta created by:
A. RUL #2
B. LUL #1-3
C. LUL #2
D. LLL #6
D. LLL #6
Which segment would NOT produce a right lateral chest wall “silhouette sign” below the minor fissure?
A. RML #4
B. RML #5
C. RLL #8
D. RLL #9
B. RML #5
If a water density lesion in the lung was in front of or behind the lung hills, the hills would be visible through the lesion:
This is a “silhouette sign” type of question, much touch to silhouette
A. True
B. False
A. True
When a hills is enlarged unilaterally, the most likely anatomy generating mass:
A. Pulmonary arteries
B. Pulmonary veins
C. Nerves
D. Bronchus
D. Bronchus
Which fissures are visible on the lateral view? PICK ALL CORRECT
Remember they are visible when parallel to the beam on plain film which is opposite of CT
A. Inferior accessory
B. Minor
C. Azygous
D. Major
B. Minor
D. Major
Which of the following is not a characteristic of proper chest exposure, on the frontal view?
A. Pulmonary vasculature visible through the left side of the heart
B. Osseous detail above the aortic knob
C. Osseous detail through the mid and lower mediastinum
D. Faint visualization of the thoracic spine through the heart
C. Osseous detail through the mid and lower mediastinum
______ is associated with air replacement and _____ is associated with air removal? PICK TWO
A. Consolidation
B. Interstitial disease
C. Neoplasm
D. Atelectasis
A. Consolidation
D. Atelectasis
Which is incorrect in our memory aid for cardiac chambers?
A. Right is right
B. Left is left
C. Lefts are both
D. Front is right atrium
D. Front is right atrium
On a frontal chest view, which mediastinal structure, when enlarged, might cover up the left hilus?
A. Ascending aorta
B. Right atrium
C. Right ventricle
D. Pulmonary artery
A. Ascending aorta
MATCHING
Accessory Minor Fissure
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
BC. Creates left middle lobe
MATCHING
Secondary Lobule
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
AB.Compartmentalized unit of lung
MATCHING
Direct airway anastomosis
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
B. Facilitates lobar air perfusion
MATCHING
Lateral decubitus
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
AC. Utilizes gravity to facilitate diagnosis
MATCHING
Silhouettes lateral chest wall
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
CD. Anterior basal segment #8
MATCHING
Left atrium
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
A. Contact with esophagus
MATCHING
Right atrium
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
AE. Right heart border on frontal view
MATCHING
Superior vena cava
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
C. May be prominent with right hilar tumour
MATCHING
Pulmonary vasculature
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
BD. Upper to lower lung ratio 1-1 in recumbent position
MATCHING
Cortical Lung
A. Contact with esophagus
B. Facilitates lobar air perfusion
C. May be prominent with right hilar tumour
D. Run independent of bronchi
E. Separates segments #4 and #5
AB. Compartmentalized unit of lung
AC. Utilizes gravity to facilitate diagnosis
AD. No vasculature visible
AE. Right heart border on frontal view
BC. Creates left middle lobe
BD. Upper to lower lung ratio 1-1 in recumbent position
BE. Contact with RML #5
CD. Anterior basal segment #8
CE. Upper to lower lung ratio 2-1 upright position
AD. No vasculature visible
Which of the following hilar structures is responsible for the left hilus anatomical position?
A. Pulmonary veins
B. Lymph nodes
C. Nerves
D. Pulmonary artery
D. Pulmonary artery
On chest radiographs, the heart normally obscures (silhouettes- like densities touching) the ______
A. Lower sternum
B. Anterior and medial left hemidiaphragm
C. Anterior right hemidiaphragm
D. Minor fissure
B. Anterior and medial left hemidiaphragm
The silhouette sign is near always a(n) _____ finding and is usually due to _____
A. Abnormal, lung disease
B. Normal, normal structures touching
C. Abnormal, mediastinal disease
D. Normal variant, unlike densities touching
A. Abnormal, lung disease
Our rules for remembering heart borders tell us: the anterior heart border is formed by the ____ and the posterior heart border is formed by the _____
A. Right atrium
B. Right ventricle
C. Left ventricle and right atrium
D. Left atrium and ventricle
B. right ventricle
D. left atrium and ventricle
On a frontal chest view, which mediastinal structure, when enlarged, might cover up (not silhouette) the hilus:
A. Pulmonary artery
B. Right atrium
C. Right ventricle
D. Ascending aorta
D. Ascending aorta
