Pre-Orientation Chest X-Ray Module

Question 1

How many ribs should you see on an inspiratory film?

Answer 1

Ten

More than this suggests COPD. Less suggests poor inspiratory effort.

Question 2

Which is the gold standard, AP or PA?

Answer 2

PA

It allows visualization of the lungs better because the heart is smaller.

Question 3

Review the ABCs of CXR reading.

Answer 3

• A: adequacy (right patient, right film, good penetration, number of ribs) and airway (deviated, patent)
• B: bones
• C: cardiomediatstinum (edges, size)
• D: diaphragm (clear edge, symmetric, air underneath)
• E: equipment and effusions
• F: fields:
• G: gastric bubble

Question 4

What are the four bumps coming down the left side of the heart (on the right side of the image)?

Answer 4

1st: aorta
2nd: pulmonary artery
3rd: left atrium (not always visible)
4th: left ventricle

Question 5

Pulmonary vasculature should only extend to about _________ of the way to the periphery. Any more than this suggests __________________.

Answer 5

2/3; pulmonary congestion (CHF)

Question 6

________________ infiltrates blur the right heart border.

Answer 6

Middle lobe

Question 7

___________ infiltrates appear cloudy and uniform, while ___________ infiltrates appear lacy and reticular.

Answer 7

Alveolar; interstitial