Radiology Flashcards
Xray
Advantages
Disadvantages
B&W film that can show hidden material
- Black - air
- Dark grey - SC tissue, fat
- Light grey - soft tissue
- Off white - bones
- White - metal
Advantages
- cheap
- non invasive
- low radiation
- easily accessible
Disadvantages
-not good for soft tissue
When to use Xray
Symptom evaluation
-SOB, chest pain, cough, hemoptysis, fever, unexplained weight loss
Physical sign evaluation
-hypoxemia, abnormal lung exam
Placement of central lines, NG, endotracheal tubes, pacemaker placement
PT screening after lung biopsies
Evaluation of pacemaker lead fractures, shunt leads in hydrocephalus
Post procedure - chest drain placement
Xray views
PA - minimise heart magnification
-must be mobile
AP - but careful of heart size
Lateral
CXR approach
-introduction
ABCDE A-pA or Ap? B-Body position - is it rotated? (look at clavicles C-Confirm name D-Date E-Exposure F-Films for comparison
ABCDEF A-Airways -trachea and bronchus => pushed or pulled from center? B-Bones, soft tissues -ribs, clavicle, vertebral body => fracture, lytic lesions C-Cardiac silhouette, mediastinum -cardiothoracic ratio - U1/2 -RA, LV D-Diaphragm, gastric bubble -right higher than left -flat in COPD -air under diapgragm - abdo perforation E-Effusions -CPA F-Fields -consolidation - lower, mid, upper, R or L -nodules, mass G-Gadgets -lines in the right place?
What are you looking for?
Lung abnormalities Pulmonary vascular abnormalities Pleural abnormalities Mediastinal abnormalities Tubes, Lines, Catheters
Localisation using the silhouette sign
RUL - loss of AA, Rtrachea RML - R heart border RLL - Rdiaphragm LUL - Aortic knob Lingula - L heart border LLL - Ldiaphragm, DA
Air bronchogram
Consolidation (white) around airways (black)
Indications for AXR
Obstruction
Perforation
Why do AXR
Quick, easy
Approach to AXR
A-Air in lumen only B-Bowel -small -3cm, central, valvulae conivented -large-6-9cm, peripheral, haustrae D-Dense structures -bones, calcification O-Organs, soft tissues (generally CT done) X-eXternal objects -foreign bodies, lines, tubes
Air
Depends on patient positioning
- supine (air either side of bowel), upright (air under diaphragm), decubitus
- falciform ligament should not be seen
Organs
Liver edge
Inferior kidney pole
External objects
FB
