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Respiratory > Radiology > Flashcards

Radiology Flashcards

1
Q

What are the indications for CXR?

A
  • Evaluating symptoms (cough, chest pain)
  • Evaluating signs (hypoxaemia or pulmonary exam)
  • Evaluating lines, tubes and pacemakers
  • Evaluating effects of treatment
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2
Q

What systematic approach should be taken when reviewing CXR?

A
  • Patient demographics (Name, age, sex)
  • Side marker
  • Quality of image (exposure, coverage, symmetry)
  • Patient factors (PA, AP, lateral CXR)
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3
Q

What is meant by exposure of an X-ray?

A
  • How much radiation has passed through patient
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4
Q

Compare PA to AP X-rays

A
  • PA: beam passes through patient’s back
  • No magnification of heart
  • AP: do not use to measure size of heart - heart is maginified
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5
Q

How do we interpret inspiration from a CXR?

A
  • Count number of posterior ribs
  • If 8-10 ribs are seen - good inspiratory film
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6
Q

After we assess technical quality of a CXR, what system should we use to interpret it?

A
  • Airways - trachea and bronchi
  • Bones - soft tissues too
  • Cardiac contour (and mediastinum)
  • Diaphragm
  • Effusions (pleural and pericardial)
  • Fields
  • Don’t forget lines, tubes and devices
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7
Q

What should you check the ribs for in a CXR?

A
  • Fractures
  • Tumours
  • Secondary deposits
  • Previous surgery
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8
Q

What do you need to check the heart for on a CXR?

A
  • Right heart border
  • Left heart border
  • Cardio-thoracic ratio 0.4-0.55
  • Assess for cardiomegaly
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9
Q

Which parts of the heart can be seen on CXR?

A
  • Paratracheal stripe
  • Aortic arch
  • Descending aorta
  • Aorto-pulmonary window
  • Hilum
  • Concave angle
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10
Q

What features of the diaphragm can be seen on CXR?

A
  • Right and left hemi-diaphragm
  • Gastric air bubble
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11
Q

How do you check for effusions on CXR?

A
  • Costo-phrenic angles
  • Blunting of these angles could suggest pleural effusion or pericardial effusion
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12
Q

What are the lung fields?

A
  • Right lung: upper lobe, middle lobe, lower lobe
  • Left lung: upper lobe, lower lobe
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13
Q

What do we need to see on a chest radiograph?

A
  • 1st rib
  • Lateral margin of ribs
  • Costophrenic angle
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14
Q

What should the rotation of the thorax be like on chest radiography?

A
  • Alignment of spinous process and clavicles
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15
Q

What is a normal lung volume for the inspiratory phase?

A
  • 5th to 7th anterior ribs at MCL
  • Problems with incomplete inspiration could be due to cardiomegaly or increased lung markings
  • Exaggerated expansion could be due to obstructive airways disease
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16
Q

What is meant by penetration in terms of X ray?

A
  • Degree to which x-rays have passed through body
  • Adequate penetration indicated by vertebrae being just visible through heart and visible complete left hemidiaphragm
17
Q

Define artefact

A
  • External/iatrogenic material which obstructs view
  • Clothes e.g. buttons
  • Hair
  • Surgical/vascular lines
  • Pacemaker
18
Q

What might be seen on a CXR that indicates pneumonia?

A
  • Air space shadowing
  • Air bronchograms
  • Bulging or thickening of fissures
19
Q

What might be seen on a CXR that indicates lung cancer?

A
  • Rounded opacity
  • +/- pleural effusion
  • +/- lymphadenopathy
20
Q

What might be seen on a CXR that indicates pulmonary oedema?

A
  • Bats wing perihilar shadowing
  • Interstitial fluid - lots of peripheral lines
  • Pleural effusions
  • Upper lobe venous distensuin
21
Q

What might be seen on a CXR that indicates situs inversus totalis?

A
  • Dextrocardia
  • Aortic arch on right
  • Stomach on right
22
Q

What might be seen on a CXR/CT scan that indicates COVID?

A
  • Multifocal peripheral opacities
  • Fluffy appearance
  • Ground glass density on CT
23
Q

What might be seen on a CXR/CT that indicates cystic fibrosis?

A
  • Bronchiectasis
  • Thickened parallel bronchial walls
  • Airway plugging
  • +/- venous catherter
24
Q

What might be seen on a CXR/CT that indicates PE?

A
  • Often normal CXR
  • Peripheral opacity due to infarction
  • CT: filling defects
  • Straightening of interventricular septum
25
Q

What might be seen on a CXR/CT that indicates pneumomediastinum?

A
  • Streaky linear lucencies parallel to mediastinum
  • Gas in neck and axillae
  • Boerhaave syndrome: oesophageal tear
26
Q

What might be seen on a CXR/CT that indicates pleural plaques?

A
  • Usually calcified
  • Asbestos exposure
  • En-face: holly leaf
  • On diaphragm surface
27
Q

What might be seen on a CXR/CT that indicates mesothelioma?

A
  • Lung encased by rind of tissue
  • Associated with asbestos exposure
  • Lung becomes frozen
  • Presents late
  • Difficult to resect

Respiratory (21 decks)

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