Radiology Flashcards by michelle granstrom

When taking a PA view X-ray what direction do the x rays pass?

From back to front to get to the film

How well did you know this?

Not at all

Perfectly

When taking a lateral view what direction do the x rays pass?

From the lateral side of the thorax…

How well did you know this?

Not at all

Perfectly

Why do you need multiple views in an x ray?

b/c one view is no view! All the structures are superimposed into one plane & it is difficult to determine dimensionality.

How well did you know this?

Not at all

Perfectly

Put these things in order from most radiolucent to least radiolucent...
Spongy Bone
Air
Water & other tissues
compact bone
fat

Air
Fat
Water & other tissues
Spongy Bone
Compact Bone

How well did you know this?

Not at all

Perfectly

When might you see an AP view for viewing the heart?

A lying down position when a person is unable to stand up. Better than nothing…but not great. B/c makes heart look larger than it is.

How well did you know this?

Not at all

Perfectly

What is the most normal lateral view?

left Lateral view w/ the heart closest to the x ray film. This keeps from distorting the heart size.

How well did you know this?

Not at all

Perfectly

More penetration means what?

less exposure

less contrast

How well did you know this?

Not at all

Perfectly

What is the usefulness of a lateral chest film?

3D orientation
localize a lesion seen on a frontal chest x ray
clarify lobar collapse & consolidation
explore a retrosternal or retrocardiac shadow

How well did you know this?

Not at all

Perfectly

What is blunting? What can do this?

Changing the acuteness of the angle. Making it less acute…Filling it with fluid or pushing the diaphragm down. Or tension pneumothorax or lung hyperinflation.

How well did you know this?

Not at all

Perfectly

How can you make the recess more acute? Costophrenic…

by pulling up on the diaphragm.

How well did you know this?

Not at all

Perfectly

T/F A nipple shadow is normal.

True. It’s not present on all people, though. This is why 2 views are important–make sure that thing isn’t a tumor!!

How well did you know this?

Not at all

Perfectly

What important things are found underneath the left hemidiaphragm?

The gastric bubble & left colic flexure.

How well did you know this?

Not at all

Perfectly

Contrast media is especially important to view what?

coronary arteries

How well did you know this?

Not at all

Perfectly

What makes up the black hole?

the left main bronchus–it is an orientation landmark

How well did you know this?

Not at all

Perfectly

What is immediately above the black hole?

left pulmonary artery

How well did you know this?

Not at all

Perfectly

What is immediately anterior to the black hole?

right pulmonary artery

How well did you know this?

Not at all

Perfectly

What is above the left pulmonary artery?

carina of the trachea

How well did you know this?

Not at all

Perfectly

What distinguishes the right hemidiaphragm?

it reaches the mediastinum

How well did you know this?

Not at all

Perfectly

What distinguishes the left hemidiaphragm?

the gastric bubble underneath it…

How well did you know this?

Not at all

Perfectly

How do you look to see if you have a good CT? As in…one w/o rotation?

see if the spinous processes line up with the midline b/w the 2 clavicular heads
**you can also use the trachea–but not as effective…

How well did you know this?

Not at all

Perfectly

When is an air fluid level normal?

Normal: gastric bubble

How well did you know this?

Not at all

Perfectly

When is a summation shadow normal? Pathological?

Normal: rib darker in the heart
Pathologic: tumor

How well did you know this?

Not at all

Perfectly

When would a silhouette sign be normal? Pathologic?

Normal: on the left side…how the heart melts into the diaphragm
Pathologic: if it is found on the left side…

How big should the heart silhouette be?

no more than 50% of the total internal chest diameter…

When would a heart that is more than 50% of the chest diameter be normal?

if the x ray is taken during expiration. Will make the heart look bigger.

Why does inspiration make the heart look smaller? How is this related to emphysema & COPD?

The chest wall becomes bigger. Makes the heart look smaller in comparison. This relates to these pulmonary diseases b/c they causes chest wall expansion in their effort to breathe. In these cases, the heart would also look smaller.

What level of ribs on the posterior side is the diaphragm @ with inspiration? Expiration?

Inspiration: @ rib 10 Expiration: @ rib 8

What are the right & left borders of the heart? Note: these can be seen in a PA chest X-ray.

Right border: right atrium | Left border: left ventricle

What is the anterior border of the heart? Posterior?

Anterior: right ventricle Posterior: left atrium

What is the fuzzy stuff on a chest x ray coming out of the heart & in the pleural space?

pulmonary arteries.

On a PA chest xray...to the left of the spine...you see what? to the right of the spine? Why does this make sense?

Left of the spine: descending aorta Right of the spine: SVC **makes sense b/c you see the SVC emptying into the RA...the right border of the heart...

B/c of long term expansion of the chest...what does long time COPD obliterate?

the retrosternal space: the space beneath the chest ribs...

Underneath the black hole you can see the posterior border of the heart...what is this structure?

The LA of the heart.

How can you see the posterior inferior lobes of the lungs?

Only on lateral films. Obscured on PA films.

T/F a deeper than normal costophrenic sulcus can be caused by a collapsed lung.

True.

A patient has acute onset dyspnea...& you see a super fuzzy chest x ray...what accounts for this? What does this patient have?

Alveoli super filled with fluid | Pulmonary Edema

If you have a collapsed lung & a mediastinal shift-->what do you have?

tension pneumothorax

What is the biggest danger of a tension pneumothorax?

a compromised SVC & IVC b/c if you don't get return of blood to your RA...you totally mess with your cardiac output...

What is a way of getting a collapsed lung?

stabbed in the chest 3 times!! Get him to the ER!!

When you see the outline of a lung...what do you see?

visceral pleural lining of the lung.

What can cause a crazy huge heart...as seen on a chest X-ray?

cardiac tamponade. | you get air or fluid in your pericardial sac

What will you see if you have an ascending aortic aneurysm?

It looks like a huge heart above your heart! You see all this nasty white stuff on the chest X-ray.

What does CAT scan stand for?

computerized axial tomography

What is the perspective of a CAT scan?

``` looking up from the feet of the patient. Top: anterior of the patient Bottom: Posterior of the patient Left side: right of the patient Right side: left of the patient ```

Once again...what are the 5 layers of the superior mediastinum?

``` Glandular Venous Arterial Respiratory Digestive ```

Which of the brachiocephalic veins will always look bigger on a CT?

the left brachiocephalic vein. b/c of where it is traveling...

In the superior mediastinum...the arterial layer you see BCS going in a clockwise direction...what does this stand for?

Brachiocephalic Artery Left Common Carotid Left Subclavian Artery

What do the L & R brachiocephalic veins merge into? What does BCS merge into?

SVC | Aorta

@T4/T5what are we at the junction of?

the superior & middle mediastina.

what happens to the arch of the azygos?

it swings superiorly to the root of the lung

When do we start to see the SVC in the CT?

@ T4

Where is the arch of the aorta?

superior mediastinum

What looks crazy huge on the T4 level?

arch of the aorta

What is posterior to the esophagus @ the T5 level?

the azygos vein

At what level do you see a nice picture of the heart?

At what thoracic level does the IVC come thru the diaphragm? Go into the heart?

Thru the diaphragm @ T10 | Into the heart @ T8 to T9

the lung & pleural cavities can overlap @ what levels?

T11