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Block 2; Week 8 > Radiology > Flashcards

Radiology Flashcards

1
Q

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

A

From back to front to get to the film

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2
Q

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

A

From the lateral side of the thorax…

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3
Q

Why do you need multiple views in an x ray?

A

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

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4
Q 
Put these things in order from most radiolucent to least radiolucent...
Spongy Bone
Air
Water & other tissues
compact bone
fat
A 
Air
Fat
Water & other tissues
Spongy Bone
Compact Bone
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5
Q

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

A

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.

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6
Q

What is the most normal lateral view?

A

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

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7
Q

More penetration means what?

A

less exposure

less contrast

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8
Q

What is the usefulness of a lateral chest film?

A

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

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9
Q

What is blunting? What can do this?

A

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.

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10
Q

How can you make the recess more acute? Costophrenic…

A

by pulling up on the diaphragm.

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11
Q

T/F A nipple shadow is normal.

A

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

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12
Q

What important things are found underneath the left hemidiaphragm?

A

The gastric bubble & left colic flexure.

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13
Q

Contrast media is especially important to view what?

A

coronary arteries

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14
Q

What makes up the black hole?

A

the left main bronchus–it is an orientation landmark

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15
Q

What is immediately above the black hole?

A

left pulmonary artery

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16
Q

What is immediately anterior to the black hole?

A

right pulmonary artery

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17
Q

What is above the left pulmonary artery?

A

carina of the trachea

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18
Q

What distinguishes the right hemidiaphragm?

A

it reaches the mediastinum

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19
Q

What distinguishes the left hemidiaphragm?

A

the gastric bubble underneath it…

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20
Q

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

A

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…

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21
Q

When is an air fluid level normal?

A

Normal: gastric bubble

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22
Q

When is a summation shadow normal? Pathological?

A

Normal: rib darker in the heart
Pathologic: tumor

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23
Q

When would a silhouette sign be normal? Pathologic?

A

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

24
Q

How big should the heart silhouette be?

A

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

25
Q

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

A

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

26
Q

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

A

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.

27
Q

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

A

Inspiration: @ rib 10
Expiration: @ rib 8

28
Q

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

A

Right border: right atrium

Left border: left ventricle

29
Q

What is the anterior border of the heart? Posterior?

A

Anterior: right ventricle
Posterior: left atrium

30
Q

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

A

pulmonary arteries.

31
Q

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?

A

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…

32
Q

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

A

the retrosternal space: the space beneath the chest ribs…

33
Q

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

A

The LA of the heart.

34
Q

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

A

Only on lateral films. Obscured on PA films.

35
Q

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

A

True.

36
Q

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

A

Alveoli super filled with fluid

Pulmonary Edema

37
Q

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

A

tension pneumothorax

38
Q

What is the biggest danger of a tension pneumothorax?

A

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

39
Q

What is a way of getting a collapsed lung?

A

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

40
Q

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

A

visceral pleural lining of the lung.

41
Q

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

A

cardiac tamponade.

you get air or fluid in your pericardial sac

42
Q

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

A

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

43
Q

What does CAT scan stand for?

A

computerized axial tomography

44
Q

What is the perspective of a CAT scan?

A 
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
45
Q

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

A 
Glandular
Venous
Arterial
Respiratory
Digestive
46
Q

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

A

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

47
Q

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

A

Brachiocephalic Artery
Left Common Carotid
Left Subclavian Artery

48
Q

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

A

SVC

Aorta

49
Q

@T4/T5what are we at the junction of?

A

the superior & middle mediastina.

50
Q

what happens to the arch of the azygos?

A

it swings superiorly to the root of the lung

51
Q

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

A

@ T4

52
Q

Where is the arch of the aorta?

A

superior mediastinum

53
Q

What looks crazy huge on the T4 level?

A

arch of the aorta

54
Q

What is posterior to the esophagus @ the T5 level?

A

the azygos vein

55
Q

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

A

T7

56
Q

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

A

Thru the diaphragm @ T10

Into the heart @ T8 to T9

57
Q

the lung & pleural cavities can overlap @ what levels?

A

T11

Block 2; Week 8 (6 decks)

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