Radiology

Question 1

xray view of azygous fissure

Answer 1

normal variant azygous vein drains into the SCV above the R upper lobe bronchus forms fissure when vein invaginates into developing lung and pulls in visceral/parietal pleura see a linear opacity ending in almond shape

Question 2

Pancoast tumor

Answer 2

lung cancer arising in the peripheral upper lobe. lung apices

Sx: upper extremity pain, radiculopathy,Paresthesia/Weakness

Horner syndrome-Extension of neoplasm into the sympathetic chain ganglia
(Ptosis, Miosis, and Anhidrosis)

Question 3

area with increased attenuation, therefore more opaque to X-rays, producing a lighter (clear) area on the image.

Answer 3

Opacity

Question 4

CT: Pancoast tumor

Answer 4

lung cancer arising in the peripheral upper lobe. lung apices

Sx: upper extremity pain, radiculopathy,Paresthesia/Weakness

Horner syndrome-Extension of neoplasm into the sympathetic chain ganglia
(Ptosis, Miosis, and Anhidrosis)

Question 5

Line vs. Edge

Question 6

xray: PA vs. AP position

Answer 6

–AP = X-rays enter front, back against sensor
–PA = back to front against sensor

*Geometric magnification makes the heart shadow larger on the AP vs PA (greater divergence of xray beams)

Question 7

xray:
“LUCENCY”

Answer 7

Black – where Xrays penetrate,

gas/air

Question 8

xray: OPACITY

Answer 8

White – where Xrays are blocked

–Metal > bone > muscle/water > fat > air

Question 9

xray Orientation: Lat

Answer 9

–Lat = nose points to left of screen

Question 10

xray Orientation:
sagittal

Answer 10

–Sagittal = nose points to left of screen

Question 11

xray Orientation:
axial

Answer 11

–Axial = looking up from feet

Question 12

xray Orientation:
coronal

Answer 12

–Coronal = looking at patients face

Question 13

Positioning: Straight or Oblique?

Answer 13

straight

Spinous process (vertebra) should be midline, between the clavicles (head)

Question 14

xray: Density

Answer 14

the quality of an object that blocks light (on a film) or X-rays (on a radiograph

Question 15

“Silhouette Sign”

Answer 15

“Silhouette Sign”
(Don’t see the normal interface)
the LOSS of a normal anatomic border btwn structures by the apposition of a structure/lesion of similar radiographic density

usually caused by an intrathoracic radiopaque mass that touches the border of the heart or aorta.

xray: check edges of mediastinum: cardiophrenic angle, costophrenic angle, and aortico-pulmonary window for lesions

Question 16

Opacity

Answer 16

nany area with increased attenuation, therefore more opaque to X-rays, producing a whiter/brighter area on the image. (on a photographic negative)

Question 17

Edge

Answer 17

Edge: a boundary or demarcation between two different densities, such that the transition is sharp.

Question 18

Line

Answer 18

Line: a visible opacity that is contrasted against more lucent areas on BOTH sides. (also, the reverse)

Question 19

Varicella pneumonia

Answer 19

Small Nodular Lung Calcifications from Varicella Pneumonia
(healed Chicken Pox) and overlying breast shadows

Sx: rapidly evolving cough, dyspnea, and hemoptysis

Question 20

25 y/o sudden onset SOB, ß breath sounds on L.

Tracheal deviated to R. on physical exam.

Answer 20

Shifted =>Tension Pneumothorax

Compare opacity (whiteness) of lungs from side to side and from top to bottom

Question 21

Chest Radiology: ET Tube Position

Answer 21

CORRECT ET tube placement

ET tube in trachea 5-7cm above carina btwn L/R bronchi

estimate location of carina ~T5-T6 disk space

Question 22

estimate location of T1

Answer 22

where fist rib attaches

above T2 whose rib attaches to angle of louis

Question 23

Chest Radiology: position of the carina

Answer 23

above junction of R/L mainstem bronchi

near T5/6 or T6/7 disk space

Question 24

verify endotracheal tube placement

Answer 24

bad placement!

ET tube too LOW~ T5/6 and CURVES to R

intubation of R aminstem bronchus

contralateral lung becomes opaque (no air fill)

sx: atelectasis/collapse, diaphragm elevation, mediastinal shift

Question 25

verify endotracheal tube placement

Answer 25

BAD ET tube esophageal intubation air in stomach (distented abdomen) ET tube cruves R below the R minstem bronchus (does not follow trachea) also taveling alongside feeding tube

Question 26

main concern?

Answer 26

pneumonia

Question 27

concern with hypoedense area on chest exam

Answer 27

pocket of air

Question 28

main concern?

Answer 28

L pneumothorax vasculature does not extend to chest wall in apex hypodense "empty" space at edge of lung

Question 29

landmark on mediastinum

Answer 29

aortico-pulmonary window indent between aortic knob and main pulmonary artery swollen lymphnodes/cancers can appear here xray: " Silhouette Sign" on mediastinum

Question 30

main concern?

Answer 30

pneumonia and partial lobe colapse (+) sihouette sign opacity in R middle lobe loss of sharp heart boarder

Question 31

Air bronchogram

Answer 31

xray: "see air surrounded by fluid"= tubular lucencies An air bronchogram is a tubular outline of an airway made visible by filling of the surrounding alveoli by fluid. Six causes of air bronchograms are; lung consolidation, pulmonary edema, nonobstructive pulmonary atelectasis, severe interstitial disease, neoplasm, and normal expiration. \*\*pneumonia and cystic fibrosis

Question 32

bronchiectasis

Answer 32

dilated bronchi can be caused by cystic fibrosis:chronic thick fluid--\>bronchitis--\>bronchial wall weakens--\>expands

Question 33

Achalasia

Answer 33

Achalasia is a disorder of the esophagus, the tube that carries food from the mouth to the stomach. a failure of smooth muscle fibers to relax, which can cause a sphincter to remain closed and fail to open when needed

Question 34

what is the directoin of the posterior ribs? Anterior and lateral ribs are in what direction?

Answer 34

horizontal; diagonal

Question 35

a coin in the trachea is in what plane on a radiograph? in the esophagus?

Answer 35

in the trachea: sagittal plane in the esophagus: coronal plane (flat and facing you)

Question 36

If you want to see all of the branches of the aorta, what view do you want to see?

Answer 36

a Left Anterior Oblique

Question 37

If you want to see the esophagus in a barium swallow, what radiogrph view do you want?

Answer 37

a right anterior oblique

Question 38

What is the space between the aorta and pulmonary artery?

Answer 38

the aorticopulmonary notch

Question 39

what are the two places in the body where you will see air mixed with liquid contents?

Answer 39

in the stomach and the colon

Question 40

where does the aorta usually break?

Answer 40

right where the ligamentum arteriosum attaches: between the end of the arch and the descending aorta

Question 42

what forms the right heart border?

Answer 42

the right atrium

Question 43

on a radiograph, the pulmonary (arteries/veins) are superior and the pulmonary (arteries/veins) are inferior

Answer 43

**arteries** are superior, **veins** are inferior

Question 44

what passes under the aortic arch on radiograph?

Answer 44

the pulmonary trunk ("outflow tract")

Question 45

what passes over the left main bronchus?

Answer 45

the left pulmonary artery