Radiology Flashcards
xray view of azygous fissure
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
Pancoast tumor
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)
area with increased attenuation, therefore more opaque to X-rays, producing a lighter (clear) area on the image.
Opacity
CT: Pancoast tumor
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)
Line vs. Edge
xray: PA vs. AP position
–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)
xray:
“LUCENCY”
Black – where Xrays penetrate,
gas/air
xray: OPACITY
White – where Xrays are blocked
–Metal > bone > muscle/water > fat > air
xray Orientation: Lat
–Lat = nose points to left of screen
xray Orientation:
sagittal
–Sagittal = nose points to left of screen
xray Orientation:
axial
–Axial = looking up from feet
xray Orientation:
coronal
–Coronal = looking at patients face
Positioning: Straight or Oblique?
straight
Spinous process (vertebra) should be midline, between the clavicles (head)
xray: Density
the quality of an object that blocks light (on a film) or X-rays (on a radiograph
“Silhouette Sign”
“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
Opacity
nany area with increased attenuation, therefore more opaque to X-rays, producing a whiter/brighter area on the image. (on a photographic negative)
Edge
Edge: a boundary or demarcation between two different densities, such that the transition is sharp.
Line
Line: a visible opacity that is contrasted against more lucent areas on BOTH sides. (also, the reverse)
Varicella pneumonia
Small Nodular Lung Calcifications from Varicella Pneumonia
(healed Chicken Pox) and overlying breast shadows
Sx: rapidly evolving cough, dyspnea, and hemoptysis
25 y/o sudden onset SOB, ß breath sounds on L.
Tracheal deviated to R. on physical exam.
Shifted =>Tension Pneumothorax
Compare opacity (whiteness) of lungs from side to side and from top to bottom
Chest Radiology: ET Tube Position
CORRECT ET tube placement
ET tube in trachea 5-7cm above carina btwn L/R bronchi
estimate location of carina ~T5-T6 disk space
estimate location of T1
where fist rib attaches
above T2 whose rib attaches to angle of louis
Chest Radiology: position of the carina
above junction of R/L mainstem bronchi
near T5/6 or T6/7 disk space
verify endotracheal tube placement
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
verify endotracheal tube placement
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
main concern?
pneumonia
concern with hypoedense area on chest exam
pocket of air
main concern?
L pneumothorax
vasculature does not extend to chest wall in apex
hypodense “empty” space at edge of lung
landmark on mediastinum
aortico-pulmonary window
indent between aortic knob and main pulmonary artery
swollen lymphnodes/cancers can appear here
xray: “ Silhouette Sign” on mediastinum
main concern?
pneumonia and partial lobe colapse
(+) sihouette sign
opacity in R middle lobe
loss of sharp heart boarder
Air bronchogram
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
bronchiectasis
dilated bronchi
can be caused by cystic fibrosis:chronic thick fluid–>bronchitis–>bronchial wall weakens–>expands
Achalasia
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
what is the directoin of the posterior ribs? Anterior and lateral ribs are in what direction?
horizontal; diagonal
a coin in the trachea is in what plane on a radiograph? in the esophagus?
in the trachea: sagittal plane
in the esophagus: coronal plane (flat and facing you)
If you want to see all of the branches of the aorta, what view do you want to see?
a Left Anterior Oblique
If you want to see the esophagus in a barium swallow, what radiogrph view do you want?
a right anterior oblique
What is the space between the aorta and pulmonary artery?
the aorticopulmonary notch
what are the two places in the body where you will see air mixed with liquid contents?
in the stomach and the colon
where does the aorta usually break?
right where the ligamentum arteriosum attaches: between the end of the arch and the descending aorta
what forms the right heart border?
the right atrium
on a radiograph, the pulmonary (arteries/veins) are superior and the pulmonary (arteries/veins) are inferior
arteries are superior, veins are inferior
what passes under the aortic arch on radiograph?
the pulmonary trunk (“outflow tract”)
what passes over the left main bronchus?
the left pulmonary artery
