Radiology Flashcards
What do the lung hila consist of?
Major bronchi and pulmonary veins/arteries
Are the hila symmetrical?
No
Are hilar lymph nodes normally visible?
No, only when abnormal
Which lung hila is higher?
Left
Which hemidiaphragm is higher?
Right
What is under the right hemidiaphragm?
Liver
What is under the left hemidiaphragm in a bean shape?
Stomach
What does the aortic knuckle depict?
Aortic arch
What part of the aorta can be seen following the aortic arch?
Descending (thoracic) aorta
What heart chamber forms the right heart border?
Right atrium
What heart chamber forms the left heart border?
Left ventricle
What can be seen branching off the right tracheal wall?
Azygous vein
What can cause a tracheal shift towards the affected lung?
Pneumothorax (not tension) or pneumonectomy
What can cause a tracheal shift away from the affected lung?
Tension pneumothorax or large pleural effusion
What does bilateral hilar enlargement suggest?
Sarcoidosis
What are some differentials of bilateral hilar enlargement?
Lymphoma, metastatic disease, infection
What is asymmetrical hilar enlargement (especially with pulmonary nodules) most likely to be?
Malignant metastases
What is something which can be seen on a CXR which suggests previous cancer?
Mastectomy
What part on a CXR can also be moved, similar to the trachea?
Lung hila
What are 4 causes of consolidation?
Pneumonia (pus)
Oedema (fluid)
Haemorrhage (blood)
Cancer (cells)
What are 3 causes of complete white out?
Consolidation, pneumonectomy or massive pleural effusion
What is classed as a large pneumothorax?
Lung border more than 2cm away from the inner chest wall
What does the loss of the right heart border suggest?
Right middle lobe consolidation
When are both costophrenic angles blunt and hemidiaphragms flattened?
Lung hyperexpansion
What are 2 causes of lung hyperexpansion?
COPD and alpha1 anti-trypsin deficiency
What does the loss of ONLY the left heart border suggest?
Left upper lobe lingular consolidation
What does the loss of BOTH the left heart border and obscured left hemi-diaphragm suggest?
Left lower lobe consolidation
What is the first step of viewing a CXR?
Check patient details and date/time of CXR
What is the second step of viewing a CXR?
Note the image projection
If the image projection isn’t on the X-ray, what is it most likely to be/
Standard PA view
What is step 3 of viewing a CXR?
Comment on image quality and presence of medical artefacts
What are the 3 things considered when assessing image quality?
Rotation, inspiration, penetration
How do you tell a CXR is not rotated?
The spine is in the midpoint between the medial ends of two clavicles
How do you tell a CXR is on inspiration?
Ribs 5-7 anteriorly intersect hemi-diaphragm in the mid-clavicular line
How do you tell a CXR is well penetrated?
The spine is visible behind the heart
What words can be used to describe abnormalities?
Opacities, shadows or densities
What should you mention when describing opacities?
Tissue involved (lung), size, side, number, distribution, position, shape
What should you always check for when looking at a CXR?
Pneumothorax- always state your finding
What are some features of a left lower collapse?
- Displaced left oblique fissure
- Obscured medial part of left hemi-diaphragm
- Left hemi-diaphragm higher than right
- Triangular shape behind heart
What are some features of a right upper collapse?
- Right horizontal fissure displaced upwards
- Whiteness at upper zone
- Sail sign
What are some features of a left upper collapse?
- Obscured left heart border
- Whole lung looks white
- Veil sign
