Radiology

Question 1

What do the lung hila consist of?

Answer 1

Major bronchi and pulmonary veins/arteries

Question 2

Are the hila symmetrical?

Answer 2

No

Question 3

Are hilar lymph nodes normally visible?

Answer 3

No, only when abnormal

Question 4

Which lung hila is higher?

Answer 4

Left

Question 5

Which hemidiaphragm is higher?

Answer 5

Right

Question 6

What is under the right hemidiaphragm?

Answer 6

Liver

Question 7

What is under the left hemidiaphragm in a bean shape?

Answer 7

Stomach

Question 8

What does the aortic knuckle depict?

Answer 8

Aortic arch

Question 9

What part of the aorta can be seen following the aortic arch?

Answer 9

Descending (thoracic) aorta

Question 10

What heart chamber forms the right heart border?

Answer 10

Right atrium

Question 11

What heart chamber forms the left heart border?

Answer 11

Left ventricle

Question 12

What can be seen branching off the right tracheal wall?

Answer 12

Azygous vein

Question 13

What can cause a tracheal shift towards the affected lung?

Answer 13

Pneumothorax (not tension) or pneumonectomy

Question 14

What can cause a tracheal shift away from the affected lung?

Answer 14

Tension pneumothorax or large pleural effusion

Question 15

What does bilateral hilar enlargement suggest?

Answer 15

Sarcoidosis

Question 16

What are some differentials of bilateral hilar enlargement?

Answer 16

Lymphoma, metastatic disease, infection

Question 17

What is asymmetrical hilar enlargement (especially with pulmonary nodules) most likely to be?

Answer 17

Malignant metastases

Question 18

What is something which can be seen on a CXR which suggests previous cancer?

Answer 18

Mastectomy

Question 19

What part on a CXR can also be moved, similar to the trachea?

Answer 19

Lung hila

Question 20

What are 4 causes of consolidation?

Answer 20

Pneumonia (pus)
Oedema (fluid)
Haemorrhage (blood)
Cancer (cells)

Question 21

What are 3 causes of complete white out?

Answer 21

Consolidation, pneumonectomy or massive pleural effusion

Question 22

What is classed as a large pneumothorax?

Answer 22

Lung border more than 2cm away from the inner chest wall

Question 23

What does the loss of the right heart border suggest?

Answer 23

Right middle lobe consolidation

Question 24

When are both costophrenic angles blunt and hemidiaphragms flattened?

Answer 24

Lung hyperexpansion

Question 25

What are 2 causes of lung hyperexpansion?

Answer 25

COPD and alpha1 anti-trypsin deficiency

Question 26

What does the loss of ONLY the left heart border suggest?

Answer 26

Left upper lobe lingular consolidation

Question 27

What does the loss of BOTH the left heart border and obscured left hemi-diaphragm suggest?

Answer 27

Left lower lobe consolidation

Question 28

What is the first step of viewing a CXR?

Answer 28

Check patient details and date/time of CXR

Question 29

What is the second step of viewing a CXR?

Answer 29

Note the image projection

Question 30

If the image projection isn't on the X-ray, what is it most likely to be/

Answer 30

Standard PA view

Question 31

What is step 3 of viewing a CXR?

Answer 31

Comment on image quality and presence of medical artefacts

Question 32

What are the 3 things considered when assessing image quality?

Answer 32

Rotation, inspiration, penetration

Question 33

How do you tell a CXR is not rotated?

Answer 33

The spine is in the midpoint between the medial ends of two clavicles

Question 34

How do you tell a CXR is on inspiration?

Answer 34

Ribs 5-7 anteriorly intersect hemi-diaphragm in the mid-clavicular line

Question 35

How do you tell a CXR is well penetrated?

Answer 35

The spine is visible behind the heart

Question 36

What words can be used to describe abnormalities?

Answer 36

Opacities, shadows or densities

Question 37

What should you mention when describing opacities?

Answer 37

Tissue involved (lung), size, side, number, distribution, position, shape

Question 38

What should you always check for when looking at a CXR?

Answer 38

Pneumothorax- always state your finding

Question 39

What are some features of a left lower collapse?

Answer 39

- Displaced left oblique fissure - Obscured medial part of left hemi-diaphragm - Left hemi-diaphragm higher than right - Triangular shape behind heart

Question 40

What are some features of a right upper collapse?

Answer 40

- Right horizontal fissure displaced upwards - Whiteness at upper zone - Sail sign

Question 41

What are some features of a left upper collapse?

Answer 41

- Obscured left heart border - Whole lung looks white - Veil sign