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CCP S2 > radiology > Flashcards

radiology Flashcards

1
Q

What is a saggital view

A

longitudinal view

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2
Q

What is a coronal view

A

latitudinal view

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3
Q

What is a transverse view

A

axil view

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4
Q

pros of CT

A
  • excellent bone/anatomy detail
  • good soft tissue/air contrast
  • CT angiography ( cardiac, neuro, peripheral)
  • 3D image
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5
Q

cons of CT

A
  • radiation
  • weight limit
  • contrast reactions
  • artifact with metal and bone
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6
Q

pros of MRI

A
  • no radiation

- superior to CT for soft tissue

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7
Q

cons of MRI

A
  • timely
  • expensive
  • contraindicated in pts with pacemakers, intraoccqular metals ect
  • poor imaging of the lungs
  • doesn’t accurately show calcium
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8
Q

pros of ultrasound

A
  • realtime
  • repeatable
  • portable
  • inexpensive
  • doppler will show blood flow
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9
Q

cons of ultrasound

A
  • operator dependent
  • difficult in obese pts
  • view often obscured by bone or air
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10
Q

10 steps of x-ray interpretation

A
  1. Pt ID
  2. prev. images
  3. technique (eg AP supine)
  4. adequacy (see all structures, inspiration)
  5. heart
  6. mediastinum
  7. lungs and boarders
  8. soft tissue
  9. bones
  10. lines/tubes
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11
Q

how do you gauge adequacy of a chest x-ray

A
  1. penetration: are lower vertebrae visible through heart
  2. rotation: spinous process centred between clavicular heads
  3. inspiration: posterior 10 or anterior 6 at right cadiophrenic sulcus
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12
Q

what is a normal and abnormal cardio thoracic ratio

A

normal: within diameter of inner rib margins
abnormal: PA > 0.5
AP >0.6

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13
Q

how do you assess the mediastinum

A

should be midline between the pleura of each lung and extend from the sternum to the vertebral column. Divided into superior and inferior mediastinum (anterior, middle,posterior)

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14
Q

What does the superior mediastinum include?

A
  • aortic arch and great vessels
  • upper SVC
  • lymph nodes
  • trachea
  • esophagus
  • thymus
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15
Q

What is the normal width of the mediastinum and what will cause an enlarged mediastinum

A
  • width> 6cm on PA
  • width>8cm on AP

causes of enlargement: widening of vessels, mass

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16
Q

Is the right lower lobe visible on AP view

A

yes, barely in the right costophrenic angle

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17
Q

What does silhouette sign mean

A

the pathological loss of boarders between adjacent structures

18
Q

Cause of opacities on chest x-ray

A
  • ARDS
  • pneumonia
  • neoplasm
  • pulmonary edema
  • hemothorax
19
Q

What is an air bononchogram and what are it’s causes

A

water filled lung with air filled airway. air-filled bronchi (dark) being made visible by the opacification of surrounding alveoli (grey/white). It is almost always caused by a pathologic airspace/alveolar process, in which something other than air fills the alveoli. Air bronchograms will not be visible if the bronchi themselves are opacified (e.g. by fluid) and thus indicate patent proximal airways.

causes
pulmonary consolidation
pulmonary edema: especially with alveolar edema 
non-obstructive atelectasis
severe interstitial lung disease
neoplasms: bronchioloalveolar carcinoma; pulmonary lymphoma
pulmonary infarct
pulmonary hemorrhage
normal expiration
20
Q

radiographic stages of CHF

A

1- cephalization: abnormal thickening of upper vasculature relative to lower
2- interstitial pulmonary edema: increased interstitial markings, pulm vascular hypertension (upper zone hilar venous distension)
3- airspace pulmonary edema: diffuse patchy distribution (bat-wing), peripheral haze

21
Q

signs of interstitial edema

A

1- peribronchvascular- connective tissue thickening(peri-bronchial cuffing)
2- septal connective tissue thickening (kersey-B line)
3- interlobular thickening

22
Q

definition of ARDS

A
  • resp symptoms within 1 wk of known clinical insult
  • bilateral opacities not explained by other pulmonary disease
  • resp failure not explained by cardiogenic pulmonary edema
  • decreased P/F
23
Q

Proper Et tube location

A

5cm above carina with neck neutral

24
Q

proper central line placement

A

tip in SVC or CAJ

25
Q

proper chest tube placement

A

between visceral and parietal pleura, anterosuperiorly to drain a PTX, posterorinerferiorly to drain a hemo

26
Q

What is riglers sign

A

suggesting free intraperitonal air

27
Q

approach to c-spine x-ray

A
  • alignment
  • bone
  • cartilage
  • soft tissue
28
Q

assessing alignment of the cervical spine

A

smooth line along the outside of the anterior, posterior, spinolaminar and spinous process

29
Q

assessing soft tissue on cervical spinal

A

normal pre-vertebral spaces:
at C3 <7mm
at c7 <21mm

30
Q

approach to CT head

A 
ABBCS
asymmetry
blood
brain
CSF space
skull/scalp
31
Q

what will an acute hemorrhage look like on a head CT

A

hyperdense

32
Q

what does hypodensity indicate on a head CT

A

edema, infarct, air

33
Q

what will a subdural hematoma look like on CT

A

concave inner margin, convex outer margin following normal curve of skull, won’t cross midline

34
Q

what will a epidural hematoma look like on CT

A

biconvex hyper dense elliptical collection with sharp edges. doesn’t cross sulcus unless # present

35
Q

what will a subarachnoid hemorrhage look like on CT

A

hyper dense blood in subarachnoid spaces (such)

36
Q

what does peribronchial cuffing look like and what is it

A

dark spot in an opacity. It is a sign of a bronchus with edema in the wall…common in CHF

37
Q

what is cephalization

A

where the superior pulmonary vasculature appears the same or larger in diameter as the inferior vasculature….normally the superior vasculature is less dilated than inferior. Sign of CHF

38
Q

What is the left atrial appendage

A

a small, muscular out-pocketing of theleft atrium, one of the upper chambers of the heart. It fills with and empties blood when theleft atriumrelaxes and contracts.

Where clots can for in the setting of a-fib

39
Q

what is deep sulcus sign

A

costophernic angles pulled downwards when pt is supine. Common in pneumothorax

40
Q

signs of lung consolidation or pleural effusion of ultrasound

A
  • spine sign
  • hepatotization
  • lack of anechoic line, indicating fluid (consolidation)

CCP S2 (10 decks)

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