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ESA 3 - Respiratory System > Radiology of Chest and Pleura > Flashcards

Radiology of Chest and Pleura Flashcards

1
Q

Label this chest x-ray

A
  1. Trachea
  2. Hila
  3. Lungs
  4. Diaphragm
  5. Heart
  6. Aortic knuckle
  7. Ribs
  8. Scapulae
  9. Breasts
  10. Stomach
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2
Q

Label this diagram

A
  • A - Right main bronchus
  • B - Trachea
  • C - Aorta
  • D - Left main bronchus
  • E - Carina
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3
Q

What happens at the carina?

A

The right and left main bronchus join

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4
Q

Label this diagram

A
  • A - Costophrenic recess
  • B - Costophrenic angle
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5
Q

What is this radiograph showing?

A

A lobar collapse

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6
Q

What is the radiological indicator of lobar collapse?

A

Displacement of the horizontal fissure

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7
Q

When is the horizontal fissure displaced upwards?

A

If there is volume loss of the right upper lobe (i.e. in a collapse)

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8
Q

When is the horizontal fissure displaced downwards?

A

If there is volume loss of the right lower lobe (i.e. in a collapse)

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9
Q

What is this radiograph showing?

A

Consolidation

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10
Q

How can consolidation be identified on a radiograph?

A

Compare the middle zones

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11
Q

When is the lung said to be consolidated?

A

If the alveoli and small airways fill with dense material

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12
Q

What may consolidation be due to?

A
  • Infection
  • Fluid
  • Blood
  • Cells
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13
Q

What may cause consolidation in infection?

A

Pus

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14
Q

When may consolidation due to infection occur?

A

In pneumonia

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15
Q

When may consolidation due to fluid occur?

A

Pulmonary oedema

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16
Q

When may consolidation due to blood occur?

A

Haemorrhage

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17
Q

When may consolidation due to cells occur?

A

Cancer

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18
Q

What happens on an x-ray if an area of the lung is consolidated?

A

It becomes dense and white

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19
Q

How can you tell if larger airways have been spared in consolidation of the lung?

A

They are of relatively low density, and therefore appear blacker on a x-ray

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20
Q

What is the phenomenon whereby the x-ray of a patient with consolidation appears dense and white known as?

A

Air bronchogram

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21
Q

What is being shown in this diagram?

A

A large, round, thick-walled lung cavity

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22
Q

What has caused the cavity in this x-ray?

A

Squamous cell lung carcinoma

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23
Q

What is being shown in this x-ray?

A

Pleural effusion

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24
Q

What is a pleural effusion?

A

A collection of fluid in the pleural space

25
Q

Where does fluid gather in a pleural effusion?

A

In the lowest part of the chest, depending on the patient’s position

26
Q

What will be shown on an x-ray of a patient with pleural effusion if the x-ray is taken when the patient is standing?

A

The pleural effusion will obscure the costophrenic angle/hemidiaphragm

27
Q

When is a pleural effusion difficult to see on a x-ray?

A

When the patient is supine

28
Q

Why is a pleural effusion difficult to see on a x-ray when the patient is supine?

A

Because the pleural effusion layers along the posterior aspect of the chest cavity

29
Q

How do pleural effusions appear on x-rays?

A

Uniformly white, with the Meniscus sign

30
Q

What is the Meniscus sign?

A

A concave area on the top of a pleural effusion, shown on x-ray

31
Q

When does a pneumothorax form?

A

When there is air trapped in the pleural space

32
Q

Why may a pneumothorax occur?

A
  • May occur spontaneously
  • May occur as a result of underlying lung disease
  • Trauma
33
Q

How does trauma cause a pneumothorax?

A

Laceration of the visceral pleura by a fractured rib

34
Q

When is a pneumothorax a medical emergency?

A

When it is a tension pneumothorax

35
Q

What is a tension pneumothorax?

A

If there is tracheal or mediastinal shift away from the pneumothorax, the pneumothorax is said to be under tension

36
Q

What pushes the trachea in a tension pneumothorax?

A

Air in the pleural cavity

37
Q

Why is the left hemithorax black in a x-ray of a tension pneumothorax?

A

Because of air in the pleural cavity

38
Q

What are the signs of a tension pneumothorax on an x-ray?

Illustrate these signs on an x-ray

A
  • The lung lung is completely depressed (arrowheads)
  • The trachea is pushed to the right (arrow)
  • The heart is shiften to the contralateral side, and the right heart border is pushed to the right (red line)
  • The left hemidiaphragm is depressed (yellow line)
39
Q

What should you do if you diagnose a pneumothorax clinically?

A

Treat the patient, do not request an x-ray to confirm

40
Q

What is shown in this x-ray?

A

Trachael displacement

41
Q

Label this x-ray

A
  • A - Soft tissue mass
  • B - Tracheal shift
  • C - Spinous process
  • D - Medial clavicles
42
Q

When may the trachea not genuinely be displaced to one side?

A

If the patient is rotated

43
Q

What should you do if the trachea is displaced to one side?

A

Try to establish if it has been pushed or pulled by a disease process

44
Q

What will push the trachea and mediastinum away from it?

A

Anything that increases pressure or volume in one hemithorax

45
Q

Give 3 examples of things that may push the trachea and mediastinum away from it

A
  • Tension pneumothorax
  • Pleural effusion
  • Tumour
46
Q

What will pull the trachea towards it?

A

Any disease that causes loss of volume in one hemithorax

47
Q

Give two examples of things that may pull the trachea towards it?

A
  • Collaped lung
  • Fibrosis
48
Q

What is this x-ray showing?

A

Calcified asbestos related pleural plaques

49
Q

Are asbestos plaques malignant or benign?

A

Generally considered to be benign

50
Q

What is the characteristic apperance of asbestos plaques?

A
  • Irregular
  • Well-defined
  • Classically said to look like holly leaves
51
Q

What does this x-ray show?

A

Lung hyper-extension

52
Q

What can lead to hyperinflation of the lungs?

A

COPD

53
Q

What does lung hyper-expansion lead to on an x-ray?

A
  • Blunting of both costophrenic angles
  • Flattened hemidiaphragms
54
Q

What condition is shown in this x-ray?

A

Pneumoperitoneum

55
Q

What is seen on x-ray with a pneumoperitoneum?

A

Lungs are normal, but air is seen under the diaphragm

56
Q

What is pneumoperitoneum a sign of?

A

Bowl perforation

57
Q

What is measured when calculating the cardiac index (cardiothoracic ratio)?

A

The widest part of heart and ribcage

58
Q

When is the heart said to be enlarged?

A

If the heart is over 50% the width of the thorax

ESA 3 - Respiratory System (14 decks)

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