the chest radiographic appearances Flashcards
how should you read a chest XR
in appropriate lighting conditions
what must be checked when reading a chest radiogrpahy
name
date
time
orientation (l and r markers)
how radiograph was taken
what is the ABC method when reading a chest xray
A - airways
B - bones
C - cardiac silhouette
D - diaphragm
E - effusions
F - fields
G - gastric gas bubbles
H - hilar appreances
S - soft tissue
what is the hilar appearance on an xray
hilar region reveals a shadow that consists of the combination of lymph nodes, the pulmonary arteries, and the pulmonary veins.
what might it mean if you cannot see the trachea and bronchi on chest radiography
surrounded by fluid
what is an air bronchogram
refers to the phenomenon of air-filled bronchi (dark) being made visible by the opacification of surrounding alveoli (grey/white)
air in the bronchi but fluid in surrounding tissue
what are something to look out for when looking at bones on an chest xray
ribs and clavicle:
- are the ribs symmetrical/ evenly spaced on both sides
- any erosion or deposits
- any notching of ribs (deformation of superior or inferior surface of rib)
- fractures of callus formation
what is coarctation of aorta
birth defect in which aorta is narrower than usual
what are some things to look out for when looking at the cardiac outline
- is size within normal limits
- shape norma?
- uniform opacity on either side of spine
- normal position or pushed/pulled to either side of spine
- evidence of calcification in pericardium/valves
what is the cardiac-thoracic ratio
cardiothorcic ratio AA should be at least half of BB
in other terms
width of heart should be at least half of the width of the thorax as seen on xray
what might it mean if the mediastinum is pushed or pulled by the lung
pushed = increased pressure in one semi thorax
pulled = loss of pressure in one semi-thorax
how can you tell that theres fluid in the lungs through an xray
when the cardiac borders are not clearly defined = ‘fluid’ in lungs
what are some things to consider when looking at the diaphragm on CXR
- is right higher than left
- are domes curved
- do they form sharp boundary to lung
- is there abnormally large gas bubble in stomach or colon
- any free gas under diaphragm
why might the right diaphragm be higher than the left
- liver is beneath
- gas below right semi-diaphragm
- damage in phrenic nerve
what might cause a fuzzy diaphragm appearance on xray
- localised pleural effusion
- fluid
define erect, supine, semirecumbent
erect = standing up, arms by side
supine = horizontally on back
prone = horizontally on torso
semirecumbent = elevated upper body , half laying down half sitting up
whats the difference between transudative and exudative pleural effusions
- Transudative effusions are caused by some combination of increased hydrostatic pressure and decreased plasma oncotic pressure.
- Exudative effusions result from increased capillary permeability, leading to leakage of protein, cells, and other serum constituents.
how does fluid move in pleural space when in a supine, semirecumbant position
supine = fluid extends throughout the pleural space
semirecumbant = no fluid level, might increase density of lower lobes
what is a sub pulmonary effusion
accumulation of fluid between the base of the lung and the diaphragm
- easier to see on erect position
why is a sub pulmonary effusion easier to see on the left
because distance between stomach air and lung is normally narrow
what is pleural plaque
areas of thickened tissue that form in the lining of the lungs
what do you look at when considering lung fields on an xray
costophrenic and cardiophrenic angles
- apices (tip of lung) (equal shape and radiolucency)
- periphery
- vascular pattern, symmetry etc
what is costophrenic and cardiophrenic angles
costophrenic = a sharply-pointed, downward indentation (dark) between each hemi-diaphragm (white) and the adjacent chest wall (white)
cardiophrenic = the angle between the heart and the diaphragm
what is the only lung lobe to tough the right heart border
middle lobe
