Understanding the abnormal chest X-ray Flashcards
how do you check position of equipment
CXR
pushed away from pathology and trachea too black
pneumothorax
pushed away from pathology trachea too white
pleural effusion
pulled towards pathology and too white
collapse/atelectasis or fibrosis
tension pneumothorax
the mediastinum is pushed away
deviated trachea towards pathology
pneumonectomy/lobectomy
lobar collapse
trachea deviated away from pathology
tension pneumothorax
massive pleural effusion, or any mass effect
opacity adjacent to heart show
left upper lobe
opacity not adjacent to heart shadow
left lower lobe
consolidation
replacement of normal air space gas with fluid or solid material
consolidation vs collapse
consolidation keeps volume where as collapse loses volume
blurring of heart border
consolidation
horizontal fissure on a CXR
anterior 4th rib
atalectasis
Collapsing of a lung - reduction in inflation of all or part of the lung
atalectasis chest xray telling signs
Volume loss Displacement of trachea Displacement of diaphragm Displacement of lung fissures Compensatory over inflation of non collapsed lung Crowding of vessels & bronchi
Opacification, Too white or white in the wrong place
- Fluid
* Increased tissue e.g lymphadenopathy
What signs would you find on clinical examination?
Inspection Palpation Percussion Auscultation
five causes of consolidation
Pus = infection blood = pulmonary haemorrhage fluid = pulmonary oedema, drowned lung cells = lung cancer protein = alveolar proteinosis
Air bronchogram. -snow on trees
Large airways are spared so become visible (black) against the white background
Dull to percussion
Increased vocal resonance Bronchial breathing
Left upper lobe atelectasis
- “veil like” opacification of left lung field
- Elevated hemi diaphragm
- Loss of cardio mediastinal contour
Covid
Patchy opacification
Bilateral
Peripheral distribution Towards the base of the lungs
Pleural effusion
fluid collecting within the pleural cavity
• Trachea is pushed away
• Left lower zone uniformly white
• Concave upper border (meniscus)
- Sample the effusion (USS guided)
- Exudate (high protein) malignancy , infection, rheumatoid
- Transudate (low protein) CCF ,
Pulmonary oedema ABCDE
A - alveolar oedema = bat bind appearance
B - Kerley B lines
C - Cardio-thoracic ratio (cardiomegaly)
D - dilated upper lobe vessels
E - pleural effusion
Bilateral hilar lymphadenopathy
• Lymphoma (hodgkins) • Sarcoid
If unilateral or asymmetrical
TB
Metastatic spread
