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Cardiorespiratory introducing practice > week 4 > Flashcards

week 4 Flashcards

1
Q

What are less dense tissue such as air or air filled structures referred to as (X ray)?

A

radiolucent (black)

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2
Q

What are more dense structure referred to as (X ray)?

A

radiopaque (white)

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3
Q

What is the most common type of chest X ray?

A

posteroanterior

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4
Q

Describe a posteroanterior X-ray

A

X-ray passes posterior to anterior with the plate anterior to the patients chest
patient is upright and the scapula are rotated away from the lung fields

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5
Q

What type of chest X ray is commonly used for portable chest X ray?

A

Anteroposterior

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6
Q

Describe an anteroposterior chest X ray

A

X-ray passes anterior to posterior
heart size is magnified

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7
Q

Why would you do an oblique X-ray?

A

It is used to project abnormalities away from overlying structures

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8
Q

Why would you use a lordotic X-ray?

A

provides better view of the lung apex, lingula and right middle lobes

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9
Q

Why would you use an expiratory chest X ray?

A

is used to demonstrate a small pneumothorax or unilateral airway obstruction

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10
Q

Why would you use a lateral decubitus x ray?

A

it is used to identify the presence of free pleural fluid or to confirm an air-fluid level

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11
Q

When your looking at a chest X ray what questions should you ask?

A

who?
What?
When?
Why?
How?

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12
Q

What system should you follow when looking at a chest X ray?

A

A - Alignment
B - Bones
C - Cardiac
D - Diaphragms
E - Expansion
F - Lung fields
G - Gadgets (drips, drains and tubes)

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13
Q

What do you want to think about when looking at alignment on a chest X ray?

A

Is this a straight film?
Look at the proximal ends of the clavicles in relation to the spinous processes

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14
Q

What do you think about when you look at bones on a chest X ray?

A

Are they all there, intact and in a normal position?
don’t just look at the ribs

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15
Q

What do you think about when you look at cardiac/mediastinum on a chest x-ray?

A

Is there a clear heart border?
Is it a normal size (around 1/3 of the chest diameter)
is there anything else of note in the mediastinum?
Is there any evidence of shifting of structures?

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16
Q

What should you think about when looking at the diaphragm on a chest X ray?

A

Are both hemidiaphragms clearly visible?
what about angles, cardiophrenic and costophrenic?

17
Q

What should you think about when looking at expansion on a chest X ray?

A

How well expanded is the chest?
the 10th rib posteriorly should bisect the right hemidiaphragm at mid clavicular line and its the 6th rib anteriorly

18
Q

What should you think about when looking at fields on a chest X ray?

A

Are the lung fields clear?
Are there any areas where the density either increases or decreases?
Can you see a lung edge?
Can you see a fluid level?
With a collapse and consolidation you will see increased opacity but with collapse you can see shifting of structures or crowding of lung markings

19
Q

What should you think about when looking at gadgets on a chest X ray?

A

What drips, drains, tubes, line and other gadgets are visible?
Are they in, on or around the patient?

20
Q

Name some common abnormalities seen on chest X rays?

A

Consolidation
atelectasis/ collapse
pleural effusion
Pneumothorax
Pulmonary oedema
Fracture

21
Q

Describe a CT scan

A

Computer enhancement of a large series of two-dimensional X-ray images
taken around a single axis of rotation
Produces cross-sectional view
supplements chest X ray rather than replacing
differentiates between lung and pleural tissues
shows bony/thoracic wall lesions very clearly
very useful to visualise mediastinum
can be 3D

22
Q

Describe an MRI

A

MRI uses the magnetic properties of the hydrogen atom to produce clear images of tissue
MRI image can be viewed in any plane

23
Q

What is a consolidation of the lungs?

A

a condition in which lung tissue becomes firm and solid rather than elastic and air-filled because it has accumulated fluids and tissue debris

24
Q

What is seen on a chest X ray for consolidation?

A

White/grey shadow, no loss of volume

25
Q

What are the main causes of consolidation of the lungs?

A

pneumonia
chest infection
lung constitution following trauma

26
Q

What will you hear on auscultation of a patient with consolidation?

A

Increased breath sounds/bronchial breathing, or decreased breath sounds, with or without crackles or wheeze

27
Q

What is atelectasis/ collapsed lung?

A

An airless state of the lung tissue which may involve all or part of the lung

28
Q

What is seen on an X ray of a patient with atelectasis/collapsed lung?

A

White/grey shadow, with loss of volume and shifting of structures
a total collapse may displace (pull) the mediastinum towards the affected side

29
Q

What are the main causes of atelectasis/ collapsed lung?

A

shallow breathing
bronchial obstruction
absorption of trapped gas
surfactant depletion
compression from external pressure such as pleural disorder
abdominal or cardiothoracic surgery

30
Q

What is pleural effusion?

A

excess fluid in the pleural cavity (usually less than 20ml of fluid is present in normal lungs)

31
Q

What does a chest X ray look like for pleural effusion?

A

a small amount of fluid (at least 500ml) will result in loss of costophrenic angle. as the amount increases a fluid line may be visible with tracking up the pleura laterally
large amounts of fluid will displace the mediastinum towards the non-affected side

32
Q

What would you hear on auscultation for someone with pleural effusion?

A

quiet breath sounds over the pleural effusion with bronchial breathing just above the top of the fluid level

33
Q

What are the main causes of pleural effusion?

A

disturbed osmotic or hydrostatic pressure in the plasma
changes in membrane permeability
malignancy
heart, kidney or liver failure
abdominal or cardiothoracic surgery
pneumonia
TB

34
Q

What is a pneumothorax?

A

air in pleural space secondary to a rupture in either pleural layer.
lung squashed towards the hilum in proportion to the amount of pleural air

35
Q

What does a chest X ray of pneumothorax look like?

A

Air in pleural space is very black as there are no lung markings
with significant pneumothorax the lung is squashed and appears a white density towards the hilum. The mediastinum may be displaced to the non-affected side

36
Q

What will you hear on auscultation of a pneumothorax?

A

Quiet over the area of pneumothorax

37
Q

What are the main causes of pneumothorax?

A

fast growth particularly in young men
blebs particularly in smokers
trauma such as rib fractures, surgery, insertion of a line
Barotrauma with high pressure positive pressure devices
bullae in emphysema

Cardiorespiratory introducing practice (10 decks)

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