Week 6 - CXR

Question 1

What are the differences between a PA and AP X-ray?

Answer 1

PA - most common, patient is upright and scapula rotated away from lung fields
AP - commonly used for portable CXRs, heart size is magnified

Question 2

What are the preliminary checks for an X-ray?

Answer 2

Name/ date/ time
Projection (AP vs. PA)
Exposure
Position (supine, erect, rotated)
Inspiration

Question 3

What does ABCDEFG stand in the systematic approach?

Answer 3

A - alignment
B - bones - intact and in normal position?
C - Cardiac - clear heart border, normal size?
D - Diaphragms - both halves visible? cardio-phrenic and costo-phrenic angles
E - Expansion - how well expanded
F - lung Fields (should be mainly black with a little whiteness, fluid level? shifting of structures)
G - gadgets (drips, drains, etc)

Question 4

What might you see in a consolidation?

Answer 4

White, grey shadow

No loss of volume, no shifting of structures

Question 5

What might you see in atelectasis/ collapse?

Answer 5

White/ grey shadow
Loss of volume
Shifting of structures - only with significant collapse

Question 6

What might you see in pleural effusion?

Answer 6

Fluid is white
At least 500ml will result in loss of costophrenic angle
Fluid line may be visible with tracking up pleura laterally
Large amounts will displace mediastinum toward non-affected side

Question 7

What might you see in pneumothorax?

Answer 7

Air in pleural space is very black, no lung markings
Lung may be squashed and appear as white density toward helium
Mediastinum may be displaced to non-affected side

Question 8

What might you see with pulmonary oedema?

Answer 8

Bilateral fleecy opacities spreading from cilia

Known as bat wing or butterfly wing shadows