Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHTY 800 > Week 9 - CXR Interpretation > Flashcards

Week 9 - CXR Interpretation Flashcards

1
Q

Spirometry (Measures)

A

Measure the volume of air that the patient can forcible expel from their lungs after a max inspiration / How quickly the air can be expelled
- Measurements include FEV1 and FVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is spirometry used for?

A

Aid diagnosis, detect/quantify the degree of airway obstruction or restriction, monitor effects of treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

FEV1

A
  • Forced expiratory volume in 1 second
  • After a full inspiration, the volume of air expired in the 1st second of forced expiration.
  • values between 80-120% of avg. are considered normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

FVC

A
  • Forced vital capacity
  • After a max inspiration, the max volume of air that can be forcibly expired in one breath.
  • Critical in the diagnosis of obstructive + restrictive diseases.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ratio of FEV1/FVC

A 
Normal = ~ 80%
Abnormal = <70%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Normal reading spirometry

A

FEV1/FVC > 70% (avg = 80)
FVC > 80% of predicted
FEV1 > 80% of predicted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Obstructive meaning spirometry

A
  • Pt’s cannot EXHALE the air in their lungs quickly as something is obstructing their airways
  • FVC often preserved or reduced but to a lesser degree.
  • Pre/post bronchodilators used to assess degree of reversibility.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Obstructive reading spirometry

A
  • Decreased FEV1/FVC ratio (<70%)
  • Decreased FEV1 (<80% predicted)
  • FVC normal or decreased but to a lesser degree
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Obstructive gold classification (FEV1)

A

Mild - >/= 80%
Moderate = 50-79%
Severe = 30-49%
Very Severe = < 30% predicted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Obstructive airways could be due to:

A
  • Bronchospasm (tightening of the muscles that line the airways (bronchi) in your lungs. When these muscles tighten, your airways narrow)
  • Inflammation
  • Secretion/mucus
  • Loss of elasticity in bronchial walls (floppy airways)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Restrictive reading spirometry

A
  • Something restricting the INSPIRATION of air into the lungs, so lung volumes are reduced.
  • Look mainly for a decrease in FVC
  • Increased or normal FEV1/FVC ratio
  • Decreased FVC (<80% predicted)
  • Decreased FEV1 (proportional to decreased FVC or normal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Restriction in airways due to:

A
  • Lung issues: Pulmonary fibrosis
  • Chest wall issues: scoliosis, obesity
  • Weak muscles/damaged nerves: MND, SCI (lacking ability to fully inspire)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mixed reading spirometry

A
  • Issue is with both intake of air into lung (restrictive) & exhaling of air out of lungs (obstruction)
  • Decreased FEV1/FVC (<70% - obstruction)
  • Decreased FVC (<80% predicted - restriction)
  • Decreased FEV1 (<80% predicted - shows severity of obstruction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chest x-ray (CXR)

A

A 2 dimensional representation of a 3 dimensional object- height/width maintained, depth lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Black on XR

A

(Translucent/translucency) Air/gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gray on XR

A

(Opaque/opacity) Fat, soft tissues, + water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

White on XR

A

(Opaque/opacity) Bone and metal

The denser the tissue- the whiter it is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Patient & film details

A
  1. Labels: Name, MRN, date, time
  2. Orientation
  3. Projection
19
Q

Projection (PA)

A
  • Postero-anterior

- Rays passing from back to front, usually standing, scapula removed from view.

20
Q

Projection (AP)

A
  • Antero-posterior
  • Rays passing from front to back, pt can be supine, scapula seen in XR
  • less ideal
  • Shows magnification of the heart/widening of the mediastinum (especially supine)
21
Q

Film quality

A

Exposure, inspiratory effect, pt position.

- You should just see the intervertebral(IV) disc spaces behind the heart (but can see them easily behind the trachea)

22
Q

Film quality (over-exposure)

A
  • Film is darker (more translucent)
  • Can see IV disc spaces behind the heart easily
  • Easy to miss problems
23
Q

Film quality (under-exposed)

A
  • Film is whiter (more opaque)
  • Can’t see IV disc spaces behind the heart/trachea
  • May over-diagnose
24
Q

Film quality (inspiratory effect)

A
  • Taken at end of full inspiration

- Good inspiration: Count 6 ant. ribs or 9-10 post. ribs, cutting the diaphragm mid-clavicular line.

25
Q

Film quality (position)

A

Medial ends of clavicles should be equidistant from spinous processes

26
Q

Extrathoracic/thoracic (Soft tissues)

A
  • Subcutaneous emphysema: Air/gas in the subcutaneous layer of the skin, often associated w/ a pneumothorax.
27
Q

Extra-thoracic/thoracic (thoracic cage)

A
  • Signs of osteoporosis (thinning)
  • Rib fractures/abnormalities
  • Chest shape abnormalities (i.e. scoliosis)
28
Q

Intrathoracic

A

Mediastinum, Diaphragms, Lungs field

29
Q

Intrathoracic (mediastinum)

A

Trachea - should be midline
Hila - made up of major bronchi, pulmonary veins/arteries, & lymph nodes (L hila higher than R)
Heart - < half of the internal diameter of the chest wall (positions 2/3 to the L + 1/3 to the R)

30
Q

Intrathoracic (diaphragm- shape/angle)

A

Shape: coned
Angle: Costophrenic (betw. ribs/diaphragm) / cardiophrenic (betw. heart/diaphragm)
- blunting of costophrenic angle most commonly caused by PLEURAL EFFUSION

31
Q

Intrathroacic (diaphragm- position)

A
  • @ level of 6th ant. rib, 9-10 post. rib
  • Lower on the L side than R
  • Higher/raised: can’t take in DB, part of the lung on that side has collapsed, phrenic nerve damage.
  • Lower/flatter: Hyper-inflated lungs (emphysema)
32
Q

Intrathoracic (Lung Fields)

A

Looking for: lung boundaries, markings (fine white lines which are the pulmonary blood vessels), Horizontal fissure, lung zones

33
Q

Lung zones

A

Upper- above 2nd ant. rib
Middle - Betw. 2nd/4th ant. ribs
Lower - Below 4th ant. rib

34
Q

Apical Intercostal Catheter (ICC)

A

Drains air from pleural cavity; basal ICC drains fluid/blood

35
Q

Abnormal CXR (CONSOLIDATION)

A

Define: Fluid filled alveoli (associated w/ pneumonia)
Signs: patchy opacity, air bronchogram’s, silhouette

36
Q

Air bronchogram

A

A tubular outline of an airway (darker) made visible by filling of the surrounding alveoli by fluid (opaque)

37
Q

Silhoette sign

A

Loss of the clear outline of a border of a thoracic structure
Lung appears opaque where air has been replaces
Can help localise which lobe is affected

38
Q

Abnormal CXR (COLLAPSE)

A
  • Also known as Atelectasis
    -Define: Loss of air in the alveoli
  • Causes: inhaled foreign body, mucus plug, endobronchial tumour
  • Signs: increased opacity in area, if large enough- there will be loss of lung volume w/ a shift of struc. towards the area of collapse (i.e. horiz. fissure, trachea, diaphragm, hila region)
    Can also get silhouette sign
39
Q

Abnormal CXR (PLEURAL EFFUSION)

A
  • Define: Fluid in the pleural space

- Signs: Increased opacity, blunting of costophrenic angle, meniscus/fluid line

40
Q

Abnormal CXR (PNEUMOTHORAX)

A
  • Define: Air in the pleural cavity
  • Signs: Visible pleural margin/edge, lack of lung markings betw. visceral + parietal pleural layers; increased translucency, collapsed (deflated) lung can appear more opaque
41
Q

Tension pneumothorax

A

Air enters the pleural space during inspiration but cannot leave on expiration
- Signs: same as regular pneumothorax w/ the addition of a shift of structures away from side of pneumo.

42
Q

Abnormal CXR (EMPHYSEMA)

A
  • Define: Progressive disease of the lungs that primarily causes SOB, due to over-inflation of alveoli; lung tissue in exchange of gases (O2/CO2) is impaired/destroyed.
  • Signs: Increased translucency, decreased lung markings, hyperinflation (low, flattened diaphragms, small long heart, horizontal ribs)
43
Q

Hyperinflation

A

Low flat diaphragms, horizontal ribs, elongated heart

44
Q

Abnormal CXR (PULMONARY OEDEMA)

A
  • Define: Fluid in the extra-vascular spaces of the lungs.
  • Signs: Bilateral patchy opacity +/- air bronchograms, enlarged hila regions w/ ‘bat wing’ pattern, “cotton wool” “fluffy”
    Increased heart size

PHTY 800 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions