X-Rays

Question 1

State an indication for a chest x-ray.

Answer 1

1) Evaluation of symptoms e.g. shortness of breath, chest pain, cough.
2) Evaluation of physical signs e.g. hypoxemia, abnormal pulmonary examinations.
3) Evaluation of placement of central lines, nasogastric tubes, endotracheal lines.
4) Screening for pneumothorax after lung biopsies, central lines placement, pacemakers.
5) Evaluation of pacemaker lead fractures, evaluation of shunt leads in hydrocephalus

Question 2

State the different sections to interpreting a chest x-ray.

Answer 2

Airways. 
Bones (soft tissue). 
Cardiac silhouette (mediastinum). 
Diaphragm (gastric bubble). 
Effusions (pleura). 
Fields (lung fields). 
Lines/tubes/devices/surgeries.

Question 3

What is assessed on the airways?

Answer 3

The trachea and main bronchi. There is no pulling/pushing on the trachea.

Question 4

State a condition picked up by the airways.

Answer 4

Pneumothorax. Atelectasis (collapse or closure of the lung).

Question 5

State 3 things looked at for bones and soft tissue.

Answer 5

Ribs. Clavicle. Vertebral bodies. Fracture/lesions.

Question 6

What does the cardiac silhouette and mediastinum refer to?

Answer 6

Cardiothoracic ratio (are there abnormal bumps on the x-ray which I don’t recognise).

Question 7

What should you be looking for on the diaphragm?

Answer 7

Can you differentiate between the diaphragms clearly?

Question 8

State one thing to be looking for with effusion (pleura).

Answer 8

Any plaques (asbestosis). Can I visualise both costophrenic angles.

Question 9

State one thing to be looking for with lung fields.

Answer 9

Lung consolidation (when air that usually fills the small airways in your lungs with something else). Nodules/mass/abnormality.

Question 10

State what you might find on an x-ray for a patient with respiratory distress syndrome (breathing disorder that affects newborns).

Answer 10

Central line. Defibrillation pad. Nasogastric tube.