Term
| advantages/disadvantages to X-rays: |
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Definition
- advantages: fast, non-invasive, cheap
- disadvantages: radiation, 2-D, static |
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Term
| The PA film is taken with the patient facing the casette, meaning their __ is against the plate and the x-ray goes through their __ first. The xray tube is placed __ feet away to diminish effect of divergence and magnification of structures. |
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Definition
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Term
| The AP projection of the chest is done with the patients __ to the film so that the x-rays penetrate their __ first. the patient is usually __, __ in bed, or __. This __ the heart and gives a poorer inspiration. |
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Definition
- back
- chest
- sitting
- erect in bed
- supine
- enlarges |
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Term
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Definition
Heart appears larger
Mediastinum appears wider
Diaphragms are elevated
Pleural effusions layer posteriorly and so are more difficult to see |
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Term
| With the left lateral view, the patient's __ side is against the film so that the __ is closer to the film. This means the __ side is more magnified. |
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Definition
- left side
- heart
- right side is more magnified |
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Term
| The stomach bubble is the mark of the __ hemidiaphragm. |
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Definition
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Term
| The right ribs (red arrows) are larger due to magnification and usually projected posterior to the left ribs if the patient was examined in a true lateral position. |
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Definition
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Term
| The left hemidiaphragm is usually __ than the right. Also, the heart in the left lateral film silhouttes out the __ anterior semidiaphragm, whereas the __ stays visible. |
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Definition
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Term
| The lateral decubitus position can be helpful in assessing the __ of a __ __ and to demonstrate whether it is __ or __. |
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Definition
- volume of a pleural effusion
- mobile or loculated |
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Term
| LOOK AT AND KNOW THE FILMS FROM THE CHEST RADIOGRAPH LECTURE. |
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Definition
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Term
| When you look at a CT, the __ are torwards you. |
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Definition
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Term
| When looking at PA and lateral films how should you look at them? |
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Definition
| - hang them side by side, PA on left, lateral on right |
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Term
| Ribs 1-7 are __ ribs. Ribs 8-12 are __ ribs. |
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Definition
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Term
| Margins of the mediastinum starting on the pts right side and going up: |
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Definition
| - diaphragm> right atrium> ascending aorta> superior vena cava> right inominate vein> left inominate vein> aortic arch> aortopulmonary window> left pulmonary artery> left ventricle> descending aorta> diaphragm |
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Term
| LOOK AT SLIDE 36 AND 37 OF CHEST RADIOGRAPHY PPT |
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Definition
|
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Term
R = ROTATION
I = INSPIRATION
P = PENETRATION
A = AIRWAY
B = BONES
C = CARDIAC SILHOUETTE
D = DIAPHRAGMS
E = EMPTY SPACE/EFFUSIONS
F = FIELDS
G = GASTRIC BUBBLE
H = HARDWARE |
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Definition
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Term
Rotation:
Is pt rotated? Loot at clavicles and make sure ribs, vertebral bodies superimposed.
Inspiration:
Should see 9 ribs on each side; 8 or less = poor inspiratory effort, more than 10 = hyperaeration.
Penetration:
Should be able to barely see intervertebral disc spaces: if none, underpenetrated; if well-defined, overpenetrated. |
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Definition
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Term
| With inspiration you should see __ ribs on each side. _ or less means poor inspiratory effect. More than 10 means __ like with __. |
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Definition
- 9
- 8 or less
- hyperaeration like with COPD |
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Term
| To determine penetration, you should barely be able to see __ __ __. |
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Definition
| intervertebral disc spaces |
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Term
| On inpsiration, the diaphragm should be found at the level of the __ to __ __ rib or __ to __ __ rib. |
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Definition
- 8-10th posterior rib
- 5-6th anterior rib |
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Term
| A patient can appear to have an abnormal chest if the film is taken during expiration. Look at the case above - on the first film, the loss of the right heart border silhouette would lead you to the diagnosis of a possible pneumonia. However, the patient had taken a poor inspiration. On repeat exam with improved inspiration, the right heart border is normal. |
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Definition
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Term
| Penetration: The thoracic spine disc spaces should be barely visible through the heart but bony details of the spine are not usually seen. |
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Definition
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Term
| On the lateral view, you can look for proper penetration and inspiration by observing that the spine appears to be darker as you move caudally. This is due to more air in the lung in the lower lobes and less chest wall. |
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Definition
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Term
| To describe the location of a lesion in the thorax, __ provide the horizontal axis while the vertical lines provide the vertical axis. |
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Definition
- ribs
"Lesion is located in the right midclavicular line at the level of the 8th rib" |
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Term
| Effusions may cause __ to be visible. |
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Definition
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Term
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Definition
| - crackles, rales, decreased breath sounds, dullness to percussion |
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Term
| Pneumothorax is air inside the thoracic cavity but outside the lung. A spontaneous PTX occurs without obvious inciting injury, examples include: |
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Definition
- idiopathic
- asthma
- COPD
- pulmonary infection
- neoplasm
- Marfan's syndrome
- smoking tobacco
- cocaine |
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Term
| On CXR, a PTX appears as air without lung markings in the least dependent part of the chest. Generally, the air is found peripheral to the white line of the pleura. In an upright film this is most likely seen in the ___. |
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Definition
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Term
| With a pneumothorax, no __ __ __ are seen outside of the line. |
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Definition
| - no pulmonary vascular markings |
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Term
| The above film shows a right sided tension pneumothorax with right sided lucency and leftward mediastinal shift. This is a medical emergency. Failure to place a right chest tube immediately could allow venous return to diminish and lead to possible death. |
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Definition
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Term
| __ is one of the most common abnormalities seen on CXR. It may progress to __ __ __ and __ __. |
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Definition
- CHF
- pulmonary venous hypertension
- pulmonary edema |
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Term
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Definition
- absense of silhouette or loss of lung/soft tissue interface caused by a mass/effusion in normally air filled lung
- opacity obscures normal borders |
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Term
For the heart, the silhouette sign can be caused by an opacity in the ___, ___, __ segment of the ___ lobe, ___aspect of the ____ fissure, __ mediastinum, and ___ portion of the pleural cavity. This contrasts with an opacity in the posterior pleural cavity, posterior mediastinum, of lower lobes which cause an overlap and not an obliteration of the heart border. Both the presence and absence of this sign is useful in the localization of pathology.
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Definition
- RML
- lingula
- anterior segment of the upper lobe
- lower aspect of the oblique fissure
- anterior mediastinum
- anterior portion of pleural cavity |
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Term
| An air bronchogram is a __ __ of an airway made visible by filling of the __ __ by __ or __ __. |
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Definition
- tubular outline
- surrounding alveoli by fluid or inflammatory exudate |
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Term
| Six causes of air bronchograms: |
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Definition
Little People Need Some New Names.
- lung consolidation
- pulmonary edema
- nonobstructive pulmonary atelectasis
- severe interstitial disease
- neoplasm
- normal expiration |
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Term
| On a normal CXR, you can visualize the air-filled trachea, mainstem bronchi and initial portions of the lobar bronchi. Further branchings should only be seen with the injection of contrast during a bronchogram. When air can be visualized in the more peripheral intrapulmonary bronchi, this is known as the __ ___ __. This abnormality is usually caused by an ____that surrounds the bronchi. |
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Definition
- air bronchogram sign
- infiltrate/consolidation |
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Term
| The term air bronchogram is used to describe a condition in which the bronchi stand out prominently due to increased contrast brought about by changes in the surrounding lung tissue. The change can be due to pneumonic consolidation, collapse of a part of the lung, or inflammatory edema in the lung tissue. It is not specific to any disease. |
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Definition
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Term
| In a normal chest x-ray, the trachobronchial tree is not visible beyond the __ order. It becomes visible if the surrounding alveoli is __ providing a contrast, or if the bronchi get __. The term air bronchogram is used and signifies __ __. |
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Definition
- 4th order
- filled
- bronchi get thickened
- ALVEOLI DISEASE |
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Term
| Mycoplasma pneumonia is an __ pneumonia. |
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Definition
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Term
| Kerley B lines are ___ lines less than __cm long, commonly found in the __ __ __. These are __, __ __ __. |
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Definition
- horizontal lines less than 2 cm long
- lower zone periphery
- thickened, edematous interlobar septa |
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Term
| Causes of Kerley B lines: |
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Definition
- pulmonary edema
- lymphangitis carcinomatosa
- malignant lymphoma
- viral/mycoplasma pneumonia
- intersitial pulmonary fibrosis
- pneumoconiosis
- sarcoidosis |
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Term
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Definition
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Term
| what if the heart and gastric bubble are on the right side. what is this called? |
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Definition
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Term
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Definition
| - oligemia (loss of air to an area)to area of involvment with PE |
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Term
| Signs that may indicate PE: |
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Definition
- Westermark's sign
- Increased hilum size due to thrombus impaction
- Atelectasis with elevation of hemidiphragm
- Linear or disk shaped densities
- Pleural effusion
- Consolidation
- HAMPTOMS HUMP (rounded pleural base opacity) |
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Term
| Hampton's Hump is a __ __ __ __ that may signify a _ __. |
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Definition
- rounded pleural base opacity
- pulmonary embolus |
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Term
| TB usually hits the __ lobes first. |
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Definition
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Term
| On a CXR of emphysema you may see __ __ of the diaphragms and significant __ demonstrated by visualization of __ posterior ribs. |
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Definition
- bilateral flattening
- hyperinflation
- 11 |
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Term
| In the left lateral film, the stomach bubble is a marker of the __ __. This view helps to __ findings and assess __ ___. The lateral film is also more sensitive for ___. |
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Definition
- left hemidiaphragm
- localize
- AP diameter
- effusions |
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Term
| In the left lateral x-ray, the __ ribs are larger. |
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Definition
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Term
| In a left lateral chest x-ray, the right ribs project __ to the left ribs. |
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Definition
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Term
| In a lateral chest x-ray, the left hemidiaphragm is lower than the right. It is normal for the anterior left hemidiaphragm to be silhouetted out since the heart is on it, whereas the anterior right hemidiaphragm remains visible. |
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Definition
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