Chest X rays Flashcards Preview

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Flashcards in Chest X rays Deck (26)
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1
Q

How does an x ray work

A
  • X ray machine
  • Pass through soft tissues, heart and lungs easily these appear darker on the x ray
  • Bones/fluid absobr x rays and appear white
2
Q

what are 5 shades of grey

A
  1. Black = air
  2. Dark grey = fat
  3. Light grey = soft tissue
  4. White = bone and fluid
  5. Brihgt white = metal
3
Q

why do we use x rays

A
  • TO IDENTIFY CHEST PATHOLOGY I.E. PNEUMONIA, HEART FAILURE, PNEUMOTHORAX, LUNG LESIONS
  • TO IDENTIFY ABDOMINAL PATHOLOGY - PNEUMOPERITONEUM IF SUSPICION OF BOWEL PERF air under the diapragram tells you something is wrong with it
  • TO IDENTIFY FOREIGN OBJECTS ?INHALED
  • TO CONFIRM PROPER PLACEMENT OF DEVICES AND LINES
4
Q

How do you do image interpretation

A
Firstly check 
-	Patient detials 
-	Date and time 
-	Any previous imaging 
Then RIPE
R otation 
I nspiration 
P rojection 
E xposure 
-	Clavicle should be equidistatn from spinous process
5
Q

what does RIPE stand for

A

R otation
I nspiration
P rojection
E xposure

6
Q

what should you see when inspiration happens in an X ray

A
  • Should be able to identify 6 antieor ribs

- Should be able to identlfy 10 posterior ribs visible

7
Q

what are the projections of the x rays

A
  • Normal is PA – x ryas goes in from behind

- AP veiws – bed bound patinets, nelagred hard

8
Q

why do you use PA over AP

A
  • REDUCES MAGNIFICATION OF HEART THEREFORE PREVENTING APPEARANCE OF CARDIOMEGALY
  • REDUCES RADIATION DOSE TO RADIATION SENSITIVE ORGANS I.E. THYROID, EYES, BREAST
  • MOVES SCAPULA AWAY FROM LUNG FIELD so you can see the lung field clearer
  • REDUCES PATIENT MOVEMENT AND STABILISES THE PATIENT – CAN HOLD ONTO THE UNIT IF NEEDS BE, reduces patient movement
  • CLEARER IMAGE OF SPINE AND POSTERIOR RIBS
9
Q

what are the 3 ways to check that the view is PA

A
  • Clavicel will be in lung field wherease in AP projected higher than usual
  • Scaupla not in lung field whereas in AP it is lung field
  • Heart magnification in AP
10
Q

what are the two types of exposure

A
  • Overprentrated - too black

- Underprenentrated - too white

11
Q

what does ABCDE stand for

A
A – AIRWAY 
B BREATHIGN 
C CIRCULATION 
D DIAPHRGAM 
E EVERYTHING ELSe
12
Q

how do you interpret an airway

A

ABCDE

13
Q

Describe what part of the airway should be visible in the x ray

A
  • TRACHEA, BRONCHI VISIBLE (BRANCHING AT CARINA)

* TRACHEA PASSES TO RIGHT OF AORTA

14
Q

what is it when the trachea is pushed away

A
  • Due to an increase in volume or pressure in one side of the throax which pushes the treachea away from that side
15
Q

what can cause the trachea to be pushed away

A
  • Mass
  • Tension
  • Pneumothorax
16
Q

what is it when the trachea is pulled towards the abnormality

A
  • Due to a loss of volume/prssues in one hemithroax which pulls the traceha toward that side
17
Q

what can cause the trachea to move towards the abnormality

A
  • Collapse

- Consodildation

18
Q

describe how breathing is interpreted

A
  • Lungs assesed and described as zones
  • zones do not equate to lungs
  • Lung makring occupy enxtire zones
  • Full of air so should be dark
19
Q

when are pleura spaces visible

A
  • Pleura and plerual spaces only visible when there is an abnorality present
  • Lung marking should reach thoracic wall
20
Q

what is the place called where the diaphragm and lung meet and what does it look like when it is abnormal

A
  • costophrenic - blunted when it is abnormal
21
Q

what is the place called where the diaphragm and heart meet and what does it look like when it is abnormal

A

cardiphrenic angle – blunted when it is abnormal

22
Q

what circulations are made up of

A
  • Aoritc knuckle
  • Heart size
  • Heart borders – RA – right border and LV – left border
23
Q

what is the aortic knuckle and what does it look like when it is abnormal

A
  • Represents left lateral edge of the aorta – when the arota is benidng down and becoming the descendign aorta
  • Loss of definiction due to aneurysm and adjacent cosolidation
24
Q

describe the heart border and size

A
  • CTR = CARDIAC WIDTH : THORACIC WIDTH
  • > 50 % CONSIDERED ABNORMAL
  • LEFT HEART CONTOUR = LV
  • RIGHT HEART BORDER = RA
25
Q

what does the diaphragm look like when it is normal

A
  • RIGHT IS HIGHER THAN LEFT
  • WELL DEFINED CARDIO/COSTOPHRENIC ANGLES
  • STOMACH UNDERNEATH LEFT
  • LOOK ABOVE + BELOW
26
Q

what is everything else

A
  • BONES – FRACTURES, LYTIC LESIONS
  • SOFT TISSUE – ?HAEMATOMA
  • TUBES – NG
  • VALVES – ARTIFICIAL VALVE
  • PACEMAKER – BELOW LEFT CLAVICLE
  • LINES – ECG