Interpretation of a Normal Xray Flashcards Preview

Y2S1 CARDIO. > Interpretation of a Normal Xray > Flashcards

Flashcards in Interpretation of a Normal Xray Deck (19)
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1
Q

What are some indications for a chest X-ray

A
  • Acute deterioration in SOB
  • Acute chest pain
  • Suspected malignancy
  • Pneumonia
  • Pleural disease (mesothelioma)
  • Peritonitis (erect for at least 10 mins pre image)
  • Chronic lung disease
  • Following invasive procedure e.g. central line, chest drain
2
Q

what are the two types of chest X-ray

A

PA AND AP

are they supine or erect

3
Q

what are the three stages of penetration

A

underexposed
well-exposed
over-exposed

4
Q

what’s important when looking at the rotation of an xray

A

look for asymmetry between trachea and clavicles etc

5
Q

what does it mean if a structure is too black

A

Increased translucency
• Air (gas)
• Loss of tissue density

6
Q

what does it mean if a structure is too white

A

Opacification
• Fluid
• Increased tissue e.g lymphadenopathy

7
Q

what if something is EXTREMELY white

A
Think hardware: pacemaker
ETT
NG tube
Sternal wiring 
prosthetic heart valves CVP line
chest drain
8
Q

Systematic Approach to Searching a CXR

A
A Airway
B Breathing
C Cardiac (heart)
D Diaphragm
E External Structures & Equipment
F Fat & soft tissue
G Great vessels
H Hidden areas
9
Q

airway

A
  • Check if trachea is straight • Aim to see carina (T4)

* Right main bronchus is more vertical, wider & shorter than the left main bronchus

10
Q

Breathing

A

• Check expansion
• Anterior 6th rib should cross dome
of right hemi-diaphragm • Under-expansion
• Over-expansion

11
Q

if you can’t see the lobes of the lung what can you use

A

upper zone
middle zone
lower zone

12
Q

Lung Markings

A
  • Opacity will increase from top to bottom

* Diminution of lung markings as you move out

13
Q

cardiac

A
  • Measure the heart
  • Should be <50% diameter of the chest
  • 1/3 should be visible to the right of the sternum (2/3 to the left)
14
Q

Diaphragm

A
  • Right hemi-diaphragm is usually one rib higher than the left
  • Identify the gastric bubble
  • Look below the right (and the left) hemi-diaphragm for air from a ruptured hollow abdominal viscus
15
Q

external structures, including hardware

A
Bones
• Ribs, thoracic spine, clavicles,
scapulae &amp; humeral heads
Medical devices
• Oxygen tubing
• Pacemakers / heart valves / sternotomy wires
• Chest drains
• NG tubes
16
Q

• Fat & soft tissues

A
  • Look for breast shadows

* Examine subcutaneous fat for signs of surgical emphysema

17
Q

over exposed breast shadows

A

implants ?

18
Q

Great vessels

A

• Look for aortic arch, pulmonary
arteries & veins in the mediastinum
• Look for calcium deposits in the elderly

19
Q

Hidden areas (or commonly missed)

A
  • Neck
  • Apices
  • Mediastinum: widening, adenopathy, mediastinal emphysema
  • Behind the heart
  • Costophrenic angle
  • Behind/below diaphragm
  • Soft tissues
  • Bones