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Patient Evaluation

Imaging Studies Chest XRay/Radiogram/Roentgenogram

QuestionAnswer
many pulmonary problems will be detected on a x-ray before their presence is detected by any other clinical examinations as; pneumothorax, foreign bodies, displaced tubes, etc.
Imaging Studies Chest X-Ray/ Normal X-Ray/Hemidiaphragms - both hemidiaphragms are rounded = dome shaped. - the right hemidiaphragm = slightly higher than left. - the right hemidiaphragm = at level 6th rib (anterior)
Imaging Studies Chest X-Ray/ Normal X-Ray/Trachea/Clavicle - trachea is midline, bilateral radiolucency, with sharp costophrenic angels. - clavicle should be level.
Imaging Studies Chest X-Ray/ Major Airway Patency the right lung should comprise 55% of the total lung volume and should appear larger than the left lung.
Imaging Studies Chest X-Ray/ Loss of Airway Patency the loss of airway is obvious EMERGENCY = - foreign body obstruction - edema= croup (epiglottis) - tracheal spasm - internal & external spasm - trauma leading to air leak
Imaging Studies Chest X-Ray/ Assessment of Major Airways done by evaluating the mediastinum X- Rays do not typically show the airway beyond mainstem bronchi.
Imaging Studies Chest X-Ray/ Anatomical Landmarks/Trachea - seen as a dark area midline. - tracheal shift = pathological problem - same size of vertebral column - major bronchi should NOT be narrow = bronchogenic carcinoma.
Imaging Studies Chest X-Ray/ Mediastinum - the area between the lungs where the heart, lungs ,lymphatics, blood vessels, major bronchi. - shifts with = pleural effusion and pneumothorax
Imaging Studies Chest X-Ray/A-P Diameter increased with COPD, barrel chest, hyperinflation
Imaging Studies Chest X-Ray/ Costophrenic Angles - angle made by the outer curve of the diaphragm and chest wall. - these angles are obliterated by pleural effusions.
Imaging Studies Chest X-Ray/ Diaphragm dome-shape = normal flattened = COPD hemidiaphragms shift down = pneumothorax on one side.
Imaging Studies Chest X-Ray/ Vascular Markings blood vessels, lymphatics, lung tissue= increased fluid
Imaging Studies Chest X-Ray/ Heart Shadow left ventricle = seen normally cardiomegaly (enlarged heart) CHF
Imaging Studies Chest X-Ray/ Soft Tissue tissue surrounding the chest and above in the neck subcutaneous emphysema = hyperlucency surrounding soft tissue.
Imaging Studies Positions/ Projections/ A-P AP projection to anterior, posterior = film behind the back
Imaging Studies Positions/ Projections/ P-A PA projection posterior, anterior = film in front touching chest
Imaging Studies Positions/ Projections/ Lateral Position - projection from either side right or left - adds a third dimension to structures viewed AP- PA films
Imaging Studies Positions/ Projections/Oblique Position - slanting or diagonal view - detects pleural effusion
Imaging Studies Positions/ Projections/ Apical Lordotic projection lung apices
Imaging Studies Positions/ Projections/ End Expiratory Film - taken at end- exhalation - detects small pneumothorax
Imaging Studies Positions/ Projections/ Endotracheal Tube - the tip of endotracheal tube position = below vocal cords - 2cm or 1 in above the carina. - same level aortic knob or aortic arch - clavicle too high
Imaging Studies Positions/ Projections/ Observe - observation and auscultation will quickly determine adequate ventilation before an x-ray.
Imaging Studies Positions/ Projections/Tracheostomy - do not pose the problem of intubation of one lung. but problems position in trachea.
Imaging Studies Positions/ Projections/ET, Tracheostomy Hyperinflation - the cuff should not extend over the end of the endotracheal or tracheostomy tube.
Imaging Studies Projections/Pacemaker - should be normally position in the right ventricle.
Imaging Studies Projections/ Pulmonary Artery Catheters - should appear in the right lower lung field.
Imaging Studies Projections/Central Venous Catheters - right or left subclavian or jugular vein - rest in the vena cava or right atrium of the heart.
Imaging Studies Projections/ Chest Tubes - should be located in the pleural space surrounding the lung.
Imaging Studies Projections/Nasogastric Tube - NG and feeding tubes should be positioned in the stomach 2-5 cm below the diaphragm.
Imaging Studies Projections/ Airway Narrowing/Neck X-Ray - a lateral x-ray is a valuable diagnostic tool for identifying obstruction in children (croup and epiglottis)
Imaging Studies Projections/ Airway Narrowing/Neck X-Ray/Croup - croup = laryngotracheobronchitis - viral disorder common in infants (subglottic) * x-ray findings - steeple sign - picket fence - pencil point
Imaging Studies Projections/ Airway Narrowing/Neck X-Ray/Epiglottis - a potential life- threatening inflammation (supraglottic) - bacterial infection - swollen aryepiglottic folds * lateral x-ray finding - thumb sign
Imaging Studies Projections/ Airway Narrowing/Neck X-Ray/Narrowed - airway can be narrowed by: - edema -secretions -tumors -aspirated foreign bodies - would be identified on chest x-ray or lateral x-ray
Imaging Studies Extrapulmonary Air defined = air found outside of lungs examples: - pneumothorax - pneumoperitoneum - pneumomediastnium - subcutaneous emphysema
Imaging Studies Radiolucent described = dark pattern diagnosis = normal for lungs
Imaging Studies Radiodense/Opacity described = white pattern , solid, fluid diagnosis = normal, for bones and organs
Imaging Studies Infiltrate described = any ill-define radiodensity diagnosis = atelectasis
Imaging Studies Consolidation described = solid white area diagnosis = pneumonia/ pleural effusion
Imaging Studies Hyperlucency described = extra pulmonary air diagnosis = COPD, asthma attack, pneumothorax (one side)
Imaging Studies Vascular Markings described = lymphatics, vessels, lung tissue diagnosis = increased = CHF = absent = pneumothorax
Imaging Studies Diffuse described = spread throughout diagnosis = atelectasis/pneumonia
Imaging Studies Opaque described = fluid, solid diagnosis = consolidation
Imaging Studies Bilateral described = on both sides
Imaging Studies Unilateral described = on one side
Imaging Studies Descriptions and Interpretations/Fluffy Infiltrates description = diffuse whiteness diagnosis = pulmonary edema
Imaging Studies Descriptions and Interpretations/Butterfly/Batwing description =infiltrate in shape of butterfly diagnosis = pulmonary edema
Imaging Studies Descriptions and Interpretations/Patchy Infiltrates description = scattered densities diagnosis = atelectasis
Imaging Studies Descriptions and Interpretations/Platelike Infiltrates description = thin- layered diagnosis =atelectasis
Imaging Studies Descriptions and Interpretations/Ground Glass description = reticulogranular diagnosis =ARDS/IRDS
Imaging Studies Descriptions and Interpretations/Honeycomb description = reticulogranular diagnosis =ARDS/IRDS
Imaging Studies Descriptions and Interpretations/Diffuse Bilateral diagnosis =ARDS/IRDS
Imaging Studies Descriptions and Interpretations/Air Bronchogram diagnosis = pneumonia
Imaging Studies Descriptions and Interpretations/Peripheral wedge-shape diagnosis = pulmonary embolus
Imaging Studies Descriptions and Interpretations/Concave superior interface/border diagnosis =pleural effusion
Imaging Studies Descriptions and Interpretations/Basilar Infiltrate with Meniscus diagnosis =pleural effusion
Created by: sukar