| Question | Answer |
| What can make a normal study look pathologic? | Underpenetration.
**Creates a flase brightness. |
| What type of Xray is more likely to pass through? | High |
| Know the 5 basic radiographic densities ***Test | 1.Air (black).
2.Fat (Dark Grey).
3.Soft tissue/fluid (light Grey).
4.Mineral (white).
5.Metal (bright white).
...Seriously... if you miss these, Ill punch you straight in the jejunum |
| What does MD PLOTS stand for? | 1.M: mediastinum.
2.D: diaphragms.
3.P: pleura.
4.L: lungs.
5.O: osseous structures.
6.T: trachea.
7.S: stomach. |
| What else can you add to MD PLOTS? | VITAMINS:
1.Vascular.
2.Infection.
3.Trauma.
4.Autoimmune.
5.Metabolic.
6.Inflammatory.
7.Neoplastic.
8.Structural. |
| What is a common occurance at the Aortic-pulmonic window? (space b/w aortic knob and pulmonary artery) | Adenopathy, it will no longer be indented. |
| Which hemidiaphragm SHOULD ALWAYS be higher? | R |
| Which hilum SHOULD ALWAYS be higher? | L.
**If no, pathologic |
| Know the lung lobes for the test*** | |
| Lower 1/2 of R lung on a PA view? | RML.
**Most common spot for silhouette sign |
| What does the RML sit right in from of? | The R Lower lobe.
**This is why you MUST get 2 CXR views. |
| How many CXR views should you get? | 2. PA and Lateral |
| On a PA CXR, where does the L Upper Lobe end? | It goes from the apex ALL THE WAY DOWN to the diaphragm.
**can cause a silhouette sign on the L side of the heart. |
| What can block pathology in the L lower Lobe on a PA CXR? | Diaphragm.
**It is behind the LUL, starting 1/3 down from the apex and goes below the diaphragm. |
| If you see something abnormal on a plain view CXR, what is the NEXT study you do? ***TEST*** ***TEST*** | Chest CT |
| What are the two types of disease you can see in the lungs on CXR? | 1.Airspace (alveolar) disease.
2.Intersitial disease.
***Know how to differentiate on the test. |
| What are 2 important signs you MUST KNOW FOR THE TEST that are associated with alveolar (airspace) disease? ***TEST | 1.Air bronchogram.
2.Silhouette sign (2 similar densities abutting eachother) |
| Alveolar or Interstital lung disease based on CXR findings: Cloud-like | Alveolar.
**means focal and acute |
| What is the most common alveolar lung disease? what is the most common cause? | Pneumonia. BACTERIAL |
| Alveolar or Interstital lung disease based on CXR findings: Pulmonary edema | Alveolar |
| Alveolar or Interstital lung disease based on CXR findings: Air bronchogram | Alveolar |
| Alveolar or Interstital lung disease based on CXR findings: Silhouette sign | Alveolar |
| Alveolar or Interstital lung disease based on CXR findings: line-like (linear, Kerly B lines) | Interstitial |
| Alveolar or Interstital lung disease based on CXR findings: Lungs look coarse, fine reticular, nodular, reticulonodular | Interstitial |
| What is Silhouette sign? give some examples of it | the border of a normally visible structure is obscured by adjacent pathology.
1.ex: RML pneumonia obscures the right heart border**.
2.ex: Lingular pneumonia obscures the left heart border**. |
| What is air bronchogram sign? | Occurs when blood, pus or fluid fills the alveoli providing a background such that air within bronchi becomes visible.
**The air bronchogram is the hallmark of alveolar lung disease |
| What three things can enter/fill the alveoli to cause Airspace disease? | 1.Blood (pulmonary contusion).
2.Pus (pneumonia).
3.Fluid (pulmonary edema). |
| Alveolar or Interstital lung disease based on CXR findings: Bat Wing/ Butterfly sign | Alveolar (pulmonary edema) |
| Alveolar or Interstital lung disease based on CXR findings: Large Hila, Normal heart, Sharp gutters, and indistinct interstitial space | Interstitial |
| What is the best way to interpret CXRs? | Compare to OLD films |
| CXR findings with COPD | 1.Hyperlucency.
2.Hyperinflation.
3.Flattening of the hemidiagphragms (FIRST SIGN).
4.Barrel Chest.
5.Rapid tapering of the vasculature.
6.Inc size of RETROSTERNAL CLEAR SPACE.
7.Bulla.
8.Bleb |
| What type of things tend to cause Interstitial disease? is it usually Acute or Chronic? | 1.Viral.
2.Chronic |
| Alveolar or Interstital lung disease based on CXR findings: consolidation | Alveolar |
| List the conditions that cause hyperinflation in the lungs | 1.Emphysema.
2.Asthma.
3.Bronchitis.
4.Foreign bodies.
5.ET tube in MSB.
6.Positive pressure ventilation. |
| Differentiate b/w a Bleb and a Bulla | 1.BULLA: coalescence or alveoli.
2.BLEB: focal air collection in pleural space.
**BULLA are much LARGER |
| are bullas or blebs prone to infections? | Bullas |
| What is another word for volume loss in the lungs? list the classic findings | Atelectasis:
1.Elevation of ipsilateral diaphragm.
2.Traction effect on trachea and mediastinum (pulls it towards that side).
3.Crowding of pulmonary markings |
| 4 causes of Atelectasis (volume loss) | 1.Airway Obstruction (mucous plug, tumor).
2.Airway Compression (pleural effusion).
3.Scarring.
4.Adhesion (Dec surfactant) |
