Resp Radiology - Maki
Help!
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| What can make a normal study look pathologic? | Underpenetration.
**Creates a flase brightness.
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| What type of Xray is more likely to pass through? | High
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| 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
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| 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.
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| 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.
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| 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.
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| Which hemidiaphragm SHOULD ALWAYS be higher? | R
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| Which hilum SHOULD ALWAYS be higher? | L.
**If no, pathologic
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| Know the lung lobes for the test*** |
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| Lower 1/2 of R lung on a PA view? | RML.
**Most common spot for silhouette sign
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| What does the RML sit right in from of? | The R Lower lobe.
**This is why you MUST get 2 CXR views.
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| How many CXR views should you get? | 2. PA and Lateral
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| 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.
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| 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.
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| If you see something abnormal on a plain view CXR, what is the NEXT study you do? ***TEST*** ***TEST*** | Chest CT
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| 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.
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| 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)
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| Alveolar or Interstital lung disease based on CXR findings: Cloud-like | Alveolar.
**means focal and acute
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| What is the most common alveolar lung disease? what is the most common cause? | Pneumonia. BACTERIAL
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| Alveolar or Interstital lung disease based on CXR findings: Pulmonary edema | Alveolar
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| Alveolar or Interstital lung disease based on CXR findings: Air bronchogram | Alveolar
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| Alveolar or Interstital lung disease based on CXR findings: Silhouette sign | Alveolar
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| Alveolar or Interstital lung disease based on CXR findings: line-like (linear, Kerly B lines) | Interstitial
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| Alveolar or Interstital lung disease based on CXR findings: Lungs look coarse, fine reticular, nodular, reticulonodular | Interstitial
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| 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**.
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| 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
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| What three things can enter/fill the alveoli to cause Airspace disease? | 1.Blood (pulmonary contusion).
2.Pus (pneumonia).
3.Fluid (pulmonary edema).
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| Alveolar or Interstital lung disease based on CXR findings: Bat Wing/ Butterfly sign | Alveolar (pulmonary edema)
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| Alveolar or Interstital lung disease based on CXR findings: Large Hila, Normal heart, Sharp gutters, and indistinct interstitial space | Interstitial
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| What is the best way to interpret CXRs? | Compare to OLD films
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| 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
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| What type of things tend to cause Interstitial disease? is it usually Acute or Chronic? | 1.Viral.
2.Chronic
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| Alveolar or Interstital lung disease based on CXR findings: consolidation | Alveolar
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| 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.
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| 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
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| are bullas or blebs prone to infections? | Bullas
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| 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
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| 4 causes of Atelectasis (volume loss) | 1.Airway Obstruction (mucous plug, tumor).
2.Airway Compression (pleural effusion).
3.Scarring.
4.Adhesion (Dec surfactant)
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