Chest imaging

Question 1

What is a standard chest radiograph view(s)

Answer 1

PA and lateral views

Question 2

When would we use a supine AP position chest image

Answer 2

• for patients who can’t stand

Question 3

What are the issues with Supine AP view

Answer 3

• makes the heart appear bigger
• pulmonary vasculature is altered

Question 4

What is lateral decubitus position assessing

Answer 4

• volume of pleural effusion
• demonstrates whether pleural effusion is stationary or mobile

Question 5

Why do we lay on side for pleural effusion

Answer 5

gravity dependent position

Question 6

What structures can we see on a normal PA chest

Answer 6

• Trachea
• vascular hilum
• aortic knob
• diaphragm

Question 7

Why are rotated chest images bad

Answer 7

• misaligns the lungs

Question 8

During what part of the breathe do we take a chest image

Answer 8

inspiration almost always

Question 9

Diaphragm sits between what ribs

Answer 9

ribs 9-10

Question 10

What is the difference in inspiration and expiration chest images

Answer 10

• inspiration is clearer and allows us to see more ribs
• expiration is more cloudy and you can’t see as much

Question 11

What is the difference between underpenetrated and overpenetrated

Answer 11

• underpenetrated: has less radiation
• overpenetrated: highly radiolucent because too much radiation

Question 12

What are the 3 things to evaluate radiograph quality

Answer 12

• Rotation
• Inspiration
• Penetration
  (RIP it!)

Question 13

What is the costophrenic angle

Answer 13

angle between the diaphragm and ribs

Question 14

What side of the diaphragm is more visible

Answer 14

• right side
• left side is blocked by the heart

Question 15

What does it mean if there is a lump or opacity blocking the costophrenic angle

Answer 15

need to investigate
- may be lower lobe pneumonia

Question 16

What should the size of the heart be

Answer 16

• should be slightly less than 50% of transverse dimension

Question 17

What is a mediastinal shift

Answer 17

trachea shifts to one side because of a collapsed lung
- usually see opacity on the collapsed lung side

Question 18

What does it mean if we have a very long dark field (can see more than 8-10 ribs)

Answer 18

hyperventilated
- emphysema = lots of air but not useable

Question 19

Define Barrel chest

Answer 19

• round bulging chest
• hyperventilation