Chest X-ray

Question 1

A

Answer 1

Alignment
· Look at angle of clavicle
· Should be equally bilateral
· Rotation could indicate poor patient position
·
· Trachea should be central not shifted
· Towards affected side = pneumothorax, atelectasis
· Away from affected side = pleural effusion, cancer
·
· Vertebral body and spinous process visible, should be centrally located

Question 2

B

Answer 2

Bone (soft tissue)
· Look for fractures
· Soft tissue - any subcutaneous emphysema

Question 3

C

Answer 3

Cardiac
· Approx 2/3 left, 1/3 right
· 50% of the lung field is covered by the heart on PA
· 60% of lungs field is covered by heart on AP film
· Look at the shape
· Any shadows around heart border (pulmonary oedema)
· Cardio phrenic angles (border between heart and diaphragm)

Question 4

D

Answer 4

Diaphragm
· X2 domed hemidiaphragms
· Right slightly higher than left - because of liver sitting higher
· Costophrenic angles
· Tenting (volume loss)
· Flattening (hyperinflation)

Question 5

E

Answer 5

Expansion
· Count anterior ribs
· 5-7th anterior rib should intersect middle of right hemidiaphragm
· Less than 5 ribs indicates incomplete inspiration
· More than 7 ribs suggests lung hyper-extension

Question 6

F

Answer 6

Lung fields
· Hilar markings consisting of pulmonary and bronchial vasculature
· If hilar can be seen, the lung field is clear
· Lung markings should extend to peripherals of lung field

Hilar is where artery and veins exit

Question 7

G

Answer 7

Gadgets
* anything in chest wall
* pacemarker, stitches

Question 8

What colour is air

Answer 8

Black