Thoracic Imaging

Question 1

CXR and CT can see

Answer 1

solid tissue- appear white
air filled space- appear dark

Question 2

MRI

Answer 2

use magnets and radio frequency pulses

Question 3

ultrasound

Answer 3

use high frequency sound waves reflected from tissue

Question 4

Nuclear medicene imaging

Answer 4

radioactive medication is injected then picked up with a gama camera

Question 5

conditions we can use imaging for

Answer 5

chest infection
respiratory failure
adult respiratory distress syndorme
pulmonary embolisim
trauma

we can also see diseases

Question 6

chest X ray used for

Answer 6

diagnosis
pre op assessment
check correct position of medical therapy

Question 7

Chest X ray

Answer 7

non-invasive
low radiation investigation

Question 8

limitation of Chest X-ray

Answer 8

provides 2D view of complex 3D

requires multiple chest x-RAY

Question 9

PROCESS OF CHEST X-ray

Answer 9

taken Posterior anterior view

rays past P to A with plate in front of pateint

Question 10

advantage of Lateral chest x-ray

Answer 10

shows heart in greater detail

Question 11

use of A-P Chest X-ray

Answer 11

when patient is unable to stand or can’t go to radiology

Question 12

technical details of Chest X-ray

Answer 12

name/ date/ time/ MRN
side marker= PA/ AP
LEFT/RIGHT

Question 13

Image quality of chest X-ray

Answer 13

rotation/ alignment
look at medial ends of clavicle in terms of spinous process

level of inspiration- should be taken at full inspiration- anterior ribs 5-6 posterior 9-10 with diaphragm

Question 14

underexposed vs overexposed

Answer 14

under- whiter/ unable to see IV disc

over- blacker/ loss of lung markings

Question 15

diaphragm on a chest X-ray

Answer 15

should be domed
costophrenic and cariophrenic angles clear and acute
right hemi should be higher than left
if it is raised on the paralysed/ lower lobe collapse/ low lung volume
if it is low- hyperinflation/ gas in pleural space

Question 16

trachea on X-ray

Answer 16

midline
bifurcates at carina t5-t7

Question 17

hilarious regions on x ray

Answer 17

pulmonary arteries/ veins, bronchi, lymph nodes

Question 18

absent of Lung Markings in Chest X-ray

Answer 18

absent in pneumothorax

Question 19

extra shadowing of lung fields

Answer 19

pneumonia
collapse
cancer or tumour

Question 20

3 types of Chest CT

Answer 20

standard- contrast used

CTPA- looking for blood anomalies

High resolution- no contrast used - small sections

Question 21

advantages of CT

Answer 21

3d images
greater diagnostic accuracy
better imaging of structures

Question 22

disadvantages of CT

Answer 22

cost
access
radiation dose is greater
ct scan contrast can be bad on kidneys

Question 23

silhouette sign

Answer 23

loss- if area of lung becomes collapsed or consolidated as less air in there

BECOMES MORE WHITE

Question 24

loss of L heart border

Answer 24

Lingua is affected

Question 25

loss of R heart border

Answer 25

RML is affected

Question 26

loss of diaphragm border

Answer 26

lower lobe is affected

Question 27

air bronchogram

Answer 27

where air-filled bronchi are made visible by opacification of surrounding alveoli something other than air fills alveoli e.g pus/ blood

Question 28

loss of volume and increased density

Answer 28

lung becomes more white structures move towards area of collapse

Question 29

consolidation

Answer 29

alveoli filled with fluid lung becomes solid and more white because air filled spaces filled with fluid

Question 30

hyperinflation

Answer 30

increased blackness- lung has more air increased volume- low flat diaphragm elongated heart -

Question 31

bullae

Answer 31

numerous thin walled, air containing structures

Question 32

acute pulmonary oedema

Answer 32

fluid accumulation because- heart failure/ sepsis/ drowning features- increased opacity/ septal lines/ large heart/ pleural effusions

Question 33

pleural effusion

Answer 33

increased opacity blunting of costophrenic angle meniscus sign

Question 34

tension pneumothorax

Answer 34

air build up usually due to a lung laceration shift of structures

Question 34

pneumothorax

Answer 34

air in pleural space lung edge visible area increased blackness

Question 35

subcutaneous emphysema

Answer 35

areas of increased blackness