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33 Cards in this Set
- Front
- Back
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color & what to look for:
1. Ca++ 2. water/soft tissue 3. fat 4. air |
1. white; manifestation of trauma
2. gray; mediastinum & cardiac silhouette 3. dark gray; not useful in CXR 4. black; air in lungs |
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mediatinum/hila
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1. sup. mediastinum formed by great vessels (veins/arteries coming of arch)
2. narrow w/ no extra soft tiss 3. concav @ aortic arch and pulm trunk |
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lateral view
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tracheal air column
aorta anterior: R pulm aa/R vent posterior: L pulm aa/L atrium |
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mediastinal masses
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- XR then CT scan
- use IV contrast unless CI to distinguish nL from abnL |
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ddx for mediastinal masses?
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- tetroma
- thyroid mass-goiter - thymoma - lymphoma |
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pleura/diaphragm
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- pneumothorax - air
- effusion/hemothor - fluid - pleural masses/tumors/mets - calcif (asbestosis, lung ca, mesothelioma) |
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silhouette sign
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- use differences in densities to visualize structures on XRs
- if densities are same, borders obscured |
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US
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can be used for pleural effusions if probe b/w ribs
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consolidation
--ddx |
opacity due to filling of alveoli
--blood (hemorrhage), pus (bacT PNA), fluid (pulm edema) |
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hallmark of consolidation?
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air bronchograms
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lung locations a/w structures in thorax:
RML RLL LLL Lingua LUL |
RML - R cardiac border
RLL - R hemidiaphragm LLL - L hemidiaphragm lingua - L cardiac border LUL - mediastinum |
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pleural effusion v. consolidation
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consolidation - air bronchogram
pleural effusion - blunting costophrenic angle; L lateral decubitis shows fluid movement - consolidation won't move w/ LLD view |
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interstitial lung ds (pulm parenchymal ds)
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- linear/reticular density
- linear density in peripheral - advanced = honeycombing |
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how should CT be configured w/ interstitial lung ds?
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1 mm slices every 10mm vs. 5-7mm thick slices
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pleural effusion v. consolidation
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consolidation - air bronchogram
pleural effusion - blunting costophrenic angle; L lateral decubitis shows fluid movement - consolidation won't move w/ LLD view |
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distribution of interstitial lung ds:
basilar |
- collagen vasc ds
- asbestosis (lower lung base) v. silicosis (upper lobes) - drug tox (lower lung base) - chronic asp. - idiopathic pulm fibrosis |
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interstitial lung ds (pulm parenchymal ds)
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- linear/reticular density
- linear density in peripheral - advanced = honeycombing |
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bibasilar dist. of interstitial lung ds w/ esophageal abnL
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scleroderma
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nodule vs. mass
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nodule = <2 cm
mass = >2cm |
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- 1 nodule
- coin lesion -- ddx |
- primary lung ca
- lung apex (get apical lordotic view) - neoplasm, infxn/inflamm, vascular -- compare w/ old XR; if stable for 2 yrs = benign |
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how should CT be configured w/ interstitial lung ds?
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1 mm slices every 10mm vs. 5-7mm thick slices
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distribution of interstitial lung ds:
basilar |
- collagen vasc ds
- asbestosis (lower lung base) v. silicosis (upper lobes) - drug tox (lower lung base) - chronic asp. - idiopathic pulm fibrosis |
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multiple b/L nodules?
-ddx |
mets
- septic emboli (peripherally and cavitary w/ air density), histioplasmosis |
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MRI for pulm parenchymal ds?
what's better? what does PET do? |
- MRI not good (no protons)
- CT (primary lung lesion will not respect surround tissue) --+400H = Ca++ (benign calcified granuloma) - pet = hypermetabolic state |
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atelectasis
- v. consolidation |
vol loss collapse
- atelectasis will have volume loss - could be caused by benign PNA to endobronchial lesion to foreign body |
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airway ds
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brocheictasis easy to see
- abnL dilation of bronchi - wider as more peripheral |
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emphysema
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- dec lung density
- inc lung vol - flat hemidiaphragm - inc AP diameter |
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CHF --> ---> few steps down
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- pulm venous HTN
- interstital edema - alveolar edema |
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interstitial edema
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- linear densities (lower lobes)
- Kerley b lines (parallel to each other; perpendicular to pleura; at lung base) |
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ground glass opacity
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- b/w interstital and alveolar edema
- look for dist of opacities |
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b/L symmetrical w/ peri hilar central distribution
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- pulm edema
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PE
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doppler US
- gray = thrombus |
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V/Q scan
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- Q = perfusion
- V = ventilation --> mismatch would be seen as segmental perfusion defect d/t the thrombus impeding blood flow |
