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20 Cards in this Set
- Front
- Back
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Indications for CXR Examiniations |
Detecting alterations of the lung Direct to the appropriate therapy Evaluating the effectiveness of treatment Tube and catheter placement Progression of lung disease |
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Review of the thoracic imaging : Overview |
X ray beams poass through chest After passing through chest, beams strike film The more intense beams cause dark Air (lungs ) is less dense = black, while x rays absorbed by more dense tissue = white REsulting chest radiograph represents various hades of gray shadows |
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Review of thoracic imaging : overview |
4 different tissue densities are visible on normal chest radiograph :Air, fat, water and bone AIr (lung) absorbs x rays least (radiolucent Bone (ribs) absorb most x ray (radiopague) Fat and water shoadows are different degrees of gray |
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Review of thoracic imaging overview |
FIlm is now digital Digital films have advantages :Can be manipulated to enhace interpretation :Can be stored and retrieved quickly from any location/time :Can be copied, shared and transported quickly :Image quality does not deteriorate over time |
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Radiographic views |
Standard views :Posteroanterior, traditional department film :Lateral LAnteroposterior- portable film Special views :Lateral decubitus :Apical lordotic :oblique :Expiratory |
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Distance of object from xray tube |
Normal distance is 6 feet Closer to the x ray tube the greater the magnification oand distortion Because of the tendency to scatter, the beam will spread as distance from x ray tube increases |
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PA chest film |
PA usually dr office Film placed against patients chest High quality film with minimal magnification of heart shadow Later view: usually, left lateral due to less cardiac enlargement LL and LLL |
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In the PA projection the diameter of the heart should not exceed black of the chest |
half of the diameter |
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Cardiac to thoracic ratio |
Measure from the midline (spine_ to the right heart border and see whether that distance will fit into the piece of the lung field to the left side of the heart Measure at the widest point, should be no more than 1/2 the width of the thorax |
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AP chest film |
Indications for AP portable films :Evaluate the lung status :Evaluate lines and tubes :See results of invasive therapeutic maneutvers Taken with portable x ray machine in ICU X ray source is in front of the patient and film is behind patient Distance from x ray source to film is 4 feet |
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AP cchest film |
AP films are often more difficult to read because quality is not as good as PA film Heart shadow is more magnified with AP film since heart is closer to X ray source Rotation of patient is more likely |
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Lateral decubitus radiograph |
The lateral decubitus radiograph is obained by having the patient lie on the left or right side rather than standing or sitting in upright position The naming of the decubitus radiograph is determined by the side on which the patient lies :Thus a right lateral decubitus radiograph means that the patients right side is down |
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Apical lordotic |
45 degree angle from below looking up Looks at right middle lobe or apical areas |
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Oblique views |
turned 45 degrees to either side Helps to localize abnormality Used in lung perfusion scans |
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Lateral neck xray or thumb sign is for |
Epiglottitis |
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Ap NECK is for croup, steeple |
steeple |
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When is an expiratory film used |
Can help in identifying a small pneumothorax Upon exhalation the lung because more radiopaque The pneumothorax remains radiolucent |
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Approach to reading chest film |
Disciplined approach si needed First, patient match Second, evaluate quality of film (proper patient position, x ray penetration etc Third systematiaclly evaluate all anotomical structures seen on film following prescribed series of steps |
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Approach to reading cehst film |
Correct orientation of the film, the heart shadow should descent downward toward the right as the film is viewed on the view box |
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More approach |
Rotation is determined by locating the neck of the clavicles and verifying that the spine lies equidistant between them :Clavicles should be flat/ striaght side to side Penetration is determined by examining the spinal column through the cardiac shadow. The vertebral bodies should just barely be distinguishable, without obvjous dark spaces between them |
