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56 Cards in this Set
- Front
- Back
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How can you recognize the trachea and the main bronchi on a CXR?
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They are slightly darker against the other structures.
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What is the aortopulmonary window? Where is it on the CXR vs the CT?
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CXR: The notch between the aortic knuckle and the pulmonary trunk on the left upper side.
CT: between the two legs of the aorta |
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What abnormality can you look for in the aortic pulmonary window?
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Enlargement of the lymph nodes.
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How can you see where the azygous vein is on a PA CXR?
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It is the middle line of opacity down the vetebral column.
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Where are the paraspinal lines on a PA CXR?
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They are the outlines of either side of the vertebrae on a CXR.
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What can you identify with the paraspinal lines?
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Bone cancers.
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Where is the left cardiophrenic angle?
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Where the left atrium meets the diaphragm.
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What is Correra's line? What do they look like?
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The outline of our ribs. The look like the ridges of a shell due to the ribs.
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How is Correra's line different on pediatrics? Why?
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They are flatter because they do less chest breathing.
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On a lateral CXR, is our left or right main bronchus higher up? Why?
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Your left because it is at a less steep angle.
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On a lateral CXR, is our left or right hemidiaphragm higher up? Why?
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The left because of the spleen coming so far up.
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Is a CT scan on the same side that your are facing or the opposite?
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the opposite like in a CXR
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Where are you looking from on a CT?
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From the feet.
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Are the veins feeding into the superior vena cava or the main arteries coming off the aorta more anterior.
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The veins are more anterior. The arteries branching off the aorta go behind the veins.
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What two structures does the posterior junction line connect?
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The esophagus and the vertebral body.
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What is the pulmonary sulcus?
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In the CT view, this is the bottom part which would get air fluid levels in a pleural effusion.
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What happens at the anterior junction line?
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Where the pleura connect anteriorly
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Where are the lymph nodes in relation to the esophagus?
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They line the esophagus longitudinally
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What is the mnemonic to remember which structures are most superior in the right and left hilum?
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R BAV
Right: Bronchi, Artery, Vein L ABV: Left Artery Bronchi Vein |
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What symptoms can a pancoast tumor cause? What will it pinch?
Mnemonic? |
Horner's Syndrome because it pinches the superior sympathetic ganglion.
Symptoms: Ptosis, Anhydrosis, and Miosis PAM is HORNy |
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What are the two little dots on the ribs of a chest CT near either side of the manubrium?
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The internal thoracic arteries.
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What do the fissures look like in the CT?
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Nothing. they are dark and where there is no little lines.
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Are the pulmonary arteries or veins more superior?
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The arteries.
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How many pulmonary veins do we have feeding into the pulmonary trunk?
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4, 2 on each side.
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What are the two types of connective tissue disorders? What does this predispose them to?
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Marfan's Syndrome and Ehler-Danlos syndrome.
They are predisposed to aortic aneurysms |
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After your trachea ends, what is that large circular structure that is midline and above the vetebral body in the CT?
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The descending aorta
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Is the right side of the heart more anterior or the left side?
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The right. Think about the sternal tapping capabilities.
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What is that giant white spot that appears on the right anterior on a CT as you go inferiorly, but while you still have the heart visible?
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The top of the liver
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Is the stomach or the spleen more anterior?
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The stomach
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Where is Ewing's Sarcoma located?
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The lateral aspect of the ribs
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How can you identify a rib fracture on a CXR?
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Look for a step off where the rib line is not straight and continuous.
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What can cause a pleural effusion?
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Anything that causes inflammation or causes fluid to leak from the vessels to the outer intrapleural space.
ex.) cancer, pneumonia, hypoalbuminia |
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What is Beck's Triad?
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1. Decreasing arterial pressure
2. Increasing venous pressure 3. Decreaing breath sounds |
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What are two causes of Beck's Triad?
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1. Tension Pneumothorax - which will restrict blood flow into the heart
2. Cardiac Tamponade - heart is restrcited from filling up all the way and cannot do it's job. Backup ensues. |
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What is the left lingula? What does it look like?
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The thin lip of the superior left lobe that extends all the way to the bottom of the lung.
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What would pneumonia on the right middle lobe obscure? Would the other lobes obscure this?
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The right heart border.
No |
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What would pneumonia on either lower lobe obscure?
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The diaphragm.
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What happens to the retrocardial and retrosternal space in cardiomegaly?
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They would get smaller as the heart enlarges.
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What happens to the angle of your main bronchi when you have right ventricular hypertrophy?
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It gets wider
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Do your left and right atria overlap from a frontal view? What does this look like on the CXR?
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Yes. It looks more opaque in the CXR due to the double density effect.
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What is a pathological possibility when you see a raised diaphragm?
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Pneumoperitoneum, air in the abdomen lifting the diaphragm up.
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Which ventricle is more affected by a pericardial effusion (cardiac tamponade)? Why?
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The right. It doesn't have as strong walls to keep it open and also has a lot less pressure inside.
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What is pruning of the pulmonary arteries? What does it look like and what kind of patient may you find this in?
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Where there is blood back up in the pulmonary arteries. They look like stunted isoceles triangles of the pulmonary arteries off the hilum instead of the normal branching.
You will find this in people with pulmonary HTN like COPD patients. |
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What is saber sheath trachea
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On an AP CXR, the trachea appears to get thinner as you go inferior. (But it is actually getting wider in the lateral view)
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What is coarctation of the aorta?
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Stenosis of the aorta
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When will you see a collateral system of arteries off the aorta due to coarctation?
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When it is a gradual, chronic stenosis.
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What is the #3 sign for aortic coarction on a CXR? Why would this happen?
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Where you see the border of the aorta, pulmonary trunk, and aortic window bulge out into an outline of a "3" because the aorta is expanding from being backed up.
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How can you tell rib notching from coaraction apart from a step off from a rib fracture?
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It will only have the notch on the inferior border where the artery is whereas on a rib fx, you would have it superior and inferior to the rib.
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Does the esophagus sit slightly to the right or the left? Why is this advantageous?
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It starts out midline and bends towards the left because that is where the stomach is.
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What four things will cause indents of the esophagus you would normally see on a barium swallow?
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The aortic arch, the left atrium, the left main bronchus, and the esophageal hiatus (diaphragm)
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How would you tell the difference between a button battery and a coin on a CXR?
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The button battery will have a small inner concentric circle outline.
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How would you treat these two differently?
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You would let a coin just pass on it's own, but a battery requires surgical intervention because they will leak acid.
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What may cause esophageal varices? What is it?
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It is engorgement of the veins that may be caused by backup of blood flow due to portal hypertension of the liver.
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What is the main clinical symptom of esophageal varices? Why does this happen?
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Coughing up blood from the engorged veins that are prone to rupture from all the friction imposed on them.
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Do men or women have a wider bronchial angle?
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Women
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What is that giant thing on the right side of a newborn CXR? What is this sign called?
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The giant thymus gland before we lose it.
It is called Sail's sign. |
