Cxr

Front 1

Less than full inspiration

Back 1

interstitial pulmonary edema, chronic interstitial lung disease, volume loss, cardiomegaly

Front 2

supine CXR

Back 2

redistribution of blood vessels to apices is more prominent - looks like venous hypertension seen in CHF

Front 3

Appropriate levels of inspiration

Back 3

Posterior 9th-10th

Front 4

Extrathoracic soft tissues

Back 4

neck, supraclavicular fossa, lateral chest wall soft tissue, pectoralis muscles, breast shadows

Front 5

Extrathoracic bony structures

Back 5

clavicle, scapula, humerus, acromioclavicular joint, glenohumeral joint

Front 6

Thoracic cage

Back 6

ribs - fractures, lytic/blastic lesions, rib notching, costal cartilage calcifications, vertebral column (spinous & transverse processes)

Front 7

Which diaphragm is usually higher?

Back 7

Right diaphragm

Front 8

Which side is the gastric air bubble on?

Back 8

Left

Front 9

What to examine in pleura?

Back 9

Pleural thickening, calcifications
Costophrenic angle
Minor fissure (thin line from R hilum to lateral chest wall)

Front 10

Mediastinum

Back 10

deviation? (pl effusion, PTX, atelectasis)
trachela air column - deviation? (should be to right)
carinal angle (widening - LAE, subcarinal adenopathy)

Front 11

What is aortopulmonary window?

Back 11

Between aortic arch and left pulmonary artery
If opacified - mediastinal adenopathy

Front 12

Which pulmonary artery is higher - left or right?

Back 12

Left is higher

Front 13

What parts of the lung field might you forget to look at?

Back 13

Apices, retrocardiac area, below the diaphragm

Front 14

In lateral view, does density incr or decr as go down the spine?

Back 14

Decrease

Front 15

Diaphragms on lateral view?

Back 15

Right should be higher than left, anterior portion of left is obscured by cardiac border

Front 16

Lateral trachea/bronchi

Back 16

RUL bronchus is higher than LUL bronchus

Front 17

Which ventricles form posterior heart border?

Back 17

Left atrium, left ventricle

Front 18

What is immediately anterior to LUL bronchus?

Back 18

right pulmonary artery

Front 19

Left pulmonary artery relationship to aortic arch?

Back 19

Immediately inferior (LPA is on top of RPA)

Front 20

Hilar enlargement is due to?

Back 20

Adenopathy (nodular/lobulated), vascular enlargement (smooth contours)

Front 21

Hilar enlargement unilateral

Back 21

primary lung cancer, TB, fungal, metastatic carcinoma, lymphoma

Front 22

HIlar enlargement bilateral

Back 22

pulmonary HTN, sarcoid, lymphoma, met carcinoma, TB/fungal, leukemia, silicosis

Front 23

Nodule v. mass v. nodular pattern

Back 23

nodule <3 cm, mass > 3m
innumerable, small/discrete round opacities 2-10 mm in diameter (ILD)

Front 24

Malignant causes of nodules

Back 24

lung carcinoma, met, carcinoid tumor, primary lung lymphoma

Front 25

benign causes of nodules

Back 25

infectious granuloma, hamartoma, round PNA, AV malformation, rheumatoid nodule, wegener's, abscess, pseudonodule

Front 26

Nodular pattern

Back 26

Sarcoidosis, miliary TB, early histiocytosis X (eosinophilic granuloma), silicosis, coal workers' pneumoconiosis, met lung disease, bronchioalveolar carcinoma

Front 27

Air bronchogram sign

Back 27

Air space disease
Air in bronchus surrounded by airless lung

Front 28

Air space disease pattern on CXR

Back 28

Pneumonia, PE, Hemorrhage

Front 29

Air space disease results from

Back 29

Water/pulmonary edema
Pus
Blood
Cells (bronchoalveolar carcinoma, lymphoma)
Lipoprotein (pulmonary alveolar proteinosis)

Front 30

Reticular pattern looks like

Back 30

mesh/net lines

Front 31

Reticular pattern examples

Back 31

Idiopathic pulmonary fibrosis
Pulmonary edema
Lymphangitic carcinomatosis
Asbestosis (Pneumoconiosis)
Sarcoidosis
Interstitial pneumonia
Collagen Vascular Disease
Eosinophilic grnuloma

Front 32

Pleural fluid accumulates where?

Back 32

Costophrenic angles

Front 33

supine film - ground glass, diffuse haziness

Back 33

pleural effusion

Front 34

Where can fluid go before costophrenic angles?

Back 34

Subpulmonic space

Front 35

Subpulmonic effusion

Back 35

elevated hemidiaphragm, lateral displacement of peak of hemidiaphragm

Front 36

Transudates

Back 36

CHF, cirrhosis, nephrotic syndrome

Front 37

Exudate

Back 37

neoplastic disease, infection, pulmonary embolism, collagen vascular disease, drug induced, pancreatic disease, hemothorax, chylthorax

Front 38

Mediastinal origin

Back 38

Mass effect on mediastinal structures
Sharp, SMOOTH margins
OBTUSE angles with adjacent lung

Front 39

anterior mediastinal mass ddx

Back 39

lymphoma, thymoma, teratoma (germ cell tumors), retrosternal thyroid/thyroid lesions

Front 40

middle mediastinal mass ddx

Back 40

lymphadenopathy, bronchogenic cyst, vascular abnomralities (aortic aneurysm), trachel tumors, esophogeal abnormalities (esophogeal tumor, hiatal hernia)

Front 41

posterior mediastinal mass ddx

Back 41

neurogenic tumors, esophogeal abnormalities (esophogeal tumor, hiatal hernia), vascular abnomralities (aortic aneurysm)

Front 42

Atelectasis

Back 42

loss of volume of lung (collapse)
- resorption (airway obstruction)
- passive/relaxation (intrathoracic abnormality impairs expansion of lung, leads to volume loss)
- adhesive (surfactant abnormalities)
- cicatrization (diffuse, infiltrative disease where volume loss is result of scarring process)

Front 43

Atelectasis radiographic finding

Back 43

displacement of fissures
parenchymal opacity (resorption of alveolar gas, accumulation of fluid within lung)
displacement of diaphgrams/mediastinum (towards affected side)
hyperinflation
hilar discplacement
approximation of ribs (get narrower in between)

Front 44

Lobar Atelectasis endobronchial obstructionddx

Back 44

Tumor, foreign body, mucoid impaction, stricture

Front 45

Lobar Atelectasis extrinsic obstruction

Back 45

LAD (malignant, benign), adjacent mass

Front 46

Multiple pulmonary nodules ddx

Back 46

metastatic disease
lymphoma
bronchioalveolar carcinoma
infectious - septic emboli, fungal, nocardia, myobacteria
wegener's, rheumatoid nodules, sarcoid
AVMs, silicosis