Notes in chest x ray

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Status	Last Update	Fields
Published	09/08/2024	1. {{c1::trachea}}
Published	09/08/2024	2. {{c1::hilum (hila)}}
Published	09/08/2024	3. {{c1::lungs}}
Published	09/08/2024	4. {{c1::diaphragm}}
Published	09/08/2024	5. {{c1::heart}}
Published	09/08/2024	6. {{c1::aortic knuckle}}
Published	09/08/2024	7. {{c1::ribs}}
Published	09/08/2024	8. {{c1::scapulae}}
Published	09/08/2024	9. {{c1::breasts}}
Published	09/08/2024	10. {{c1::bowel gas}}
Published	09/08/2024	1. {{c1::clavicles}}
Published	09/08/2024	this is an {{c1::anterior}} view
Published	09/08/2024	this is a {{c1::lateral}} view
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Published	09/08/2024	Most common chest x-ray order is 2 view chest x-ray, {{c1::PA}} and {{c2::Lateral}}
Published	09/08/2024	{{c2::PA}} view: Taken standing with detector {{c1::in front}} of patient
Published	09/08/2024	{{c1::AP}} view: typically taken {{c2::portably}} with detector {{c3::behind}} the patient
Published	09/08/2024	On {{c1::AP}} projection, heart appears {{c2::enlarged}} because the heart is relatively farther from the detector, and also becau…
Published	09/08/2024	{{c1:: Lateral}} view: taken with patient standing upright with {{c2::left}} shoulder against the detector, arms {{c3::raised…
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Published	09/08/2024	ALWAYS check the {{c1::Patient ID}} & {{c1::Date }}
Published	09/08/2024	•Look for {{c1::prior studies}} for comparison
Published	09/08/2024	PIER stands for: {{c1::Position   Inspiration   Exposure   Rotation/Angulation}}and should be used when assessing for {{c2::a…
Published	09/08/2024	Proper Positioning ensures that the {{c1::thorax}} is centered with complete views of the {{c2::apices}} and {{c3::costophrenic angles}}
Published	09/08/2024	adequate patient inspiration is indicated by {{c1::5-6 anterior}} ribs ({{c3::further away}} in image) and {{c2::8-9 posterior}} ribs (seen {{c4::clos…
Published	09/08/2024	Exposing the patient/film to an adequate level will allow for the {{c1::thoracic spine}} to be viewed through the {{c2::heart shadow}}-{{c5::Under}}-p…
Published	09/08/2024	the right is an example of {{c1::under}}-penetrated.the left is an example of {{c1::over}}-penetrated.
Published	09/08/2024	rotation:When x-ray beams are not directly perpendicular, the images will appear {{c1::distorted}} Look for symmetry between the {{c2::clavicular hea…
Published	09/08/2024	Systematic Approach to Reading Chest X-rays A        {{c1::Airway}}  B        {{c2::Bones}…
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Published	09/08/2024	A - Airway•Look at the {{c1::trachea}} and its {{c1::branches}} •Is it {{c2::patent}}? Any {{c3::narrowing}}? •Is it {{c…
Published	09/08/2024	B - Bones Look at all the visible bony structures: 6 •{{c1::Clavicles}} •{{c2::Ribs}} •{{c3::Sternum}} •{{c4::Scapulae}} •{{c5::Vertebrae}} •{{c6…
Published	09/08/2024	C - Cardiac Look at the {{c1::size}}, {{c2::shape}}, and {{c3::location}} of the heart  Normal Cardiac size ◦ < {{c4::50}}% PA…
Published	09/08/2024	D - Diaphragm•Follow the {{c1::outline}} of the diaphragm, should be {{c1::smooth}} •The RIGHT hemidiaphragm should be {…
Published	09/08/2024	E&F  - Equal lung Fields•Normal chest x-ray should have equal {{c1::radiolucency}} between left and right lungs and upper and lower fiel…
Published	09/08/2024	G – Gastric Bubble•You should see an {{c1::air bubble}} within the gastric {{c2::fundus}} underneath the {{c3::left}} he…
Published	09/08/2024	H - Hilum & Mediastinum • Hilum: contains the main {{c1::bronchus}} and {{c2::pulmonary arteries}} •Look for {{c3::masses}}&nb…
Published	09/08/2024	•{{c1::Lobar}} pneumonia: Confined to a single lobe, may see a very prominent fissure with air bronchograms
Published	09/08/2024	•{{c1::Multifocal}} pneumonia: involves more than one segment of the lung and rarely has {{c2::air bronchograms}}
Published	09/08/2024	•{{c1::Interstitial}} pneumonia: typically viral or PCP; involves the airway walls and septa of the alveoli, seen as a fine, reticular pattern
Published	09/08/2024	•{{c1::Round}} pneumonia: typically H flu, more common in children; lower lobes and posteriorly
Published	09/08/2024	{{c1::•Cavitary}} pneumonia: typically TB; usually in the {{c2::upper}} lobes with {{c3::thin}}-walled cavity without an {{c4…
Published	09/08/2024	•{{c1::Aspiration}} pneumonia: most often in the dependent portion of the lung (RLL vs posterior portion)
Published	09/08/2024	{{c1::lobar}} pneumonia
Published	09/08/2024	{{c1::Multifocal}}Pneumonia
Published	09/08/2024	{{c1::Atypical/Interstitial}} Pneumonia
Published	09/08/2024	{{c1::Round}}Pneumonia
Published	09/08/2024	{{c1::Cavitary}} Pneumonia
Published	09/08/2024	{{c1::Aspiration}} Pneumonia
Published	09/08/2024	{{c1::ATELECTASIS}} is:•Temporary collapse of the alveoli •Small volume {{c2::linear}} shadows, usually {{c3::peripherally}} or at…
Published	09/08/2024	{{c1::CARDIOMEGALY}} is: Enlarged cardiac silhouette ◦ > 50% PA diameter ◦> 60% AP diameter Commonly seen with CHF, cardiomyopathy HT…
Published	09/08/2024	{{c1::PLEURAL EFFUSION}}
Published	09/08/2024	{{c1::PLEURAL EFFUSION}}:•Collection of fluid between the visceral and parietal pleura (potential space) •Appearance will change based on positioning,…
Published	09/08/2024	{{c1::PULMONARY EDEMA}}:Indistinct/patchy airspace densities •Usually centrally located •May have associated pleural effusion •Can occur more slowly o…
Published	09/08/2024	Kerley B lines are seen in {{c1::pulmonary edema}}: horizontal lines in the lung periphery that extend to the pleural surface. They denote …
Published	09/08/2024	{{c1::PNEUMOTHORAX}}:  •Air in the pleural space, causing collapse of the associated lung tissue •Identified by an absence of {{c2::lung mar…
Published	09/08/2024	{{c1::TENSION PNEUMOTHORAX}}:• Air continues to leak into the pleural space causing complete collapse of the lung and increased intrathoracic pressure…
Published	09/08/2024	Pneumothorax on Ultrasound•Use the {{c1::linear}} probe, placed on the anterior chest wall, {{c4::2nd}} ICS, MCL •Orient the prob …
Published	09/08/2024	Pneumothorax on Ultrasound•Using M mode, a normal lung will create “{{c1::waves on a beach}}” •A PTX will create a “{{c2::Barcode Sign}}”
Published	09/08/2024	{{c1::COPD}}:•{{c2::Hyperinflation}} of the lungs •{{c2::Flattening}} of the diaphragms •Increased retrosternal “{{c2::clear space}}” •Promi…
Published	09/08/2024	{{c1::COPD}}
Published	09/08/2024	{{c1::COPD}}
Published	09/08/2024	{{c1::PULMONARY EMBOLISM}}
Published	09/08/2024	{{c1::PULMONARY EMBOLISM}} {{c1::PE}} → clot present in the pulmonary vasculature, may have formed distally and then traveled and lodge…
Published	09/08/2024	•{{c1::Hampton’s Hump}}: Wedge-shaped peripheral air space disease (infarcted area of lung). caused by pulmonary infarction and no…
Published	09/08/2024	•{{c1::Westermark Sign}}: the distal collapse of the pulmonary vessel leading to increased lucency;  an area of lung parenchy…
Published	09/08/2024	•{{c1::Knuckle/Fleischner Sign}}: a prominent pulmonary artery caused by vessel distention due to a large pulmonary embolus&n…
Published	09/08/2024	GOLD STANDARD for diagnosing PE → {{c1::CT Angiography of the Chest}}
Published	09/08/2024	{{c1::PE}}
Published	09/08/2024	{{c1::PE}}
Published	09/08/2024	But what if the patient can’t have IV contrast for a CT? → {{c1::VQ SCAN}} which is the second line eval tool for a PE
Published	09/08/2024	a {{c1::VQ Scan}} is a radioactive administration examining ventilation and perfusion, especially evaluating for a mismatch
Published	09/08/2024	Chest Radiology: CT-Can give greater details on ◦{{c1::Pleural effusion}} ◦{{c2::Pneumonia}} ◦{{c3::Masses}} ◦{{c4::Lymphadenopathy}} -Great fo…
Published	09/08/2024	{{c1::Free Air Under Diaphragm}}
Published	09/08/2024	{{c1::Diaphragmatic Rupture}}
Published	09/08/2024	Widened Mediastinum: concern for {{c1::aortic dissection}} or {{c1::injury}}, typically < 8 CM on CXR
Published	09/08/2024	{{c1::Pneumomediastinum}}: {{c2::free air}} in mediastinum, causes: tracheobronchial perforation with gas tracking, perforation of esophagus (Boerhaav…
Published	09/08/2024	Free Air → indicative of a {{c1::perforated viscous}}
Published	09/08/2024	{{c1::Diaphragmatic Rupture}} → due to significant trauma, will see disruption of smooth diaphragm borders and gastric bubble and other abdominal…
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