Types of chest images
Chest X-rays
CT
ultrasound
MRI
Chest imaging
Crucial in practice of pulmonary & critical care
2 views of chest xrays
AP (anteroposterior)
PA (posteroanterior)
Nuclear medicine
Radioactive
help confirm brain death
conform cancer spread
PET scan
ventilation-perfusion (V/Q)
4 types of tissue densities
air
bone
fat
soft tissues
radiolucent
Appears black
radiopaque
appears whites
PACA
picture archiving & communication system
Outpatient chest xray
unexplained dyspnea
severe persistent cough
fever and sputum production
postivite
inpatient chest xray
Placement of ET tubes
Placement of pulmonary artery catheter
Reading a chest xray
identify patient info
review the technique and quality of the image
systematically review the anatomical structures to assess their normality or abnormality
AP xray
usually done with a portable X-ray
sit up as much as possible (supine)
Anatomical structures seen on xrays
Bones
soft tissues
lungs
pleura
mediastinum
upper abdomen
lower back
types of CT scans
HRCT
PET scan
CT angiography
MRI (radio waves)
MRI
helps determine
no metal (i.e., plates or screws, vents)
ultrasound
blood
fluid
portable equipment
Pleura
thin membrane surrounding the lung (parenchyma)
2 thin pleural membranes (outer & inner pleural membrane)
Pleural effusion
no angle (costophrenic angle)
lateral decubitus
at least 175-200 mL of pleural fluid (loculation)
Categorized tansudate or exudate
hemothorax (blood in the pleural space)
empyema (infection)
Lung parenchyma
air sacs (alveoli)
interstitium (lungs)
disease involves both components