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