Chest x-ray Interpretation
39905Clinical and Radiographic Findings in Lung Diseases
Atelectasis
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•Loss of lung volume is seen on the chest film
•Areas of white shadows are common
•Major structures may demonstrate displacement
•Elevation of a hemidiaphragm is common
Pneumothorax
x-ray
•Pleural line may be seen on the lateral part of the chest
•Shift of mediastinal structures may be seen with tension pneumothorax
Hyperinflation
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•Most often seen with asthma and COPD
•Large lung volumes seen on the chest film
•Increased anterior airspace seen on the lateral view
•Depressed hemidiaphragms common
•Small narrow heart seen with severe COPD
Interstitial Lung Disease
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•Most fibrotic lesions form in the lower lung fields
•An alveolar pattern is seen when alveoli begin to fill up with blood, pus, protein, or cells
•Air bronchograms may be seen with alveolar pattern
Congestive Heart Failure
Image result for congestive heart failure chest x ray
•Chest x-ray reveals redistribution of pulmonary vasculature to the upper lobes
•The width of the heart shadow exceeds half the width of the thorax on the chest film
•Kerley B lines are often present when pulmonary edema is a problem
Pleural Effusion
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•Blunting of the costophrenic angle
•Partially obscured diaphragm
•Whiteout of the involved side with large pleural effusion
•Lateral decubitus useful for recognition of small pleural effusions
Consolidation
Image result for consolidation chest x ray
•Minimal signs of volume loss
•Lobar pattern of whiteout common
•Homogeneous density late in the process
•Air bronchograms may be seen
Prompt
When interpreting chest x-rays, evaluating the fundamental structures of the thoracic cavity is important.
For this assignment, you will provide detailed responses to the following questions.
1.Describe each of the following x-ray abnormal patterns listed below. In your answer indicate the disease of which it is associated.
•Bat wing
•Kerley B lines
•Honeycomb appearance
•Ground glass appearance
•Air bronchograms
2. What is the optimal position of the tip of the endotracheal tube? What are 3 procedures you could perform at the bedside immediately after intubation to evaluate tube position before the CXR?
3. Case Study
Sam brings a 71-year-old man to the emergency department. He claims that her father has experienced breathing problems for many years, but now he’s worse. The patient is alert and has trouble completing sentences because of apparent shortness of breath and pursed-lip breathing. His temperature is 100.8o F; his respiratory rate is 28 breaths per minute, with diminished breath sounds. Low-flow oxygen is administered, and the patient appears to be in less distress. A chest radiograph reveals diaphragms that are lowered and flattened with blunted costophrenic angles, and possible presence of bullae.
•What disease process do these radiographic findings suggest? Explain.
You must cite at least three references in APA format to defend and support your position.
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