Introduction to Chest X-rays

Flashcards covering the fundamentals of chest x-ray interpretation, including densities, common views, and basic anatomical findings.

CXR

Abbreviation for chest x-ray, also known as a radiograph, which serves as a quick diagnostic tool to see the internal structures of the lungs and heart.

PACS system

Individual hospital radiology databases where digital chest x-rays are stored for healthcare team access.

Radio opaque

A whiter appearance on film caused by dense tissue or structures absorbing more x-ray beams and preventing penetration to the cassette.

Radiolucent

A darker appearance on film caused by less dense structures, such as air, allowing more x-ray beams to penetrate and hit the cassette.

Metal

The most dense material appearing on x-ray; it shows as bright white (e.g., pacemakers, staples, or prosthetic replacements).

Bone

A density represented by white or gray on film, such as ribs, clavicles, or the spine; it is less dense than metal.

Fluid/Tissue

A density level representing muscle, blood-filled organs, or the heart; it appears gray on the radiograph.

Air

The least dense substance in the body, appearing most radiolucent (dark/black) on film (e.g., lung fields or stomach bubble).

Pneumothorax

An abnormal finding on a chest x-ray characterized by a black, radiolucent area where lung tissue has collapsed and is no longer visible.

PA view

Posterior to Anterior; the standard preferred chest x-ray view shot from $6\text{ feet}$ away with the patient standing and the anterior chest against the cassette.

AP view

Anterior to Posterior; the view used for portable chest x-rays shot from $3\text{ feet}$ away, often making the heart appear larger and the image less sharp.

Lateral view

A side-view chest x-ray used to delineate or separate structures from the anterior, middle, and posterior parts of the lungs.

Left lateral

The preferred lateral view because the heart is closest to the cassette, resulting in less beam scattering.

Lateral decubitus

A view where the patient lies on their side, used to confirm the presence and degree of pleural effusions or a pneumothorax.

Pleural effusion

Fluid collected in the pleural space; to detect this on a lateral decubitus film, the patient should lie with the affected side down.

Pneumothorax (Positioning)

Air collected in the pleural space; to detect this on a lateral decubitus film, the patient should lie with the affected side up.

Apical lordotic

An uncommon view shot upward at an angle while the patient stands or leans back to evaluate lesions in the apex of the lungs.

Anterior oblique

An uncommon view where the patient is angled at $45\text{ degrees}$ to separate the mediastinal structures.

Expiratory film

An x-ray taken during exhalation to compress lung parenchyma and make small amounts of air (pneumothorax) appear more clearly as black.

Gastric bubble

A small pocket of air at the top of the stomach seen on chest x-rays, sometimes referred to as an 'unborn fart.'

Mediastinum

The area in the middle of the chest containing the heart, great vessels, esophagus, and spine.

Diaphragm placement

On a normal chest x-ray, the right diaphragm sits approximately $2-3\text{ cm}$ higher than the left diaphragm.

Well-penetrated film

A high-quality chest x-ray where the vertebral discs and spaces between the vertebra are visible behind the heart.