Learning Radiology Chapter 2 - Recognizing Normal Pulmonary Anatomy

Fill-in-the-blank flashcards covering technical adequacy, normal anatomy, and key diagnostic cues for chest radiography and CT.

On an adequately _ chest radiograph, you should be able to see the spine through the heart.

penetrated

An adequate inspiratory effort shows at least _ posterior ribs above the diaphragm.

eight to nine

Underpenetrated (too light) studies may obscure the _ lung base and spuriously accentuate lung markings.

left

Overpenetrated (too dark) studies may mimic or pneumothorax.

emphysema

The spinous process should fall equidistant between the medial ends of the when the patient is not rotated.

clavicles

Portable AP films magnify the slightly compared with standard PA films.

heart

Semi-upright patients often produce an apical _ image that distorts normal anatomy.

lordotic

Virtually all lung markings on a chest x-ray represent pulmonary .

blood vessels

In the upright position, pulmonary vessels are normally _ (larger/smaller) at the bases than at the apices.

larger

On the frontal view, the fissure is usually visible on the right but has no left-sided counterpart.

minor (horizontal)

The five key areas to inspect on the lateral chest radiograph are the retrosternal clear space, hilar region, fissures, thoracic spine, and .

diaphragm/costophrenic sulci

Filling-in of the retrosternal clear space on the lateral view suggests an anterior _ mass or adenopathy.

mediastinal

Soft tissue of the patient’s _ can falsely appear to fill the retrosternal clear space if they are not raised.

arms

A discrete, lobulated mass shadow in the hilar region on the lateral view indicates possible hilar or tumor.

adenopathy

Fluid or fibrosis can cause of a fissure, making it thicker than a fine pencil-thin line.

thickening

On the lateral view, the thoracic spine should appear progressively _ (darker/lighter) from shoulder to diaphragm.

darker

Loss of vertebral body height with depression of the superior endplate suggests a(n) __ fracture, often from osteoporosis.

compression

The hemidiaphragm is usually slightly higher and visible in its entirety from front to back on the lateral view.

right

The left hemidiaphragm becomes obscured anteriorly by the _.

heart

Approximately ____ mL of pleural fluid will blunt the posterior costophrenic angle on a lateral projection.

75

Blunting of the lateral costophrenic angles on the frontal view usually requires about mL of pleural fluid.

250 to 300

CT lung windows are optimized to evaluate parenchyma and bronchial anatomy.

lung

CT mediastinal windows best display the mediastinum, hila, and structures.

pleural

The space beneath the aortic arch and above the pulmonary artery is called the window, a common site of lymphadenopathy.

aortopulmonary

On CT, the pulmonary _ is normally larger than its accompanying bronchus; reversal suggests bronchiectasis.

artery

Only aerated lung should be seen posterior to the ___; soft tissue there raises concern for tumor or nodes.

bronchus intermedius

The major fissure separates the lower lobe from the upper (and middle on the right) and courses from T5 to a point a few centimeters behind the .

sternum

The minor fissure lies horizontally at about the level of the _ anterior rib on the right.

fourth

In the coronal CT view, an avascular zone marks the location of the _ fissure.

major

The lingula is the left-sided analog of the lobe.

middle

Maximum-intensity projection (MIP) reconstructions enhance visualization of on CT angiography.

pulmonary vessels (or vascular structures)

The trachea normally measures about ____ cm in diameter and appears oval on CT.

2

The thoracic spine should have rectangular vertebral bodies with endplates that remain to each other.

parallel

A lateral chest radiograph showing the lower thoracic spine becoming whiter instead of darker indicates the “_ sign,” often due to lower-lobe pneumonia.

spine

Adequate chest-x-ray technique is judged by five parameters: penetration, inspiration, rotation, , and angulation.

magnification

You only see what you look for, and you only look for what you .

know