Xray exam review

Here is a clear, exam-ready study guide based exactly on what you listed for RES 131 – X-ray Exam Review. I organized it by section and focused on definitions, indications, and “testable” points for multiple-choice and T/F questions.

RES 131 – X-RAY EXAM STUDY GUIDE

50 Questions | Multiple Choice & True/False

GENERAL X-RAY PRINCIPLES

Why RTs Review X-ray Films

  • Confirm correct diagnosis

  • Assess patient status and progression

  • Verify proper placement of tubes/lines

  • Evaluate effectiveness of treatment

Indication for Chest X-ray

  • Respiratory distress

  • Suspected pneumonia, pneumothorax, effusion

  • Tube/line placement

  • CHF, pulmonary edema

  • Trauma

Radiolucent vs. Radiopaque

  • Radiolucent: Allows x-rays through → appears black

    • Air, lungs

  • Radiopaque: Blocks x-rays → appears white

    • Bone, metal, fluid

Overexposed vs. Underexposed Film

  • Overexposed: Too dark → excess radiation

  • Underexposed: Too white → insufficient radiation

“Gray Pattern” on X-ray

  • Represents soft tissue or fluid

  • Indicates infiltrate, edema, pneumonia

Clavicles & Spine Form a “T”

  • Indicates proper patient positioning

  • No rotation of chest

Types of Density

  • Bone: White (high density)

  • Fat/Soft Tissue: Gray

  • Air: Black

Systematic Review of X-rays

FIRST thing to check:

  • Patient name, date, time, and orientation
    Then:

  • Airway

  • Breathing

  • Circulation

  • Devices/lines

  • Lung fields

Causes of Tracheal Shift

  • Toward affected side:

    • Atelectasis

  • Away from affected side:

    • Tension pneumothorax

    • Large pleural effusion

    • Tumor

Immediate Treatment for Tension Pneumothorax

  • Needle decompression

  • Followed by chest tube placement

AP vs. PA & LATERAL DECUBITUS FILMS

AP (Anteroposterior)

  • Portable / ICU patients

  • Heart appears larger

  • Shorter distance: 40 inches

  • Used when patient cannot stand

PA (Posteroanterior)

  • Standard chest x-ray

  • Best image quality

  • Heart size more accurate

  • Distance: 72 inches

  • Patient standing upright

Lateral Decubitus

  • Patient lying on side

  • Used to detect:

    • Pleural effusions

    • Air-fluid levels

  • Affected side down for fluid

Best Patient Position

  • PA upright

  • Full inspiration

Good Lung Expansion

  • 10 posterior ribs visible

  • or 6 anterior ribs

FILMS TO REVIEW (9)

Pneumothorax

  • Air in pleural space

  • Black area with absent lung markings

  • Lung collapse

Pleural Effusion

  • Fluid in pleural space

  • White opacity

  • Blunted costophrenic angle

Atelectasis

  • Lung collapse

  • Tracheal shift toward affected side

  • Increased density

Infiltrate / Pneumonia

  • Patchy white areas

  • Consolidation

Asthma / Hyperinflation

  • Flattened diaphragm

  • Increased lung volumes

  • Dark lung fields

Fluid Overload / CHF / Pulmonary Edema

  • Bat-wing pattern

  • Kerley B lines

  • Enlarged heart

  • Increased vascular markings

LINES & ANATOMY IDENTIFICATION

Endotracheal Tube (ETT)

  • Tip 2–4 cm above carina

Tracheostomy Tube

  • Midline in trachea

Chest Tubes

  • Positioned in pleural space

  • Apical for air

  • Basal for fluid

Anatomy to Identify

  • Lung lobes

  • Trachea

  • Diaphragm

  • Costophrenic angles

  • Carina

  • Right mainstem bronchus = more vertical

  • Subcutaneous emphysema = air in tissues (black streaks)

CT SCAN

Anatomy Planes

  • Axial

  • Coronal

  • Sagittal

Diagnostic Test For

  • Tumors

  • PE

  • Trauma

  • Lung disease

Identify on CT

  • Normal lung

  • Atelectasis

  • Pneumothorax

  • Pleural effusion

Tumor Size Visible

  • As small as 1–2 mm

Pulmonary Emboli

  • CT Pulmonary Angiography (CTPA)

Helical CT

  • Continuous imaging

  • Faster

  • Better vascular detail

MRI

Advantages

  • Excellent soft tissue detail

  • No radiation

Disadvantages

  • Expensive

  • Long scan time

  • Cannot be used with metal

Contraindicated Implant

  • Pacemaker

  • Cochlear implant

  • Metal aneurysm clips

PULMONARY ANGIOGRAPHY

Indications

  • Gold standard for pulmonary embolism

  • When CT is inconclusive

CHEST ULTRASOUND

Advantages

  • No radiation

  • Portable

  • Good for effusions, pneumothorax

Disadvantages

  • Operator dependent

  • Poor air penetration

FLUOROSCOPY

Advantages

  • Real-time imaging

  • Used for procedures

Disadvantages

  • Higher radiation exposure

  • Requires contrast

RULE OF THUMB (COMMON EXAM POINTS)

  • Black = air

  • White = bone/fluid

  • Trachea shifts away from pressure

  • Always check patient info first

  • PA > AP when possible

If you want, I can also:

  • Turn this into practice questions

  • Create a 1-page cheat sheet

  • Make flashcards

  • Quiz you like your actual exam

Just tell me 👍