Chest Xray Interpretation
X-ray Colors - Answer The big two densities are:
(1) WHITE - Bone
(2) BLACK - Air
The others are:
(3) DARK GREY- Fat
(4) GREY- Soft tissue/water
And if anything Man-made is on the film, it is:
(5) BRIGHT WHITE - Man-made
Trachea is coming down. The dark structures coming down you
can see the bifurcation of trachea. Aortic knob is on left side.
Hilum is area where pum vessel and art coming off where you get
alot of lymph node involvment or inflammatory process or tumors.
If xray not labeled: Remember aortic knob is always on left side
and gastric bubble is always on left side - Answer Normal CXR
Silhouette Sign - Answer
Systematic Approach to Reading CXR - Answer ABCDEF System
A: Assess technical quality/Airways
B: Bones (soft tissue)
C: Cardiac Silhouette (and mediastinum)
D: Diaphragm (and gastric bubble)
E: Effusions (i.e. Pleura)
F: "Fields" (Lung Fields)
*Lines, tubes, devices, and prior surgeries*
Airways - Answer Right Bronchus
Left Main Bronchus
Trachea
Bones - Answer 4 types of bones:
Ribs posterior rib (horizontal and easier to see on PA view) and anterior (45 degree
angle)
Clavicle (right and left)
Sternum
Vertebral Bodies
Cardiac Silhouette Picture View - Answer
, Chest Xray Interpretation
Cardiac Silhouette X-Ray View - Answer
Diaphragm and Pleura - Answer
Gastric Bubble - Answer
Lung Fissures - Answer
Right Upper Lobe - Answer
Right Middle Lobe - Answer
Right Lower Lobe - Answer
Left Upper Lobe - Answer
Left Lower Lobe - Answer
PA - Answer is taken of ambulatory pt
AP - Answer is taken in ICU in bed; less preferred because of the x rays scattering
when they hit the board in the back; quality is less than PA film
X axis malrotation - Answer "Crooked Patient"
Y- axis malrotation "Lordotic View" - Answer X-Ray machine not perpendicular to the
patient. causing apex of lungs to be under clavicle instead of above
R/O TB or Cancer
* Improved view of apices
* Diminished view of lung bases and costophrenic angle
* Distortion of cardiac silhouette
* Lung Volumes appear Falsely Low
Z-axis malrotation - Answer Consequence size and shape of structures are distorted
Adequate Inspiration Posterior Ribs - Answer 9-10 ribs visible
Adequate Inspiration Anterior Ribs - Answer 6-7 ribs visible
Airway Narrowing - Answer important radiographic finding in croup and tracheal
stenosis
Deviation of Trachea AWAY from affected side - Answer Pneumothorax
Pleural Effusion
Large Mass
X-ray Colors - Answer The big two densities are:
(1) WHITE - Bone
(2) BLACK - Air
The others are:
(3) DARK GREY- Fat
(4) GREY- Soft tissue/water
And if anything Man-made is on the film, it is:
(5) BRIGHT WHITE - Man-made
Trachea is coming down. The dark structures coming down you
can see the bifurcation of trachea. Aortic knob is on left side.
Hilum is area where pum vessel and art coming off where you get
alot of lymph node involvment or inflammatory process or tumors.
If xray not labeled: Remember aortic knob is always on left side
and gastric bubble is always on left side - Answer Normal CXR
Silhouette Sign - Answer
Systematic Approach to Reading CXR - Answer ABCDEF System
A: Assess technical quality/Airways
B: Bones (soft tissue)
C: Cardiac Silhouette (and mediastinum)
D: Diaphragm (and gastric bubble)
E: Effusions (i.e. Pleura)
F: "Fields" (Lung Fields)
*Lines, tubes, devices, and prior surgeries*
Airways - Answer Right Bronchus
Left Main Bronchus
Trachea
Bones - Answer 4 types of bones:
Ribs posterior rib (horizontal and easier to see on PA view) and anterior (45 degree
angle)
Clavicle (right and left)
Sternum
Vertebral Bodies
Cardiac Silhouette Picture View - Answer
, Chest Xray Interpretation
Cardiac Silhouette X-Ray View - Answer
Diaphragm and Pleura - Answer
Gastric Bubble - Answer
Lung Fissures - Answer
Right Upper Lobe - Answer
Right Middle Lobe - Answer
Right Lower Lobe - Answer
Left Upper Lobe - Answer
Left Lower Lobe - Answer
PA - Answer is taken of ambulatory pt
AP - Answer is taken in ICU in bed; less preferred because of the x rays scattering
when they hit the board in the back; quality is less than PA film
X axis malrotation - Answer "Crooked Patient"
Y- axis malrotation "Lordotic View" - Answer X-Ray machine not perpendicular to the
patient. causing apex of lungs to be under clavicle instead of above
R/O TB or Cancer
* Improved view of apices
* Diminished view of lung bases and costophrenic angle
* Distortion of cardiac silhouette
* Lung Volumes appear Falsely Low
Z-axis malrotation - Answer Consequence size and shape of structures are distorted
Adequate Inspiration Posterior Ribs - Answer 9-10 ribs visible
Adequate Inspiration Anterior Ribs - Answer 6-7 ribs visible
Airway Narrowing - Answer important radiographic finding in croup and tracheal
stenosis
Deviation of Trachea AWAY from affected side - Answer Pneumothorax
Pleural Effusion
Large Mass
