AANA Journal course: update for nurse anesthetists--fundamentals of chest radiography: techniques and interpretation for the anesthetist.
The chest roentgenogram (chest x-ray) is an essential tool in the perioperative evaluation of high-risk surgical patients. It can provide information on chest pathologies that will influence the anesthetic or surgical plan. An understanding of chest radiography requires several steps. Knowledge of physics, or how the radiological images are produced, is essential. Basic components include radiographic density, geometric magnification, and radiographic technique. An awareness of physics will also permit correct identification and interpretation of chest anatomy and existing pathology. The clinician should use a systematic approach to interpretation. This consists of evaluating the overall quality of the film, followed by an examination of the anatomy, working from the periphery and moving toward the center to note any chest, pulmonary, or heart abnormalities. The air bronchogram and silhouette sign are indications of pathology and can assist the clinician in locating and identifying infiltrates or lesions. Once an abnormality or area of interest is identified, he or she can focus on a clinical interpretation of the pathology. Emphasis is placed on the identification of pulmonary infiltrates and the location of invasive medical devices commonly found in the perioperative patient.
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D001995:Bronchography; D004509:Education, Nursing, Continuing; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008297:Male; D009719:Nurse Anesthetists / Q000193:education; D011300:Preoperative Care; D013902:Radiography, Thoracic / Q000379:methods; D013896:Thoracic Diseases / Q000000981:diagnostic imaging