Anatomy of the Chest Flashcards
Respiratory System
an excretory system that excretes carbon dioxide
How many lobes does the right lung have and what are they?
3 lobes - upper, middle, and lower
How many lobes does the left lung have and what are they?
2 lobes - upper and lower
Thorax or thoracic cavity
the section of the body between the neck and diaphragm
Diaphragm
muscular wall separating abdomen and thoracic cavity
How many openings does the diaphragm have?
3 openings -
- aorta (artery)
- esophagus
- inferior vena cava (vein)
Routine chest radiographs are taken ______ and exposed on ____ ______ to allow _____ to move to it’s _____ position
routine chest radiographs are taken UPRIGHT and exposed on DEEP INSPIRATION to allow DIAPHRAGM to move to it’s LOWEST position
Trachea
muscular tube anterior to esophagus with C-shaped rings of cartilage for rigidity
The trachea ______ (divides) into # ______ at the carina and ends in the ____ ____ where ____ are exchanged: ____, in ____ ____ out
the trachea BIFURCATES (divides) into TWO BRONCHI at the carina and ends in the ALVEOLAR SACS where GASES are exchanged: OXYGEN in, CARBON DIOXIDE out
Pleura or Pleural Cavity
space between lungs and chest wall (we don’t want air there, outside of lungs)
Mediastinum
potential space between lungs that is bound anteriorly by the sternum that contains heart, trachea, and esophagus
Atelectasis
collapse of whole or part of lung from obstruction of bronchus
Emphysema
one type of chronic obstructive pulmonary disease (COPD) characterized by excessive air in lungs — decrease x-ray exposure to maintain proper contrast
Pneumonia
infection caused by bacteria or viruses that causes inflammation of the lungs and air sacs filled with fluid - increase x-ray exposure to penetrate fluid better
Pneumothorax
accumulation of air in pleural cavity resulting in collapse of lungs — appears as dark density with no visible pulmonary markings
Pleural Effusion
collection of fluid in pleural cavity
Aspiration
inhalation of foreign material into airway or lungs (anything that’s not supposed to be there)
What pathological condition of the chest do you decrease x-ray exposure to maintain proper contrast?
emphysema
What pathological condition of the chest do you increase x-ray exposure to penetrate fluid better?
pneumonia
What pathological condition of the chest appears as dark density with no visible pulmonary markings?
pneumothorax
What are routine projections for chest x-rays?
PA and lateral
What does kVp stand for?
kilovoltage peak — highest voltage that will be produced by the x-ray machine during an exposure
What does mA/mAs stand for?
mA= milliamperage mAs= milliampere-seconds
measure of radiation produced (milliamperage) over a set amount of time (seconds) via an x-ray tube
What is the kVp for a grid chest x-ray?
115 kVp
What is the kVp for a non-grid chest x-ray?
80 kVp
At what SID are chest x-rays taken?
72”
Why is a 72” SID used?
to minimize magnification of heart and increase detail
When taking a PA chest x-ray, how is the patient placed?
upright facing vertical grid
Why is the erect position ideal when doing a PA chest x-ray?
so the diaphragm can move to it’s lowest position to best visualize air/fluid levels
The height of the IR should be adjusted so it’s upper border is how many inches above the shoulder?
1 to 2 inches
When doing a PA chest x-ray and patient is already positioned in front of bucky, what 4 things should patient be doing with their body?
- patient should be extending their chin and/or placed on top of vertical grid.
- patient should place the back of their hands on their hips
- patient should be rolling their shoulders forward (to move scapulae laterally from the lung fields)
- patient should depress (relax) the shoulders to lower clavicles from apices
What 2 things do you direct the central ray to? Where will the central ray be after those 2 things?
Direct central ray to:
- midsaggital plane of patient’s body and
- the IR
the central ray will then be at level of T7.
After coning to the chest (and using markers), exposure is made at the ___ of ___ _____ to expand the ____ and depress the ____.
(The lungs will expand more and without strain on the second breath).
after coning to the chest (and using markers), exposure is made at the END of FULL INSPIRATION to expand the LUNGS and depress the DIAPHRAGM.
A high mA station is used to get ___ possible exposure time in order to ____ motion.
a high mA station is used to get SHORTEST possible exposure time in order to DECREASE motion
What 4 things should be demonstrated on an optimal chest x-ray?
- entire lung fields from apices (superior) to costophrenic angles (inferior)
- faint shadow of ribs visible through the heart shadow
- 10 pairs of ribs should be demonstrated above diaphragm on deep inspiration
- sternal ends of clavicles equidistant from vertebral column (SC joints equal in size) to minimize distortion of heart caused by malrotation
What position are routine lateral chest x-rays taken in?
left lateral position
Why are routine lateral chest x-rays taken in left lateral position?
because the heart is closer to the IR to minimize magnification
In a lateral chest x-ray, the patient is ____ in a ___ ____ position with the ________ plane centered to the midline of the IR.
in a lateral chest x-ray, the patient is UPRIGHT in a LEFT LATERAL position with the MIDCORONAL plane centered to the midline of the IR.
How many inches should the height of the IR be adjusted so that it’s upper border is above the patient’s shoulder?
1 to 2 inches
How should the patient be standing in the left lateral position for a chest x-ray?
with their arms extended upward with forearms resting on the head (there should be no shadow of arms superimposed over the upper lungs)
Where should the central ray on a lateral chest x-ray be directed?
through the midcoronal plane to the midpoint of the IR.
When should the exposure of lateral chest x-ray be made and why?
at the end of full inspiration to allow diaphragm to move to it’s lowest position
What 3 things should be demonstrated in a lateral chest x-ray?
- entire lung field from apices to costophrenic angles
- no rotation of the sternum
- ribs posterior to the vertebral column will be superimposed
When is the lordotic position used?
used when wanting to evaluate possible lesions within apex area (places clavicles superior to the apices)
How is the patient placed in the lordotic position?
- patient is placed upright before the vertical grid, facing x r-ray tube and standing ~ 1 foot in front of the vertical grid
- have patient lean backward to rest the shoulders on the vertical grid
Where should the central ray be directed in a lordotic position?
central ray should be directed to the midsaggital plane and to the center of IR
Why is a decubitus chest x-ray done?
done because it’ll show fluid on the down side and/or free air on the up side
How is patient placed in a lateral decubitus position?
- patient lies on affected side (side down is side ordered)
- body should be elevated several inches on a firm pad to demonstrate down side
Does the patient extend their arms above their head during a lateral decubitus?
yes
Where is the IR placed in a lateral decubitus position?
IR is placed against the posterior surface of the chest and adjusted so that it extends 1 to 2 inches above shoulders
Where should the central ray be directed in a lateral decubitus position?
horizontal and perpendicular to the center of the IR
