Assessing the quality of a CXR: RIPE Flashcards
Assessing the quality of a CXR: RIPE
Rotation - rotation is assessing whether the XRAY hit the person straight on or at an angle of some sort. Ideally, the patient should be as straight as possible.
Inspiration - It is how well did the patient breathe in during the CXR. To assess the degree of inspiration it is conventional to count ribs down to the diaphragm. The diaphragm should be intersected by the 5th to 7th anterior ribs in the mid-clavicular line. Less is a sign of incomplete inspiration.
Projection - Tells us whether the CXR is posterior to anterior or anterior to posterior. Usually it is PA.
Exposure -
Assessing the quality of a CXR: Rotation
What is rotation?
How do you assess sufficient rotation?
Rotation is assessing whether the XRAY hit the person straight on or at an angle of some sort. Ideally, the patient should be as straight as possible.
Find the medial aspect of the clavicles and find the vertebral spinous processes. Ideally, the spinous processes should lie halfway between medial ends of the clavicles.
Rotation: what happens to heart size if the patient is rotated to the left too much?
Heart size become exaggerated
Rotation: what happens to heart size if the patient is rotated to the right too much?
The true size of the heart may be under-estimated.
Rotation: what is the affect of rotation on the lungs?
Assessing the quality of a CXR: Inspiration
What is inspiration?
How do we assess inspiration?
It is how well did the patient breathe in during the CXR.
To assess the degree of inspiration it is conventional to count ribs down to the diaphragm. The diaphragm should be intersected by the 5th to 7th anterior ribs in the mid-clavicular line. Less is a sign of incomplete inspiration.
Assessing the quality of a CXR: Projection
Tells us whether the CXR is posterior to anterior or anterior to posterior.
Most CXRs are PA.
Assessing the quality of a CXR: Exposure
A well-penetrated CXR is on where the vertebra can be seen behind the heart.
