Ch. 10 Chest Flashcards
What is in the thoracic viscera?
- Lungs and heart (organs of respiratory system)
- cardiovascular and lymphatic systems
- inferior portion of the esophagus
- thymus gland
What separates the thoracic cavity from the abdominal cavity?
The diaphragm
What are the 3 separate chambers within the thoracic cavity?
- pericardial cavity
- right pleural cavity
- left pleural cavity
Where is the mediostinum located?
Mediostinum is the area of the thorax bounded by the sternum anteriorly, the spine posteriorly, and the lungs laterally
What are the structures associated with the mediostinum?
Heart, greater vessels, trachea, esophagus, thymus, lymphatics, nerves, fibrous tissue, and fat
What organs are part of the Respiratory System?
pharynx, trachea, bronchi, and two lungs,
How do the air passages of the respiratory organs communicate with the exterior?
Through the pharynx, mouth, and nose
What is the position of the trachea in relation to the esophagus?
Anterior to the esophagus
How many divisions are there on each side of the primary bronchus?
- 3 divisions in Right lung
- 2 divisions in Left lung
Where is the Apex of the lung?
Top part of the lung; reaches above the level of the clavicles
The double-walled serous membrane that encompasses the lung Is called what?
Pleura
Where is the thymus gland and how is it positioned?
-lies in the lower neck area; superior mediastinum, anterior to the trachea and greate vessels of the heart and posterior to the manubrium
What is the optimum position of a patient for a chest x-ray
PA upright
Why is a left lateral done?
Used to show the heart, aorta, and left-sided pulmonary lesions
Why is a right lateral done?
Used to show right-sided pulmonary lesions
What is COPD and what does it stand for?
Chronic Obstructive Pulmonary Disease: chronic condition of persistent obstruction of bronchial airflow
What exposure technique is required to penetrate thoracic anatomy?
High kVp
Why is a 72 in. SID used?
To minimize magnification of heart and to increase recorded detail (spatial resolution)
What does the patient do to move the scapula out of the way?
move shoulders forward
According to the book, where are the hands placed for a PA chest x-ray?
Resting back of hands low on the hips, below the level of the costophrenic angles
What is the optimal respiration phase for lateral?
End of second deep inspiration
How many ribs should you see above the diaphragm on a PA chest?
10
How long should a patient be in position before an exposure for a decubitus position?
For 5 min
If decubitus is done for fluid. which side should the patient lie on?
Patient should lie on affected side
If decubitus is done for free-air, which side should the patient lie on?
Patient should lie on unaffected side
What should be demonstrated in a decubitus position?
free-air or fluid
Terminals communicate with what?
Alveolar ducts
What is the medial border of the lungs called?
Hilum
What projection can you see the medial border better?
Lateral Chest x-ray
Why is the right lung shorter than the left lung?
Due to the presence of the liver and also it is broader than the left lung
Movement of Lungs during inspiration
inferiorly
Movement of Lungs during expiration
superiorly
Where is the aortic arch?
the portion of the main artery that bends between the ascending and descending aorta.
Why might two separate images be taken, one on inspiration and one on expiration?
-To demonstrate pneumothorax, diaphragm movement, presence of foreign body, or atelectasis
Upright position demonstrates what?
air or fluid levels and allows diaphragm to move to its lowest position
Rolling shoulders forward does what?
Rotates the scapulas to get them out of the way of the chest x-ray
PA Chest CR positioning
- CR perpendicular to center of IR
- Enters at MSP @ level of T7
When should the exposure be made in a PA chest x-ray?
At the end of the second deep inspiration
Is the MSP parallel or perpendicular with the IR in a Lateral Chest x-ray?
Parallel
Lateral Chest CR positioning
CR is perpendicular to IR and enters patient on MCP at level T7
-Same breathing as PA Chest (at end of second deep inspiration)
Side of interest is farther from IR in a PA Oblique Chest…True or False
True
**55-60 degree oblique position is used for barium cardiac series
Part position for PA oblique
45 degree left anterior oblique (LAO) or right anterior obliqe (RAO)
-Top of IR about 1 1/2 - 2 in. above vertebra prominens
Vertebra prominen is located where?
Lateral spinous process of C7
AP Oblique side of interest?
Side of interest is closer to the IR
-45 degree left posterior oblique (LPO) or right posterior oblique (RPO)
When is exposure made in AP Oblique?
ON second full inspiration
CR positioning for AP Oblique
Perpendicular to IR and enters 3 in. below jugular notch
AP Axial Chest: Lordotic Position is ordered when?
Usually specifically requested by radiologist
-CR enters MSP at midsternum
If there is fluid in the right lung, which side would the patient lie on for a decubitus position?
Right side
When is the exposure made for a Lateral Decubitus?
Made on second full inspiration
When is the exposure made for a Lateral Decubitus?
Made on second full inspiration
What is the respiration phase for AP or lateral projections performed in the decubitus position? A. suspended respiration B. full inspiration C. full expiration D. slow, shallow breathing
B. full inspiration
Which of the following will be observed on a supine AP chest radiograph?
(1) clavicles projected higher
(2) lung fields appear shorter
(3) all 12 ribs are seen
A. 1 and 2
B. 1 and 3
C. 2 and 3
D. 1, 2, and 3
A. 1 and 2
Why isn’t a right lateral done opposed to a left lateral?
Because the left lateral displays the heart better
What is Pneumothorax?
accumulation of air in the pleural cavity resulting in a collapsed lung
What is Bronchitis?
inflammation of the bronchi
collection of fluid in the pleural cavity
Pleural Effusion
replacement of air with fluid in the lung interstitium and alveoli
Pulmonary Edema
Where is the costophrenic angle?
Below the lungs
