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Image Analysis (mine) > Chapter 3: Chest and Abdomen > Flashcards

Chapter 3: Chest and Abdomen Flashcards

1
Q

What are the criteria for a PA chest?

A
  • clavicles are in the same plane
  • SC joints equal from manubrium
  • one inch of apical lung field
  • No foreshortening
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2
Q

Where do we center for PA chest?

A

Center to T7 (inferior angle of scapula)

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2
Q

What level is the manubrium in a good PA chest or good image?

A

The manubrium is at the level of the 4th vertebra or T4

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3
Q

How does the lung expand?

A

The lung expand in 3 dimensions: transversely, anteroposterteriorly, vertically or superior/ inferiorly

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4
Q

How many inches can the lung expand to?

A

could be as much as 4 inches

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5
Q

In a good breath how many ribs do you see in a PA chest?

A

10 posterior ribs or 11

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6
Q

How do you know is a PA chest

A

the markers are reverse

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7
Q

What should be seen through the T-spine in a PA chest?

A

T-spine through the heart shadow

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8
Q

Done on inspiration and expiration

A

Pneumothorax

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9
Q

lack of lung markings

A

pneumothorax

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9
Q

Where does pneumothorax happen?

A

up in the apices

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10
Q

What breathing technique shows heart shadow broader and shorter

A

expiration

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11
Q

Expiration will show how many ribs?

A

will only show 8th to 9th posterior ribs diaphragm

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12
Q

What breathing technique is used for foreign body location?

A

expiration

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13
Q

What bronchi is more vertical and larger in diameter?
- easier for foreign body to get stuck

A

Right bronchi

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14
Q

Which bronchi is more horizontal and narrower?

A

Left bronchi

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15
Q

Collapse of the lung

A

atelectasis

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16
Q

How is free air found?

A

Free air is found by using upright or decubitus chest images

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17
Q

lungs and heart foreshorten, which will lower the manubrium at the level of the 5th vertebra or lower, more than one inch of apices show
- clavicles long + angled
- manubrium below T4

A

Anterior tilt of PA chest

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18
Q

lung and heart foreshorten manubrium will move up at the level of 1st or 3rd vertebrae, clavicles will move superiorly, less than one inch of apices show
- clavicles move superior than apices
- manubrium above T4
- Apices + ribs horizontal
- heart is broader and larger
- lordotic view

A

Posterior tilt of PA chest

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19
Q

When pt’s shoulders are elevated

A

clavicles will be angled but the manubrium stays at T4

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20
Q

Why do we do a left lateral chest?

A

We do the left side because the heart is closer to the IR and reduces magnification

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21
Q

The trachea is more

A

anterior

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22
Q

The esophagus is more

A

posterior

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23
Q

What’s in profile for the lateral chest

A

sternum is in profile

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24
Q

How should the posterior and anterior ribs be for a lateral chest

A

posterior and anterior ribs superimposed no more than 1/2 inch

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24
Q

What should be open for the lateral chest

A

Invertebral foramina of T-spine should be open

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25
Q

In a good inspiration of the lateral chest what shows

A

It shows right and left hemidiaphragms at the level of T11

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26
Q

The heart continues beyond the sternum and into anterior lung

what rotation is this?
( away from IR)

A

left lung anteriorly
( away from IR)

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27
Q

When you do a left lung anteriorly ( away from IR)

what happens to the shoulder

A

left shoulder anteriorly
right shoulder posterior

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27
Q

Sternum is not in profile for a what

A

rotation

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28
Q

the heart shadow does not extend into the anterior lung but ends at the sternum
- not passing sternum
- heart moves posteriorly moving off sternum
What rotation is this?
( towards IR)

A

right lung anterior

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29
Q

when you do a right lung anteriorly ( towards IR)

What happens to the shoulder?

A

Right shoulder anteriorly
Left shoulder posteriorly

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30
Q

When you should repeat for rotation of lateral chest with right lung or left lung anteriorly?

A

If more than 2cm or 2 finger breaths shift in posterior ribs

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31
Q

What are the common mistakes for lateral chest?

A

tilt the hips and shoulder too much
- Poor midsagittal plane positioning

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32
Q

Why does the right diaphragm sits higher than the left?

A

because of the liver

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33
Q

When you turn the hips tilt (towards Ir) what happens

A

the right hemidiaphragms sits inferiorly than the left

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34
Q

What lung sits further away when doing a lateral chest

A

the right lung is further away which is magnified

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34
Q

In a good lateral at what levels are the diaphragm?

A

diaphragm is at the same level in a good lateral

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35
Q

What should you make sure regarding the spine in the lateral chest?

A

that the spine is straight and horizontal

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36
Q

On which side is the fundus of the stomach

A

on the left side

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37
Q

Sternum is not in profile
- diaphragms are at the same level but not superimposed

A

rotation

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38
Q

when gastric bubble is posteriorly this is vertifying what

A

right lung is situated anterior to the sternum ( right thorax rotated anteriorly)

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38
Q

When the right diaphragm is more anterior and the left diaphragm more posteriorly

what happens to the shoulder

A

right shoulder anteriorly and left shoulder posteriolry

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39
Q

When sternum is in profile is it a rotation or tilt?

A

tilt

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39
Q

Hips tilted to IR causes what to the diaphragms

A

left hemidiaphragms superior than right

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40
Q

One diaphragm is more superior than the other

A

tilt

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41
Q

forward or posterior diaphragm

A

rotation

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42
Q

superior or inferior left or right

A

tilt

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43
Q

Fundus sits on what diaphragm

A

left side of diaphragm

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43
Q

used to inflate lungs

A

ETT tube

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44
Q

What does ETT tube stand for

A

Endotracheal tube

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44
Q

Where should the ETT tube be centered

A

should be centered 1 to 2 inches above carina

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45
Q

What is the most common misplaced when inserting ETT tube

A

most commonly misplaced into right main bronchus

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46
Q

used for infusion

A

CV line

46
Q

How should the CV line be placed

A

Should be 2 to 3cm above the right atrial junction

47
Q

Done when pt can’t stand

A

decubitus

48
Q

Pleural effusion (fluid in lungs) is best seen on

A

decub

49
Q

In decub if the manubrium is superimposed over the fifth T- vertebra what does this indicate

A

the superior MCP was tilted anteriorly

50
Q

In decub if the manubrium is superimposed over 3rd T-vertebra what does this indicate

A

the superior MCP plane was tilted posteriorly

50
Q

What side do you mark up in a decub

A

you mark side up

51
Q

How do you know what kind of decub it is

A

you put the affected side in contact with the table

52
Q

air goes

A

up

53
Q

fluid goes

A

down

54
Q

In AP RPO when the ribs are rotated the side down is ( central ray angle)

A

elongated

54
Q

In AP RPO when the ribs are rotated the side up is ( at a angle)

A

foreshorten

55
Q

How to tell if is a AP chest

A

able to see bodies and disk space with no distortion
- disk space are open

56
Q

How to tell if is a PA chest

A

the bodies are distorted
- disk space are closed
- spinous processes and laminae are well demonstrated

56
Q

What are other names for AP axial chest

A

Limbolm method
- Lordotic view

57
Q

Why do we do the limbolm method

A

we do it for the apices

58
Q

Where does TB typically start

A

starts in the apices

59
Q

How is the patient position for a lordotic chest

A

patient is positioned one foot from IR and tilted backwards

60
Q

Why do we do the lordotic view

A

for the clavicles to be above the apices

61
Q

How should the clavicles look in a limbolm method

A

the clavicles should look horizontal

62
Q

If patient can’t tilt back for the limbolm method what do we do

A

we angle the tube 15 to 20 degrees cephalic

63
Q

If superimposed posterior ribs look obscure what does this mean for a limbolm method

A

back was arched too much or central ray was angled too much

64
Q

If you over tilt for limbolm what happens

A

can take clavicles right back into the apices

65
Q

For obliques what side do we mark

A

we mark side down

66
Q

RAO=

A

LPO

67
Q

LAO=

A

RPO

68
Q

When not given a degree for oblique what degrees do we do

A

we do a 45 degrees

69
Q

What degree will help get heart off the spine

A

LAO 60 degrees

70
Q

Done for cardiac series

A

LAO 60 degrees

71
Q

twice as much lung field as you do on the other side

A

45 degrees rotation oblique

72
Q

heart shadow will be slightly superimposed over t spine

A

45 degrees oblique

72
Q

For mobile positioning what should you make sure that must be accurately aligned

A
  • pt
  • IR
  • central ray
72
Q

RAO shows what lung field

A

shows left lung field

side further away

73
Q

LAO shows what lung field

A

shows right lung field

side further away

73
Q

trachea will be demonstrated on which side for oblique

A

demonstrated in lung field farther away from IR

74
Q

in how many directions should you evaluate the tube for mobile positioning

A

evaluate in two directions

74
Q

When pt is centered to the bed for mobile positioning how should the tube be center

A

tube should be centered with the foot of the bed to avoid off centering

74
Q

Whe doing a AP chest mobile positioning and you have 72 inches how should you be centered

A

CR should be perpendicular to the sternum

75
Q

What breathing technique is decreased in a mobile positioning

A

inspiration

76
Q

When doing a AP chest mobile positioning at 40 inches where should you centered

A

downward angle of 3 degrees to the sternum should be used ( slightly caudal apperance)

77
Q

In a mobile positioning the heart shadow is further away from the IR what can we conclude from this

A

the heart will appear larger broader

78
Q

in mobile positioning what happens to the diaphragm

A

the diaphragm flattens out

79
Q

For upright abdomen what should you get on

A

need diaphragm

80
Q

for supine abdomen what should you get on

A

need pubic symphysis

81
Q

Good technique for abdomen will show

A

you should see psoas muscles

82
Q

When doing decub abdomen which side should be up

A

the right side up

82
Q

what should be equal in a good abdomen x-ray

A

pedicle, ribs, transverse process

83
Q

why should the right side be up for a decub abdomen

A

because the liver is on the right side

84
Q

what kind of study is a decub

A

a time study

84
Q

what decub do we do for abdomen

A

left lateral decub

85
Q

how much is a time study for decub

A

5 minutes

86
Q

what must you get on for decub

A

needs crests and diaphragm

87
Q

laying on stomach

A

ventral

88
Q

laying on back

A

dorsal

88
Q

What should be mindful of when doing AP peds chest

A

be mindful of collimation

89
Q

For infants what should we infer about the distance for AP chest

A

don’t need to do 72 in the nursery

90
Q

Where should you center for AP peds chest

A

4th vertebra in center of collimated field

91
Q

In AP peds chest how are the anterior ribs

A

the anterior ribs are projected downwards

92
Q

In AP peds chest how are the posterior ribs

A

posterior ribs are gentle cephalic bow ( look horizontal)

93
Q

What are not developed as newborns

A

alveolar sacs

94
Q

At what age do alveolar sacs develop

A

8 years old

95
Q

How many ribs are shown for a AP peds chest

A

8th posterior ribs demonstrated above diaphragm

96
Q

What must you do with the head for peds

A

keep the head straight since it keeps the body straight

97
Q

How do the lungs appear for peds

A

the lungs appear smaller, denser, fluffy, and white because they don’t have sacs

98
Q

Why do neonate tend to have a lordotic apperance

A

because of the lack of a kyphotic thoracic curvature seen in an adult

98
Q

How can we fix the lordotic appearance in neonate and infants

A

this can be offset by a 5 or 3 degrees caudal angle

99
Q

What is the tendency to do with neonate

A

there is a tendency to center to inferior when we should center high at T4

99
Q

When we angled too low or center too low what happens in neonate

A

foreshortens lungs and mediastinal structures, causing the cardiac Apex to appear uptilted

100
Q

Rotation of the chest commonly happens when an infants

A

rotation of the chest commonly happens due to head rotation

101
Q

Chest will rotate towards what in neonate

A

chest will rotate towards the side the head moves

101
Q

How many ribs should neonate demonstrate

A

should demonstrate 8 posterior ribs

102
Q

how many days are they considered neonate

A

28 days

102
Q

how many days are they considered infant

A

1 month

103
Q

how many ribs should be demonstrated for infants

A

9 posterior ribs

103
Q

Where should we center for neonate and infants for lateral chest

A

center mid-coronal plane at the 5th T vertebra

104
Q

why should neonate be done as a cross table

A

because overhead lateral tends to collapse the lung adjacent to the IR squish lung that they are laying on

104
Q

to prevent superimposition in neonate and infants lateral chest what should we do

A

raise chin

105
Q

if a child is being held what should we do

A

the holder hands should remain out of the radiation field

106
Q

how will the posterior ribs look for neonate and infants lateral chest

A

posterior ribs will be directly superimposed due to the close OID of the right and left lung

106
Q
A
107
Q
A

Image Analysis (mine) (5 decks)

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