CHEST Flashcards
PP: Upright/seated-upright (always); chin extended
upward; arms hanging at the side and flex arms and
to the rest of the back f the hands low on the hips;
depress the shoulders and adjust to lie in the same
transverse plane; exposure after second full
inspiration (general) or end of full inspiration &
expiration (for presence of pneumothorax & foreign
body)
RP: T7
CR: ┴ CR enters at the level of T7
SS: Entire lung field
* Sharp outline of heart
* Sharp outline of diaphragm (expiration)
* Ten posterior ribs above diaphragm
Upright Position Rationale:
* Diaphragm at its lowest position
* Air-fluid levels are seen
* Avoid engorgement of the pulmonary
vessels
CI: Pleural effusion, Pneumothorax, Atelectasis
PA PROJECTION
PP: Supine/upright; back against IR; place hands on
hips; elbow flexed; hand pronated
RP: 3 in. inferior to jugular notch
CR: ┴
SS: Somewhat similar to PA but magnified
* Magnified heart & great vessels
* Lung fields appear shorter
* Clavicle projected higher
* Ribs assume horizontal position
Resnick Recommendation:
* CR 30o caudad to midsternal region
* Rationale: to free basal portions of the lung
fields from superimposition by anterior
diaphragmatic, abdominal & cardiac
structures
CI: Pleural effusion, Pneumothorax, Atelectasis
AP PROJECTION
PP: Upright/seated-upright; left side against the IR
(for heart & left lung) or right side against the IR (for
right lung); MSP // to IR; MCP ┴ to IR; arms
extended directly upward; elbow flexed; forearm
resting on elbows
RP: T7
CR: ┴ to IR, CR enters on the MCP at the level of
T7
SS: Heart, aorta & left-sided pulmonary lesions (left
lateral)
* Right-sided pulmonary lesions (right lateral)
ER:
* Employed to demonstrate the interlobar
fissures
* To differentiate the lobes
* To localize pulmonary lesions
LATERAL PROJECTION
PP: Upright/seated-upright; LAO/RAO (affected
side up); body rotated 45o
toward unaffected side;
55-60o
(for cardiac series; )10-20o
(for study of
pulmonary diseases); shoulder of unaffected side
against IR; weight of pt must be equally distributed
on both feet;
RP: T7
CR: ┴
SS: Entire lungs, Trachea filled with air,
* LAO:
o Maximum area of right lung
o Trachea & carina
o Entire right branch of bronchial tree
o Heart, descending aorta & aortic arch
o Esophagus (if barium filled)
* RAO:
o Maximum area of left lung
o Trachea
o Entire left branch of bronchial tree
o Best image of left atrium, anterior
portion of apex of left ventricle &
right retrocardiac space
o Esophagus (if barium filled)
* Medial part of right middle lobe & lingula of
the left upper lobe free from hilum (CR 10-
20o
)
CI: Pleural effusion, Pneumothorax, Atelectasis
PA OBLIQUE PROJECTION
PP: Upright/supine; LPO/RPO (affected side down);
body rotated 45o
toward affected side; shoulder of
affected side against IR; flex elbows and place hands
on the hips with palms facing outward or pronate
hands beside hips; raised hands closer to IR
RP: 3 in. inferior to jugular notch
CR: ┴ to IR at a level 3 inch below jugular notch
SS: Both lungs and its entirety; Trachea filled
with air; Visible identification markers
* LPO: maximum area of left lung; similar to
RAO
* RPO: maximum area of right lung; similar
to LAO
ER:
* Used when patient is too ill to be turned in
prone position
* Supplementary position in investigation of
specific lesions
* Used with recumbent patient in contrast
AP OBLIQUE PROJECTION
PP: Upright; step 1 foot in front; lean backward in
extreme lordosis; elbow flexed; pronate hands beside
the hips; shoulder against IR;
RP: Midsternum
CR: ┴ or 15-20o cephalad (no leaning backward)
SS: Lung apices inferior to shadow of clavicles;
clavicles lying superior to the apices
* Demonstrate interlobar effusions
ER: Used in preference to PA axial projection in
hyperstenic patient & whose clavicles occupy a
high position
CI: Rule out calcifications and masses beneath the
clavicles
LINDBLOM METHOD
AP AXIAL PROJECTION
PP: Upright; chin rested against the IR; elbow
flexed; pronate hands on hips; depress shoulder &
rotated forward; exposure at end of full inspiration
RP: T3
CR: 10-15o cephalad (expiration optional) or ┴ to IR
and centered at the level of T7
SS: Lung apices superior to shadow of clavicles;
Apices in their entirety; Clavicles lying below the
apices
CI: Pleural effusion, Pneumothorax, Atelectasis
PA AXIAL PROJECTION
PP: Upright/supine; flex pt elbows and place hands
on hips with the palms out; place shoulders back
against the grid.
RP: Midsternum
CR:15-20 deg cephalad to the center of IR
SS;Apices lying below the clavicles; Clavicles lying
superior to the apices; Superior lung region adjacent
to the apices.
CI: : Pleural effusion, Pneumothorax, Atelectasis
AP AXIAL PROJECTION
PP: Lateral decubitus; patient lie on affected side
(for pleural effusion) or unaffected side
(pneumothorax); body elevated 2-3 in.; arms well
above the head; remain in position for 5 minutes
before exposure
RP: 3 in. inferior to jugular notch (AP) or T7 (PA)
CR: Horizontal and ┴ to the center of the IR at a
level of 3 inch
SS: Apices; affected side and its entirety;
demonstratesthe change in fluid position and
reveals any obscured pulmonary areas
Cl: Pleural effusion, Pneumothorax, Atelectasis
AP/PA PROJECTION
R or L Lateral Decubitus
PP: Supine/prone; thorax elevated 2-3 in.; remain in
position 5 minutes before the exposure; extend arms
well above the head; affected side against the IR
RP: 3 in. inferior to jugular notch (ventral decubitus)
or T7 (dorsal decubitus)
CR: Horizontal
SS: Shows aa change in position of fluid and
reveals pulmonary areas that are obscured by fluid
in standard projection
* Entire lung fields; Upper lung fields not
obscured by the arms; no rotation of thorax
Cl: Pleural effusion, Pneumothorax, Atelectasis
LATERAL PROJECTION
R or L Position
Ventral/Dorsal decubitus Position
