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Basic Procedures Class > Chest > Flashcards

Chest Flashcards

1
Q

Structures that form the Thoracic Cage:

A

•Sternum
•Ribs/Costal Cartilages
•Thoracic Vertebrae

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2
Q

Sternum

A

-Creates anterior boundary
-Components: Manubrium Body
-Xiphoid Process
-Jugular notch

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3
Q

Ribs

A

•Creates lateral boundary
•Articulates with the thoracic spine

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4
Q

Ribs names & numbers

A

True ribs: 1-7
attach directly to sternum

False ribs: 8-12
Don’t attach directly to sternum

Floating ribs: 11-12
Only articulate with vertebrae

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5
Q

Thoracic spine

A

-Vertebral bodies
-Intervertebral disks
-Pedicles
-Spinous Processes

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6
Q

Landmarks for chest x-rays

A

Jugular notch
T7 = Inferior angle of the scapula

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7
Q

Airway structures

A

•Trachea
•Bronchial Tree
•Right and Left Lungs

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8
Q

Trachea

A

-Trachea: C6-T4/T5
-Carina: T5

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9
Q

Right Main Bronchus

A

•Upper lobar
•Middle lobar
•Lower lobar

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10
Q

Left Main Bronchus

A

•Upper lobar
•Lower lobar

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11
Q

Bronchi’s and bronchioles

A

-Primary bronchi
-Secondary bronchi
-Tertiary bronchi
-Bronchioles
-Terminal bronchioles

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12
Q

Alveoli

A

Site of oxygen and carbon dioxide exchange by diffusion

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13
Q

Lungs

A

Organ of respiration
•Apex
•Base
•Hilum

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14
Q

Pleura

A

Double membrane that encloses each lung
•Visceral pleura: adheres to surface of the lung
•Parietal pleura: lines the thoracic cavity
-Pleural cavity: space between two layers

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15
Q

Right lung

A

3 lobes
-Oblique fissure: Separates inferior lobe from middle and superior
-Horizontal fissure: Separates middle lobe from superior lobe

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16
Q

Left lung

A

2 lobes
-Oblique fissure: Separates inferior lobe from superior

Cardiac notch: Large area on the medial surface

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17
Q

Diaphragm

A

Separates thoracic and abdominal cavities

18
Q

During Inhalation the diaphragm __________ and moves to ________ position

A

-contracts, lower

19
Q

During Exhalation the diaphragm _________ and moves _________ pushing air out of lungs

A

-relaxes, upwards

20
Q

Mediastinum

A

•Heart
•Great Vessels
•Trachea
•Esophagus
•Thymus/Lymphatics
•Nerves
•Fibrous Tissue
•Fat

21
Q

Position of the heart

A

-Lies obliquely in the mediastinum
-Apex toward the left side of the body

22
Q

How should patient position usually be for chest x-rays and why?

A

Upright when possible

•Prevents engorgement of pulmonary vessels
•Gravity depresses diaphragm
•Demonstrates air fluid levels (with horizontal beam)
•Allows for full expansion of lungs

23
Q

Inspiration/Expiration breathing are required for

A

•Pneumothorax
•Excursion (movement) of diaphragm
•Foreign body
•Atelectasis

24
Q

Images obtained with high or low kVp?

A

High

25
Q

If using ______ pay attention to cells/detectors

A

AEC

26
Q

Why do we use 72 SID?

A

Decreases magnification of the heart and obtains greater spatial resolution of lung structures

27
Q

Body habitus

A

-Asthenic (CR cassette is placed LW for PA/AP): very slender
-Sthenic: moderate heavy build
-Hyposthenic: intermediate between asthenic and sthenic
-Hypersthenic: large build

28
Q

Patient preparation

A

-Patient changes into a gown and removes any metal objects (including bra and jewelry)
-Always ask “Do you have any metal on your chest?”
-Beware of shirts with pockets (gum, coins, glasses, cough drops, credit cards)
-Long hair should be moved
-Inpatients/ED patients: Look/Ask about monitoring devices, safety pins

29
Q

Chest PA SID, IR,Position, CR, Collimation, Respiration

A

SID: 72”

IR: 14x17 LW or CW, upper border 1.5”-2” above relaxed shoulders

Position: Upright
•MSP centered to IR
•Weight equally distributed
•Chin extended upward
•Elbows flexed with hands on lower hips
•Shoulders depressed and in same plane
•Shoulders rotated forward

CR: Perpendicular to center of IR at T7 (inferior angle of scapula)

Collimation: 14”x17”

Respiration: Suspend after second inspiration

30
Q

Viewing chest radiographs

A

PA or AP views
•Patient’s right is always on viewers left
•Left marker will be on viewer’s right side

31
Q

Chest PA Evaluation Criteria

A

-Entire lung fields from apices to the costophrenic angles
-No rotation:
•Sternal ends of clavicles equidistant to spine
•Trachea in the midline
•Equal distance from the vertebral column to lateral border of the ribs
-Proper shoulder rotation demonstrated by scapulae projected outside the lung fields
-Proper inspiration demonstrated by ten posterior ribs visible above the diaphragm
-Sharp outlines of heart and diaphragm
-Ribs and superior thoracic vertebrae visible through the heart shadow
-Lung markings visible from the hilum to the periphery of the lung

32
Q

Chest Lateral SID, IR,Position, CR, Collimation, Respiration

A

SID: 72”

IR: 14x17 LW, upper border 1.5”-2” above shoulders Position: Left Lateral, Upright
•MSP is parallel with IR, shoulder is touching grid
•Mid coronal plane perpendicular to midline of IR
•Arms extended upwards, forearms resting on head
•Avoid leaning or forward bending

CR: Perpendicular to IR
•entering midcoronal plane at the level of T7 (inferior aspect of scapula)

Collimation: 14”x17”

Respiration: Suspend after second inspiration

33
Q

Chest lateral evaluation criteria

A

-Arms not overlapping superior lung field
-Costophrenic angles and the apices of the lungs not obscured by arms and shoulders
-No rotation:
•Hila in the center of the radiograph
•Superimposition of ribs posterior to the vertebral column
•Sternum in profile
•Trachea visible in the midline
-Long axis of the lung fields in vertical position, without forward or backward leaning
-Open thoracic intervertebral spaces and intervertebral foramina (except in patients with scoliosis)

34
Q

What if my patient can’t stand?

A

Use wheelchair or stretchor

35
Q

Chest AP SID, IR,Position, CR, Collimation, Respiration

A

SID: 72”
IR: 14x17 LW or CW, upper border 1.5”-2” above relaxed shoulders

Position: Supine or Upright
•MSP centered to IR
•Flex elbows, place hands on hips
•Shoulders in same plane

CR: Perpendicular to long axis of sternum, entering 3” inferior to jugular notch

Collimation: 14”x17”

Respiration: Suspend after second inspiration Watch patient’s chest if unable to follow commands

36
Q

Chest AP Evaluation Criteria

A

-Entire lungs (apices to angles)
-No rotation:
•Sternal ends of clavicles equidistant from spine
•Trachea in midline
•Equal distance from spine to lateral border of ribs
-Clavicles appear more horizontal than PA projection
-1 inch of pulmonary apices should be seen superior to clavicles

37
Q

Chest AP Portable SID, IR,Position, CR, Collimation, Respiration

A

SID: 72”
IR: 14x17 LW or CW, upper border 1.5”-2” above relaxed shoulders

Position: Upright if possible
•MSP centered to IR
•Chin extended upward
•Shoulders depressed/relaxed
•Torso not rotated or leaning

CR: Perpendicular to long axis of sternum, entering 3” inferior to jugular notch

Collimation: 14”x17”

Respiration: Suspend after second inspiration Watch patient’s chest if unable to follow commands

Annotate image: Portable, Supine or Upright

38
Q

T or F: for Chest AP portable incorrect angulation of the CR causes an apical (lordotic) appearance

A

True

39
Q

Chest AP Portable Evaluation Criteria

A

-No motion; well-defined (not blurred) diaphragmatic domes
-Lung fields in their entirety Pleural markings
-Ribs and thoracic intervertebral disk spaces visible through the heart shadow
-No rotation, medial portion of clavicles and lateral border of ribs equidistant from vertebral column

40
Q

What is Atelectasis?

A

Partial or complete collapse of the lung

41
Q

What is Pneumothorax?

A

Accumulation of air in the pleural resulting in collapse of the lung

42
Q

What is pneumonia?

A

Acute infection of the lung parenchyma

Basic Procedures Class (11 decks)

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