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MRT Year 2 > Chest Comp > Flashcards

Chest Comp Flashcards

1
Q

PA chests are good for visualizing?

A
  • pneumothorax
  • pleural effusions
  • atelectasis
  • signs of infection
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2
Q

Why is erect chest better than supine?

A
  • diaphragm allowed to move farther down (gravity)
  • air fluid levels visualized
  • engorgement and hyperemia of pulmonary vessels (distended and swollen with fluid) may be prevented
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3
Q

What is a lateral chest good for visualizing?

A

-pathologies situated posterior to the heart ,great vessels, and sternum

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4
Q

How much rotation is acceptable on a lateral chest?

A

1/4 to 1/2”

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5
Q

How do you identify the left hemidiaphragm from the right?

A

The gastric air bubble and inferior border of the heart shadow

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6
Q

What is better about a right lateral compared to a left?

A

Increased radiographic detail in the right lung because is it placed closer to the IR

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7
Q

What is best seen on a supine chest?

A

-pathologies including the lungs, diaphragm, and mediastinum

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8
Q

Why do we do a PA expiration chest?

A
  • foreign bodies

- pneumothorax

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9
Q

How many ribs are seen on a PA expiration chest?

A

8 or fewer

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10
Q

What do we do to our technique for an PA expiration chest?

A

Increase mAs, lungs more dense without air

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11
Q

Why do we do a lateral decubitus?

A

-better detects small amounts of fluid in the pleural space

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12
Q

How do we position for fluid vs. air on a lateral decubitus?

A

Fluid: affected side down
Air: affected side up

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13
Q

3 parts of the chest

A
  • bony thorax
  • respiratory system proper
  • mediastinum
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14
Q

What is the bony thorax?

A

Provides protective framework for the parts of the chest involved with breathing and blood circulation (thoracic visera)

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15
Q

Parts of the sternum (breast bone)

A
  • manubrium
  • body
  • xiphoid process
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16
Q

Parts of the bony thorax?

A
  • sternum
  • clavicles
  • scapulae
  • ribs
  • thoracic vertebrae
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17
Q

Positioning landmarks and their vertebral levels?

A
  • Vertebral prominens C7
  • Jugular notch T3
  • xiphoid process T9/T10, T11/T12 on inspiration (approx level of anterior diaphragm which separates the chest and abdominal cavity
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18
Q

4 divisions of the respiratory system?

A
  • larynx
  • trachea
  • bronchi
  • lungs
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19
Q

What is the diaphragm for?

A

Primary muscle of inspiration

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20
Q

How does the diaphragm affect chest volume and thoracic pressure?

A

Diaphragm down (inspiration) = decreased thoracic pressure = increased chest volume = sucking action

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21
Q

What does the esophagus connect?

A

The pharynx to the stomach (laryngeopharynx down)

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22
Q

Where is the larynx (voice box) located?

A

C3/C6, suspended from hyoid bone

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23
Q

What does the larynx consist of?

A
  • thyroid cartilage (laryngeal prominence and cricoid cartilage)
  • vocal cords
  • epiglottis
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24
Q

What vertebral level is the trachea at?

A

C6-T4/5

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25
Q

Where is the thyroid gland located?

A

Anterior and inferior to larynx,

Stored and releases hormones

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26
Q

Where are the parathyroid glands located?

A

Posterior/lateral lobes of the thyroid gland

Store and release hormones for maintenance of blood calcium levels

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27
Q

Where is the thymus gland located?

A

Inferior to thyroid gland

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28
Q

Right bronchi?

A
  • wider and shorter, more vertical than left
  • 25 deg angle
  • things more likely to go down here***
  • divides into 3 secondary bronchi
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29
Q

Left bronchi?

A
  • smaller, longer than right

- divides into 2 secondary bronchi

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30
Q

What is the carina?

A

Where the right and left mainstem bronchi split off from the trachea, left of the midline

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31
Q

Branches off of the mainstem bronchi?

A

Mainstem bronchi-secondary bronchi-bronchioles-alveoli

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32
Q

How many lobes/fissures does the right lung have?

A
  • 3 lobes (superior, middle, inferior)
  • 2 fissures (horizontal (s and m) , oblique (m and i)
  • 1” shorter than left lung because of the liver
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33
Q

How many lobes/fissures does the left lung have?

A
  • 2 lobes (superior and inferior)

- 1 fissure (oblique)

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34
Q

What are the lungs composed of?

A

Parenchyma that allows for the breathing mechanism of expansion and contraction

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35
Q

What are the lungs contained in?

A

Pleura

  • parietal
  • visceral (close to lung) (aka pulmonary pleura)
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36
Q

Where is the apex located?

A

Above the clavicles (T1)

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37
Q

What are the costophrenic angles?

A

Extreme outermost lower corners of lungs

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38
Q

What is the hilum?

A

Central area of lungs where bronchi, blood vessel, lymph vessels, and nerves enter and exit the lungs

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39
Q

What projection are the hemidiaphragms seen?

A

Lateral

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40
Q

Parts of the mediastinum?

A
  • thymus gland
  • heart
  • great vessels
  • trachea
  • esophagus
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41
Q

What does the thymus gland do?

A

Prominent in infancy, reaches max size at puberty, shrinks into adulthood
-aids with immune system and helps body resist disease, helps body produce antobodies

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42
Q

The heart and great vessels are enclosed in?

A

The pericardial sac

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43
Q

Where are the heart and great vessels located?

A

Posterior to body of sternum, anterior to T5-T8

2/3rds of heart to the left of the median plane

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44
Q

Esophagus sits between?

A

Anterior to descending aorta and posterior to trachea

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45
Q

Body habitus and thorax/lung size

A

Hypersthenic: broad and deep thorax, shallow vertically
Asthenic: narrow and long thorax, long vertically

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46
Q

Breathing movements, inspiration changes?

A
  • vertical diameter (downward movement of diaphragm)
  • transverse diameter (ribs outward and upward)
  • anteroposterior diameter (raising of ribs especially 2-6)
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47
Q

Technique for chests?

A

Long scale contrast, more greys

-110-125 kVp

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48
Q

Special considerations for older patients??

A

-have less inhalation capability which results in more shallow lung fields and high CR location

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49
Q

What is aspiration?

A
  • foreign object swallowed

- soft tissue technique

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50
Q

What is atelectasis?

A
  • collapse of portion of lung, region appears more radiodense
  • increase technique
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51
Q

What is bronchiectasis?

A

Irreversable dilation or widening of the bronchi or bronchioles, walls destroyed, chronically inflammed, increase mucous, chronic cough
-common in lower lobes, regional radiodensity

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52
Q

What is bronchitis?

A

Acute/chronic excessive mucous secreted into bronchi

  • common in lower lobes
  • hyperinflation and more dominant lung markings
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53
Q

What is COPD-chronic obstructive pulmonary disease

A

-persistent obstruction of airways
-emphysema or chronic bronchitis
-asthma
(Blunted bases)

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54
Q

What is cystic fibrosis?

A
  • inherited
  • heavy mucous causes clogging of bronchi and bronchioles
  • hyperinflation and increased radiodensities
  • increase technique with sever condition
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55
Q

What is dyspnea?

A
  • shortness of breath, difficulty breathing

- most common in older people

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56
Q

What is emphysema?

A

Irreversible chronic lung disease

  • alveolar wall destruction, loss of elasticity, air not expelled during expiration (increased lung dimensions)
  • flat diaphragm (blunted bases), radiolucent lungs
  • decrease technique
57
Q

90% of cancers start where?

A

Bronchi

58
Q

What is epiglottitis?

A
  • inflammation of the epiglottis
  • life threatening, rapid
  • most common in children aged 2-5
  • soft tissue lateral technique
59
Q

What is hamartoma?

A
  • most common benign pulmonary mass, peripheral regions of lung
  • small, radiodense, sharp outlines
60
Q

What is a pleural effusion? (Hydrothorax)

A
  • accumulation of fluid is the pleural cavity
  • increase technique
  • lateral decubitus affected side down or erect
61
Q

What is empyema?

A

Pus in the pleural space, can develop from pneumonia

62
Q

What is a hemothorax?

A

Blood in the pleural space

63
Q

What is pleurisy?

A

Inflammation of the pleura

Causes rubbing of pleura

64
Q

What is pneumonia?

A
  • inflammation of lungs resulting in accumulation of fluid in certain sections of the lungs
  • increased lung markings
65
Q

Types of pneumonia?

A
  • aspiration
  • bronchopneumonia
  • lobar
  • viral (interstitial)
66
Q

What is aspiration pneumonia?

A

Aspiration resulting in edema

67
Q

What is bronchopneumonia?

A

Bronchitis of both lungs

68
Q

What is lobar pneumonia?

A

Pneumonia confined to 1 or 2 lobes of the lungs

69
Q

What is viral (interstitial pneumonia)?

A

Pneumonia in the alveoli and connecting structures

70
Q

What is a pneumothorax?

A
  • air in the pleural space
  • no lung markings
  • best seen in the apex on expiration
  • erect or lateral decub, affected side up
71
Q

What is pulmonary edema?

A
  • excess fluid within the lung “bat sign”
  • most commonly caused by CHF or coronary artery disease
  • increased radiodensity in hilar region
  • increase technique in severe cases
72
Q

What is RDS/hyaline membrane disease/ARDS?

A
  • HMD: infants: decreased surfactant, alveoli stick together
  • ARDS: adults
  • air bronchogram sign
  • increase technique
73
Q

Types of TB?

A

Primary

Secondary

74
Q

What is primary TB?

A
  • never had disease before

- small lesions found in lungs and unilateral pleural effusion

75
Q

What is secondary TB?

A
  • adults, upper lobes
  • upward retraction of the hila
  • calcifications
  • increase technique
76
Q

When is TB best seen?

A

On AP lordotic so clavicles are above the apices

-if supine, angle 15-20 deg cephalad

77
Q

Types of occupational lung disease?

A
  • Anthracosis
  • Asebestosis
  • Silicosis
78
Q

What is anthracosis?

A

-deposits of coal dust, small opaque spots

Black lung pnuemoconosis

79
Q

What is asbestosis?

A

-inhalation of asbestosis that results in pulmonary fibrosis

80
Q

What is silicosis?

A
  • permanent condition
  • inhalation of silica (quartz dust)
  • nodules and scarring
  • 3x more likely to develop TB
81
Q

What is subcutaneous emphysema?

A

Cracking skin

-air in subcutaneous

82
Q

Anterior oblique chests best demonstrate?

A
  • pathology involving the lung fields, trachea, and mediastinal structures
  • determine the size and contours of the heart
83
Q

Oblique lungs: degree of rotation to see the heart?

A

60 LAO

84
Q

Do lung fields appear shorter on anterior or posterior obliques? Why

A

They appear shorter on posterior obliques because of increased magnification of the anterior diaphragm

85
Q

Do the heart and great vessels appear larger on anterior or posterior obliques?

A

Posterior obliques, farther from the IR

86
Q

Which side is best demonstrated on an anterior oblique?

A

PA away (side away from the IR)

87
Q

Costochondral joint calssification?

A

-synarthrodial, no movement

88
Q

Sternoclavicular joint classification?

A
  • diarthrodial, synovial

- double plane/gliding

89
Q

Sternocostal- rib 1 joint classification?

A
  • synarthrodial

- cartilagenous, synchondrosis type

90
Q

Sternoconstal rib 2-7 joint classification?

A
  • diarthrodial, synovial

- plane/gliding

91
Q

Interchondral joints?

A
  • diarthrodial, synovial

- plane/gliding

92
Q

Costovertebral joint classification?

A
  • diarthrodial, synovial

- plane/gliding

93
Q

Costotransverse ribs 1-10 joint classification?

A
  • diarthrodial, synovial

- plane/gliding

94
Q

Tracheostomy

A
  • opening into the trachea to provide an airway

- distal end at 1-2” above carina

95
Q

Endotracheal tube?

A
  • nose/mouth to trachea, for ventilation and sucking
  • distal end 1/2” above carina
  • infants between thoracic inlet and carina (T4)
96
Q

Pleural drainage tube?

A
  • remove fluid/air from pleural space
  • fluid: laterally in pleural space at 5-6th intercostal space
  • air: anterior in pleural space at midclavicle
97
Q

Central venous catheter?

A
  • infusion of toxic substances

- subclavian or jugular veins, extends to SVC, 2.5cm above right atrial junction

98
Q

Umbilical artery catheter?

A
  • measures oxygen saturation

- T6-T9 or below levels of renal arteries L1/L2

99
Q

Pulmonary arterial catheter (swan-ganz)

A
  • measures atrial pressures, pulmonary artery pressures, cardiac output
  • subclavian, internal/external jugular, or femoral vein
  • advances through right atrium into pulmonary artery
100
Q

Umbilical vein catheter?

A
  • deliver fluids/meds
  • junction of right atrium and IVC
  • anterior and superior to heart
101
Q

Pacemaker?

A
  • regulates heart rate by supplying electrical stimulation
  • in subcutaneous fat in anterior chest wall
  • catheter tips directed to right atrium or right ventricle
102
Q

Automatic implantable cardioverter defibrillator (ICD)

A
  • anterior chest wall
  • catheter tips directed to the right atrium or right ventricle
  • detects heart arrythmias and then delivers and electrical shock
  • seen laterally on PA chest
103
Q

What is the sail boat sign?

A

Thymus gland

104
Q

Inspiration/expiration views done for?

A
  • pneumothorax
  • foreign body
  • moving diaphragm
  • ? Opacity on lung vs rib
105
Q

Where does the mediastinum shift for atelectasis?

A

To affected side

106
Q

RDS

A

Alveoli are injured causing fluid to leak in/around them

Increase technique

107
Q

How is TB transmitted?

A

Airbourne

108
Q

Image taken for croup?

A

Ap soft tissue

109
Q

Croup?

A

Narrowing of subglottic portion

Gothic arch sign

110
Q

What is congenital goiter?

A

Enlarged thyroid

111
Q

Dextracardia?

A

Heart is on right side

Congential

112
Q

Situs inversus?

A

Major vessels or organs are on the opposite sides from where they would normally be

113
Q

Open cones to see?

A

Croup

Diaphragmatic hernia

114
Q

How do you see a foreign body if it is radiolucent

A

Forced expiration

115
Q

Cretinism?

A

Hypothyroid in children
Jaundice and decreased growth
Long bones and skull

116
Q

Airborne precautions?

A
  • Sars
  • Small pox
  • TB
  • Varicella (chicken pox)
  • Rubeola (red measles)
117
Q

Droplet size for airborne precautions?

A

5 micrometers or smaller

118
Q

Droplet precautions?

A
  • Influenza
  • Rubella (german measles)
  • Mumps
  • Pertussis (Whooping cough)
  • Most pneumonias
  • Diphtheria
  • Pharyngitis
  • Scarlet fever
  • Meningococcal meningitis
119
Q

Contact precautions?

A
  • Hepatitis
  • Herpes simplex and zoster
  • Impetigo
  • Scabies
  • MRSA
  • VRE
  • Ebola
  • Varicella
  • Norwalk
  • Lice
120
Q

Droplet size for droplet precautions?

A

Greater than 5 micrometers

121
Q

Contract drug resistant?

A
  • C.Difficile
  • E.Coli
  • Rotavirus
  • Shigella
122
Q

Airborne and Contact?

A
  • Varicella
  • SARS
  • Herpes zoster
123
Q

Droplet and Contact

A

-Diphtheria

124
Q

3 main functions of NG tubes?

A
  1. Feeding
  2. Decompression
  3. Radiographic examination
125
Q

Types of NG tubes?

A
  1. Dobbhoff (most common for feeding)
  2. Levin (one lumen with holes)
  3. Salem-sump (one lumen)
126
Q

3 main functions of NE tubes?

A
  1. Feeding
  2. Decompression
  3. Radiographic examination
127
Q

Types of NE tubes?

A
  1. Miller-abbott (2 lumen, drainage, balloon)
  2. Harris (1 lumen)
  3. Cantor (1 lumen)
128
Q

Another name for NE tubes?

A

NI (nasointestinal)

129
Q

Why NE instead of NG tube?

A
  • decrease or absence of peristalsis in the stomach, but not intestines
  • delayed gastric emptying
  • patient has had a gastric resection
130
Q

CVCs are for?

A
  • administration of chemo/long term drugs
  • total parenteral nutrition
  • dialysis
  • blood transfusions
  • blood drawing
  • allows venous pressure monitoring
131
Q

Types of CVCs

A
  • Hickman (long term, meds, venous pressure, withdraw blood)
  • Groshong (1 or 2 lumen, meds, fluid, withdraw blood)
  • Raaf (2 lumen, dialysis)
  • Port-a-cath (infusion, venous access)
  • PICC (short/long term)
132
Q

What is a swan ganz catheter also known as?

A

A pulmonary artery catheter

133
Q

Purpose of a swan ganz?

A
  • cardiac output
  • heart pressures
  • right and left ventricular failure
  • monitor meds
  • measure core temps
  • oxygen in blood
134
Q

Grid ratio formula?

A

h/D (interspace width)

135
Q

Contrast improvement factors?

A

No grid: 1

5: 1 : 2
8: 1 : 4
12: 1 : 5
16: 1 : 6

136
Q

Types of grids?

A
  • Parallel
  • Crossed
  • Focused
  • Moving
137
Q

Grid problems?

A
  • Off-level
  • Off-center
  • Off-focus
  • Upside down
138
Q

Is high kVp and high ratio grid better than low kVp and low ratio grid?

A

Yes

139
Q

Which grid problem occurs with parallel, crossed, and focused grids?

A

Off level

MRT Year 2 (18 decks)

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