Chest PP Flashcards
What determines the shape, position, and movement of the internal organs?
Body habitus
What separates the thoracic cavity from the abdominal cavity?
Diaphragm
Name the structures contained within the thoracic cavity.
- Lungs
- Heart
- Organs of the respiratory, cardiovascular, and lymphatic systems
- Inferior portion of the esophagus
- Thymus gland
What separates the pleural cavities?
Mediastinum
Which structures make up the respiratory system?
- Pharynx
- Trachea
- Bronchi
- Two lungs
What is the diameter and length of the trachea?
Diameter = approximately ½ inch (1.3 cm); Length = 4½ inches (11 cm)
What is the carina?
A hooklike process on the last cartilage where the trachea bifurcates
Which primary bronchus is shorter, wider, and more vertical?
Right primary bronchus
List the subdivisions of the bronchial tree.
- Primary bronchi
- Secondary bronchi
- Tertiary bronchi
- Bronchioles
- Terminal bronchioles
What are alveolar ducts and what do they end in?
Alveolar ducts end in alveolar sacs.
What is the function of the organs of respiration?
Responsible for the exchange of oxygen and carbon dioxide
What are the two layers of the pleura?
- Visceral pleura
- Parietal pleura
How many lobes does the right lung have?
Three lobes
What is the apex of the lung?
The superior portion that reaches above the clavicles
What divides each lung into lobes?
Deep fissures
Why is the right lung shorter than the left lung?
Because of the presence of the liver
What structures are located in the neck?
- Thyroid gland
- Parathyroid glands
- Larger part of the submandibular glands
What is the isthmus?
The narrow median portion connecting the two lateral lobes of the thyroid gland
How long is the pharynx?
Approximately 5 inches (13 cm) in length
What are the subdivisions of the pharyngeal cavity?
- Nasopharynx
- Oropharynx
- Laryngeal pharynx
What is the function of the larynx?
Organ of voice
What guards the larynx?
- Epiglottis (superiorly and anteriorly)
- Folds of mucous membrane (laterally and posteriorly)
What is the mediastinum?
Area of thorax bounded by sternum anteriorly, spine posteriorly, and lungs laterally
Which lung has three lobes?
Right lung
Aspirated foreign objects are more likely to lodge in which bronchus?
Right primary bronchus
What is the level of the trachea bifurcation?
Carina
Which structure is located in front of the vertebrae and behind the nose and mouth?
Pharynx
What is the recommended SID for chest radiography?
At least 72 inches (183 cm)
What should be included on each image for identification?
Right or left side markers
What is the purpose of gonad shielding?
To reduce patient anxiety and comply with state regulations
When should exposures be made during breathing instructions?
After the second deep inspiration
What are essential projections of the chest?
- Posteroanterior (PA)
- Lateral
- PA oblique
- Anteroposterior (AP) oblique
- AP
- AP axial
What is the position of the patient for a PA chest radiograph?
Upright either standing or seated
Where does the central ray enter for a PA chest radiograph?
At MSP and level of T7 (inferior angle of the scapula)
What should be visible in a PA chest evaluation?
- Entire lung fields from the apices to the costophrenic angles
- 10 posterior ribs visible above the diaphragm
What is the patient position for a PA Chest X-ray?
Upright, either standing or seated
Demonstrates air or fluid levels and allows diaphragm to move to its lowest position.
What is the central ray (CR) direction for a lateral chest X-ray?
Directed perpendicular to IR, enters patient on MCP at level of T7
Exposure is made at the end of the second deep inspiration.
What structures are shown in a left lateral chest X-ray?
Heart, Aorta, Left-sided pulmonary lesions
A right lateral position demonstrates right-sided pulmonary lesions and interlobular fissures.
What are the evaluation criteria for a lateral chest X-ray?
- Arm or its soft tissues not overlapping the superior lung field
- Costophrenic angles and the lower apices of the lungs
- No Rotation
- Hilum in the center
- Superimposition of the ribs posterior to the vertebral column
- Sternum in profile
- Trachea in midline
What is the part position for a PA Oblique Chest X-ray?
45-degree left anterior oblique (LAO) or right anterior oblique (RAO)
Side of interest is farther from IR (elevated side).
What is the central ray (CR) direction for a PA Oblique Chest X-ray?
Perpendicular to IR, enters at level of T7
Exposure made after second full inspiration.
What structures are shown in a LAO position during a PA Oblique Chest X-ray?
- Right lung field
- Anterior portion of left lung superimposed by spine
- Trachea
- Carina
- Entire right bronchial tree
- Heart
- Descending aorta (in front of spine)
- Arch of the aorta
What is a key evaluation criterion for a PA Oblique Chest X-ray?
Both lungs in their entirety
Heart and mediastinal structures within the lung field of the elevated side in oblique images of 45 degrees.
What is the patient position for an AP Oblique Chest X-ray?
Supine or seated upright in wheelchair or stretcher
Used when the patient is too ill to sit or stand.
What structures are shown in an AP Chest X-ray?
- Both lungs
- Heart and great vessels magnified
- Lung fields appear shorter
- Clavicles projected higher
- Ribs appear more horizontal
What are the evaluation criteria for an AP Chest X-ray?
- Entire lung fields
- No rotation
- Sternal ends of the clavicles equidistant from the vertebral column
- Trachea visible in the midline
- Equal distance from the vertebral column to the lateral border of the ribs on each side
What is the central ray (CR) direction for an AP Axial Chest (Lordotic Position)?
Perpendicular to IR, enters MSP at midsternum 3 to 4 inches below jugular notch
Exposure made after second full inspiration.
What structures are shown in an AP Axial Chest (Lordotic Position)?
- Lung apices
- Interlobar effusions
What is the evaluation criterion for a lateral decubitus position?
- Affected side in its entirety
- No rotation of the patient
- Sternal ends of the clavicles equidistant from the spine
- Patient’s arms not visible in the field of interest
- Faintly visible spine and pulmonary vascular markings from the hilar regions to the periphery of the lungs
To demonstrate fluid in a lateral decubitus position, the patient should lie on the ______?
affected side
What is the purpose of allowing the patient to remain in position for 5 minutes before exposure during a lateral decubitus X-ray?
Allows fluid to settle or air to rise
What is the central ray (CR) for a dorsal decubitus position?
Horizontal and perpendicular to IR, enters at level of MCP, 3 to 4 inches below jugular notch
For T7 in the ventral decubitus.
What is the projection for a patient in a left lateral decubitus position?
AP or PA projection
Right or left lateral decubitus position can be used.
What are the evaluation criteria for a lateral projection in the ventral or dorsal decubitus position?
- Entire lung fields, including the anterior and posterior surfaces
- Upper lung field not obscured by the arms
- No rotation of the thorax
- T7 in the center of the IR
- Pulmonary vascular markings from the hilar regions to the periphery of the lungs
What is the significance of the top of the IR being positioned 1½ to 2 inches above the shoulders in chest X-rays?
Ensures proper coverage of lung fields
