Chest study Flashcards
How many posterior ribs should be seen above the diaphragm for a well-inspired PA chest projection?
10
What are the breathing instructions for chest?
inspiration, let out, expose on second full inspiration
What are the reasons for erect chest position?
allows diaphragm to move farther down
demonstrates air/fluid
prevents swelling of pulmonary vessels
What is the hand spread method?
thumb-to-fifth finger
Topographic landmark for PA chest
CR 7-8 inches down from vertebra prominens
What is the recommended kV range for adult chest radiography?
110 to 125 kVp
What should be used for a chest study in a young pediatric patient?
Pigg-O-Stat
What is the minimum SID for erect chest radiography?
72 inches (183 cm)
Where is the CR for PA chest?
T7
Which of the following exposure factors is recommended for a chest study of a young pediatric patient?
A. 110-125 kVp, short exposure time
B. 90-105 kVp, medium exposure time
C. 70-85 kVp, short exposure time
D. 60-75 kVp, long exposure time
C. 70-85 kVp, short exposure time
Which of the following is not a valid reason to perform chest projections with the patient in the erect position?
A. to reduce patient dose
B. to demonstrate air and fluid levels
C. to allow the diaphragm to move down farther
D. to prevent hyperemia of pulmonary vessels
A. to reduce patient dose
Why are the shoulders rolled forward for a PA projection of the chest?
A. to remove scapulae from lung fields
B. to prevent hyperemia of pulmonary vessels
C. to allow the diaphragm to move down farther
D. to reduce chest rotation
A. to remove scapulae from lung fields
Where is the CR placed for an AP supine projection of the chest?
A. 7 to 8 inches (18-20 cm) below vertebra prominens
B. 1 to 2 inches (2.5-5 cm) below the jugular notch
C. 3 to 4 inches (8-10 cm) below the jugular notch
D. 3 to 4 inches (8-10 cm) below the thyroid cartilage
C. 3 to 4 inches (8-10 cm) below the jugular notch
A PA chest radiograph shows that the left sternoclavicular joint is superimposed over the spine (in comparison with the right joint). What specific positioning error is involved?
A. poor inspiration
B. rotation into a RAO position
C. rotation into a LAO position
D. tilting of the chest toward the left
C. rotation into a LAO position
A PA and lateral chest radiographic study has been complete. The PA projection shows the right costophrenic angle was collimated off, but both angles are included on the lateral projection. Would you repeat the PA projection?
Yes
A lateral chest radiograph demonstrates the soft tissue of the upper limbs is superimposed over the apices of the lungs. How can this situation be prevented?
A. deeper inspiration
B. extend chin
C. slight rotation to the patient’s left
D. raise upper limbs higher
D. raise upper limbs higher
A lateral chest radiograph shows that the posterior ribs and costophrenic angles are separated by approx. inch (slightly less than 1” (2.5 cm)). Should the technologist repeat this projection?
yes
A radiograph of an AP lordotic projection shows the clavicles projected within the apices. The instructor informs the student technologist to repeat, but during the repeat exposure the patient complains of being too unsteady to lean backward. What other options are there?
A. perform the PA lordotic projection
B. perform an AP semiaxial projection
C. perform both lateral decubitus projections
D. perform inspiration and expiration PA projections1
B. perform an AP semiaxial projection
An ambulatory patient with a clinical history of advanced emphysema enters the ER. The patient is having difficulty breathing and is receiving oxygen. The physician has orders a PA and lateral chest study. Should the technologist alter the manual exposure factors for the patient?
A. No. Use the standard exposure factors
B. Yes. Increase the exposure factors.
C. Yes. Decrease the exposure factors
D. No. Increase the SID instead of changing the exposure factors
C. Yes. Decrease the exposure factors
A patient enters the ER with an injury to the chest. The ER physician suspects a pneumothorax may be present in the right lung. The patient is unable to stand or sit erect. Which specific position or projection can be performed to confirm the presence of pneumothorax?
A. left lateral decubitus
B. inspiration and expiration PA
C. right lateral decubitus
D. AP lordotic
A. left lateral decubitus
A PA and lateral chest study shows a suspicious mass located near the heart in the right lung. The radiologist would like a radiograph of the patient in an anterior oblique position to delineate the mass from the heart. Which position or projections should the technologist use?
A. 45 degree LAO
B. 45 degree RAO
C. 60 degree LAO
D. AP lordotic
B. 45 degree RAO
A patient with a history of pulmonary edema comes to the radiology department and is unable to stand. The physician suspects fluid in the left lung. Which specific projection should be used to confirm this diagnosis?
A. right lateral decubitus
B. AP semiaxial
C. AP lordotic
D. left lateral decubitus
D. left lateral decubitus
Which of the following objects should be removed (or moved) before chest radiography? (Choose all that apply)
A. necklace
B. bra
C. religious medallion around neck
D. dentures
E. pants
F. hair fasteners
G. oxygen lines
A. necklace
B. bra
C. religious medallion around neck
F. hair fasteners
G. oxygen lines
Is chest radiography the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors?
yes
Do you need to use radiographic grids for adult patients for PA or lateral chest radiographs?
yes
What should you be able to see on a PA chest radiograph
faint outlines of at least middle and upper vertebrae + ribs through heart and other mediastinal structures
T/F, Because the heart is always located in the left thorax, the use of anatomic markers on a PA chest projection is not necessary
false
T/F: because they have shallower lung fields, the CR is often centered higher for geriatric patients
true
T/F: CR centering for the PA chest projection on an obese patient is 1-2 inches (2.5-5 cm) lower than for a sthenic patient.
false; it’s the same
To ensure better lung inspiration during chest radiography, exposure should be made during the _________ inspiration.
second
List 4 possible pathologic conditions that suggest the need for inspiration and expiration PA chest projections.
- small pneumothorax
- fixation/lack of normal diaphragm movement
- foreign body
- opacity in rib or lung
3 reasons chest projections should be taken with the patient in the erect position (when patient’s condition permits).
- diaphragm can move farther down
- air and fluid levels can be seen
- prevention of engorgement and hyperemia of pulmonary vessels
Why do the lungs expand more with the patient in an erect position than a supine position?
abdominal organs drop, moving the diaphragm down which allows lungs to fully aerate
What is the primary purpose and benefit of performing chest radiography using a 72-inch (180 cm) SID?
decreases magnification of the heart
Which of the following anatomic structures is examined to determine rotation on a PA chest radiograph?
A. appearance of ribs
B. shape of heart
C. symmetric appearance and location of sternoclavicular joints
D. symmetric appearance and location of costophrenic angles
C. symmetric appearance and location of sternoclavicular joints
Which positioning tip will help prevent the patient’s chin and neck from being superimposed over the upper airway and apices of the lungs for a PA chest radiograph?
extend the neck upward
Why is it important to raise the patient’s arms above the head for lateral chest projections?
prevents upper chest field from being superimposed
What is the traditional CR centering technique for the chest placed at the top of the IR?
1.5 to 2 inches (5 cm) above shoulders
What is the recommended CR centering technique for a PA chest projection?
palpate vertebra prominens and measure down from bony landmark
For a PA chest projection how many inches down from the bony landmark do you go for a male? female?
8 for male
7 for female
Which of the following bony landmarks is palpated for centering of the AP chest projection?
A. vertebra prominens
B. jugular notch
C. thyroid cartilage
D. sternal angle
B. jugular notch
Should more collimation be visible on the lower margin of the chest image than on the top for a PA or lateral chest projection?
no; should be =
Which of the following chest projections/ positions is recommended to detect calcifications or cavitation within the upper lung region beneath the clavicles?
A. left lateral decubitus
B. PA
C. RPO and LPO
D. AP lordotic
D. AP lordotic
T/F: Multislice CT (MSCT) can produce high-resolution images of the heart on one breath-hold.
true
T/F: Single-photon emission computed tomography (SPECT) is frequently used to diagnose myocardial infarction.
true
Which type of body habitus is associated with a broad and deep thorax?
hypersthenic
Which of the following types of body habitus may cause the costophrenic angles to be cut off if careful vertical collimation is not used?
A. hypersthenic
B. hyposthenic
C. sthenic
D. hyposthenic and asthenic
D. hyposthenic and asthenic
Optimal technical factor selection ensures proper penetration of the:
A. heart
B. great vessels
C. lung regions
D. hilar region
E. all of the above
E. all of the above
A narrow thorax that is shallow from the front to back but very long in the vertical dimension is characteristic of a(n) _____________ body habitus.
A. hypersthenic
B. sthenic
C. hyposthenic
D. asthenic
D. asthenic
Identify the best technical factors for adult chest radiography from the following choices:
A. 70-85 kVp, 40-inch (100-cm) SID
B. 110-120 kVp, 40-inch (100-cm) SID
C. 110-120 kVp, 60-inch (150-inch) SID
D. 125 kVp, 72-inch (180-cm) SID
D. 125 kVp, 72-inch (180-cm) SID
What vertebra is the jugular/sternal notch?
T2-T3
What vertebra is the sternal angle?
T4
What vertebra is the xiphoid process?
T10
Vertebra prominens is..
C7-T1
What vertebra is the inferior angle of scapula?
T7
What vertebra is the thyroid cartilage?
C4
What is another term for diaphragm?
base
how do the lungs exchange oxygen?
parenchyma (elastic substance) allows for expansion and contraction of lungs, which brings oxygen into and removes carbon dioxide from the blood
When do we have the patient remove metallic objects for chest?
if they are in the anatomy of the projection
G.I tract from start to finish
mouth
oropharynx
laryngopharynx
esophagus
stomach
duodeneum
jujuneum
ileum
ascending colon
right colic flexure/hepatic flexure
transverse colon
left colic/splenic flexure
descending colon
sigmoid colon
rectum
anus
What is a chest tube used for?
to remove air, blood, or excess fluid from the pleural space and re-expand the involved lung
