Chest (Thoracic Viscera) Flashcards
PA/AP Upright Chest
Positioning
- Upright to lower diaphragm (seated or standing)
- chest or back flat against IR (AP or PA)
- roll shoulders forward
- top of IR 1.5-2” above relaxed shoulders
- arms slightly abducted with dorsal hands on hips
- SID 72”
- Center at T7
- expose on second full inspiration
PA/AP Upright Chest
Image Eval
- all of lungs visible including:
- apices
- costophrenic angles
- no rotation
- sternal ends of clavicles equidistant from center
- scapulae projected outside lung field
- at least 10 ribs visible in light field
Lateral Upright Chest
Positioning
- turn patient in true lateral position
- MSP parallel to IR
- MCP perpendicular to IR
- top of IR 1.5-2” above shoulders
- extend arms directly upward, bend elbows, and rest on top of head
- SID 72”
- Center at T7
- expose on second full inspiration
Lateral Upright Chest
Image Eval
- arms out of lung field
- costophrenic angles and apices visible
- no rotation, seen by superimposition of posterior ribs
AP Lordotic Chest (Lindblom Method)
Positioning
- patient stands 1 foot in front of IR
- lean backward onto IR until MCP is 15-20 degrees with plane of IR
- top of IR 3” above shoulders
- SID 72”
- Center at T7 (midsternum)
- expose on second full inspiration
AP Lordotic Chest (Lindblom Method)
Image Eval
- apices projected below sternums
- no rotation
- clavicles approx. horizontal and covering only 1st or 2nd ribs
AP Supine Chest
Positioning
-patient supine with back against IR
-top of IR 1.5-2” above patient’s shoulders
-if possible, flex elbows and place backs of hands on hips
-center 3” below jugular notch; perp. to long axis of sternum
SID 60-72” if possible
-expose on second full inspiration
AP Supine Chest
Image Eval
- entire thoracic viscera
- apices
- costophrenic angles
- clavicles projected higher with horizontal appearance
- sternal ends of clavicles equidistant from center of spine to show no rotation
AP or PA, Lateral Decubitus Chest
Positioning
- patient on side with back or chest against IR and arms out of the FOV
- affected side down if pleural effusion is suspected
- affected side up if pneumothorax is suspected
- elevate body 2-3” from bed/table (better for effusion)
- position patient and wait 5 minutes before exposure (allows air and fluid to settle)
- Center at T7 (PA) or 3” below jug. notch (AP)
- SID 60-72” if possible
- expose on second full inspiration
AP or PA, Lateral Decubitus Chest
Image Eval
- affected side in it’s entirety (angles and apices)
- no rotation (sternal ends of clavicles…)
AP and PA Oblique Chest
Positioning
- AP (LPO/RPO) side of interest is closest to IR
- PA (LAO/RAO) side of interest is farthest from IR
- turn body 45 degrees from IR
- side closest to IR: arm is elevated
- side farthest from IR: elbow is bent and back of hand is on hip
- SID 72”
- Center at T7 (PA) or 3” below jug. notch (AP)
- expose on 2nd full inspiration
AP and PA Oblique Chest
Image Eval
- both lungs in their entirety (angles and apices)
- max visualization of left lung on LPO and RAO
- max visualization of right lung on RPO and LAO
- proper rotation of 45 degrees
How many sets of ribs should be visible on a PA chest with good inspiration?
10
How should the clavicles appear for a AP Lordotic Chest? What method is used?
- horizontal, only covering 1st or 2nd ribs
- Lindblom
The affected side of a patient should be up or down for a Lateral Decubitus of the Chest if:
- pleural effusion
- pneumothorax
- effusion: affected side down
2. pneumo: affected side up
