Chp 2 Chest Flashcards
What topographic landmarks are used for positioning the chest?
Anterior:
-The jugular notch (T2-T3)
-Xiphoid process tip (T9 or T10)
Posterior:
-C7 vertebral prominens
-T7 midthorax
Where is the mid thorax relative to the thoracic spine?
T7
Bony thorax
Part of the skeletal system, that is the protective framework of the chest that involves breathing and circulation.
sternum, clavicles (2), scapulas (2) and thoracic vertebrae (12),
12 pairs of ribs
Three sections of the chest (thorax)
Bony thorax
Respiratory system
Mediastinum
Thoracic viscera
Parts of the chest, consisting of lungs and mediastinum (organs: esophagus, heart, thymus, trachea)
Location of trachea
-Anterior to esophagus
-extending from C6 (larynx junction) to T4 or T5 (carina) where it divides into left and right bronchi’s.
How many lobes does each bronchi have?
Right bronchi- three lobes connecting to three individual lobes of the right lung. Shorter, wider and more vertical.
Left bronchi- two lobes that connect to two lobes of the left lung. These lobes are long and narrow.
Why does the left lung only have two lobes?
The left lung has a depression on the medial side to make room for the heart
What is pneumothorax?
A pathology in which air or gas has leaked into the pleural cavity.
Pressure of the air or gas may cause the lung to collapse.
Hemothorax
When blood gets into the pleural cavity.
Where does gas exchange occur in the lungs?
Alveoli
Pleura
A delicate double walled sack that contains the lungs.
Outer layer - parietal pleural
Inner layer - visceral pleura.
In between these layers is the pleural cavity.
Primary muscle of inspiration
Diaphragm
What happens to the diaphragm during inspiration?
The diaphragm moves downward and increases lung capacity.
What are the three divisions of the pharynx?
Nasopharynx
Oropharynx
Laryngopharynx
Uvula
Inferioposterior aspect of the soft plate of pharynx.
Identifies the boundary between the nasopharynx and oropharynx.
Little dangly thing in the back of your throat.
Epiglottis
Functions as a lid, covering the laryngeal opening during swallowing to prevent food from entering the larynx and bronchi.
What is the lungs composed of?
The lungs are composed of a light spongy, highly elastic substance called parenchyma.
Allows for expansion and contraction.
What are the important radiographic parts of the lung?
Apex - rounded upper area above the level of the clavicles. Extending up into the lower neck area to T1. (Must be shown in chest radiographs)
Carina - The point where the trachea separates into right, and left bronchi.
Base - the lower concave area of each lung that rest on the diaphragm.
Costophrenic angle - the extreme outermost lower corner of each lung where the diaphragm meets the ribs.
Hilum - known as the root region is the central area of each lung where the bronchi, blood vessels, lymph vessels, and nerves, enter and leave the lungs. “Party at the hilum”
Which lung is shorter?
The right lung is about 1 inch shorter than the left.
Because the large space occupying the liver, which is located in the right upper abdomen and pushes up on the right hemi diaphragm.
Where is the esophagus located?
Posterior to the trachea and the larynx.
Connects the pharynx to the stomach.
Hyoid bone
Horseshoe shaped bone in the anterior midline of the neck between the chin and the thyroid cartilage.
The only bone in the human body, not connected to any other bones.
Aids and swallowing, speech and movement of tongue.
Pigg-o-stat
Pediatric positioning device used for x-ray exams.
Where is the approximate area of the xiphoid process?
T9 to T10
What marks the boundary between the oropharynx and the nasopharynx?
Uvula
From what part of the anatomy is the larynx suspended?
Hyoid bone
How many fissures are in the right lung?
Two deep fissures separating the superior lobe, middle lobe, and inferior lobe.
What is the double-walled membrane that contains the lungs?
Pleura
What is the medial portion of the thoracic cavity between the lungs called?
Mediastinum.
For structures in the mediastinum: trachea, esophagus, thymus gland, heart and great vessels
Hypersthenic
Body habitus associated with a broad and deep thorax
What are the criteria’s for a PA and lateral chest radiograph?
PA Chest
-No rotation. Make sure patient is standing evenly with feet slightly spread apart, shoulders rolled forward and downward.
- Both the right and left sternal ends of the clavicle are the same distance from the centerline of the spine.
-Extending the neck and chin up insures. They are not super imposing the upper regions (apices) of the lung.
-Image during inspiration.
-ideally want at least 10 ribs in image.
-Apex of lungs at the top and costophrenic angles at the bottom are shown.
Lateral
-Left lateral to IR unless indicated otherwise
-No rotation or tilt ensuring ribs are super imposed.
-Arms raised
CR chest positioning method for PA chest
Locating the vertebra prominens (T1) and using hand spread method to find The center of the lungs field. 7 inches for females 8 inches for males.
CR chest positioning method for AP Chest
Locating the jugular notch. 3 to 4 inches below jugular notch for CR (about the hand width with the fingers together is approximately 3 inches)
What is the typical kilovoltage range for chest x-ray of adult patients?
110-125 kVp
Pleural effusion
Abnormal accumulation of fluid in the pleural cavity.
Which anterior oblique projection would best elongate the left thorax?
RAO
Pulmonary edema
A condition in which excess fluid builds in the lungs, as a result of obstruction of the pulmonary circulation
Atelectasis
Condition, in which all or a portion of the lung is collapsed
When a patient is in a left lateral decubitus position is the coronal plane parallel or perpendicular to the image receptor?
Parallel
What are the different names for the notch on the top portion of the sternum?
Jugular notch, manubrial notch, or suprasternal notch
Where is the jugular notch in reference to the thoracic spine?
T2-T3
Asthenic
The extreme opposite of hypersthenic body habitus. Thorax is very narrow and shallow from front to back, but very long, vertical dimension.
Sthenic
Average thoracic chest space.
Hyposthenic
Slender body habitus
Pulmonary emboli
Sudden blockage of artery in lung
What are the four general divisions of the respiratory system system?
Pharynx
Trachea
Bronchi
Lungs
Why do we do a chest x-ray at 72” SID?
Less magnification occurs at a greater SID.
Less magnification of the heart and other structures within the thorax.
Higher resolution.
What is the purpose of a grid? Would you need a grid for a PA x-ray?
A grid absorbs scatter radiation before it hits the IR.
It is important in a Chest x-ray. It would help create a better radiograph and improve image contrast.
The boundary between the nasopharynx and oropharynx
Uvula
Emphysema
Irreversible and chronic lung disease, where the alveoli air spaces are enlarged and have lost elasticity. Lungs become radiolucent and elongated. Requires less mAs.
Pleurisy
Inflammation of the pleura
What pathologies require an expiration chest x-ray?
Pneumothorax and COPD
Where would you place the CR for most geriatric patients?
A little higher, because geriatric patients have a shallow lung field.
They may also have kyphosis (hunchback)
