Exam 2 (part 4) Flashcards
PA chest
SID - 72
KVP range - 100-125
CR at MCP parallel, MSP perpendicular, at T7
2 full inspirations
Lateral chest
only difference is center at MSP parallel, MCP perpendicular
Describe the positioning for an AP chest x-ray in detail. Give central ray location, SID and average kVP range with a grid.
SID: 72 Center at MSP perpendicular IR 1.5 to 2" above relaxed shoulders Adjust shoulders to lie in same transverse plane Flex patients elbows and pronate hands Place hands on hip to draw the scapulae laterally 2 full inspirations CR 3" below jugular notch KVP: 100-125 with grid
Describe the positioning for a decubitus chest x-ray in detail. Give central ray location, SID and average kVP range with a grid.
Air: lay on unaffected side Fluid: lay on affected side SID: 72" KVP: 100-125 Elevate body True lateral Arms above head IR 1.5 - 2" inches above shoulders 2 full inspirations
Describe how you would evaluate your final images for quality and accurate positioning. How would you identify rotation? Tilt? Adequate inspiration?
AP+PA Chest: Equal SC Joints, equidistance spine to lateral border of ribs, marker
Lateral chest: Posterior ribs superimposed, no arms in lung field
Decubitus: equal SC joints, arms out of lung field
Why is it always best to take a chest radiograph after the 2nd full inspiration?
Ensures maximum expansion of lungs
Why is it best to use a 72” SID for a routine chest x-ray?
Decreases magnification of the heart
Why is a PA projection preferred over an AP projection of the chest?
Places heart closer to IR to reduce magnification
Why is it best to always take a chest x-ray with the patient fully upright?
Prevent engorgement of pulmonary vessels, gravity helps keep diaphragm at lowest point, air/fluid levels
If the patient cannot be fully upright for a chest x-ray what adjustment should be made to the x-ray tube?
Angle the tube caudad 5 degrees
How can you identify the level of T7 when centering for a PA chest x-ray? (What anatomical landmark would you use?)
Inferior portion of scapulae
How can you identify the level of T7 when centering for an AP chest x-ray? (What anatomical landmark would you use?)
3” below jugular notch, at nipple line
When taking a chest x-ray on a young child what technical factor should be adjusted to lessen the chance of motion?
Short exposure time, 80-90 kvp, time it for full inspiration
What kVp would be used for a routine abdomen, per Merrill’s? (No contrast media used)
80-85 kvp
If the proper kVp range was used which abdominal structures should be well visualized?
Psoas muscle
Lower border of the liver
Kidneys
Ribs and transverse processes
How would you determine rotation on a supine abdomen image?
Spinous processes – middle of vertebral column
Iliac wings - symmetrical
Obturator foramen - symmetrical
What breathing instructions should be given for a routine abdomen?
2 inspirations, hold out on second
Which projection of the abdomen would give the least gonadal radiation dose to the patient?
PA
Describe positioning for a routine supine abdomen x-ray. What is the position, projection, CR location, SID, kVp, breathing instructions.
SID: 40”
Center at MSP perpendicular to midline of IR
Arms/hands out of area of interest
IR centered at level of illiac crest
ASIS & shoulders equidistance to the table
2 breaths, hold out on last
How would you evaluate a supine abdomen radiograph for quality? What are you looking for? What anatomy must be included?
Kidneys Psoas muscle Lower border of the liver Transverse process No rotation: Spinous processes – middle of vertebral column Iliac wings - symmetrical Obturator foramen - symmetrical Marker
Describe positioning for an upright abdomen x-ray, AP projection. What is the CR location, SID, kVp, breathing instructions. What anatomy must be included on an upright abdomen?
SID: 40" center at MSP perpendicular, 2" above illiac crest to midline of IR Weight equally distributed Arms/hands out of area of interest IR centered at 2” above level of Iliac Crest ASIS & shoulders equidistant to the IR Anatomy: Kidneys Psoas muscle Lower border of the liver Transverse process
KVP: 80-85
Describe positioning for a lateral decubitus abdomen x-ray. What is the CR location, , projection , position, SID, kVp, breathing instructions.
KVP: 90-95 SID: 40" Center MCP to midline of IR Arms/hands out of area of interest IR centered at 2” above level of Iliac crest Shoulders & ASIS equidistant to table Flex knees for comfort Wait 5 minutes for air/fluid to settle
