Lecture 4-Chest Flashcards
What indicates a full inspiration on a PA chest?
10 posterior ribs on left side above diaphragm
What should the collimation of a PA chest inlude?
Costophrenic angles to above the 1st rib
What vertebral level should the sternum be located at in a PA chest? How can we check radiographically for this?
-Manubrium is superimposed on T4
-We can check this by counting the number of ribs, below T1 since the bottom of the clavicles line up with the manubrium
In practice, it should be at T2/T3
How can you decrease time for an exposure?
Use large mA, and large focal spot
What is the one slight error made in this PA chest? Would this be a repeat?
-Slightly lordotic looking patient
-Not a repeat
(good image)
What errors have been made in this image of the PA chest?
-Kyphotic looking
-Scapula is not off ribs
-Clipping superior portion of ribs
What error(s) have been made in this image of the PA chest?
-Trachea to the left of the spinous process-RAO
-Lordotic looking image
-Scapula is over ribs
What error(s) have been made in this image of the PA chest?
-Not a full inspiration-only seeing 8 ribs
-LAO
-Scapula on ribs
What errors have been made in this image of the PA chest?
-First rib clipped
-Slightly lordotic
What error(s) have been made in this image of the PA chest?
-Lordotic looking
-LAO rotation
Did not get the scapula off ribs
Not a full inspiration
What error(s) have been made in this image of the PA chest?
-Not a full inspiration (could mimic cariomegaly)
-RAO looking
What error(s) have been made in this image? What projection is this?
-LPO looking
-Scapula not off ribs
-This is an AP supine chest image
How does an ET tube appear if the patient is in a more kyphotic position? A more lordotic position?
Kyphotic image: ET tube appears too low
Lordotic image: ET tube too high in image
What error(s) have been made in this image of the PA chest?
Shoulders not depressed
What error(s) have been made in this image of the PA chest?
-RAO looking
-Slightly kyphotic
What errors have been made in this image of the PA chest?
-Shoulders too high
-RAO looking
What chambers are the pacemakers located in?
Pacemaker in R ventricle and R atrium
What projection is this? What errors have been made in this image?
-Lordotic projection
-Clipping the top of the rib
T/F
We cannot acess the CT ratio when the chest is AP
True
What error is made in this image of the PA chest?
-Lordotic looking image
-Scapula on
-Not a full inspiration
What error(s) have been made in this image of the PA chest?
None
What error(s) have been made in this image of the PA chest?
-Slightly clipped first ribs
-Slightly lordotic looking
ET tube in the right mainstem bronchus
What errors have been made in this image of the PA chest?
-Not full inspiration
-Lordotic looking
What error(s) have been made in this image of the PA chest? Would this be a repeat?
-Scapula over ribs
-Clipped the first rib and the base of the lung
-Would we repeat for scapula on image; wouldn’t repeat for this image because they would probably have more x rays after surgery
-PTX; hard to see with the scapula over top
What error(s) have been made in this image of the PA chest?
-Scapula is on the ribs
-Shoulders elevated
(hiding a PTX)
What errors have been made in this image of the PA chest?
-Slight RAO
-Shoulders are shrugged up
-Scapula on
T/F
Right hemi-diaphragm is often higher on PA
True
If right hemidiaphragm is lower than left in a left lateral, what does that mean?
Hips have been pushed against wall detector
Where does the Left hemi-diaphragm appear to stop anteriorly?
Left hemi-diaphragm appears to stop at the posterior margin of the heart
What one landmark we can use to tell where the left hemidiaphragm is?
Gas bubble is under left hemi-diaphragm
What error(s) have been made in this image of the lateral chest?
None; minus the face down marker
(radiologist flips the image, so marker was put on incorrectly to begin with)
What error(s) have been made in this image of the lateral chest?
Arms out rather than up
(necklace is fine)
What error(s) have been made in this image of the lateral chest?
-Arms not straight up
What error(s) have been made in this image of the lateral chest?
-Arms not straight up
-Patient in an LAO position
What error(s) have been made in this image of the lateral chest?
-LPO position looking
-Arms straight out
What error has been made in this image of the lateral chest?
Not a full inspiration
ensure that the breath is completely held before pressing on the roter
What error has been made in this image of the lateral chest?
Patient rotated LAO and arms are straight out
(you can look at the humeri)
What error has been made in this image of the lateral chest?
-Arms are in the image
-LPO (identify by the gas bubble)
-Disc space is perfect, so for some reason the hemidiaphragms are not at the same level
What error has been made in this image of the lateral chest?
Patient rotated LAO
What error has been made in this image of the lateral chest?
Right hip rotated posterior
Not LPO because the upper ribs are fine
What error has been made in this image of the lateral chest?
Right hip too anterior
Shoulders are in a lateral (but humeri are off)
Don’t care as much about the top
What error has been made in this image of the lateral chest?
Hips are tilted towards the bucky (lost the disc spaces)
How do you position a patient with a recently placed pacemaker for a lateral chest?
Raise elbow 90 degrees and hold the biceps with the other hand
CANNOT RAISE THE ELBOW ABOVE THE SHOULDER AFTER PACEMAKER PLACEMENT (pacemaker hasn’t been anchored to the body yet)
