Oblique and Decub Chest, Soft Neck 11/2/15 Flashcards
An LAO position is equivalent to the ____ position.
RPO
When performing an RAO position of the chest, which lung will be best demonstrated?
Left
Proper respiration for routine chest radiography is ____.
Double Inspirtation
If performing a Dorsal Decubitus position the patient is laying ____.
Supine
If performing a Ventral Decubitus position the patient is laying ____.
Prone
During preliminary positioning for a Decubitus chest exam, the patient should lie in required position for approximately ____ minutes.
5
Name the 3 things that make something Decubitus.
1) Recumbent patient
2) Vertical IR
3) Horizontal CR
The degree of a “steep” chest oblique would be ____.
oblique is greater than 45 degrees
The degree of a “shallow” chest oblique would be ____.
rotation less than 45 degrees
When performing an LAO position of the chest the lung being best demonstrated would be ____.
Right
Why do we prefer to perform chest radiography in PA position if possible?
Decrease magnification of the heart
What is the routine when visualization of a PICC line is necessary?
PA Chest
Name one reason for insertion of a “line” or catheter into chest cavity.
Medication Delivery
Give one example of a “line” or catheter that may be inserted.
Swan Gantz Catheter
The CR should directed to the level of ____ for the soft tissue lateral neck procedure.
C4 (Adam’s Apple)
What is being visualized when performing a soft tissue lateral neck procedure?
1) Pharynx (air filled)
2) Foreign Bodies
3) Enlarged Adenoids
What should the proper breathing instructions be for soft tissue lateral neck radiograph?
Inspiratory phase of quiet nasal breathing to ensure that nose and throat passages are air filled.
What are the 2 things that could be demonstrated when doing a right or left lateral Decubitus chest.
1) Demonstrate change in fluid levels and reveals any previously obscured pulmonary areas
2) In case of suspected Pneumothorax, the presence of free air
Where should the CR be directed for an oblique view of the chest on a prone patient?
T7 and 2” off MSP toward elevated side
Why and how should we elevate the patient for a lateral Decubitus chest?
Elevate the body 5-8 cm (2-3 in) on a suitable platform or firm pad. Get them off mattress to get foreign bodies out of the way.
What should be done to the technical factors when performing a soft tissue lateral neck procedure?
decrease approximately 10 kV from bony neck studies
Label Lateral Decubitus.
Apices, Fluid levels, Heart
Give an example of a “positive” contrast used in radiology and what color will a “positive” contrast be on the finished radiograph?
Barium and it will be white
What Decubitus position should be performed if a patient is suspected of having excessive fluid within their right lung?
Right Lateral Decubitus
What is the medical term used for “enlarged adenoids” that may appear on a patient order slip and /or voucher for a soft tissue lateral neck?
Adenoidal Hypertrophy
When performing routine chest radiography, the CR should be directed to this vertebral level.
T7
When performing a routine chest radiograph, why should the shoulders be rolled anteriorly?
To remove the scapular shadows from the lung field.
What body habitus would be a massive build with organs that are high, broad, and typically away from the mid-line?
Hypersthenic
What method name describes the removal of the clavicles from the apices on a chest radiograph using the movement of the patient?
Lindblom
If you (the student) were performing a lateral soft tissue neck on a pediatric patient, how could you explain the proper breathing technique to them in a way they would understand?
Smell a flower-sniff in
What is the term used to describe the area of the chest cavity that contains all thoracic structures except the lungs and pleura?
Mediastinum
What anatomic structures are used to determine rotation of the PA or AP chest radiograph?
SC joints equidistant from vertebral column
What anatomic structures are used to determine rotation of the lateral chest radiograph?
superimposition of the ribs posterior to the vertebral column
If a filter was to be used on any Lateral Decubitus chest exam, where would the think end of the filter be placed and why?
This end is used on upper lung (air filled lung); evens out densities. It is easier to penetrate than fluid on side down.
When the esophagus is filled with barium, how much should the patient be obliqued in order to demonstrate the great vessels?
55-60 degree
AP or PA projection ( Rt or Lt Decub position)- A small amount of ____ in the pleural cavity is usually best shown with pt lying on affected side ( mediastinal shadows and fluid won’t overlap).
Fluid (looking for fluid)
AP or PA projection (Rt or LF Decub position)- A small amount of free ____ in the pleural cavity is generally best demonstrates with the pt lying on the unaffected side.
Air (looking for air)
AP or PA projection (Rt or Ft Decub position)- Allow pt to remain in position on their side for 1 minutes prior to exposure (best allows 2 to settle and free 3 to rise).
1) 5 minutes
2) water
3) air
AP or PA projection (RT or LF Decub position)- Adjust IR 1 beyond shoulders. CR is 2 and 3 to center of IR and at 4 for AP or at 5 for PA. No Rotation (6).
7 side in its entirety; apices.
1) 1 1/2-2”
2) perpendicular
3) horizontal
4) a level 3” below the jugular notch (mid-sternum)
5) T7
6) clavicles equidistant from the spine
7) affected side
Fluid is 1 on radiograph and air is 2.
1) white
2) black
Lateral projection (Ventral or Dorsal Decub position)- Place IR to level of the 1 and CR should enter the 2 3-4” below 3 for dorsal decub and 4 for ventral decub. Shows changes in position of 5 and reveals 6 areas obscured by fluid in standard projections. Entire 7 fields (including anterior and posterior surfaces).
1) Thyroid Cartilage (C4-C5)
2) MCP
3) the jugular notch (mid-sternum)
4) T7
5) fluid
6) pulmonary
7) lung
AP projection (Trachea)- It is important to use a __1__ technique for trachea demonstrations to reduce secondary radiation because 2 must be high enough to penetrate both the 3 and 4.
1) grid technique
2) kVp
3) sternum
4) cervical spine
AP projection (Rt or Lt position) Trachea - May examine pt recumbent, 1, or 2. Center IR at level of 3. Instruct pt to inhale 4 during exposure to ensure trachea is filled with 5. Includes mid-cervical to 6. Use 7 bucky. Center CR at a point 4-5” lower of the superior 8.
1) supine
2) upright
3) manubrium
4) slowly
5) air
6) mid-thoracic
7) upright
8) mediastinum
Anterior Neck- Occupies region between skull and 1. The act of swallowing is called 2. Enlarged adenoids (aka 3 tonsils).
1) Thorax
2) deglutition
3) pharyngeal
Pharynx/Larynx- 1 Projection is standard. Center IR and CR at level of or slightly below 2. Instiratory phase of quiet nasal breathing to ensure that nose and throat passages are 3 filled (breathe in through nose).
1) AP projection
2) Laryngeal Prominence (aka thyroid cartilage, adam’s apple, C4-C5)
3) air
Lateral Projection (Rt or Lt)- 1 centered to midline of IR. CR can
a. Center IR 1” below the 2. (dem. nasopharynx and cleft palate studies).
b. Center IR at the level of 3 angles. (dem. orotharynx)
c. Center IR at level of 4. (dem. larynx, laryngeal pharynx, and upper esophagus)
Inspiratory phase of quiet nasal breathing to ensure that nose and throat passages are 5 filled.
1) TMJs
2) EAM
3) manibular
4) laryngeal prominence
5) air
____- leads go via the subclavian vein into the brachiocephalic vein into the superior vena cava to the right atrium through the tricuspid valve to the right ventricle.
Pacemaker
____- Catheter goes through the subclavian vein into the brachiocephalic vein into the superior vena cava to the righ atrium. From there it goes through the right AV valve to the right ventricle through the pulmonary semi-lunar valve into the pulmonary artery and wedged into the right or left pulmonary artery.
- Measure pulmonary wedge pressure
- Cardiac function
Swan Gantz Catheter
____- catheter goes through the subclavian and brachiocephalic vein into the superior vena cava.
-Medication goes through this catheter (Mediport)
Central Line
____- Catherter goes through the subclavian and brachiocephalic vein to the superior vena cava.
- Chemotherapy is administered via this catheter (Mediport)
- Catheter insertion can also be done through the femoral vein, external iliac vein, to the common iliac vein to the inferior vena cava.
Hickman Catheter
____- Tube goes to the stomach.
Feeding Tube
____- Nasogastric tube goes to the stomach.
NG-Tube
____- Tube goes to the duodenum-mercury weighs it down.
MA Tube
____- Do a PA chest only.
PICC Line
