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SRJC RADTECH > Positioning 1- Chapter 10/week 5 > Flashcards

Positioning 1- Chapter 10/week 5 Flashcards

1
Q

Body habit us

A

Determines shape, position, and movement of the internal organs

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2
Q

Four types of body habitus

A

Sthenic
Hypersthenic
Asthenic
Hyposthenic

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3
Q

Thoracic cavity

A

• bounded by walls of thorax
• extends from the superior thoracic aperture to the inferior thoracic aperture
• diaphragm separates thoracic cavity from abdominal cavity
• contains the kings and heart; the organs of the respiratory, cardiovascular, and lymphatic systems; and the thymus gland
• three separate chambers
-pericardial
-right and left pleural
• mediastinum separates pleural cavities
-contains all thoracic structures, except lungs and pleurae

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4
Q

Respiratory system

A

• consists of

  • pharynx
  • trachea
  • bronchi
  • two lungs
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5
Q

Trachea

A

• fibrous, muscular tube with 16 to 20 c-shaped cartilaginous rings in its walls for strength
• measurements
-diameter= approximately 1/2 inch(1.3 cm)
-length = 4 1/2 inches (11cm)
-posterior aspect is flat
• lies in midline, anterior to esophagus
• carina is hooklike process on the last cartilage
• trachea divides, or bifurcates, at carina
-right primary bronchus
-left primary bronchus
• each primary bronchus enters the corresponding lung

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6
Q

Bronchi

A

• right primary bronchus is shorter, wider, and more vertical than left
-position and size make it easier for foreign bodies to enter the right bronchus
• subdivisions of bronchial tree
-primary bronchi
-secondary bronchi
-tertiary bronchi
-bronchioles
-terminal bronchioles
• terminals communicate with alveolar ducts

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7
Q

Alveoli

A

• alveolar ducts end in alveolar sacs
• walls of alveolar sacs lined with alveoli
-oxygen and carbon dioxide exchanged by diffusion In alveoli
• millions of alveoli in each lung

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8
Q

Lungs

A 
• Organs of respiration
• superior portion = apex
   -reaches above clavicles
• inferior = base 
   -rests obliquely on diaphragm
   -lower in back and sides
• sides = costophrenic angles
• medial border = hilum 
• right lung is shorter than left because of presence of liver
   -broader than left
• move inferiorly- inspiration
• move superiorly- expiration
• each lung enclosed in a double walled serous membrane sac called the pleura
   -inner layer = visceral pleura
   -outer layer = parietal pleura
• each lung divided into lobes
   -right has three lobes
   -left has two lobes
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9
Q

Mediastinum

A 
• area of thorax bounded by sternum anteriorly, spine posteriorly, and lungs laterally
• structures associated
   -heart
   -great vessels
   -trachea
   -esophagus
   -thymus
   -lymphatics 
   -nerves
   -fibrous tissue
   -fat
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10
Q

Which lung has three lobes?

A. Right
B. Left
C. Neither
D. Both

A

A. Right

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11
Q

Aspirated foreign objects are more likely to lodge in the:

A. Right primary bronchus
B. Left primary bronchus
C. Carina of the trachea
D. Esophagus

A

A. Right primary bronchus

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12
Q

The level of the trachea bifurcation is the:

A. Thyroid cartilage
B. Carina
C. Larynx
D. Diaphragm

A

B. Carina

At the bottom of it

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13
Q

General procedural guidelines for thoracic viscera

A
  • patient preparation
  • general patient position
  • image receptor(IR)/collimated field size
  • source-image receptor distance (SID)
  • identification (ID) markers
  • radiation protection
  • patient instructions
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14
Q

Patient preparation

A

• patient preparation for thoracic viscera procedures requires removal of artifacts from the anatomy of interest
- long earrings
- necklaces
- clothing artifacts
• secure all patient possessions in designated manner and location

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15
Q

General patient position

A

• ambulatory patients
- upright or seated erect
• nonambulatory patients
- determine wether air-fluid levels are critical to diagnosis
- may have to substitute a decubitus position if patient cannot sit upright

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16
Q

IR/collimated field size

A
  • textbook gives guidelines
  • use smallest IR that will demonstrate anatomy
  • collimate field size to anatomy of interest
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17
Q

SID

A
  • source to image receptor distance
  • recommended SID for chest radiography is at least 72 inches (183 cm) to minimize magnification of heart and increase recorded detail
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18
Q

ID markers

A
  • right or left side markers must be included on each image
  • avoid using digital annotation to put side markers on images
  • other required ID markers must be in the blocker or elsewhere on the final image
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19
Q

Radiation protection

A

• shield patients of reproductive age and pediatric patients
-refer to guidelines on pp. 33-34, volume 1
• other radiation protection measures
- close collimation
- optimum technique factors

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20
Q

Patient instructions

A

• explain and demonstrate positions, when possible
• respiration instructions are critical to image lung aeration
• exposures are usually made after the second deep inspiration
• two separate radiographs may be taken, one on inspiration and one on expiration
- demonstrates pneumothorax
- diaphragm movement
- presence of foreign body
- atelectasis- partial un-expanded lungs

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21
Q

Essential projections of the chest

A
  • posteroanterior
  • lateral
  • PA oblique
  • anteroposterior (AP) oblique
  • AP
  • AP axial

• all use same collimated field size
- 14x 17 inches (35 x43 cm)

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22
Q

What is the patient position for a PA chest?

A

• Upright, if possible, to demonstrate air or fluid levels and allow diaphragm to move to its lowest position

• part position
- patient faces vertical grid device with midsagittal plane (MSP) centered
- weight equally distributed on both feet
- top of IR 1 1/2 to 2 inches (3.8 to 5 cm) above shoulders
- flex elbows and rest back of hands low on hips
- depress shoulders into same transverse plane
- roll shoulders forward
• central Ray (CR)
- perpendicular to center of IR
- enters at MSP and level of T7
* exposure should be made at the end of second deep inspiration

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23
Q

Lateral chest position

A

• Left lateral is routinely used to minimize magnification of heart
• upright, if possible
• top of IR 1 1/2 to 2 inches (3.8 to 5 cm) above shoulders
• part position
- true lateral position
- MSP parallel with IR
- mid coronal plane (MCP) perpendicular to IR
- shoulder in contact with grid
- extend arms over head, flex elbows, and rest forearms on head
• CR
- directed perpendicular to IR
- enters patient on MCP at level of T7
• exposure made at end of second deep inspiration

24
Q

Structures associated with the mediastinum

A
  • heart
  • great vessels
  • trachea
  • esophagus
  • thymus
  • lymphatics
  • nerves
  • fibrous tissue
  • fat
25
Q

What kV is used for chest x-ray?

A

110-130 with a grid

Up to 100 without a grid

26
Q

Patient position for AP Chest

A
  • supine or sitting upright

* used when patient is too ill for upright positions

27
Q

Part position for AP chest

A
  • Center MSP to IR
  • top of IR 1 1/2 to 2 inches (3.8 to 5 cm above shoulders
  • if patient condition permits, flex elbows, pronate hands, and place hands on hips to draw scapula laterally
  • adjust shoulders into same transverse plane
28
Q

Central ray(CR) for AP chest

A
  • perpendicular to long axis of sternum and center of IR

* enters 3 inches (7.6 cm) below jugular notch

29
Q

What is atelectasis

A

Collapse or part of the lung

30
Q

Define COPD

A

Chronic obstructed bronchial airflow

31
Q

Define tuberculosis

A

Tubercule bacillus

32
Q

Define metastasis

A

CA transferred from one area to another

33
Q

Define pleural effusion

A

Fluid in the pleural cavity

34
Q

Define pneumonia

A

Acute infection

35
Q

Define pneumothorax

A

Air in pleural cavity

36
Q

Image evaluation of PA chest

A

• evidence of proper collimation
• entire lung fields from the apices to the costophrenic angles
• no rotation
- sternal ends of the clavicles equidistant from the vertebral column
- trachea visible in the midline
- equal distance from the vertebral column to the lateral border of the ribs on each side
• proper shoulder rotation demonstrated by scapulae projected outside the lung fields
• proper inspiration demonstrated by ten posterior ribs visible above the diaphragm. At least one less rib visible on expiration
• sharp outlines of the heart and diaphragm
• faint shadows of the ribs and superior thoracic vertebrae visible through the heart shadow
• lung markings visible from the hilum to the periphery of the lung

37
Q

What cavity contains the heart and lungs?

A

Thoracic

38
Q

Which structure separates the thoracic cavity from the abdominal cavity?

A

Diaphragm

39
Q

Which part of the thoracic cavity contains all thoracic organs except the lungs and pleurae?

A

Mediastinum

40
Q

Which bony structure forms the anterior border of the mediastinum?

A

Sternum

41
Q

What mediastinal structure consists of C-shaped cartilaginous rings?

A

Trachea

42
Q

What area of the trachea divides into two lesser tubes?

A

Carina

43
Q

Which structures branch from the distal end of the trachea?

A

Primary bronchi

44
Q

Which primary bronchus is shorter and wider than the other?

A

Right

45
Q

What thoracic structures are the organs of respiration?

A

Lungs

46
Q

What is the name of the medial aspect of each lung in which the primary bronchus enters?

A

Hilum

47
Q

What is the name of the superior portion of each lung?

A

Apex

48
Q

Which structures are at the terminal end of the respiratory system?

A

Alveoli

49
Q

How many lobes are found in the right lung? Left lung?

A

Three in right and two in left

50
Q

Which lung (right or Left) is shorter and broader than the other? Explain why.

A

Right, because of its close proximity to the liver and heart

51
Q

With reference to the patient, where should the upper border of the IR/collimated field be placed?

A

About 1 1/2 to 2 inches (3.8 inches to 5 cm) above the top of the shoulders

52
Q

What is the purpose of depressing the shoulders?

A

To keep the clavicles below the apices

53
Q

Why should the shoulders be rotated forward?

A

To move the scapulae laterally away from the lung field

54
Q

Which thoracic structures are of primary interest with the left lateral projection?

A

Heart and left lung

55
Q

Which thoracic structure is of primary interest with the right lateral projection?

A

Right lung

SRJC RADTECH (15 decks)

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