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ARRT > Procedure - Thorax & Abdomen > Flashcards

Procedure - Thorax & Abdomen Flashcards

1
Q

How many ribs should you seen on a fully inspiration CXR

A

10 ribs above diaphragm

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2
Q

Where should CR be directed for a PA CXR?
a. MCP at T7
b. MSP at T7
c. at level of scapular spine
d. at level of 12th rib

A

B

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3
Q

T7 corresponds to a horizontal plane through _________ of scapular

A

inferior angles

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4
Q

What is the primary indicator of full inspiration on the following radiograph?
a. visualization of posterior ribs through heart shadows
b. minimum of 10 posterior ribs above diaphragm
c. minimum of 10 anterior ribs above diaphragm
d. fine vascular markings are visible within lungs

A

B

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5
Q

CR entrance point for lateral CXR? be specific

A

midcoronal plane at level of T7

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6
Q

What should be visualized on a lateral CXR? (4)

A

apices
costophrenic angles
posterior ribs
sternum

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7
Q

Why 72” SID for CXR

A

compensate for increased OID bw heart and IR AND reduce the magnification of heart

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8
Q

for PA CXR, how should the IR be positioned in relation to patient;s shoulder?
a. 1.5-2” above shoulder
b. 2” below shoulder
c. directly at level of shoulders

A

A

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9
Q

Lordotic position mainly shows which anatomy of the lungs

A

apices

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10
Q

For Lordotic position, how should the IR positioned in relation to the patient;s shoulder

A

3” above shoulder

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11
Q

what is the CR for lordotic CXR

A

mid-sternum

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12
Q

for AP CXR on a stretcher, what is the SID and angulation

A

SID: 72”
angulation: caudal to match IR

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13
Q

For AP lordotic CXR, CR should be directed:
a. 1-2” below jugular notch
b. 2-3” below jugular notch
c. 3-4” below jugular notch
d. 4-5” below jugular notch

A

C

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14
Q

AP axial projection of the chest refers to which position

A

lordotic

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15
Q

for lordotic, patient is instructed to lean backward how many degrees
a. 5
b. 5-10
c. 10-15
d. 15-20

A

D

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16
Q

When performing an AP upright CXR when pt is on stretcher, technologist must ensure angle of tube matches angle of ___
a. IR
b. pt’ chest

A

A

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17
Q

Why is it important to make sure CR matches the angle of the IR

A

prevent grid cutoff and processing errors

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18
Q

what is SID for lordotic CXR
a. 72”
b. 40”

A

72”

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19
Q

When positioning pt for a lateral chest on a stretcher, which side of the pt should be placed against the IR?
a. RT side
b. LT side
c. Either side
d. depend on pathology

A

B

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20
Q

how many posterior ribs will be demonstrated above diaphragm in a correctly AP portable CXR
a. 8-9
b. 9-10

A

A

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21
Q

What is the preferred position for AP CXR when pt cannot stand
a. supine
b. semi erect
c. lateral decub

A

B

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22
Q

To ensure AP mobile CXR is free of rotation, what structures should appear symmetrical
a. ribs and clavicle
b. sternum and xiphoid process
c. lung apicec & costophrenic angles

A

A

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23
Q

SID for lateral Soft Tissue Neck

A

72”

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24
Q

CR for lateral soft tissue neck

A

laryngeal prominence

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25
Q

SID for AP Soft Tissue Neck

A

40”

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26
Q

Breathing instruction for AP soft tissue neck
a. slow deep inspiration
b. suspend after inspiration

A

A

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27
Q

CR for AP soft tissue neck
a. 1” superior to jugular notch
b. 0.5” superior to jugular notch
c. 2” inferior to jugular notch

A

A

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28
Q

what is the correct marker and correct marker placement used to indicate the left side of pt for an L lateral soft tissue?
a. left marker placed posteriorly
b. left marker placed anteriorly

A

B

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29
Q

what is the optimal vertical collimation for a lateral soft tissue neck

A

12”

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30
Q

Which of the following is the carina associated with?
a. superior wall of aortic arch
b. horizontal fissure of lung
c. hilum of lung
d. bifurcation of trachea

A

D

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31
Q

Trachea is split into ___

A

L & R bronchi

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32
Q

Which of the following statement is accurate in reference to lung’s vascular marking on PA CXR
a. vascular marking are only visible when there is pulmonary pathology
b. vascular marking appear thinner in superior portions of the lungs
c. caliber of vascular marking should be same from superior to inferior lung
d. vascular marking are only visible in hilar region near the heart

A

B

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33
Q

vascular markings are most prominent at the _____ regions

A

hilar

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34
Q

vascular markings appear thicker in ___ lung zones
a. inferior
b. superior

A

A

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35
Q

vascular markings appear thinner in ____ lung zones
a. inferior
b. superior

A

B

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36
Q

A pathological condition in which air or gas enters the pleural space:
a. pneumothorax
b. pleural effusion
c. emphysema

A

A

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37
Q

which conditions would demonstrate as the absence of diaphragm contour and blunting of costophrenic angles
a. emphysema
b. pleural effusion
c. pneumothorax
d. atelectasis

A

B

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38
Q

when evaluating PA CXR, radiologist note absence of lung markings and pleural line on pt’s right side. which conditions cause this appearance?
a. pneumonia
b. pneumothorax
c. pleurisy
d. croup

A

B

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39
Q
A
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40
Q

Why is it better to do PA chest in erect position

A

Detect air/fluid level
Diaphragm is lowered
Full lungs are shown

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41
Q

Why is it better to do PA over AP for chest

A

Lower OID for lungs & heart

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42
Q
A
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43
Q

What is Lithotomy position?

A

Legs are higher than head

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44
Q

Why 72” SID for chest x-ray

A

-Increased SID
-avoid magnification of heart
-capture bilateral lungs
-less divergence of x-ray beam = less distortion

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45
Q

3 body landmarks for CXR

A
  1. vertebral prominen
  2. jugular notch
  3. xiphoid tip
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46
Q

Vertebral prominen is at

A

C7

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47
Q

Jugular notch is at

A

T2

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48
Q

Xiphoid tip is at

A

T9/10

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49
Q

What is the tissue that make up the lungs

A

parenchyma

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50
Q

How do you know the exposure is good for PA chest

A

-no motion
-sharp outline of ribs
-visualization of vascular marking

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51
Q

The heart appears larger as a result of _____

A

shorter SID
increased OID

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52
Q

[CHEST CXR] What is the kVP for pediatric pt? Why?

A

70-80
they have low body mass

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53
Q

[CXR]
To indicate there are no rotation, the separation of posterior ribs should be ____

A

no more than 1/4 to 1/2”

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54
Q

Pneumothorax is detected on the right side of the lung, which position should the patient be placed in?

A

L lateral decub because the affected RIGHT lung should be up for us to see air.

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55
Q

Hemothorax is detected in the left side of the lung, which position should the patient be placed in?

A

L lateral decub because the right side needed to be away from the mediastinum

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56
Q

[CXR]
LPO corresponds to which position? Why?

A

RAO
Both see L lung best

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57
Q

[CXR] RPO corresponds to which position? Why?

A

LAO
Both see R lung best

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58
Q

Which positions can see the right lung best?

A

LAO
RPO

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59
Q

Which positions can see the left lung best?

A

RAO
LPO

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60
Q

For ___ oblique, lung will be closest to IR

A

posterior

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61
Q

[CHEST CXR] Which oblique position will cause the lung field to be shorter

A

POSTERIOR because the diaphragm is being magnified

62
Q

[CXR] why posterior oblique results in larger heart and great vessels

A

farther away from the IR

63
Q

Why lung is shorter and why

A

Right lung because liver located in RUQ of abdomen which pushes up on RT hemidiaphragm

64
Q

Costophrenic angle is where ____

A

diaphragm meets ribs

65
Q

Cardiophrenic angle located in ____

A

LT ventricle
RT atrium

66
Q

Hilum is where ____ (4) enter & leaves lungs

A

bronchi
blood
lymph vessels
nerve

67
Q

The difference b/w these disease:
1. Empyema
2. Hemothorax

What are the positions for any type of pleural effusion ?

A
  1. fluid is pus
    -caused by chest wound, ruptured lung abscess, obstruction of bronchi
  2. fluid is blood
    -RT: caused by heart failure
    -LT: trauma, pancreatitis, pulmonary infarct, subphrenic abscess

erect PA
lateral decub with affected side DOWN

68
Q

____ is an accumulation of air in pleural space that can cause ____. Results in ___ (2)?

A

Pneumothorax
collapse of lung
==> SOB & chest pain

70
Q

Parietal pleura lines ___

A

inner surface of chest wall & diaphragm

71
Q

What pleura cover surfaces of lungs

72
Q

What is the primary muscle for breathing

73
Q

what are the 3 openings in the diaphragm

A

IVC
Esophagus
Aorta

74
Q

Bronchi on the left or right is more prone to foreign bodies? why?

A

Right because of larger diameter

75
Q

What is the recommended source-to-image distance SID for a lateral
erect radiograph of the sternum?

A

72 inches (183 cm)

76
Q

What is the recommended source-to-image distance SID for a
posteroanterior PA oblique sternum, right anterior oblique RAO
position?

A

30 inches (76 cm)

77
Q

Which of the following is the correct breathing instruction for a lateral projection of the sternum?
a. Normal breathing
b. Suspend on deep expiration
c. Suspend on deep inspiration
d. Shallow breathing

78
Q

For a lateral sternum radiograph, the central ray is directed at the:
a. Midline of the jugular notch
b. Lateral border of the midsternum
c. T7 vertebra
d. Level of the clavicles

A

b. Lateral border of the midsternum

79
Q

Which of the following is the correct central ray entrance point for a posteroanterior PA sternum projection, right anterior oblique RAO
position?
a. Midcoronal plane at the level of T7
b. Midsagittal plane at the level of T7
c. Enters the dependent side 1 inch 3 cm) lateral to the spine at the level of
T6
d. Enters the elevated side 1 inch 3 cm) lateral to the spine at the level of T7

80
Q

which vertebra corresponds to the level of inferior angle of scapula

82
Q

where is the midpoint of sternum in RAO position

A

1” from MSP

83
Q

where is the midpoint of sternum in Lateral position

84
Q

Which three of the following are considered correct patient positioning for a lateral sternum radiograph? (Select three)
a. Prone on the table
b. Supine on the table
c.Standing or sitting at the upright bucky
d. Laying laterally on the table

85
Q

What is the appropriate degree of rotation for a posteroanterior PA
oblique sternum, right anterior oblique RAO position?

86
Q

Which two of the following patient positions are appropriate when
positioning for a posteroanterior PA) oblique sternum, right anterior oblique RAO) position?

A

Prone on the table
Standing or sitting at the upright bucky

87
Q

Which of the following is the correct breathing instruction for a posteroanterior PA oblique sternum, right anterior oblique RAO
position?

A

shallow breathing or suspend on expiration

88
Q

What does the bony thorax consists of ? (3)

A

1 sternum
12 thoracic vertebrae
12 rib pairs

89
Q

What is the purpose of bony thorax

A

protects respiratory & mediastinum

90
Q

What are the 3 parts of the sternum

A
  1. manubrium
  2. body
  3. xiphoid tip
91
Q

Which structure is located at T2-3

A

Jugular notch

92
Q

What does the body of sternum articulate with

93
Q

What is the articulation angle of the body to the manubrium called?

A

sternal angle

94
Q

Location of sternal angle

95
Q

What structure provide anterior articulation of the cartilage of the rib

A

facet of the body of the sternum

96
Q

There are no bony articulation of the rib ____
a. anteriorly
b. posteriorly

97
Q

Ribs articulate with bony joint ____
a. anteriorly
b. posteriorly

98
Q

Which structure articulate laterally to the jugular notch?

A

medial end of clavicle

99
Q

SC joint is the formation of ____ & _____

A

medial end of clavicle and clavicular notch

100
Q

How many ribs articulate with the sternum

101
Q

Ribs articulate with the sternum through ____

A

costocartilage

102
Q

Why does costocartilage show up as a gap on radiograph?

A

cartilage is not dense enough for Xray attenuation

103
Q

What are other names for jugular notch

A

suprasternal & manubrial notch

104
Q

The 1st pair of ribs articulate with which part of the sternum

105
Q

the 2nd pair of ribs articulate with the ____ of the sternum

A

sternal angle

106
Q

___ through ___ pair of ribs connect directly to the body of sternum through costocartilage

107
Q

___ through ____ pair of ribs connect to costocartilage 7, which then connects to sternum

108
Q

Routine for sternum. Which routine is usually preferred?

A

RAO
Lateral

Lateral

109
Q

[Sternum] kVp?

110
Q

Why RAO sternum over LAO sternum

A

Rotate sternum away from vertebrae and superimpose the heart

111
Q

Why is it important for the sternum to superimpose the heart when imaging

A

increase density of sternum –> better attenuation –> more visualization of sternum

112
Q

for a bigger patient, would you need a higher or lower obliquity for RAO Sternum

A

lower (15)

113
Q

Patient with a shallow or thin chest would need ____ rotation than a patient with a deep chest

114
Q

[Sternum] If patient is unable to stand for RAO, what is the alternate position?

A

SUPINE LPO with CR angled 15-20 across right side of patient

115
Q

Lateral Sternum
For erect, arms ____
For recumbent, arms ____
What is the purpose?

A

Back
Up
Avoid superimposition of humerus over sternum

116
Q

How many ribs are considered “true” ribs

117
Q

True ribs are direct ____ attachment

118
Q

How many ribs are considered “false” ribs

119
Q

_____ ribs have no anterior attachment

A

False & Floating

120
Q

Rib 8-10th have ____ that join together at rib ____ connects to sternum

A

costocartilage
7

120
Q

does floating ribs have costocartilage?

121
Q

Which ribs do not connect to the sternum?
a. floating
b. true
c. false
d. all ribs are connect to sternum

122
Q

If floating ribs are not connect to sternum, what does it connect to?

123
Q

Which structures of the ribs are located posteriorly

A

Head
Neck
Tubercle

124
Q

Head of ribs articulate with _____

A

vertebral body

125
Q

what is the internal structure of rib

A

costal groove

126
Q

what does costal groove house

A

artery, vein, nerve

127
Q

What could happened if there is a rib fracture

A
  1. HEMOTHORAX (puncture of parietal pleural surround the lungs. The veins inside the costal groove severed and leaks into the pleural )
  2. PNEUMOTHORAX (puncture causing air leakage)
128
Q

Tubercle of ribs articulate with ____

A

transverse process of a vertebra

129
Q

On a radiograph, the part of ribs that most superior is ___, and most inferior is ____

A

posterior end (vertebral end)
Anterior end

130
Q

What is a joint between costocartilage and ribs

A

costochondral

131
Q

What is a joint between costocartilage & sternum

A

sternocostal

132
Q

What is a joint between costocartilages?

A

interchondral

133
Q

Interchondral joint is between the ___ of which ribs

A

costalcartilage / 6-10

134
Q

Sternocostal joint is between ___ & ___ ribs

135
Q

What is the joint between head of ribs and vertebral body

A

costovertebral joint

136
Q

Costovertebral joint is between ___ & ____

A

head of ribs
vertebral body

137
Q

What is the joint between tubercle to transverse process

A

costotransverse

138
Q

Costotransverse joint is between __ & ___

A

tubercle & transverse process

139
Q

Costotransverse joint are found on which ribs

140
Q

Which joint does 11th & 12th rib don’t have?

A

costotransverse

141
Q

Routines for RIB

A

PA chest
AP Above Diaphragm
AP Below Diaphragm
RPO/LPO

142
Q

kVp for RIB

143
Q

AP Above Diaphragm can be done for ____
a. bilateral
b. unilateral
c. both

144
Q

AP below diaphragm can be done for ____
a. bilateral
b. unilateral
c. both

A

A (unless otherwise noted)

145
Q

RPO/LPO ribs can be done for ____
a. bilateral
b. unilateral
c. both

146
Q

[RIB] if the right side is affected, which position will elongate the right side

147
Q

[RIB] if the right side is affected, which position will shorten the right side

148
Q

[RIB] if the left side is affected, which position will elongate the left side

149
Q

What should be included in a diagnostic dorsal decubitus abdomen radiograph (select all that applied)
a. superimposed ilia
b. kidneys
c. domes of diaphragm
d. pedicles of L spine

150
Q

which of the following is the most distal part of the small bowel
a. jejunum
b. cecum
c. ileum
d. duodenum

151
Q

which organ is positioned transversely across upper abdomen
a. pancreas
b. stomach
c. spleen
d. kidneys

ARRT (7 decks)

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