Rad Positioning - Chest - Full Deck Flashcards
1
Q
3 divisions of Chest Anatomy
A
Mediastinum
Respiratory system
Bony thorax
Acronym: MR. B
2
Q
5 parts of Bony Thorax
A
Sternum
Clavicles
Ribs - 12 pairs
Thoracic vertebrae - 12
Scapulae
Acronym: South Carolina Ribs Taste Sweet
3
Q
Vertebra Prominens location
A
C7
4
Q
3 parts of Sternum
A
Manubrium
Body
Xiphoid process
5
Q
Xiphoid Process
A
Inferior aspect of sternum
Approximate level of anterior diaphragm
At T9-T10
6
Q
Jugular notch
A
Dip between clavicles above the manubrium
At T2/T3
7
Q
Location of Mid-thorax
A
T7
8
Q
4 divisions of Respiratory System
A
Pharynx
Trachea
Bronchi
Lungs
9
Q
Trachea is anterior or posterior to the esophagus
A
Anterior
10
Q
Esophagus is anterior or posterior to the trachea
A
Posterior
11
Q
Larynx location
A
Between C3 and C6
12
Q
Laryngeal prominence is known as _______
A
Adam’s apple
13
Q
Laryngeal prominence is part of what cartilage?
A
Thyroid cartilage
14
Q
Epiglottis
A
Lid covering laryngeal opening during swallowing
15
Q
Trachea location
A
Between C6 and T4/T5
16
Q
Carina location
A
T5
17
Q
Right bronchus has ___ branches
A
3
18
Q
Left bronchus has ___ branches
A
2
19
Q
Right lung has ___ lobes
A
3
20
Q
Left lung has ___ lobes
A
2
21
Q
Outer layer of Pleura
A
Parietal
22
Q
Inner layer of Pleura
A
Visceral
23
Q
Mediastinum
A
Medial portion of thoracic cavity between lungs
Trachea
Thymus gland
Esophagus
Heart & great vessels
Acronym: Tracy Tickles Each Heart
24
Q
4 structures of Mediastinum
A
Trachea
Esophagus
Thymus gland
Heart and great vessels
25
Location of Xiphoid Process
T9 - T10
Anterior diaphragm
26
Boundary between Oropharynx and Nasopharynx
Uvula
27
From what part of anatomy is larynx suspended?
Hyoid bone
28
Thyroid gland
Located anteriorly and inferior to larynx
Divided into right and left lobes
Radiosensitive
Stores metabolism hormones
29
Right Bronchus
3 branches
Wider, shorter, more vertical than left bronchus
30
Which bronchus is more likely for obstruction?
Right
31
Left Bronchus
2 branches
Narrower, longer, more curvy than right bronchus
32
Carina
Juncture of trachea where it splits into right and left bronchi
Location at T5
33
Secondary Bronchi
Right main bronchus separates into 3 secondary bronchi
Left main bronchus separates into 2 secondary bronchi
Each secondary bronchi enters a separate lobe of lung
34
Secondary Bronchi divides into smaller branches called _______
Bronchioles
35
Terminal Bronchioles
Final, smallest bronchioles
36
Alveoli
Air sacs at end of terminal bronchioles
Where O2 and CO2 exchange occurs
37
Thoracic viscera
Lungs and organs of mediastinum
38
Viscera means ____
Organs
39
Parenchyma
Lung tissue
Light sponge-like elastic material
Allows for expansion/contraction
40
Pleura
Doubled wall sac surrounding lungs
41
Parietal Pleura
Outer layer of pleura
Covers inner surface of chest wall
42
Visceral Pleura
Inner layer of pleura
Covers surface of lungs
43
Pleural Cavity
Space inside pleura
Between parietal and visceral pleura
44
Pleurisy
Inflammation of pleura
45
Pneumothorax
Air accumulation in pleural space
Creates pressure against lung and possible lung collapse
46
Hemothorax
Blood accumulation in pleural space
47
Apex of Lung
Rounded upper area above clavicles
48
Base of Lung
Concave portion that rests on diaphragm
49
Diaphragm
Muscle that separates thorax from abdomen
Moves downward - breathe in
Moves upward - breathe out
50
Why is diaphragm higher on the right than the left?
Presence of liver
51
Costophrenic Angle
Extreme outer-most corner of each lung
52
Hilum
Central root area where bronchi, blood & lymph vessels, nerves enter/leave the lung
53
Thymus Gland
Located behind upper sternum
Anterior to and just above heart
Aids with immune system
Gradually disappears in the adult
54
Great Vessels of the Heart
Superior vena cava
Inferior vena cava
Aorta
Pulmonary arteries & veins
55
Superior Vena Cava
Returns blood to heart from upper half of body
56
Inferior Vena Cava
Returns blood to heart from lower half of body
57
Aorta
Largest artery
Carries oxygenated blood to body
Ascending aorta
Aortic arch
Descending aorta
58
Pulmonary Arteries & Veins
Supply blood to/from the lungs
59
Hypersthenic
Wider physique
5% of poplulation
60
Sthenic
Average physique
50% of population
61
Hyposthenic
Skinny physique
35% of population
62
Asthenic
Tall and skinny physique
10% of population
63
True/False Pharynx is common passageway for food & respiration
True
64
Laryngeal Prominens is a.k.a. _____
Adam's apple
65
Is epiglottis a mediastinal structure?
No
66
kVp range for adult chest X-ray
110 to 125 kVp
67
Atelectasis
Collapse of the lung
Caused by obstruction, pneumothorax, pleural effusion
68
How is rotation evident in PA chest X-ray?
Asymmetry of SC joints
69
How is rotation evident in lateral chest X-ray?
Posterior ribs not superimposed
70
CR location for PA chest
T7
7-8 inches below vertebra prominens
71
CR location for AP chest X-ray
3-4 inches below jugular notch
72
Collimation borders guidelines
Collimation borders above lung apices and below costophrenic angles should be equal
73
How many posterior ribs visible above diaphragm for PA chest?
10
74
Immobilization technique for pediatric patient
Pigg-O-Stat
75
CR location for lateral chest X-ray
1 inch below from PA T7 location
Why? Bc increase in OID causes divergent X-ray to cutoff costophrenic angles
76
AP Semierect
Heart may appear larger
Air-fluid levels not well defined
Usually not a complete inspiration
8-9 ribs
77
AP Lordotic
Horizontal CR to midsternum
78
AP Semiaxial Lordotic
Alternative to AP Lordotic - if patient can't stand
Recumbent supine position
CR 15-20 degrees cephalad to midsternum
79
Lordotic - clavicles are above or below apices?
Above
80
Lateral Upper Airway X-ray
CR at C6-7
Slow, deep inspiration to show air-filled trachea
81
AP Upper Airway X-ray
CR at T1-2
AML - acanthiomeatal line perpendicular to IR
82
Which 3 topographic landmarks are used for chest positioning?
Vertebra prominens - C7
Jugular notch - between T2/T3
Xiphoid tip - between T9/T10
83
Xiphoid Process is inferior or superior to Sternum?
Inferior
84
Xiphoid Process is inferior or superior to Vertebral Prominens?
Inferior
85
When you breathe in, diaphragm moves ____ and when you breathe out, diaphragm moves ____
Downward - breathe in
Upward - breathe out
86
Epiglottis projects downward or upwards behind the tongue?
Upwards
87
During swallowing, epiglottis flips ____ and covers laryngeal opening and prevents food/fluid from entering ____
Down
Larynx
88
3 divisions of Pharynx
Nasopharynx
Oropharynx
Laryngopharynx
89
Uvula
Inferioposterior aspect of soft palate
Separates nasopharynx and oropharynx
90
4 parts of respiratory system PROPER?
Larynx
Trachea
Bronchi
Lungs
Note: Respiratory system includes Pharynx. Respiratory system proper includes Larynx.
91
Hyoid bone, voice box and Adam's apple are located in this area
Larynx
92
Why does right lung have 3 lobes vs. left lung 2 lobes?
Heart is on the left side
93
Body habitus for PA chest taken crosswise?
Hypersthenic
94
Body habitus for narrow thorax and shallow from front to back but very long in dimension?
Asthenic
95
When performing expiration Chest X-ray, need to label expiration?
Yes, always label expiration Chest X-ray
96
True/False Heart is magnified in Left Lateral Chest X-Ray.
False
97
COPD
Chronic Obstructive Pulmonary Disease
Difficulty emptying lungs of air
Severe cases become emphysema
98
PTX
Pneumothorax
99
Patient in wheelchair for chest X-rays. Patient cannot stand due to dizziness. What do you do?
Assess patient.
Inform patient about standing.
Determine if patient can stand.
If not, consult technologist nearby.
100
CXR
Chest X-Ray
101
Patient w/right sided chest pain. Order is for CXR. You notice pneumothorax on PA chest. What should you do?
Alert the tech
Follow department protocol
Have tech contact doctor
102
When performing PCXR, patient refuses to remove multiple necklaces. What should you do?
Inform patient that chains can be put into mouth out of the way of X-ray
103
PCXR
Portable chest X-ray
104
You take an ER patient who refuses X-rays. What should you do?
Inform patient of doctor ordered X-ray
Patient has right to refuse
Document refusal and consult w/ tech
105
Pediatric patient needs CXR.
Patient not holding still.
What should you do technique wise?
Use 800 mA and .01sec to reduce motion
106
True/False You must use 110kV on portable CXR due to heart magnification and no grid.
False
107
Aspiration
Foreign objects swallowed into air passages of bronchial tree
108
Epiglottitis
Life threatening condition, most common in children ages 2-5
109
Number of full inspirations to fully expand lungs in both PA & Lateral CXR
2
110
On Lateral CXR, which plane is parallel to IR?
Midsagittal
111
On Lateral CXR, which plane is perpendicular to IR?
Midcoronal
112
On decubitus chest X-ray, do you need to include the side down?
Yes
113
Where is the centering location for Lateral Upper Airway X-ray
Level of C6 or C7
114
Exposure for Lateral Upper Airway should be made during ________
Slow, deep inspiration
115
AP bedside Chest X-ray, the CR is angled _____ to be _____ to long axis of sternum
Angled cephalad
Perpendicular to long axis of sternum
116
Beam for decubitus Chest X-ray is _____ and centered at _____
Horizontal
Level of T7
117
Artifact
Foreign object in chest area
118
Orientation of PA Chest X-ray cassette for hypersthenic patient
Crosswise (landscape)
119
kVp for portable Chest X-rays
80-90 kVp
120
Reason for using high kVp (110-125)
Penetrate heart
Produce low contrast (long scale)
Produce many shades of gray
Reduces attenuation
121
Technique factors for Chest X-ray
High kVp (110-125)
High mA
Short exposure time
Grid
122
Pediatric Chest X-rays on infant
AP Supine
Lateral Chest X-ray
Low kVp
Very short exposure time
123
When both inspiration and expiration Chest X-rays are done, do both need to be labeled "inspiration" and "expiration"?
Yes
124
Reasons for expiration images
Identify pneumothorax
Identify location of foreign body
Determine if opacity is in lung or rib
See if diaphragm is moving correctly
125
3 dimensions of Expiration vs. Inspiration
Vertical
Transverse
AP diameter
126
Reasons for Erect Chest X-ray
Diaphragm can move further down - more complete inspiration
Air & fluid levels can be visualized
Minimizes engorgement of pulmonary blood vessels
127
PA vs. AP Chest X-ray for heart diagnosis
Heart is located close to anterior chest wall
If taken AP, heart is magnified (OID increased)
Complicates diagnosis of cardiac enlargement
128
Lateral chest positioning - why left vs. right side?
Left lateral chest X-ray
Heart is on left side, so OID is reduced, heart is more accurate size
129
Structures visualized on lateral chest
Right & left hemi-diaphragm
Lungs, superimposed
Entire posterior costophrenic angle
Heart
Aorta
130
Lung dimensions & IR placement
Width of average PA/AP chest is greater than its height
Most IRs are placed crosswise
Discretion is used based on body type
131
Evaluation of PA Chest X-ray
All required anatomy is included
Clavicles - equidistant
No rotation of chest
Exposure index or S number is within range
132
Appearance of Lateral Chest X-ray that is rotated
Ribs are visible behind the chest
133
Thoracentesis
Aspiration of fluid between lungs and chest cavity with a needle
134
Aspiration of fluid
Draw in or out using a sucking motion
135
_____ may be used to locate pleural effusion and for guidance when needle is used to aspirate the fluid
Ultrasound
136
Emphysema
Lungs lose elasticity
Lungs become radiolucent, require less mAs
Lung dimensions become longer
137
Pneumonia
Accumulation of fluid in certain lung sections
Often appears in single or several lobes
Area would be whiter (or brighter)
