Rad Positioning - Chest - Test Review Flashcards
Where would fluid be in lateral decubitus chest position?
Left decubitus - left lung
Right decubitus - right lung
What device is used for pediatric chest X-ray?
Pigg-O-Statt
Sthenic
Average physique
50% of population
Hypersthenic
Wider physique
5% of population
Hyposthenic
Skinny physique
35% of population
Asthenic
Tall and skinny physique
10% of population
Why is chest X-ray SID 72” vs. 40”?
Reduces distortion (magnification)
Higher image resolution
Why is grid important in PA chest X-ray?
Absorbs scatter
Better image
What is demonstrated on lateral chest X-ray?
Lungs
Sternum
Thorax
Posterior ribs
Heart
Situs inversus
Heart is on right side of body
Use of marker indicates this to radiologist
Hemothorax
Blood accumulation in pleural space
Pneumothorax
Air accumulation in pleural space
Creates pressure against lung - possible lung collapse
Emphysema
Lungs lose elasticity
Lungs become radiolucent, require less mAs
Lung dimensions become longer
Geriatric patient
Shallow lung field
CR needs to be higher
Kyphosis
Hump-back curvature
Lateral chest position - increased OID causes costophrenic angle off the IR - what should you do?
Lower the CR by 1 inch
PA chest - rib cage and pelvis alignment
Need to be aligned right on top of each other
If not - patient is leaning to one side
RAO
Patient’s right anterior is up against IR
Side of interest is left lung
LAO
Patient’s left anterior is up against IR
Side of interest is right lung
What pathologies seen on expiration chest X-ray?
Pneumothorax
COPD
Why do we roll shoulders forward in PA chest X-ray?
Get scapulae out of the way
PA chest X-ray- midsagittal plane is parallel or perpendicular to IR?
Perpendicular
PA chest X-ray - midcoronal plane is parallel or perpendicular to IR?
Parallel
Lateral chest X-ray - midsagittal plane is parallel or perpendicular to IR?
Parallel
Lateral chest X-ray - midcoronal plane is parallel or perpendicular to IR?
Perpendicular
What happens to diaphragm when taking deep inspiration?
Moves downward
Range of kVp for chest X-ray
110-125 kVp
Lateral chest X-ray - how should weight be distributed on patient’s standing feet?
Equal weight on both feet
CR location in relation to IR
Smack in the middle of IR
What jewelry needs to be removed for chest X-ray?
Necklaces
Nipple rings
Hilum
Central root area where bronchi, blood & lymph vessels, nerves enter/leave the lung
Base of lung
Concave portion that rests on diaphragm
Apex of lung
Rounded upper area above clavicles
CR for PA chest X-ray
T7
7-8 inches below the vertebra prominens - C7
CR for AP chest X-ray
At T7
3-4 inches below jugular notch
CR 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
Technique effect with pneumothorax patient
Air in lung cavity - easier to penetrate
Decrease technique
Technique effect with hemothorax patient
Blood in pleural space - harder to penetrate
Increase technique
Pleura
Double wall sac surrounding lungs
Parietal pleura
Outer layer of pleura
Covers inner surface of chest wall
Visceral pleura
Inner layer of pleura
Covers surface of lungs
Pleural cavity
aka Pleural space
Space inside pleura
Between parietal & visceral pleura
Pleurisy
Inflammation of pleura
AP Lordotic position
Clavicles are above the lung apices
Horizontal CR to midsternum
What does decubitus position measure?
Fluid & air levels in lungs
Erect vs. decubitus - which is more ideal for viewing fluid levels?
Erect bc allows diaphragm to move farther down
Can you see fluid levels in supine position?
No
Alveoli
Air sacs at end of terminal bronchioles
Where O2 & CO2 exchange occurs
Trachea location
Between C6 and T4/T5
What makes a decubitus position?
CR is horizontal
3 divisions of chest anatomy
Mediastinum (space between lungs)
Respiratory system (lungs & airways)
Bony thorax
Acronym: MR. B
Pleural effusion
Excess fluid in pleural cavity
Atelectasis
Collapse of the lung
Caused by obstruction, pleural effusion or pneumothorax
Superior
Towards top of body
Inferior
Towards bottom of body
Proximal
Closer to the source or center of body
Distal
Away from the source or center of body
Mediastinum - 4 structures
Trachea
Esophagus
Thymus gland
Heart and great vessels
Dyspnea
Shortness of breath
Dorsal decubitus position
Recumbent supine position
Horizontal CR projection
Ventral decubitus position
Recumbent prone position
Horizontal CR projection
What is demonstrated on PA chest X-ray?
Lungs
Trachea from T1 down
Bony thorax
Hilum
Heart
Great blood vessels
Lordotic position - how do ribs appear?
Ribs distorted - straight outward like wings
No curve
Lordotic position - how do clavicles appear?
Clavicles high and above lung apices
Good lateral chest X-ray criteria
Entire lungs
No rotation
Superimposition of posterior ribs
Chin & arms elevated
Equal collimation on upper/lower margins
Full inspiration
No motion
Exposure factors
Good PA chest X-ray criteria
Entire lungs
No rotation - equidistant clavicles from midline
No superimposition of ribs
Equal collimation on upper/lower margins
Scapulae out of way
Chin up
Minimized breast shadows
Full inspiration
No motion
Exposure factors
Carina
T5
Bifurcation point of trachea - separates into right & left bronchi
RPO
Patient’s right posterior is up against IR
Side of interest is left lung
LPO
Patient’s left posterior is up against IR
Side of interest is right lung
What is demonstrated on lateral decubitus X-ray?
Lungs
Both lateral borders of ribs
RAO vs. LPO
Differences/Similarities
Both show same view
RAO - PA projection
LPO - AP projection
LAO vs. RPO
Differences/Similarities
Both show same view
LAO - PA projection
RPO - AP projection
Pulmonary embolism
Sudden blockage of artery
What position would be used to rule out calcification or masses under the clavicles?
AP Lordotic
Pneumonia
Accumulation of fluid in certain lung sections
Often appears in single or several lobes
Area would be whiter (or brighter)
Locations of:
Larynx
Laryngeal prominence
Trachea
Vertebra prominence
Jugular notch
Carina
Midthorax/Midsternum
Xiphoid tip/process
Larynx C3 - C6
Laryngeal prominence C5
Trachea C6 - T4/T5
Vertebra prominence C7
Jugular notch T2/T3
Carina T4/T5
Midthorax/Midsternum T7
Xiphoid tip/process. T9/T10
Note the path: Larynx-Trachea-Carina
C3-C6 - C6-T4/T5 - T4/T5