Radiography of the Chest Flashcards

1
Q

PA Projection Pt Position

A

Standing infront- VGD/VCH-anterior thorax dependent

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2
Q

PA Projection Comfort and Part Position

A

Both UE-raised-flexed-elbows-dorsum of hands in contact-hips-rotated forward to draw the scapula laterally and prevent superimposition with the lungs

Both LE extended- separated and weight distributed equally

Shoulders-depressed to prevent clavicles to superimpose with lung apices

Chin-raised-top of the VGD

MSP-coincide-MP of IR

Establish-RP -T7 (inferior border of scapulae) by palpation

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3
Q

PA Projection IR size and placement

A

CXT 14X17-VGD/VCH- longitudinal- MP- coincide- RP

Upper border of the IR-approximately 1 1⁄2 -2 inches from shoulder level

CRD- perpendicular- at 72”-SID-RP-exits-MP- IR/ cassette

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4
Q

To demo thoracic viscera, the air-filled trachea, well expanded lungs, diaphragmatic dome, heart and aortic knob

A

PA Projection

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5
Q

Why is exposure made at the end of second full suspended inspiration/ inhalation?

A
  • Allow the lungs to expand
  • Widen intercostal spaces
  • Depress the diaphragm
  • Costophrenic angles/sulci sharp
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6
Q

PA Projection

Prominent at the end of full expiration/exhalation

A

Vascular markings

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7
Q

PA Projection

For certain conditions, such as pneumothorax and the presence of a foreign body, radiographs are sometimes made at —

A

the end of full inspiration and expiration

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8
Q

PA Projection

For cardiac studies, patient is given a bolus of barium sulfate and instructed take a deep breath and to swallow upon instruction by the technologist. This will outline the (1) and (2).

A
  1. posterior heart
  2. aorta
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9
Q

PA Projection

  • (1) ribs should be visible
  • Grid technique is used for (2) within the lung fields
  • Chest x-ray can be done in (3)/ (4)
  • Chest x-ray is primarily done in (5) to prevent (6)
A
  1. 10 posterior
  2. opaque areas (foreign body)
  3. seating
  4. bedside radiography
  5. upright
  6. pulmonary engorgement/ dilatation
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10
Q

Lateral projection (Upright-Standing) Pt Position

A

Standing-L/R lateral position-infront of VGD/VCH

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11
Q

Lateral projection (Upright-Standing) Comfort position

A

Both UE-raised-flexed at elbows-placed on top of head with hands grasping the elbows to avoid superimposition

Both LE-extended-wt. distributed equally

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12
Q

Lateral projection (Upright-Standing) Part Position

A

Thorax-adjusted in lateral

MCP-coincide with MP of IR/cassette

Chin is raised

Establish the RP at T7

Avoid body rotation

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13
Q

Lateral projection (Upright-Standing) IR

A

14X17-placed in VGD/VCH-longitudinal with MP-coincide with MCP-level of T7

Upper edge of IR is approx. 1 1⁄2 -2” from shoulder level

CRD- Perpendicular-at 72”- distance- towards- MCP- at T7-exits at–MP- of IR

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14
Q

To demo the lateral image of the lungs

A

Lateral projection (Upright-Standing)

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15
Q

Demos the heart, aorta, left sided pulmonary lesions

A

Lateral projection (Upright-Standing)

L lateral position

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16
Q

Demos right sided pulmonary lesions

A

Lateral projection (Upright-Standing)

R lateral position

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17
Q

Demonstrate interlobar fissures, differentiate lobes, and anterior/ posterior location of tumor

A

Lateral projection

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18
Q

Lateral projection (Upright-Standing)

  • Use (1) to support weak patients
  • Avoid patient to (2), it will distort the lung image
  • Use (3) for demonstration of heart
  • For (4), same principle is applied in PA projection
  • The procedure can be done in (5) or (6) position
A
  1. IV stand
  2. lean
  3. left lateral position
  4. cardiac studies
  5. seating
  6. recumbent
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19
Q

Lateral projection (Recumbent Position) Pt Position

A

Patient to assume either L/R lateral position on top of RT

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20
Q

Lateral projection (Recumbent Position) Comfort Position

A

Both UE raised, flexed at elbows and FA (forearm) placed against the head

Both LE flexed at knees with sandbag/pillow placed in between knees and ankles for support

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21
Q

Lateral projection (Recumbent Position) Part Position

A

Thorax in lateral position

MCP-coincide with MP of IR

RP at level of T7

Avoid body rotation

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22
Q

Lateral projection (Recumbent Position) IR size/placement

A

14X17-placed inside the BD (BuckyDiaphragm/ tray)-longitudinal with MP-coincide with RP

Upper edge of IR approx. 1 1⁄2 -2” from shoulder level

CRD: Perpendicular- 72”-SID-MCP-level-T7-exit at MP of IR

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23
Q

PA Oblique Projection Pt Position

A

Stand infront-VGD/VCH-anterior thorax dependent

Adjusted either in RAO/LAO position

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24
Q

PA Oblique Projection Comfort Position

A

Dependent UE flex-elbow-dorsum of hand-in contact with hip

Opposite UE raised-grasp the top edge of VGD

Both LE extended-wt. distributed equally

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25
Q

PA Oblique Projection Part Position

A

Body obliquity-approx. 45 degrees

Midline-body-coincide-MP-IR

RP-T7

Chin is raised

26
Q

PA Oblique Projection IR size/placement

A

14x17-VGD/VCH-longitudinal-MP-coincide-RP

Top edge of IR- 1 1⁄2 -2”-from shoulder level

CRD: Perpendicular-72” SID-midline-body-level-T7-exit-MP-IR

27
Q

To demo the oblique image of the heart and lungs

A

PA Oblique Projection

28
Q
  • R lung field (side farther from the IR) is demonstrated
  • Trachea and carina and the entire R branch of the bronchial tree
  • heart, descending aorta and arch of the aorta
A

PA Oblique Projection
LAO Position

29
Q
  • L lung field (side farther from the l R) is demonstrated
  • Rrachea and entire L branch of the bronchial tree
A

PA Oblique Projection
RAO Position

30
Q

Gives the best image of the:
- L atrium
- Anterior portion of the apex of the LV
- R retrocardiac space

A

PAO Projection
RAO Position

31
Q

PA Oblique Projection

  • For cardiac studies- body obliquity is (1) degrees
  • Can be done in (2)
A
  1. 55-60
  2. recumbent
32
Q

AP Oblique Projection Pt Position

A

Stand infront-VGD/VCH-posterior thorax dependent

Adjusted either in RPO/LPO position

33
Q

AP Oblique Projection Comfort position

A

Dependent UE-raised- flex at elbow- hand-in contact with the head

Opposite UE flexed at elbows-dorsum of hand-in contact with hip

Both LE extended-wt. distributed equally

34
Q

AP Oblique Projection Part position

A

Body obliquity-approx. 45 degrees

Midline of body-coincide with MP of IR

RP-T7

Chin is raised

35
Q

AP Oblique Projection IR size/placement

A

14X17-placed in the VGD/VCH-longitudinal-MP-coincide with-RP

Top edge of IR- 1 1⁄2 -2”-from shoulder level

CRD: Perpendicular-72” SID-midline of the body-level-T7 (3” below jugular notch)-exit-MP-IR

36
Q

Elevated side usually appear shorter because of magnification of the diaphragm

Heart and great vessels also cast magnified shadows as a result of being farther from the IR

A

AP Oblique Projection

37
Q

AP Oblique Projection

The side of interest in APO is usually the (1) side
- can be done in (2)

A
  1. dependent
  2. recumbent
38
Q

RPO position corresponds with LAO position while LPO position corresponds with RAO position

A

AP Oblique Projection

39
Q

This projection is done if the patient is too ill to be positioned in upright

A

AP Projection

40
Q

AP Projection Pt Position

A

Supine on top of RT

41
Q

AP Projection Comfort Position

A

Both UE extended-abducted-hands pronated

Both LE extended-sandbag placed under ankles for support

42
Q

AP Projection Part position

A

MSP-coincide with midline of RT/coincide with MP of IR

Shoulders on same transverse plane

RP-T7

43
Q

AP Projection IR size/placement

A

14X17-inside BD-longitudinal-MP-coincide-MSP-level of T7

CRD: Perpendicular-72”SID-MSP-level of T7 (3” below jugular notch)-exit at MP of IR

44
Q
  • Heart and great vessels are magnified and engorged
  • Lung fields appear shorter due to abdominal compression
  • Clavicles are projected higher
  • Ribs in horizontal appearance
A

AP Projection

45
Q

Used to free the basal part of the lungs from superimpositions

A

Resnick recommendation- AP axial projection

46
Q

This projection also differentiates middle lobe and lingular processes from lower lobe disease

A

Resnick recommendation- AP axial projection

47
Q

Resnick recommendation- AP axial projection CRD

A

30 degrees caudal- 40”SID-MSP-level of midsternal region

48
Q

DEMONSTRATION OF AIR-FLUID LEVEL IN THE LUNGS

A

AP/PA PROJECTION: Right/Left lateral decubitus position

LATERAL PROJECTION: Ventral/Dorsal decubitus position

49
Q

AP/PA PROJECTION: R/L lateral decubitus position

Pt position

A

Right/Left lateral decubitus position-top-RT

50
Q

AP/PA PROJECTION: R/L lateral decubitus position

Comfort position

A

Both UE raised, flexed at elbows and FA (forearm) placed against the head

Both LE flexed at knees with sandbag/pillow placed in between knees and ankles for support

51
Q

AP/PA PROJECTION: R/L lateral decubitus position

Part position

A

Thorax in lateral position

MCP-perpendicular with RT

MSP-coincide with MP of IR/cassette

RP at level of T7

Avoid body rotation

Radiolucent support (2-3” thick) placed under the dependent side to elevate

52
Q

AP/PA PROJECTION: R/L lateral decubitus position

IR size/placement

A

14X17-placed-top-RT-vertical-in contact with either posterior/ anterior surface of the body-longitudinal with MP-coincide with RP; back part supported

Upper edge of IR approx. 1 1⁄2 -2” from shoulder level

CRD: Horizontal- 72”-SID-MCP-level-T7-exit at MP of IR for AP and 3” below jugular notch for PA

53
Q

To demo change in position of fluid and free air in the pleural cavity

A

AP/PA PROJECTION: R/L lateral decubitus position

54
Q

AP/PA PROJECTION: R/L lateral decubitus position

  • Wait for (1) before making an exposure to allow the fluid to settle down and for air to rise
  • For fluid level- place the part of interest (2)
  • For air level- place the part of interest (3)
A
  1. 5 minutes
  2. dependent
  3. elevated
55
Q

LATERAL PROJECTION: Ventral/Dorsal decubitus position

Patient position

A

Supine/prone on top of RT

56
Q

LATERAL PROJECTION: Ventral/Dorsal decubitus position

Comfort position

A

Both UE extended upward-hands placed over the head

Both LE extended-sandbag placed under ankles for support

57
Q

LATERAL PROJECTION: Ventral/Dorsal decubitus position

Part position

A

MSP-perpendicular with RT

MCP-coincide with MP of IR

Shoulders on same transverse plane

RP-T7

Radiolucent support (2-3”) thick-placed under the thorax to elevate

58
Q

LATERAL PROJECTION: Ventral/Dorsal decubitus position

IR size/placement

A

14X17-placed on top of RT-vertical-longitudinal-MP-coincide-MCP-level of T7

Back part-supported

CRD:
- Horizontal-72”SID-MCP-level of T7 (for ventral decubitus)-exit at MP of IR
- Horizontal-72”SID-MCP-level of 3-4” below jugular notch (for dorsal decubitus)-exit at MP of IR

59
Q

To demo. change in the position of fluid and reveals pulmonary area that are obscured by the fluid

A

LATERAL PROJECTION: Ventral/Dorsal decubitus
position

60
Q

LATERAL PROJECTION: Ventral/Dorsal decubitus position

Wait for (1) before making an exposure to allow the fluid to settle down and for air to rise

A
  1. 5 minutes