1. vertebral prominen 2. jugular notch 3. xiphoid tip

test 2 Flashcards by Naomi Ngo

Why is it better to do PA chest in erect position

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

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Why is it better to do PA over AP for chest

Lower OID for lungs & heart

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What is Lithotomy position?

Legs are higher than head

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Recumbent?

lying down in any position

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Trendelenburg?

Head is lower than feet

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Fowler

Head is higher than feet

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Sim

recumbent oblique position

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Why chest x-ray is taken in erect position rather than supine/recumbent ?

Allow lungs to fully expand.
for supine/recumbent, air will spread anteriorly–> haziness on images

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Why 72” SID for chest x-ray

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

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[PA chest] Why do shoulders need to be rolled forward?

prevent the scapula from superimposed the lungs

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[PA chest] Why does chin need to be up?

Prevent superimposition of the apices of the lungs

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3 body landmarks

vertebral prominen
jugular notch
xiphoid tip

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Vertebral prominen is at

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Jugular notch is at

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Xiphoid tip is at

T9/10

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[PA chest] If there are no rotation, how can it be seen on the radiograph

Sternal ends of clavicles are equal distance to the sternum

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[PA chest] why is it important that there should be no rotation?

prevent distortion of size/shape of heart shadows

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[PA chest] what is the kVp range ? why?

110-125
low contrast

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[Left lateral] How to determine if the patient is in true lateral

posterior surfaces of shoulders and pelvis are superimposed & perpendicular to IR

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___ pressure = ___ volume

increase / decrease

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[Left lateral] How do you know if the patient is not in true lateral position?

separation of posterior ribs and costophrenic angle

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Where would the CR be for PA chest

7-8” from vertebral prominen (C7)

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Where would the CR be for L Lateral chest

3-4” from jugular notch (T2)

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What is the tissue that make up the lungs

parenchyma

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How do you know the exposure is good for PA chest

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

How do you know the exposure is good for Lateral chest

-no motion -sharp outline of posterior ribs & lung marking through heart shadow & upper lung areas

[AB] Why do we do left decub instead of right?

away from normal air

Why do you hold your breath on 2nd inspiration?

move air inside without strain

The heart appears larger as a result of _____

shorter SID increased OID

Major organs are swapped in the opposite side of the body is termed

situs inversus

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

70-80 they have low body mass

Where is the CR for pediatrc pt

nipple line

[ROTATION] for PA, you would look at what structure? for lateral, you would look at what structure?

PA: clavicle (SC joints) Lateral: posterior ribs

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

no more than 1/4 to 1/2"

For an adequate inspiration, how many ribs pairs will you see on a PA CXR?

[CHEST CXR] What angle is the CR for AP supine/semierect ?

5 degree caudal angle

Why for AP supine/semierect we put the CR at 5 degree caudal angle?

-CR can be perpendicular to long axis of sternum, preventing clavicles from superimposing apices of lungs

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

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

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

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

What is the purpose of lordotic position in CHEST CXR?

rule out calcification & masses beneath clavicles

Where is the CR in erect lordotic position for Chest CXR?

3-4" below jugular notch

Where is the CR in supine lordotic position for Chest CXR?

15-20 degree cephalad to midsternum

LPO corresponds to which position? Why?

RAO Both see L lung best

[CXR] RPO corresponds to which position? Why?

LAO Both see R lung best

Which positions can see the right lung best?

LAO RPO

Which positions can see the left lung best?

RAO LPO

For ___ oblique, lung will be farthest from IR

For ___ oblique, lung will be closest to IR

posterior

If magnification of diaphragm increases, then the lung field is ____

SHORTER

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

POSTERIOR because the diaphragm is being magnified

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

farther away from the IR

How do you know if you are looking at a posterior oblique radiograph?

Heart is large Diaphragm is magnified Short lung field

How do you know if you are looking at AP or PA CXR?

????

What is the CR for Lateral & AP S.T. Neck

1" above jugular notch which is T1 or T2

[S.T. Neck] SID for AP? SID for Lateral?

AP: 40 Lateral: 72

[S.T. Neck] Why is it important to make sure inspiration is SLOW & DEEP

ensure air filled the trachea and upper airway

What does the BONY thorax include?

2 clavicles 2 scapula 1 sternum 12 rib pairs 12 thoracic vertebra

Why is Right lung shorter than Left lung

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

The base of lung is attached or rest on _____

diaphragm

Costophrenic angle is where ____

diaphragm meets ribs

Cardiophrenic angle located in ____

LT ventricle RT atrium

Hilum is where ____ (4) enter & leaves lungs

bronchi blood lymph vessels nerve

Why is it important to include costophrenic angle in CHEST CXR?

-where fluid accumulated in erect position -pulmonary edema

The difference b/w these disease: 1. Empyema 2. Hemothorax What are the positions for any type of pleural effusion ?

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

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

Pneumothorax collapse of lung ==> SOB & chest pain

Parietal pleura lines ___

inner surface of chest wall & diaphragm

What pleura cover surfaces of lungs

visceral

What is the primary muscle for breathing

diaphragm

what are the 3 openings in the diaphragm

IVC Esophagus Aorta

When inhale, the diaphragm moves ___

DOWN

when diaphragm go down, the volume of thoracic go ___, which ___ intrathoracic pressure. This is called ___

UP decrease Inspiration

When volume decreases, pressure increases, air go ___

OUT

When volume increases, pressure decreases, air go ___

Which structure of the oropharynx mark the boundary b/w nasopharynx and oropharynx

Uvula

What cartilaginous structure of the laryngopharynx prevent food & fluid from entering larynx & bronchi and cover the trachea

epiglottis

What structure is behind the hyoid bone

Larynx

The larynx (voice box) is located at ____

C3 - C6

What are the 3 cartilages structure of larynx

epiglottis thyroid cricoid

The trachea is located at ___

C6 - T4

Trachea is divided at ____

carina

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

Right because of larger diameter

What structures are within the Mediastinum (5)

thoracic organs esophagus trachea thymus heart

What is the role of thymus gland? how does it look in pediatric pt

development of immune system prominent in infant

What is the organ that is located behind the upper sternum and said to be temporary in infancy and disappears in adulthood?

Thymus gland

Which body habitus is described here: broad thorax, deep from back, shallow in vertical dimension, wide & short lungs

Hypersthenic

Which body habitus is described here: slender, narrow in width, shallow from front to back, long in vertical dimension

asthenic