test 2 Flashcards
Why is it better to do PA chest in erect position
Detect air/fluid level
Diaphragm is lowered
Full lungs are shown
Why is it better to do PA over AP for chest
Lower OID for lungs & heart
What is Lithotomy position?
Legs are higher than head
Recumbent?
lying down in any position
Trendelenburg?
Head is lower than feet
Fowler
Head is higher than feet
Sim
recumbent oblique position
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
Why 72” SID for chest x-ray
-Increased SID
-avoid magnification of heart
-capture bilateral lungs
-less divergence of x-ray beam = less distortion
[PA chest] Why do shoulders need to be rolled forward?
prevent the scapula from superimposed the lungs
[PA chest] Why does chin need to be up?
Prevent superimposition of the apices of the lungs
3 body landmarks
- vertebral prominen
- jugular notch
- xiphoid tip
Vertebral prominen is at
C7
Jugular notch is at
T2
Xiphoid tip is at
T9/10
[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
[PA chest] why is it important that there should be no rotation?
prevent distortion of size/shape of heart shadows
[PA chest] what is the kVp range ? why?
110-125
low contrast
[Left lateral] How to determine if the patient is in true lateral
posterior surfaces of shoulders and pelvis are superimposed & perpendicular to IR
___ pressure = ___ volume
increase / decrease
[Left lateral] How do you know if the patient is not in true lateral position?
separation of posterior ribs and costophrenic angle
Where would the CR be for PA chest
7-8” from vertebral prominen (C7)
Where would the CR be for L Lateral chest
3-4” from jugular notch (T2)
What is the tissue that make up the lungs
parenchyma
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?
10
[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
Anterior
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 ?
- fluid is pus
-caused by chest wound, ruptured lung abscess, obstruction of bronchi - 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 ___
IN
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
