Test 2 Flashcards
Where is the CR centered for a PA chest projection on an adult?
T-7
Which body habitus most often requires a landscape alignment of the image receptor (IR)?
Hypersthenic
Situation: A patient enters the ER with a pleural effusion in the right lung. He is weak but can stand. Which positions of the chest would you perform for this patient?
An erect PA and right lateral
A radiograph of a PA chest demonstrates significant asymmetry of the SC joints. The right SC joint is much farther from the mid sternum as compared to the left. Which specific positioning error is present:
Left side rotation or LAO
A radiograph of a lateral chest demonstrate the posterior ribs are not superimposed. There is a separation of 1” (2.5 cm). What type of positioning error is present? Should this projection be repeated?
There is rotation of the patient. Yes, the projection should be repeated.
Situation: A patient comes to the ER with severe rib injuries on the right thorax. The ER physician suspects a pneumothorax. The patient comes from an extended care facility and hasn’t stood up for two years. Which position would best demonstrate the pneumothorax?
Left lateral decubitus
A radiograph demonstrates an oblique projection of the chest. It demonstrates that the right thorax is elongated and the left thorax is foreshorten. List both positions that would produce this radiographic appearance.
RPO and LAO
Situation: A patient comes to radiology with a possible mass under the left clavicle. The PA and left lateral projections are inconclusive. The patient has equilibrium issues and gets dizzy when leaning backwards. What projection could you perform that would demonstrate this possible mass?
AP semi-axial with a 15 to 20 degree cephalic CR angle.
Situation: This patient may have inhaled a marble in the airway. Which projections would be performed to determine if the foreign body is in the airway or esophagus?
PA and left lateral erect positions
Where would you center the CR for an AP portable chest projection?
3-4 inches below jugular notch
Which of the following structures is not within the mediastinum?
- heart
- thymus
- great vessels
- thyroid
Thyroid gland
Which of the following pathologies of the chest is when free air enters the pleural space and prevents normal expansion of lung?
Pneumothorax
Situation: A patient enters the ER due to chest trauma. She is a 36 y/o ambulatory female. The erect PA and Left lateral are taken. The PA reveals a small possible pneumothorax near the right apex. But the physician is unsure. What additional projections can be taken to rule-out a small pneumothorax?
Inspiration and expiration PA
Situation: A patient enters the ER with a know history of situs inversus. A pre-operative chest exam is order. The patient can stand and is ambulatory. Which positioning routine would be ideal for this patient?
PA and right lateral
What is the name of the upper, rounded region of the chest?
Apices
What is the name of the structure that prevents aspiration of food and fluids into the larynx?
Epiglottis
List the structures found in the mediastinum
Heart, esophagus, trachea, thymus gland, great vessels
Which structure of the respiratory system is common to both air and food?
Pharynx
Which bony structure is palpated and located at C7
Vetebra prominens
Which of the following structures is located most inferior?
Apices
Hilum
Carina
Costophrenic angle
Costophrenic angle
List the two layers of the pleura
parietal and pulmonary (visceral)
List three of the great vessels of the chest
Superior vena cava, inferior vena cava, Aorta, pulmonary arteries, pulmonary veins
The pulmonary veins bring oxygenated blood from lungs to the heart.
True
Which vertebral level does the xiphoid process (tip) correspond?
T9-10, 9th or 10th thoracic vertebral level
Which side is elongated for LPO, RPO, LAO and RAO
LPO - Left
RAO - left
RPO - Right
LAO- Right
When there is possible fluid in the lungs, the affected side is _____, when there is free air the affected side is ______
down, up
What is TB
Airborne disease from bacteria Myobacterium Tuberculosis
How can you tell on a radiography that a patient has TB
You can see an enlarged hilar region on the lateral
Who is affected by primary and secondary TB?
primary - children
secondary - adults
what is atelectasis
lung collapse as a result of obstruction of bronchi or puncture
True or false - Atelectasis is life threatening
false
How do you distinguish between atelectasis and pneumothorax
atalectasis - mediostinal is pushed toward the collapsed lung
Pneumothorax - mediostinal is pushed away from the collapsed lung
what are the key indicators consistent of diagnosis for atelectasis ?
radiodense region of collapsed lungs, mediostinal shift towards the collapsed lung, elevation of the diaphragm on the side of the collapsed lung
If a patient can stand what position would you use for diagnose an atelectasis ?
PA and an affected side lateral
If a patient cannot stand what position would you use for diagnose an atelectasis ?
decubitus with affected side up
what is a pneumothorax?
air or gas in the pleural cavity, which can cause full or partial lung collapse
what are the most common reasons for a pneumothorax
COPD or trauma
Patient has a suspected pneumothorax, patients pain is on the right side, the patient can stand, what position would you radiograph?
PA and right lateral
Patient has a suspected pneumothorax, patients pain is on the right side, the patient cannot stand, what position would you radiograph?
Left lateral decubitus
With a patient with COPD what is the shape of the diaphragm ?
diaphragm is flattened
what does pleural thickening indicate in asbestosis
Early stages of the disease
what is pulmonary adenocarcinoma
malignant cancer cells in mucus producing glands of the lungs.
What is the most common lung cancer for non smokers
pulmonary adenocarcinoma
what percentage of lung cancers are pulmonary adenocarcinoma ?
40%
What is cystic fibrosis
Genetic disease that produces thick/stick mucus that blocks air
what is epiglottitis
bacterial or viral inflammation of the epiglottis, which swells and blocks airways
What famous person died of epiglottitis
George Washington
what position is performed to diagnose epiglottitis
AP and horizontal beam lateral of C-spine
what is pleural effusion
Excess fluid build up in the lungs
what positions are performed for a pleural effusion of a patient who can stand?
PA and affected side lateral
what positions are performed for a pleural effusion of a patient who cannot stand?
decubitus with affected side down
What is RDS?
Respiratory distress syndrome (AKA hyaline membrane disease)
What is the result of RDS
Lungs are not able to produce surfactant in premie babies
What position is performed for RDS
AP supine
What drug is given to neonates to treat RDS and improve lung tissue elasticity
surfactant (replacement therapy)
what is the current term for Hyline membrane disease
RDS
a partial or complete collapse of a lung is called?
atelectasis
the patient is diagnosed with a complete atelectasis of the left lower lobe. the patient cannot stand. which alternative would you perform beyond the routine chest projection
Right lateral decubitus
cystic fibrosis is what type of disease
genetic
what is the radiographic sign for epiglottitis
the thumb sign
Patient comes in with dyspnea and pleuritic chest pain. Pain is on the right side. What are some possible positions you could do to see the gases correctly?
PA, right lateral, or left lateral decubitus
If a patient had right atelectasis, what die would you do a decubitus on?
Left
What is a partial or complete collapse of the lung called?
atelectasis
Patient diagnosed with a complete atelectasis of the left lower lobe and cant stand. What position would you do ?
Left lateral decubitus
What views are used to compare for a pneumothorax?
inspiration/expiration
When a foreign body has blocked an airway, which way will the mediastinal are shift?
toward the blockage
What is the anatomical name:
- Breastbone
- adams apple
- shoulder blade
- voice box
- collarbone
- Sternum
- Thyroid cartilage
- Scapula
- Larynx
- Clavicle
The 7th cervicle vertebrae is known as?
vertebra prominens
a notch, or depression, located on the superior portion of the sternum is called the?
jugular notch
The trachea bifurcates and forms the
Right and left bronchi
a specific prominence, or ridge, found at the point where the internal distal trachea divides into the right and left bronchi is called the?
Carina
The are of each lung where the bronchi and blood vessels enter and leave is called the?
Hilum
The structures within the lung in which oxygen and carbon dioxide gas exchange occurs are called
alveoli
Which of the following is not an aspect of the pleura
- parietal pleura
- pleural cavity
- hilar pleura
- pulmonary pleura
hilar pleura
The condition in which blood fills the potential space between the layers of pleura is called ?
hemothorax
the extreme, outermost lower corner of each lung is called the
costophrenic angles
which structure is not found in the mediastinum
- thymus gland
- heart and great vessels
- epiglottis
- trachea
epiglottis
a narrow thorax that is shallow from the front to back but very long in the vertical dimension is characteristic of
Asthenic
what is the best kV and SID level for an adult chest
125 kV and 72”
What kV is recommended for a young pediatric patient
70-85
which of the following is not a valid reason to perform a chest projection with the patient in the erect position
- to reduce patient dose
- to demonstrate air and fluid levels
- to allow the diaphragm to move down farther
- to prevent hyperemia of pulmonary vessels
to reduce patient dose
why are the shoulders pressed downward and toward the IR for a PA projection of the chest
to reduce patient chest rotation
why are the shoulders rolled forward during a PA chest projection
to remove scapulae from the lung fields
Where is the central ray placed for an AP supine projection of the chest?
3-4” below the jugular notch
what is the medical name for shortness of breath
dyspnea
a condition in which all or a portion of the lung is collapsed.
atelectasis
a condition in which excessive fluid builds in the lungs as a result of obstruction of the pulmonary circulation is termed
pulmonary edema
a sudden blockage of an artery in the lung is called
pulmonary emboli
manual analog exposure factors for a patient with a large pneumothorax should
be reduced
a PA chest shows that the left sternoclavicular joint is superimposed over the spine. What positioning error has occurred
LAO rotation
A PA chest demonstrates 10 posterior ribs above the diaphragm. Is this an acceptable degree of inspiration
yes
a PA and lateral chest study has been completed. The PA projection shows the right costophrenic angle was collimated off, but both angles are included on the lateral projection. Would you repeat?
yes
a lateral chest radiograph demonstrates the soft tissue of the upper limbs is superimposed over the apices of the lungs. How can this situation be prevented?
raise upper limbs higher
a lateral chest shows that the posterior ribs and costophrenic angles are separated by approximately 1/2 inch should the image be repeated?
no
A radiography of an AP lordotic projection shows that the clavicles are projected within the apices. The clinical instructor informs the student that the study is unacceptable, but during the repeat exposure the patient complains of being too unsteady to lean backward, what other options are available if the student want to complete the study?
AP semi- axial projection with a 15-20 degree cephalic angle
an ambulatory patient with a clinical history of advanced emphysema enters the emergency room. The patient is having difficulty breathing and is receiving oxygen. The physician has ordered a PA and lateral chest study. Should the technologist alter the typical exposure factors for this patient.
yes. Decrease the exposure factors
a patient enters the ER with an injury to the chest. The ER physician suspects a pneumothorax may be present in the right lung. the patient is unable to stand or sit erect. Which specific position or projection can be performed to conform the presence of the pneumothorax
left lateral decubitus
a PA and lateral chest study show s suspicious mass located near the heart in the right lung. The radiologist would like a radiograph of the patient in an anterior oblique position to delineate the mass from the heart. Which position should the tech use ?
LAO (60 degrees)
a patient with a history o f pulmonary edema comes to the radiology department and is unable to stand. The physician suspects fluid in the left lung. Which projection should be used to confirm this diagnosis
Left lateral decubitus
