Test 2 Flashcards by shaylynn giroir

Where is the CR centered for a PA chest projection on an adult?

T-7

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Which body habitus most often requires a landscape alignment of the image receptor (IR)?

Hypersthenic

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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

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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

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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.

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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

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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

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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.

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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

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Where would you center the CR for an AP portable chest projection?

3-4 inches below jugular notch

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Which of the following structures is not within the mediastinum?

heart
thymus
great vessels
thyroid

Thyroid gland

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Which of the following pathologies of the chest is when free air enters the pleural space and prevents normal expansion of lung?

Pneumothorax

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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

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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

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What is the name of the upper, rounded region of the chest?

Apices

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What is the name of the structure that prevents aspiration of food and fluids into the larynx?

Epiglottis

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List the structures found in the mediastinum

Heart, esophagus, trachea, thymus gland, great vessels

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Which structure of the respiratory system is common to both air and food?

Pharynx

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Which bony structure is palpated and located at C7

Vetebra prominens

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Which of the following structures is located most inferior?

Apices
Hilum
Carina
Costophrenic angle

Costophrenic angle

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List the two layers of the pleura

parietal and pulmonary (visceral)

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List three of the great vessels of the chest

Superior vena cava, inferior vena cava, Aorta, pulmonary arteries, pulmonary veins

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The pulmonary veins bring oxygenated blood from lungs to the heart.

True

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Which vertebral level does the xiphoid process (tip) correspond?

T9-10, 9th or 10th thoracic vertebral level

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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: 1. Breastbone 2. adams apple 3. shoulder blade 4. voice box 5. collarbone

1. Sternum 2. Thyroid cartilage 3. Scapula 4. Larynx 5. 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 1. parietal pleura 2. pleural cavity 3. hilar pleura 4. 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 1. thymus gland 2. heart and great vessels 3. epiglottis 4. 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 1. to reduce patient dose 2. to demonstrate air and fluid levels 3. to allow the diaphragm to move down farther 4. 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?

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