Thoracic Viscera Flashcards
Determines the shape, position and movement of the internal organs
Body habitus
Four types of body habitus
Hypersthenic
Sthenic
Asthenic
Hyposthenic
-Bounded by the walls of the thorax
- extends from the superior thoracic aperture to the inferior thoracic aperture
Thoracic cavity
Separates the thoracic cavity from the abdominal cavity
Diaphragm
-Contains the lungs and the heart
-Organs of the respiratory
-cardiovascular
-lymphatic systems
-inferior portion of esophagus
-thymus gland
Thoracic cavity
Three separate chambers of the thoracic cavity
- pericardial
-right and left pleural cavities
-Separates the two pleural cavities
-In the middle between the two lungs
-contains all the thoracic structures , except lungs and pleurae
Mediastinum
How many chambers does the right lung have
Three
How many chambers does the left lung have
Two
Respiratory system contains
Pharynx
Trachea
Bronchi
Two lungs
Fibrous, muscular tube with 16 to 20 C shaped cartilaginous rings in its walls for strength
Trachea
The trachea is anterior to the (blank)
Esophagus
Trachea lies (blank)
Midline
Is a hooklike process on the last cartilage
Carina
Trachea divides or bifurcates at carina
- right primary bronchus
-left primary bronchus
Which bronchial is Shorter and wider and more vertical than the left
Right primary bronchus
Subdivisions of bronchial tree
Primary bronchi
Secondary bronchi
Tertiary bronchi
Bronchioles
terminal bronchioles
Where exchange of oxygen occurs
Alveolar sacs
Organs of respiration
Lungs
Which lung is shorter
Right lung is shorter than left because of presence of liver
During inspiration lungs move :
Inferiorly
During expiration lungs move :
Superiorly
Lungs move in three directions
1) inferior and superior
2) anterior and posterior
3) transversely
Enclosed in a double walled serous membrane sac called the pleura
Lungs
What pleura is the inner layer
Visceral pleura
What pleura is the outer layer
Parietal pleura
Area of thorax bounded by sternum anteriorly, spine posteriorly, And lungs laterally
Mediastinum
Structures associated in the mediastinum
Heart, great vessels, trachea, esophagus, thymus , lymphatics, nerves, fibrous tissue , fat
Aspirated foreign objects are more likely to lodge in the :
Right primary bronchus
The level of the trachea bifurcation is the :
Carina
Pt. Prep
General pt position
Image receptor / collimated field size
Source to image receptor distance
Marker
Protection
Pt instructions
General procedural guidelines
Patient prep
Removal of artifacts from the anatomy of interest (long earrings, necklace, clothing artifacts)
Upright or seated erect
Ambulatory patients
-Determine whether air fluid levels are critical to diagnosis
-may have to substitute a decubitus position if patient cannot sit upright
Nonambulatory
SID for chest X-rays
72 inches to minimize magnification of heart and increase recorded detail
Reasons to take an X-ray on one inspiration and one expiration :
Pneumothorax
Diaphragm movement
Foreign body
Atelectasis (collapse of lungs)
Essential projections for chest
PA
lateral
PA oblique
AP oblique
AP
AP axial
PA chest patient position
Upright , If possible to demonstrate air or fluid levels and allow diaphragm to move to its lowest position
PA chest
Part position
-pt faces vertical grid device with MSP centered
-weight equally on both feed
-top of IR 1 1/2 to 2 inches above shoulders
-flex elbows and rest back of hands low on hips
-depress shoulders into same transverse plane
-roll shoulders forward
PA chest central ray
-Perpendicular to center of IR
-enters at MSP and level of T7
Breathing technique for PA chest
Exposure should be made at the end of second deep inspiration
Lateral chest patient position
Upright, if possible
Top of IR 1 1/2 to 2 inches above shoulders
Lateral chest part position
-true lateral position
-MSP parallel with IR
-mid coronal plane perpendicular to IR
-shoulder in contact with grid
-extend arms over head , flex elbows , and rest forearms on head
Lateral chest CR
-directed perpendicular to IR
-enters patient on MCP at level of T7
Lateral chest breathing technique
Exposure made at end of second deep inspiration
PA oblique Chest patient position
Upright
Standing
Or seated
PA oblique Chest
Part position
-45% LAO or RAO
-top of IR 1 1/2 to 2 inches above vertebra prominens
-arms positioned out or collimated field
PA oblique chest
CR
-perpendicular to IR
-enters at level of T7
Breathing technique for PA oblique chest
Two breaths : exposure made after second full inspiration
What lung does RAO best demonstrate
Left lung
What king does LAO best demonstrate
Right lung
AP oblique chest patient position and part position
-upright or recumbent
-45% LPO or RPO
-arms out of field
-shoulders in same transverse plane
AP oblique chest
CR:
-perpendicular to IR center
- enters 3 inches below the jugular notch
-two breaths in and exposure made on second full inspiration
RAO = LPO
LAO = RPO
AP chest pt position
Supine
Used when pt is too Ill for upright position
AP chest part position
-center MSP to IR
-top of IR 1 1/2 to 2 inches above shoulders
-if permits flex elbows , probate hands and place hands on hips to draw scapula laterally
-adjust shoulders into same transverse place
AP CHEST CR:
-perpendicular to long axis of sternum and center of IR
-enters 3 inches below jugular notch
-exposure made after second full inspiration
-heart and great vessels are magnified and engorged
-lungs appear shorter due to abdominal compression
-clavicles project higher
-ribs have a more horizontal appearance
AP supine chest
Method of AP axial chest lordotic position
Lindbolm method
AP Axial chest lordotic position
-upright , facing tube
-approx 1 food in front of grid
AP axial chest lordotic position
Part position :
- MSP centered to midline of grip
-assist pt to lean backward until shoulders rest on grid
-top of IR placed 3 inches above shoulders when pt in lordotic position
AP axial chest
CR :
-Perpendicular to IR
-enter MSP at midsternum
- exposure made after second full inspiration
When a patient can not tilt backwards you can direct a 15 to 20 angle cephalic
AP axial chest (lordotic)
AP axial Lordotic chest is to mainly see:
Apices
Essential projections for lungs and pleurae
-AP or PA
-right or lateral decubitus position
- Lateral
- ventral or dorsal decubitus position
AP/PA lateral decubitus position
Patient position
-lateral decubitus on right or left side
-to demonstrate fluid, patient should lie on affected side
- to demonstrate free air, pt should be positioned on unaffected side
-pt needs to be in position for 5 minutes for optimal pathology visualization
AP/PA lateral decubitus position.
Part position :
-elevate body 2 to 3 inches if lying on affected side
-true lateral without rotation
- extend arms over head
- anterior or posterior surface of chest against vertical grid device
-top of IR 1 1/2 to 2 inches beyond shoulders
AP/PA LATERAL DECUBITUS POSITION
CR:
-horizontal and perpendicular to center of IR
-enters MSP at 3 inches below jugular notch for AP , T7 for PA
-exposure made on second full inspiration
Side up to show air level
Side down to show fluid level
Horizontal beam
Decubitus
What side shoes air level and what side shows fluid level
Side up- air level
Side down- fluid level
Lateral ventral or dorsal decubitus position
Pt position and part position:
Pt position
- prone or supine
-body elevated 2 to 3 inches (sponge)
Part position
-true prone or supine position without roatation
-affected side against vertical grid device
-arms above head
Top of IR AT LEVEL OF THYROID CARTILAGE
Lateral ventral or dorsal decubitus position
CR:
-horizontal and perpendicular to IR
-enters at level of MSP 3 to 4 inches below jugular notch dorsal decubitus , T7 for ventral decubitus
-exposure made after second full inspiration
-pt should be in position for Atleast 5 minutes before exposure to allow fluid to settle or air to rise
Decubitus is to mainly see:
Pleurasie
