week 4: chest (PA Chest and Left Lateral)

Question 1

what are the 2 forms of digital image receptors?

Answer 1

computed radiography, direct radiography

Question 1

what is the difference between CR and DR?

Answer 1

Both use an IR, but CR needs to have the IR brought somewhere to be processed

Question 2

what comprises the bony thorax?

Answer 2

sternum, manubrium, xiphoid process;
2 clavicles, 2 scapulae,
12 pairs of ribs, 12 thoracic vertebrae

Question 3

palpations at base of neck (posterior) will lead you to this anatomical landmark

Answer 3

C7

Question 4

Mid-thorax corresponds to

Answer 4

level of T7

Question 5

Xiphoid process corresponds to

Answer 5

level of T9-T10, even T11 or T12

Question 6

the anterior rib is (superior/inferior) to the posterior rib

Answer 6

inferior (lower)

Question 7

the thoracic cavity moves in 3 dimensions on inspiration. what are they?

Answer 7

Vertical diameter
Transverse diameter
AP diameter

Question 8

A general rule of average adult patients is to “show” minimum of _________ of ribs on a good PA chest

Answer 8

10 pairs

Question 9

what does SID stand for?

Answer 9

source to image distance

Question 10

how far away from IR is the bucky to be set?

Answer 10

72 inches

Question 11

why is 72 inches the correct distance for chest xrays

Answer 11

longer SID magnifies less because the xray beam has less divergence

Question 12

longer SID magnifies less because the xray beam has (more/less) divergence

Answer 12

less

Question 13

Chest xrays must be taken on _________

Answer 13

full inspiration

Question 14

for chest xrays, xray is taken in this way: hold breath on the ________ full inspiration

Answer 14

second

Question 15

All chest radiographs should be taken in the erect position (as pt condition allows) due to these reasons

Answer 15

1. Diaphragm is able to move down farther
2. Air and fluid levels in the chest may be visualized
3. Engorgement and hyperemia of pulmonary vessels may be prevented

Question 16

PA Projection

minimum SID

Answer 16

72 inches

Question 17

PA Projection

IR size

Answer 17

14x17 inches

Question 18

PA Projection

Grid/no grid?

Answer 18

grid

Question 19

PA Projection

kVp range

Answer 19

110 - 125

Question 20

Technical factors of PA projection
-Minimum SID
-IR size
-Grid/no grid?
-kVp range

Answer 20

-72 inches
-14x17 inches
-Grid
-110-125

Question 21

lengthwise IR would be helpful for a patient with a ________ body habitus

Answer 21

hypersthenic

Question 22

less magnification for heart can occur by using these factors

Answer 22

less magnification for heart → bucky at 72 inches, PA rather than AP

Question 23

three radiation protection factors for patients

Answer 23

1. limit repeat exposures
2. collimation
3. Gonadal shielding

Question 24

positioning for a PA projection

Answer 24

-T7 in middle of IR
-round drape/gonadal shielding
-hands on waist
-asking patient to roll shoulders forward
-extend chin

Question 25

collimation guidelines (from Prof.)

Answer 25

collimation on WIDTH (left to right) not on length

Question 26

Evaluation criteria for PA Chest

Answer 26

-Entire lungs included
-No rotation
-Scapulae removed from lungs
-Full inspiration
-Equal collimation top and bottom
-No motion
-Exposure factors*

Question 27

what do you need to do with shoulders in positioning a patient for a PA Chest?

Answer 27

roll shoulders forward

Question 28

when counting a minimum of 10 ribs, what is important to remember?

Answer 28

counting posterior ribs (on a PA chest, they are the ones that look more “forward”)

Question 29

what grayscale and contrast type do you want in a chest xray?

Answer 29

long scale, low contrast

Question 30

For marking a lateral chest X-ray: we mark the side that is ____________ the IR

Answer 30

closest/touching

Question 31

what marker would you use for a left lateral chest xray?

Answer 31

Left marker

Question 32

breathing instructions from PA chest (are/are not) applicable to lateral chest

Answer 32

are

Question 33

bronchitis: an acute or chronic condition in which __________ is secreted into the bronchi, causing __________ and __________; generally involves the _____ lobes of the lung

Answer 33

excessive mucus, cough and shortness of breath, lower

Question 34

aspiration: occurs when _________ are swallowed or aspirated into the air passages of the _________

Answer 34

foreign objects, bronchial tree

Question 35

emphysema: an irreversible and chronic lung disease in which air spaces in the ____ become greatly enlarged as a result of _________ and loss of ________. Air tends to _________ during expiration, causing labored breathing

Answer 35

alveoli
alveolar wall destruction
alveolar elasticity
not be expelled

Question 36

COPD: form of persistent ______________ that usually causes difficulty in ___________; may be cause by emphysema or chronic bronchitis

Answer 36

obstruction of the airways, emptying the lungs of air

Question 37

what does COPD stand for?

Answer 37

chronic obstructive pulmonary disease

Question 38

Pulmonary edema: condition of ________ within the lung that most frequently is caused by a backup in _________, commonly associated with CHF

Answer 38

excess fluid, pulmonary circulation

Question 39

what is the difference between involuntary and voluntary motion as seen on a radiograph?

Answer 39

all anatomy blurry with voluntary

only that anatomy is blurry with involuntary (ex: heart is blurry during an involuntary heartbeat)

Question 40

on a radiograph, the SC joints are found on ________________ (not precisely _______)

Answer 40

lateral borders of manubrium, midline

Question 41

No rotation on a left lateral chest x-ray is evident by ______________

Answer 41

superimposed posterior ribs (slide 40 on powerpoint)

Question 42

with collimation, You __________ collimation in order to _________ field of view

Answer 42

increase collimation to decrease field of view

Question 43

how can you determine on a chest XR if the patient has cardiomegaly?

Answer 43

if the apex of the heart “touches” the left side of the chest wall