Mrt 263

• Nasopharynx - General Radiography
• Trachea General Radiography
• Modified Barium SwallowLung Biopsy Procedure (Procedure

larynx connects pharynx to trachea

throat, passage for air/food

superiosoft palate (respiratory only)

middle portion, soft palate to hyoid bone respiratory and digestive

• inferior portion, hyoid bone to esophagus/larynx
• (respiratory and digestive)

• begins at the oral cavity
• continues as the pharynx,
• esophagus,
• stomach, small intestine,
• large intestine and terminates as the anus

Usually only Lateral View is performed

• Often done for foreign bodies
• epiglottitis
• stenosis of the trachea
• swelling of adenoids

Also known as ‘soft tissue neck’

Yes an increased dose to patient’s thyroid: be sure to collimate well

• Patient upright or supine
• Neck extended slightly

slow inspiration

• Useful for barium studies
• (swallowing),
• phonation/stress studies

CR: ┴ to laryngeal prominence

SID 72”

Pull shoulders back and extend neck to prevent superimposition of mandible

slow inspiration

• CR: ┴ to…
• 1” below EAM

•Oropharnyx – gonion (C2/3)

Larnyx, pharnyx and upper esophagus laryngeal prominence (C5)

to demonstrate vocal cords and cleft palate

• to show complete closure of the glottis. Patient is instructed to take a deep breath and bear down
• to increase both the intrathoracic and intrabdominal pressure
• used with esophageal varicies (bleeding)

• to test the elatisity of the laryngral pharnyx. Patient pinches nostrils together with the thumb and forefinger.
• Patient tries to blow their nose
• their cheeks will puff out in this procedure

may be used to visualize foreign bodies

The vocal cords and cleft palate

To distend the subglottic larynx and laryngeal pharynx with air

helps visualise pharyngeal structures

non opague foreign bodies in the pharynx or upper esophagus

• trachea, thyroid gland, thymus gland and associated pathologies
• Demonstrate an enlarged thymus or abnormalities in the thymus

localization of foreign body

• Patient supine or upright
• Neck extended slightly

• slowly inhale (air filled trachea)
• Area from midcervical to the midthoracic region

CR: ┴ to manubrium

• Patient upright
• Hands clasped behind back
• Rotate shoulders posteriorly
• Extend neck

to prevent superimposition over superior mediastinum

slow inspiration

CR: ┴ midway between the jugular notch and the midcoronal plane

• Air filled trachea
• To demonstrate the superior mediastinum center 4-5” lower

• A fluoroscopy exam preformed with a speech pathologist to view and assess the swallowing mechanism
• Recorded on video tape
• •Patient is sitting and speech pathologist or technologist feeds them different amounts and consistencies of barium and barium coated food.
• •Starts with small quantities of thin and thick barium and then pudding, applesauce, fruit cup all coated with barium •Different techniques used to demonstrate pathologies and aspiration (from penetration of liquid through vocal cords)

moving the food/liquid to the back of the mouth

moving the food/liquid over the back of the tongue and down to the pharynx or throat

the food/liquid enters the esophagus

To identifies problems that occur in the mouth, at the base of the tongue, in the pharynx, or in the esophagus

• patients with complains of swallowing, choking or regurgitating,
• patients who have had past episodes of pneumonia which have yet to be diagnosed

• information about tongue motion and coordination and timing of the swallow
• How material is managed orally just prior to the swallow and evaluates the mechanical aspects of the swallowing mechanism including airway protection and how well the material moves through the different phases of swallowing

• usually performed when the abnormal condition is near the surface of the lung, in the lung itself, or on the chest wall
• Biopsy (tissue sample) is collected for analysis

when a suspicion of primary or metastatic malignancy exists, usually based on interpretation of a chest x-ray (previously performed)

the stage and extent of disease

fluoroscopy, CT or angiography

• Collapsed lung
• (pneumothorax)
• Bleeding
• Infection

• Patient is monitored for 2-4 hrs for signs of pneumothorax
• PA chest is taken immediately post procedure and then 2-4 hrs afterward
• Signs of complications – shortness of breath, or chest pain
• - Chest tube may be required if patient has a large pneumothorax

Chest x ray

From nose to soft palate

From soft palate to hyoid bone

From hyoid bone to esophagus

false

• Forcibly blowing air against a closed airway (a closed glottis)
• Done to increase venous pressure to demonstrate pathologies such as esophageal varicies

To fill the pharynx with air to provide visualization of its structures

• Surgery to remove tumor
• Radiation therapy
• Chemotherapy

If tumor is secondary the primary site needs to be established to determine next step

the act of swallowing

difficultly swallowing

inhalation into the airways of fluid or foreign body

any forced expiratory effort against a closed airway

• Trachea
• thyroid gland
• parathyroid glands
• thymus gland

Transthoracic needle aspiration

• Emphysema bullae
• cysts
• blood coagulation disorders
• pulmonary hypertension
• severe hypoxia
• uncooperative patient

• A through explanation of examination
• Patient should be on clear liquid diet 6 to 8 hours pior to procedure