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  1. what is the thorax
    aka the chest, is the upper portion of the trunk between the neck and the abdomen
  2. what is the bony thorax
    the part of the skeletal system that provides a protective framework for the parts of the chest involved with breathing
  3. what are topographical landmarks
    they are parts of the body that are easily palpated and consistently located on patients
  4. what are the two landmarks for chest positioning
    vertebral prominens (C7) and the jugular notch of the sternum
  5. what can you see on the bony thorax when the patient gives you a good inspiration
    ten ribs above the diaphram on a radiograph
  6. Why is the right lung is shorter than the left
    b/c the diaphragm has to rise higher on the right side to accomodate the liver
  7. How many breaths is optimal for a chest x-ray procedure
    one deep inspiration and expiration followed by an inspiration and hold it
  8. How many inches muct the IR when doing a chest xray
    1.5-2 inches above the shoulders
  9. what is the position of the shoulders in the chest xray?
    depressed and rolled forward to keep the scapulae out view of other important
  10. if you cannot perform a PA projection what other option is
  11. how many inches must you lower the CR when taking the lateral position of the chest rather than the PA
    1 inch below minimum from PA
  12. what is the hypersthenic body type
    it is when the person is very stocky, has very broad and very deep thorax from front to back but is shallow in the vertical dimension
  13. how must the xray be taken on a hypersthenic person
    the IR should be used with the landscape and and to make sure that the costophrenic angles are not cut off
  14. what is the asthenic body habitus
    a person who is off extreme slender build, long narrow thorax in width and shallow from the front to back but long invertical dimension
  15. what is the hyposthenic body
    it is a person of near average build and ensure that the costophrenic angles are not cut off
  16. what is the most important reasoning of an erect chest
    visualizes possible air fluid levels
  17. what is the proper SID for a chest
    72'' SID the further the tube, the better the detail for chest
  18. What are true ribs and what do they attach to?
    1-7 and attach to the sternum
  19. ribs 8-12 are called what
    false ribs
  20. ribs 11 and 12 are?
    floating ribs
  21. what is a topographical land mark for an AP chest
    jugular notch and go 3-4in down to locate the center of the thorax
  22. how far does the lung tissue extend to
    around the length of all thoracic vertebrae (t1-t12)
  23. where is the pharynx located and how long is it
    behind the nasal cavity, mouth and larynx 12.5cm long
  24. what are the four parts of the respiratory system
    larynx, trachea, R & L bronchi, lungs
  25. what is aspiration
    happens when something goes down the wrong pipe i.e. food or foreign body goes down into the right bronchi
  26. where is the esophagus located
    posterior to the trachea
  27. what area does the trachea extend from and to
    from c6 to t4 or t5
  28. what glands are located near the trachea
    thyroid, parathyroid and thymus
  29. what technical factor must you adjust in order to notice soft tissue and achieve differential absorption of radiation in different tissue?
    lower kVp
  30. why do we use lower kVp when looking at certain situations of the trachea
    to locate certain foreign bodies
  31. what is another name for an Upper Airway Radiograph
    soft tissue neck radiograph
  32. can we see glands radiographically
    no but we have to know location
    • a = air filled trachea
    • b = esophagus
    • c = region of thyroid gland
    • d = region of thymus gland
  33. what is the bifurcation of the trachea called
    the carina
  34. what is the parenchyma of the lungs
    it is the functional tissue of the lungs made of light, spongy elastic substance
  35. what is each lung encased by on its perimeter?
    double walled sac called a  pleura
  36. what is the outer layer of of the sac that covers the inner layer of the chest and diaphragm
    parietal pleura
  37. what is the layer that lines or covers the surface of the lungs
    visceral pleura
  38. what is the area between the double walled pleura called
    pleural cavity
  39. when doing a pa what position use for the cassette
    • landscape pa
    • portrait lateral
  40. what are the three dimensions of thorax when breathing
    • vertical (goes down)
    • transverse (expands from the sides)
    • ap dimension (epands from front to back)
  41. what is the purpose of ordering a inspiration/expiration pa radiograph
    better visualization of a small pneumothorax and diaphragm excursion
  42. where the CR located on geriatrics
    lower than normal
  43. list all steps for the examination
    • CR is t7
    • top of the IR should be 1.5 to 2in above shoulders on most patients
    • shoulder de[ressed and rolled forward
    • feet spread slightly, weight distributed equally on both feet
    • second full inspiration required
  44. label the basic steps of the lateral position
    • left side has to be against IR
    • CR at t7 (3-4 in) below jug. notch
    • midsagittal plane parallel to IR
    • lower CR a min of 1 inch from the PA
    • portrait is cassette
  45. if there is a fluid in the lung, what is there difference between erect and recumbent
    erect fluid drops to bottom of lungs and recumbent fluid is distributed all over lungs
  46. what are the 3 impt reasons of an erect chest radiograph
    • allows diaphragm to move down farther
    • visualize possible air fluid levels in chest
    • prevents engorgement and hyperemia (the increase of blood flow to different tissues in the body) of pulmonary vessels
  47. what is the importance of a 72 in SID
    keeps heart in detail and minimize magnification image of heart
  48. what is proof that a radiograph is a true PA
    what happens when one clavicle is farther than the sternum or unequal
    both the right and left sternal ends of the clavicles are the same distance from the center line of the spine

    it means that the on side of shoulder was rotated away from the IR (i.e. if the clavicle is farther towards the right from the sternum the right shoulder was rotated away from IR )
  49. what is the minimum SID on AP chest
  50. what is the criteria for an AP chest
    • heart appear larger
    • there will not be full inspiration
    • and 3 posterior ribs shud be visualized above the clavicles indicating the correct CR angle was used
  51. what is the special projection used to see foreign bodies located under the clavicle
    apical lordotic projection
  52. what do you do if the patient cannot extend back for an apical lordotic projection
    angle the CR 15-20 degrees cephalad
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  55. what are the positioning considerations for a chest radiograph
    • includes removal of all metals and opaque objects from the waist up
    • long hair braided together in bunches
  56. how do we prevent no rotation on a pa chest
    • ensure patients feet is shoulder width
    • shoulders are down and rolled forward
  57. should the patients chine be extended upwards
    yes so it is not in the way of the radiograph the neck is not superimposing the uppermost regions of lungs and apices
  58. how do minimize breast shadow
    a person with large pendulous breast should be asked to lift them up and outward and to remove hands as she leans against the chest board (IR)
  59. how do we determine rotation on a L lateral chest
    excessive rotation is spotted by poor positioning errors and on a radiograph the amount of separation of the right and left posterior ribs and separation of the two costophrenic angles
  60. how do ensure no tilt on a true lateral
    • ensure patient is standing with weight evenly distributed on the feet
    • arm raised high and above head
    • and go behind and feel if the shoulders are lined up
  61. the level of c7 corresponds to what vertebrae
  62. what are the collimation guidelines for PA chest
    cr to t7 side outer skin margins; at the upper level of vertebra prominens
  63. if the patient is unable to stand what position would we use
    and what is the purpose
    • bilateral decubitus
    • to visualize fluid in the left or rt lung amd the side up will show the air
  64. List steps for decubs
    • center at t7
    • top if IR 1.5-2in above the shoulders
    • arms raised chin raised
    • no rotation
    • place sponge underneath the lung with the fluid (if left lung has fluid they should lie on left lateral decub )
  65. if radiologist suspects air in the left lung what position should you do
    right lateral decubitus
  66. steps for lateral wheelchair?
    • everything the same as regular lateral except:
    • place sponge behind back to straighten the back for no rotation
    • and should try to sit up as much as possible
    • turn wheelchair 90 degrees clost to the IR
  67. list the requirements for an apical lordotic
    • stand 1 ft from IR and lean back with shoulders neck and back of head against IR
    • hands on hips palms out
    • shoulders rolled forward
    • top of IR 3in above shoulders
    • CR to midsternum
    • expose on second inspiration
  68. if the patient is unable to stand for an apical lordotic how must it be done
    • patient must be lied down same principles as reg lordotic
    • but CR is angled 15-20 degrees to the midsternum
  69. an RPO & LPO position best visualizes which lung
    • rt lung RPO
    • lt lung LPO
  70. RAO best visualizes which lung
    left lung
  71. LAO best visualizes which lung
    rt lung
  72. how much kvp do we need for lateral position upper airway
    lower kvp
  73. what sized cassette do we need upper air way exam
    where is the CR located
    what are the breathing instructions
    • 10x12
    • between adams apple and jugular notch around C6
    • slow deep inspiration
  74. where is the CR for AP upper airway exam
    • CR to t1-t2
    • and same other principles exposure breathing tech factors as lateral upper airway
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