Chapter 2 (Review 4) procedures

A radiograph of a PA and left lateral projection of the chest reveals the mediastinum of the chest is underpenetrated. The tech used the following factors: 72 SID, upright Bucky, a full-inspiration exposure, 75 kV, 600 mAs, and a 1/60 second exposure time. What factors is most likely cause of the problem? And how can the tech improve the image when making repeat exposure

(A) 75 kV is too low; ideal range is 110-125 (B) increase kV and decrease mAs for repeat

A young child enters ER with possible foreign body in one of the bronchi of the lung. The foreign body, a peanut, can't be seen on the PA and lateral positions of chest. What position could tech perform to locate foreign body

AP and lateral upper airway obstruction

A routine chest series indicates a possible mass beneath a patient's right clavicle. The PA and lateral projections are inconclusive. What additional projections can be taken to rule out this condition

AP lordotic

A patient with a possible neoplasm in right lung apex comes to rad department for a chest exam. The PA and lateral do not clearly demonstrate neoplam because of superimposition of the clavicle over the apex. The patient is unable to stand or sit erect. Which projection can be taken to clearly demonstrate the neoplasm and eliminate superimposition of clavicle and left lung apex

AP semiaxial projection; CR angled 15-20 degrees cephalad to project clavicles above apacies and clearly demonstrate possible tumor

PA and lateral projections demonstrate a suspicious region in left lung. The radiologist orders an oblique projection that will best demonstrate or elongate the left lung. Which projection will best elongate the left lung? (More than oblique will accomplish this goal)

Both LPO and RAO oblique positions will best demonstrate or elongate left lung

A radiograph for a PA projection of the chest reveals the top of the apices are cut off and a wide collimation border can be seen below the diaphragm. In what way can this be corrected during repeat radiograph

Center CR higher to T7; make sure CR is centered and top of light is at vertebra prominens

A patient with a clinical history of advanced emphysema comes to the radiology department for a chest x-ray. AEC will not be used. How should the tech alter the manual exposure settings for this patient

Decrease the kV monderately (- -)

A radiograph of a lateral projection of the chest reveals the posterior ribs and costophrenic angles are separated more than 1/2 inch or 1 cm indicating excessive rotation. Describe a possible method of determining direction of rotation

Determine which hemidiaphragm is more posterior or anterior. The left can frequently be identified by gastric bubble or inferior heart shadow

A patient comes for a presurgical chest exam. The clinical history indicates a possible situs inversus of the thorax (transportation of structures within thorax). Which positioning step or action must be taken to perform a successful x-ray

Ensure placement of correct markers on IR because the heart and other thoracic structures may be transposed from right to left

A patient with a history of pleurisy comes into radiology. What series should be performed?

Erect PA and lateral

A patient with severe pleural effusion comes to the radiology department for a chest x-ray. AEC will not be used. How should tech alter the manual exposure settings

Increase kV slightly (+)

A patient has a possible small pneumothorax. Routine chest projections (PA and lateral) fail to reveal the pneumothorax conclusively. Which additional projection can be taken to rule of this condition

Inspiration and expiration PA projections and/or lateral decub AP chest with affected side up

A radiograph of a PA projection chest shows only 7 posterior ribs above the diaphragm. What caused this problem, and how can it be prevented on repeat

Lungs are underinflated; explain to patient the need for a deep inspiration and take exposure on 2nd deep inspiration

A patient enters the ER with a possible hemothorax in the right lung caused by motor vehicle accident (MVA). Patient is unable to stand or sit erect. Which projection would best demonstrate condition, why?

right lateral decub; in a patient with hemothorax (fluid) , side of interest down

A radiograph of a PA view of the chest reveals the sternoclavicle (SC) joints are not the same distance from the spine. The right SC joint is closer to the midline than the left SC joint. What is the positioning error

rotation; patient is rotated into slight RAO position