Bontrager CH 2 Chest
what is the name of the structure that acts as a lid over the larynx to prevent foreign objects such as food particles from entering the respiratory system?
Epiglottis
Which posterior oblique projection would best demonstrate the left lung -- RPO or LPO
LPO
Why is a PA chest preferred to an AP projection
Places the heart closer to the image receptor to reduce magnification of the heart
which anterior oblique projection would best demonstrate the left lung -- right anterior oblique (RAO) or left anterior oblique (LAO)
RAO
If a person accidentally inhales a food particle, which bronchus will it most likely enter and why?
Right bronchus it is larger in diameter and more vertical
The CR is placed at the level of the ___ vertebra for a PA chest projection
T7
The bony thorax consists of the single ______ anteriorly, two _____, two ____, 12 pairs of ____, and 12 ____ posteriorly
The bony thorax consists of the single sternum anteriorly, two clavicles two scapulae, 12 pairs of ribs, and 12 thoracic vertebrae posteriorly
The two bony land marks of the thorax that are used for locating the central ray on a PA and AP chest projection are the ____
Vertebra prominens and jugular notch
Why should a left lateral be performed unless departmental protocol indicates otherwise?
a left lateral better demonstrates the heart region
for patients with the following clinical histories, which lateral projection would you perform (right or left) a. patient with severe pains in left side of chest b. patient with no chest pain but recent history of pneumonia in right lung c. patient with no chest pain or history of heart trouble
a. left b. right c. left
a radiograph of a PA and left lateral projection of the chest show the mediastinum of the chest is under-penetrated. The tech used the following factors for the radiograph: 72 in (183 cm) SID, an upright bucky, a full inspiration exposure, 75-kV and 600-mA, and a 1/60-second exposure time a. which one of these factors will most likely cause the problem. explain b. how can the tech improve the image when making a repeat exposure
a. the 78 kV is too low. the recommended kV range is 110_125 b. increase kV and reduce mAs for the repeat exposure
what is a common radiographic sign seen on a chest radiograph for a patient with respiratory distress syndrome (RDS) a. enlargement of heart b. fluid apices c. sail sign d. air bronchogram
air bronchogram
optimal technical factor selection ensures proper penetration of the a. heart b. great vessels c. lung regions d. hilar regions e. all of the above
all of the above
What is the term for the small air sacs located at the distal ends of the bronchioles, in which oxygen and carbon dioxide is exchanged in the blood
alveoli
the trachea is located ___ (anteriorly or posteriorly) to the esophagus
anteriorly
upper, rounded portion above the level of the clavicles
apex
the three parts of the aorta are the
ascending, aortic arch, descending
collapse of al or portion of lung
atelectasis
lower concave portion of the lungs
base
irreversible dilation of the bronchioles
bronchiectasis
acute or chronic irritation of the bronchi
bronchitis
what is the name of the prominence or ridge, seen when looking down into the bronchus where it divides into the left and right bronchi
carina
To prevent the clavicles from obscuring the apices on an AP projection of the chest, the central ray should be angled _________ (caudad or cephalad) so that it is perpendicular to the ___________
caudad, sternum
a radiograph of a PA projection of the chest shows the top of the apices is cut off and a wide collimation border can be seen below the diaphragm. In what way can this be corrected during the repeat radiograph
center the CR higher ( to the level of T7 which will be found 7 to 8 inches below the vertebra prominens) make sure the IR is centered to the CR and the top collimation light border is at the vertebra prominens
most common form is emphysema
chronic obstructive pulmonary disease
extreme outermost lower corner of the lungs
costophrenic angle
one of the most common inherited diseases
cystic fibrosis
accumulation of pus in pleural cavity
emphysema
which of the following is not a form of occupational lung disease a. anthracosis b. emphysema c. silicosis d. asbestosis
emphysema
An erect chest PA radiograph aids the patient to achieve full inspiration and helps to prevent ___ and ____ of the pulmonary vessels.
engorgement and hyperemia
which positioning tip will help prevent the patients chin and neck from being superimposed over the upper airway and apices pf the lungs for a PA chest radiograph
extend the neck upward
t/f echocardiography and electrocardiography are basically the same procedure
false
t/f generally, you do not need to use radiographic grids for adult patients for a PA or lateral chest radiographs
false
t/f no lead shielding is necessary for male patients or women older than age 65 during radiographic imaging of the chest
false
t/f ultrasound is not effective modality to detect pleural effusion
false
t/f because the heart is always located in the left thorax, the use of anatomic markers on a PA chest projection may not be necessary
false - heart could be located in right thorax
t/f CR centering for the PA chest projection on an obese patient is 1 to 2 inches lower than a sthenic person
false - same location
T/F: A grid is not recommended for a LPO projection of the adult chest.
false a grid is recommended
t/f the height, or vertical dimension of the average-to-large persons chest is greater than the width, or horizontal dimension
false greater width
t/f in general for an average patient, more collimation should be visible on the lower margin of the chest image than on top for a PA or lateral chest projection
false should be equal
How much separation of the posterior ribs on a lateral chest projection indicates excessive rotation from a true lateral position?
greater than 1 cm (1/2 to 3/4 inches)
central area in which the bronchi and blood vessels enter the lungs
hilum
The ____ bone is seen in the anterior portion of the neck and is found just below the tongue or floor of the mouth
hyoid
Which type of body habitus is associated with a broad and deep thorax?
hypersthenic
which of the following types of body habitus may cause costophrenic angles to be cut off if careful vertical collimation is not used? a. hypersthenic b. hyposthenic c. sthenic d. hyposthenic and asthenic
hyposthenic and asthenic
why do the lungs tend to expand more with the patient in an erect position than the supine position
it allows the diaphragm and organs to drop
which of the following bony landmarks is palpated for centering of the AP chest projection a. vertebra prominens b. jugular notch c. thyroid cartilage d. sternal angle
jugular notch
should the 35- x 43-cm (14- x17-inch) IR be aligned in portrait or landscape orientation for a PA chest projection for a hypersthenic patient? for an asthenic patient?
landscape portrait
which specific position would be used if the patient were unable to stand but the physician suspected that the patient had fluid in the left lung
left lateral decubitis
for certain studies of the heart, the __ (right or left) anterior oblique requires a rotation of __
left, 60 degrees
where is the central ray placed for a lateral projection of the upper airway
level of C6-C7, midway between thyroid cartilage and jugular notch
what are the recommended patient instructions when performing an erect PA chest on a female patient with large pendulous breasts
lift breasts upward and outward and the remove her hands as she leans against the chest board (IR) to keep them in position
List the three divisions of the structure located proximally to the larynx that serve as a common passageway for both food and air
nasopharynx oropharynx laryngophyrynx
the outer layer of this membrane adhering to the inner surface of the chest wall and diaphragm is
parietal pleura
The heart is enclosed in a double-walled membrane called the
pericardial sac or pericardium
The four divisions of the respiratory system
pharynx, trachea, bronchi, lungs
which of the following devices should be used for the erect PA and lateral chest projections for an infant a. upright chest device b. supine table bucky c. pigg-o-stat d. plexiglass resistant board
pigg-o-stat
the delicate, double- walled sac or membrane containing the lungs is called
pleura
the potential space between these two layers (identified in B and C) is called the
pleural cavity
what is the name of the condition characterized by fluid entering the pleural cavity
pleural effusion
inflammation of pleura
pleurisy
accumulation of air in the pleural cavity
pneumothorax
air or gas that enters the space identified in D results in a condition called
pneumothorax
what is the name of the condition characterized by free air entering the pleural cavity
pneumothorax
list four possible pathologic conditions that suggest the need for both inspiration and expiration PA chest radiographs
pneumothorax fixation or lack of normal daiphragm movement presence of a foreign body distinguishing between opacity in rib or lung
explain why the right lung is smaller than the left lung and the right hemidiaphragm is positioned higher than the left hemidiaphragm
presence of the liver on the right
why is it important to raise the patients arm above their head for a lateral chest projection
prevents the upper arm soft tissues from being superimposed over upper chest fields
condition most frequently associated with congestive heart failure
pulmonary edema
the inner layer adhering to the surface of the lungs is ___ or ___
pulmonary or visceral pleura
explain the primary purpose and benefit of performing chest radiography using a 72-inch source image receptor distance (SID)
reduce distortion and magnification of the heart and other chest structures
which specific position would be used if the patient were unable to stand but the physician suspected that the patient had free air in the left pleural cavity
right lateral decubitis (affected side up)
a radiograph of a PA view of the chest show that the sternoclavicular (SC) joints are not the same distance from the spine. The right SC joint is closer to the midline than is the left SC joint. What is the positioning error?
rotation. the patient is rotated into a slight RAO position
what circumstances or clinical indications suggest that an AP lordotic projection should be ordered
rule out calcifications or masses beneath the clavicles
The shoulders need to be rolled forward for the PA projection to allow the ____ to move laterally and be clear of the lung fields
scapula
Careful collimation during a chest radiograph will improve image quality by decreasing _____ radiation to the IR.
scatter
to ensure better lung inspiration during a chest radiography, should be made during the _____ inspiration
second
dyspnea
shortness of breath
describe the way optimum density (brightness) of the lungs and mediastinal structures can be determined on a PA chest radiograph
should be able to see faint outlines of at least middle and upper vertebrae and ribs through heart and other mediastinal structures
a form of occupational lung disease
silicosis
what is another term for a condition termed visceral inversion
situs inversus
which of the following anatomic structures is examined to determine rotation on a PA chest radiograph a. appearance of ribs b. shape of heart c. symmetric appearance and location of sternoclavicular joints d. symmetric appearance and location of costophrenic angles
symmetric appearance and location of sternoclavicular joints
A radiograph of a PA projection of the chest shows only seven posterior ribs above the diaphragm. What caused this problem, and how could it be prevented on the repeat exposures?
the lungs are under inflated. explain to the patient the need for a deep inspiration, and take the exposure on the second deep inspiration
list the four important structures located in the mediastinum
thymus gland, esophagus, heart and great vessels, trachea
Identify the correct anatomic terms for the following Adam's Apple Voice Box Breast bone shoulder collarbone
thyroid cartilage of the larynx larynx sternum scapula clavicle
list and explain briefly the three reasons chest radiographs should be taken with the patient in erect position
to allow the diaphragm to move down farther to show possible air and fluid levels in the chest to prevent engorgement and hyperemia of the pulmonary vessels
t/f because they have a shallow (superior-inferior dimension) lung fields, the central ray is often centered higher for geriatric patients
true
t/f chest radiography is the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors
true
t/f long hair may produce an artifact when imaging with digital radiographic systems
true
t/f multi-detector CT can produce high-resolution images of the heart on one breath hold
true
t/f single-photon emission computed tomography (SPECT) is frequently used to diagnose myocardial infarction
true
t/f with most digital chest units, the question of IR placement into either the portrait or the landscape position is eliminated because of the larger IR
true
a contagious disease caused by airborne bacterium
tuberculosis
the recommended central ray technique for a PA chest projection requires the tech to palpate the ____ and measure down the bony landmark ___ inches (__cm) for a male patient and ___ inches (__cm) for a female patient
vertebra prominens 8inches (20 cm) for a male and 7 (18 cm) for a female
the traditional central ray technique for the chest is to place the top of the IR __ (__cm) above the shoulders
1 1/2 to 2 inches (5 cm)
what is the minimum number of ribs that should be demonstrated above the diaphragm on a PA radiograph of an average adult chest with full inspiration
10
chest radiography for the adult patient usually uses a kv of ___ to ___
110 to 125
which of the following sets of exposure factors is recommended for a chest exam of a young pediatric patient a. 70 to 85 kV, short exposure time b. 90 to 100 kV, medium exposure time c. 100 to 120 kV, short exposure time d. 120 to 150 kV, long exposure time
70 to 85 kV, short exposure time
which of the following chest projections/positions is recommended to detect calcifications or cavitations within the upper lung region beneath the clavicles a. left lateral decubitis b. PA c. RPO and LPO d. AP lordotic
AP lordotic
What position/projection would be used for a patient who is too ill or weak to stand for an AP lordotic projection?
AP semiaxial projection, central ray 15 to 20 degrees cephalad
