LRA 213 (Ch 2: Workbook Exercises A-D)

The traditional central ray centering technique for the chest is to place the top of the image receptor (IR) ---- above the shoulders. p. 82

1(1/2) to 2 inches or 4-5 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? p. 78

10 ribs

Chest radiography for the adult patient usually employs a kilovoltage peak of --- to ----kV. p. 79

110 to 125 kV

Which one of the following sets of exposure factors is recommended for a chest examination of a young pediatric patient? p. 79

70 to 85 kV, short exposure time

What is a common radiographic sign that is seen on a chest radiograph for a patient with Respiratory Distress Syndrome (RDS)? Respiratory distress syndrome (RDS) (commonly called hyaline membrane disease [HMD] in infants and adult respiratory distress syndrome [ARDS] in adults) is an emergent condition in which the alveoli and capillaries of the lung are injured or infected, resulting in leakage of fluid and blood into the spaces between alveoli or into the alveoli themselves with the formation of hyaline membranes. (HMD results from a lack of lung development in which the alveoli collapse due to lack of internal tension.) This leakage can be detected radiographically as increased density (brightness) throughout the lungs in a granular pattern as the normally air-filled spaces are filled with fluid. p. 88

Air Bronchogram

The collapse of all or portion of the lung Condition: The result of obstruction of the bronchus or puncture or "blowout" of an air passageway. p. 86 & 88

Atelectasis

Irreversible dilation or widening of bronchi or bronchioles Condition: A result of repeated pulmonary infection or obstructions. p. 86

Bronchiectasis

Acute or chronic irritation of bronchi Condition: A condition in which excessive mucus is secreted into the bronchi, causing cough and shortness of breath. p. 86

Bronchitis

Hilum (hilus)

Central area in which bronchi and blood vessels enter the lungs:

Caused by emphysema or chronic bronchitis Condition: A form of persistent obstruction of the airways that usually causes difficulty in emptying the lungs of air. p. 87

Chronic obstructive pulmonary disease (COPD)

Pneumothorax

Condition where air or gas enters pleura is:

Should the 14 x 17 in (35 x 43 cm) image receptor be aligned lengthwise or crosswise for a PA chest projection of a Hypersthenic patient? p. 83

Crosswise (Landscape)

One of the most common inherited diseases. Condition: A condition in which secretions of heavy mucus cause progressive "clogging" of bronchi and bronchioles. p. 87

Cystic Fibrosis

Shortness of breath Condition: A sensation of difficulty in breathing; is most common in older people. p. 87

Dyspnea

Is an irreversible and chronic lung disease Condition: The air spaces in the alveoli become greatly enlarged as a result of alveolar wall destruction and loss of alveolar elasticity. p. 88

Emphysema (em″-fi-se′-mah)

Accumulation of pus in the Pleural cavity Condition: Caused by chest wounds, obstruction of bronchi, or ruptured lung abscess. p. 88

Empyema

Costophrenic angel

Extreme outermost lower corner of the lungs:

Because the heart is always located in the left thorax, using the anatomic side markers on a PA chest projection may not be necessary. T/F p. 78

False

Echocardiography and electrocardiography are basically the same procedure. T/F p. 86

False

For most patients, the central ray level for a PA chest projection is near the inferior angle of the scapula. T/F p. 70

False

Generally, you do not need to use a radiography grid for an adult patient for PA or lateral chest radiographs. T/F p. 79

False

In general, for an average patient, more collimation should be visible on the lower margin of the chest image than on the top for a PA or lateral chest projection. T/F p. 85

False

The height, or vertical dimension, of the average-to-large person's chest, is greater than the width or horizontal dimension. p. 84

False

Ultrasound is not an effective modality to detect pleural effusion. p. 86

False

Optimal technical factor selection ensures proper penetration of what: p. 75

Heart Great vessels Lung regions Hilar region

Which type of body habitus is associated with a broad and deep thorax? p. 78

Hypersthenic

Which one of the following types of body habitus may cause the costophrenic angles to be cut off if careful vertical collimation is not used? p. 78

Hyposthenic and Asthenic

Thyroid cartilage

Identify the correct anatomic term for: "Adams Apple".

Sternum

Identify the correct anatomic term for: "Breastbone"

Clavicle

Identify the correct anatomic term for: "Collarbone"

Scapula

Identify the correct anatomic term for: "Shoulder"

Larynx

Identify the correct anatomic term for: "Voice box"

The Trachea is identified in this PA Chest radiograph.

Identify the following structure: "A"

Thymus gland

Identify the following structure: "A"

Arch of aorta

Identify the following structure: "B"

The Apex is identified in this x-ray.

Identify the following structure: "B"

Heart

Identify the following structure: "C"

The Carina is identified in this PA Chest radiograph.

Identify the following structure: "C"

Inferior vena cava

Identify the following structure: "D"

The Base is identified in this PA Chest radiograph.

Identify the following structure: "D"

Superior Vena Cava

Identify the following structure: "E"

The Costophrenic angle is identified in this PA Chest radiograph.

Identify the following structure: "F"

Thyroid gland

Identify the following structure: "F"

The Hilum (hilus) is identified in this PA Chest radiograph.

Identify the following structure: "G"

Trachea

Identify the following structure: "G"

Esophagus.

Identify the following structure: "H"

The Trachea is identified in this Lateral Chest radiograph.

Identify the following structure: "H"

The Hilum is identified in this Lateral Chest radiograph.

Identify the following structure: "I"

The Heart is identified in this Lateral Chest radiograph.

Identify the following structure: "J"

The R & L Diaphragm superimposed is identified in this Lateral Chest radiograph.

Identify the following structure: "K"

The Righr and Left Costophrenic angle super imposed are identified in this Lateral Chest radiograph.

Identify the following structure: "L"

Right bronchus Due to the right bronchus being larger in diameter.

If a person accidentally inhales a food particle which bronchus is the most likely to enter and why?

Which one of the following bony landmarks is palpate for centering of the AP chest projection? p. 84

Jugular notch

It is recommended that for most AP chest radiographs, a 14x17-inch (35x43-cm) IR should be placed in a Landscape or Portrait position. p. 84

Landscape

What Lateral projection would you perform on a Patient with severe pains in left side of the chest? Left or Right p. 81

Left Lateral projection

What Lateral projection would you perform on a Patient with no chest pain or history of heart trouble? Left or Right p. 81

Left Lateral projection should be performed unless departmental protocol indicates otherwise or unless certain pathology in the right lung indicates the need for a right lateral.

Should the 14 x 17 in (35 x 43 cm) image receptor be aligned lengthwise or crosswise for a PA chest projection of an Asthenic or Hyposthenic patient? p. 83

Lengthwise (Portrait)

Base

Lower concave portion of the lungs:

Which of the following objects should be removed (or moved) before chest radiography? p. 78

Necklace Bra Religious medallion around neck Hair fasteners Oxygen lines

Which one of the following devices should be used for the erect PA and lateral chest projections for an infant? p. 79

Pigg - O - Stat

Inflammation of the pleura Condition: Usually caused by a virus or bacterium) of the pleura surrounding the lungs. p. 88

Pleurisy

Accumulation of air in the pleural cavity Condition: A partial or complete lung collapse results in immediate and severe shortness of breath and chest pain. It may be caused by trauma or a pathologic condition that causes spontaneous rupture of a weakened area of the lung. p. 88

Pneumothorax

Why is it important to raise the patient's arms above the head for lateral chest projections? p. 81

Prevents upper arm soft tissue from being superimposed over upper chest fields

A condition most frequently associated with congestive heart failure. Condition: A coronary artery disease, in which blood flow to the heart muscle is restricted p. 88

Pulmonary Edema

Explain the primary purpose and benefit of performing chest radiography using a 72 inches (173 cm) source imaged receptor distance) SID). p. 81

Reduces distortion and magnification of the heart and other chest structures

What Lateral projection would you perform on a Patient with no chest pain but recent history of Pneumonia in the right lung? Right or Left p. 81

Right Lateral projection

To ensure better lung inspiration during a chest radiography, exposures should be made during the ---- inspiration. p. 79

Second inspiration

Describe how the optimum density of the lungs and mediastinal structures can be determined on a PA chest radiograph. p. 77

Should be able to see faint outline of at least middle and upper vertebrae and ribs through heart and other mediastinal structures

A form of occupational lung disease Condition: A permanent condition of the lungs that is caused by inhalation of silica (quartz) dust, a form of sand dust. p. 88

Silicosis

List four possible pathologic conditions that suggest the need for both inspiration and expiration during a PA chest radiographs. p. 80

Small pneumothorax Fixation or lack of normal diaphragm movement Presence of a foreign body Distinguishing between opacity in rib or lung

Which positioning tip will help you prevent the patient's chin and neck from being superimposed over the upper airway and apices of the lungs for a PA chest radiograph? p. 81

Sufficient extension of the patient's neck ensures that the chin and neck are not superimposing the uppermost lung regions,

Which of the following anatomic structures is examined to determine rotation on a PA chest radiograph? p. 90

Symmetric appearance and location of Sternoclavicular Joints

Sternum (anteriorly) Clavicles Scapula Ribs Thoracic vertebrae (posteriorly)

The Bony Thorax consists of:

Hyoid bone

The _______ is seen in the anterior position of the neck and is found just below the tongue or floor of the mouth.

Plura

The delicate, double-walled sac or membrane that contains the lungs is called:

Why do lungs tend to expand more with the patient in an erect position than in a supine position? p. 81

The erect position causes abdominal organs to drop, allowing the diaphragm to move farther down and the lungs to more fully aerate.

Pharynx Trachea Bronchi Lungs

The four divisions of the respiratory system are:

Pulmonary or Visceral Pleura

The inner layer of the (Pleura) that adheres to the surface of the lungs is the:

Parietal pleura

The outer layer of this prominent (Pleura) that adheres to the inner surface of the chest wall and diaphragm is the:

Plura cavity

The potential space between lung membrane is:

Anteriorly

The trachea is located ______ to the esophagus?

Vertebrae prominens on the (C7) vertebra and the Jugular notch

The two important bony landmarks of the thorax that are used for locating central ray on a PA and AP chest projection are:

T4-T5

This prominence or ridge of the (Carina) is approximately at the level of the:

List and explain the three reasons chest radiographs should be briefly taken with the patient in the erect position (when the patient's condition permits). p. 80

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

Because they have shallower (superior-inferior dimension) lung fields, the central ray is often centered higher for geriatric patients. T/F p. 79

True

Chest radiography is the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors. p. 78

True

Multidetector CT (MSCT) can produce high-quality images of the heart and lungs with just one breath hold. T/F p. 86

True

Single-photon emission computed tomography (SPECT) is frequently used to diagnose myocardial infarction. T/F pg. 84

True

With most digital chest units, the question of IR placement into either vertical or crosswise positions is eliminated because of the large IR. T/F p. 86

True

A contagious disease caused by an airborne bacterium. Condition: This resulted in more than 30% of all death p. 88

Tuberculosis

Apex (apieces)

Upper rounded portion above the level of the clavicles:

A recommended central ray centering technique for a PA chest projection requires the technologist to palpate the (a.) ______ and measure down from that bony landmark (b.) ______ p. 83

Vertebra Prominens 8 in (20 cm) for male, & 7 in (18 cm) for female

Thymus gland Heart and great vessels Trachea Esophagus

What are the four important structures located in a mediastinum:

Nasopharynx Oropharynx Laryngopharynx

What are the names of the three divisions located proximally to the larynx that serves as a common passageway for both food and air?

Carina

What is the name of the prominence that divides the bronchus into right and left bronchi?

Epiglottis

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?

Alveoli

What is the term for the small air sacs located at the distal ends of the bronchioles?

The presence of liver is on the right side of the chest cavity

Why is the right lung smaller than the left lung:

What are the forms of "Pneumoconiosis" that arise from occupational exposure? p. 88

• Anthracosis (an″-thre-ko′-sis), also called black lung pneumoconiosis, is caused by deposits of coal dust. With long-term inhalation (≥10 years), it spreads throughout the lungs and is seen on chest radiographs as small opaque spots or conglomerate masses. • Asbestosis (as″-bes-to′-sis) is caused by inhalation of asbestos dust (fibers), which results in pulmonary fibrosis. It may develop into lung cancer, especially in smokers. • Silicosis (sil″-i-ko′-sis) is a permanent condition of the lungs that is caused by inhalation of silica (quartz) dust, a form of sand dust.

Wat are the three forms of "Pneumonia" p.88

• Aspiration pneumonia is caused by aspiration of a foreign object or food into the lungs, which irritates the bronchi, resulting in edema. • Bronchopneumonia is bronchitis of both lungs that most commonly is caused by Streptococcus or Staphylococcus bacteria. • Lobar pneumonia generally is confined to one or two lobes of the lungs. • Viral (interstitial) pneumonia causes inflammation of the alveoli and connecting lung structures. It most commonly is evident as increased radiodensities in the region surrounding the hila.