Ch 3 (volume 1) Thoracic Viscera: Chest and Upper Airway
How many posterior ribs should be demonstrated above the diaphragm with proper full inspiration?
10
What are the collimation light field parameters when performing AP and lateral projections of the soft tissue neck?
12x1
which AP oblique projection produces an image very similar to that produced by the PA oblique projection RAO position?
AP oblique projection, LPO position
With reference to the patient, where should the upper border of the IR/collimated field be placed?
About 1.5 to 2 inches above the top of the shoulder
What is the name of the superior portion of each lung?
Apex
True or false. The affected side in a lateral decubitus should be up to demonstrate fluid level
False
True or false. The patient can be positioned upright in a lateral decubitus position.
False
Which thoracic structures are of primary interest with the left lateral projection?
Heart and left lung
Which primary bronchus is shorter and wider than the other?
Right
which side of the thorax best demonstrates free air when the patient is in the left lateral decubitus position?
Right
Which lung is short and broader than the other. Explain Why
Right because of its close proximity to the liver and heart
How many lobes are in the right lung? and left lung?
Right has three Left has two
Which thoracic structure is of primary interest when performing a right lateral projection?
Right lung
Describe the breathing instructions when performing the AP and lateral projections of the soft tissue neck.
Slow inspiration to ensure the trachea is filled with air
Five evaluation criteria that indicate the patient was properly positioned for an AP axial projection
The clavicles should lie superior to the apices The apices and lungs should be included in their entirety The sternal ends of the clavicles should be equidistant from the vertebral column The ribs should appear distorted with their anterior and posterior portions somewhat superimposed The clavicles should be lying horizontal, with their sternal ends overlapping only the first or second ribs
Nine evaluation criteria that indicate the patient was properly positioned for a lateral projection.
The heart and diaphragm should be seen in sharp outline The sternum should be seen in lateral view without rotation Penetration of lung fields and heart should be clearly seen The ribs should be superimposed posterior to the vertebral column Neither the arm nor its soft tissues overlaps the superior lung fields The hilum should be seen in the approximate center of the image The thoracic intervertebral spaces should be open (except in patients with scoliosis) The costophrenic angles and lower apices of lungs should be clearly demonstrated The long axis of lung fields should be demonstrated in the vertical position without forward-backward leaning.
If a patient were to remove one shoulder from contact with the grid device before the exposure, which of the following image effects would occur?
The sternal ends of the clavicles would no longer be equidistant from the vertebral column
Six evaluation criteria that indicate the patient was properly positioned for an AP projection
The trachea should be seen in the midline The lung fields should be seen from the apices to the costophrenic angles The sternal ends of the clavicles should be equidistant from the vertebral column A faint image of the ribs and thoracic vertebrae should be seen through the heart shadow The clavicles will lie more horizontal and will obscure more of the apices than in AP projections The distance from the vertebral column to the lateral border of the ribs should be equidistant on both sides Pulmonary vascular markings should b visible from the hilar regions to the periphery of the lungs
eight evaluation criteria that indicate a patient was properly positioned for a PA chest projection
The trachea should be visible in the midline The heart and diaphragm should show sharp outlines Ten posterior ribs should be seen above the diaphragm The scapulae should be projected outside the lung fields The exposure should clearly demonstrate the lung fields The entire lung fields from the apices to the costophrenic angles should be seen No rotation; the sternal ends of the clavicles should be equidistant from the vertebral column A faint shadow of the ribs and superior thoracic vertebrae should be seen through the heart shadow
What is the general purpose for using a lateral decubitus position?
To demonstrate air or fluid levels in the thorax
List two reasons why exposures can be made after both inspiration and expiration?
To demonstrate pneumothorax or to check for foreign bodies
True or false. A lateral projection image of the chest should be viewed so that the side of the patient where the central ray entered is nearer the viewer.
True
True or false. The heart and mediastinal structures should be clearly demonstrated within the lung field of the elevated side in oblique images of 45 degrees of body rotation.
True
True or false. The patient's heart will appear larger in the right lateral projection image than in the left lateral projection image.
True
True or false. When viewing PA oblique chest images (LAO position) the left lung should be partially superimposed by the spine.
True
True or false. When viewing PA oblique chest images the patients left side should be toward the viewer's right side.
True
Whic structures are at the terminal end of the respiratory system?
alveoli
respiratory sacs
alveoli
inflammation caused by inhalation of industrial substances
anthracosis or coal miner lung or black lung
mediastinal blood vessel
aorta
What part of the lung is generally the area of primary interest when using the lordotic position?
apex
superior portion of the lung
apex
inspiration of a foreign material into the airway
apsiration of a foreign body
pneumonia caused by aspiration of foreign particles
aspiration
collapse of all or part of the lung
atelectasis
inferior part of a lung
base
these branch from the trachea
bronchi
chronic dilation of the bronchi and bronchioles associated with secondary infection
bronchiectasis
inflammation of the bronchi
bronchitis
What area of the trachea divides into two lesser tubes?
carina
chronic condition of persistent obstruction of bronchial airflow
chronic obstructive pulmonary disease
disorder associated with widespread dysfunction of the exocrine glands, abnormal secretion of sweat and saliva, and accumulation of thick mucus in the lungs
cystic fibrosis
Which structure separates the thoracic cavity from the abdominal cavity?
diaphragm
inferior border of thoracic cavity
diaphragm
When performing the AP projection of the soft tissue neck, at what level do you direct the central ray for the upper airway?
direct the central ray at the level of the laryngeal prominence for upper airway
When performing the AP projection of the soft tissue neck, at what level do you direct the central ray for the larynx and superior mediastinum
direct the central ray at the level of the manubrium for larynx and superior mediastinum
inflammation of the epiglottis
eliglottitis
Destructive and obstructive airway changes leading to an increased volume of air in the lungs
emphysema
separates a lung into lobes
fissure
inflammation of the lung caused by a fungal organism
fungal disease
Condition of the lung marked by formation of granulomas
granulomatous disease
mediastinal organ
heart
What is the name of the medial aspect of each lung in which the primary bronchus enters?
hilum
where vessels enter a lung
hilum
infection caused by the yeastlike organism Histoplasma capslatum
histoplasmosis
When performing the lateral projection of the soft tissue neck, direct the central ray _____________ through the _______ plane at the level of the ____________________ for the upper airway
horizontal MCP laryngeal prominence
under-aeration of the lungs caused by lack of surfactant
hyaline membrane disease of respiratory distress syndrome
What special positioning instructions may be given to a woman with large, pendulous breasts to avoid superimposing the lower part of the lung fields?
instruct the patient to pull her breasts upward and laterally
WHen performing the lateral projection of the soft tissue neck, direct the central ray at the level of the _______________ through a point midway between the ______________ and the _________ plane for the trachea and superior mediastinum
jugular notch jugular notch MCP
THe organ of voice is the
larynx
this lung has two lobes
left
What thoracic structures are the organs of respiration?
lungs
respiratory organ
lungs
side of lung where vessels enter
medial
Which part of the thoracic cavity contains all thoracic organs except the lungs and pleurae?
mediastinum
area between the lungs
mediastinum
transfer of a cancerous lesion from one area to another
metastasis
Which body plane should e perpendicular and centered to he midline of the IR in an upright PA chest?
midsagittal
The portion of the pharynx located above the soft palate
nasopharynx
The portion of the pharynx located from the soft palate to the hyoid bone
oropharynx
The structure of the upper neck that serves as a passage for both food and air and is common to the respiratory and digestive systems is the __________
pharynx
double-walled, serous membrane sac
pleura
collection of fluid in the pleural cavity
pleural effusion
lung diseases resulting from inhalation of industrial substances
pneumoconiosis
acute infection in the lung parenchyma
pneumonia
Accumulation of air in the pleural cavity resulting in collapse of the lung
pneumothorax
For radiographic purposes, the neck is divided into ____________ and ______________ portions
posterior and anterior
What structures branch from the distal end of the trachea?
primary bronchi
Replacement of air with fluid in the lung interstitium and alveoli
pulomnary edema
To demonstrate fluid in the right thorax, the patient must be positioned in a:
right lateral decubitus position
condition of unknown origin often associated with pulmonary fibrosis
sarcoidosis
Found in each lobe
segment
inflammation cased by inhalation of asbestos
silicosis
Which bony structure forms the anterior border of the mediastinum?
sternum
anterior bony wall of the mediastinum
sternum
Radiographs are most commonly made of the upper airway from the _____________________________ to the _____________________________
superior orophraynx proximal trachea
pertaining to the chest cavity
thoracic
Which cavity contains the heart and lungs?
thoracic cavity
number of lobes in the right lung
three
Structures located in the anterior neck
thyroid gland trachea esophagus
Why is it preferable to have the patient upright for chest x-rays?
to allow the diaphragm to reach its lowest level to prevent engorgement of the pulmonary vessels
List pathologic conditions in which radiography of the soft tissue neck is performed
to demonstrate foreign bodies, swelling, masses, and fractures of the larynx and hyoid bone
What is the purpose of depressing the shoulders?
to keep the clavicles below the apices
why should the shoulders be rotated forward? (PA projection)
to move the scapulae laterally away from the lung fields
To demonstrate the heart, why should the exposure be made after normal inspiration rather than deep inspiration?
to prevent distortion of the heart by a full inferior movement of the diaphragm
What mediastinal structure consists of C-shaped cartilaginous rings?
trachea
major airway tube
trachea
chronic infection of the lung caused by the tubercle bacillus
tuberculosis
new tissue growth where cell proliferation is uncontrolled
tumor
Name the three portions of the pleura
visceral pleura - inner layer parietal pleura - outer layer pleural cavity - space between layers
