RAD 153 CHAPTER 2: WORKBOOK

True/False Ultrasound is not an effective modality to detect pleural effusion.

False

True/False: Echocardiography and electrocardiography are basically the same procedure.

False

True/False: No lead shielding is necessary for male patients or women greater than age 65 during radiographic imaging of the chest.

False

True/False: A grid is not recommended for a LPO projection of the adult chest.

False ( a grid is recommended)

True/False: The height, or vertical dimension, of the average-to-large person's chest is greater than the width, or horizontal dimension.

False, greater width

True/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.

False, should be equal

True/False CR centering for the PA chest projection on an obese patient is 1 to 2 inches lower than for a sthenic patient.

False; centering for obese patients is at the same location - T7

Which posterior oblique projection would best demonstrate the left lung?

LPO

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

Pigg-O-Stat

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 that left lung - right anterior oblique or left anterior oblique?

RAO

The CR is placed at the level of the ___ vertebra for a PA chest projection.

T7

True/False Because they have shallower lung fields, the central ray is often centered higher for geriatric patients.

True

True/False Long hair may produce an artifact when imaging with digital radiographic systems

True

True/False Multi-detector CT can produce high-resolution images of the heart on one breath-hold.

True

True/False Single photon emission computed tomography (SPECT) is frequently used to diagnose myocardial infarction.

True

True/False: Chest radiography is the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors.

True

tuberculosis

a contagious disease caused by an airborne bacterium

silicosis

a form of occupational lung disease

Why should a left lateral be performed unless departmental protocol indicates otherwise?

a left lateral better demonstrates the heart region

pneumothorax

accumulation of air in pleural cavity

empyema

accumulation of pus in pleural cavity

bronchitis

acute or chronic irritation of bronchi

What is the common radiographic sign seen on a chest radiograph for a patient with respiratory distress syndrome (RDS)?

air bronchogram

To prevent the clavicles from obscuring the apices on an AP projection of the chest, the central ray should be angled _________ so that it is perpendicular to the ___________

caudal sternum

atelectasis

collapse of all or portion of lung

pulmonary edema

condition most frequently associated with congestive heart failure

shortness of breath

dyspena

An erect chest PA radiograph aids the patient to achieve full inspiration and helps to prevent ___ and ____ of the pulmonary vessels.

engorgement and hypermia

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 positioning tip will help prevent the patient's chin and neck from being superimposed over the upper airway and apices of the lunges for a PA chest radiograph?

extend the neck upward

How much separation of the posterior ribs on a lateral chest projection indicates excessive rotation from a true lateral position?

greater than 1 cm

Optimal technical factor selection ensures proper penetration of the

heart great vessels lung regions hilar region

Which of the body habitus is associated with broad and deep thorax?

hyperstehnic

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

hyposthenic and asthenic

pleurisy

inflammation of pleura

bronchiectasis

irreversible dilation of bronchioles

Which alignment of the IR should be placed for a hypersthenic patient? For a asthenic patient?

landscape portrait

For patients with the following clinical histories, which lateral projection would you perform - right or left? patient with severe pains in the left side of chest? patient with no chest pain but recent history of pneumonia in right lung? patient with no chest pain or history of heart trouble?

left right left

Which specific position would be used if a patient were unable to stand but the physician suspected that the patient had fluid in the left lung?

left lateral decubitus

For certain studies of the heart, the ________ anterior oblique requires a rotation of _________ degrees

left, 60

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

chronic obstructive pulmonary disease

most common form is emphysema

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 laryngopharynx

cystic fibrosis

one of the most common inherited diseases

The four divisions of the respiratory system are:

pharynx trachea bronchi lungs

What is the name of the condition characterized by fluid entering the pleural cavity?

pleural effusion

What is the name of the condition characterized by free air entering the pleural cavity?

pneumothorax

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 patient's arms above the head for lateral chest projections?

prevents upper arm soft tissues from being superimposed over upper chest fields

Explain the primary purpose and benefit of performing chest radiography using 72-inch SID

reduces 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 decubitus (affected side up)

A radiograph of a PA view of the chest shows that the sternoclavicular 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

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.

scapulae

Careful collimation during a chest radiograph will improve image quality by decreasing _____ radiation to the IR.

scatter

To ensure better lung inspiration during chest radiography, exposure should be made during the ____ inspiration.

second

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

small pneumothorax fixation or lack of normal diaphragm movement presence of foreign body distinguishing between opacity in rib or lung

The bony thorax consists of the single ____ anteriorly, two ____, two ____, twelve pairs of ____, and twelve ___ posteriorly.

sternum clavicles scapulae ribs thoracic vertebrae

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

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

Identify the correct anatomic terms for the following structures: Adam's apple - voice box - breastbone - shoulder - collarbone -

thyroid cartilage larynx sternum scapula clavicle

List 3 reasons chest radiographs that should be taken with the patient in the erect position

to allow diaphragm to move farther down to show possible air/fluid levels in chest to prevent engorgement and hyperemia of the pulmonary vessels

True/False With most digital chest units, the question of IR placement into either the portrait of the landscape position is eliminated because of the larger IR.

true

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

vertebra prominens jugular notch

Which of the following landmarks is palpated for centering a PA chest? For a AP chest?

vertebrae prominens jugular notch

The traditional central ray centering technique for the chest is to place the top of the image receptor _______ inches above the shoulders

1 1/2 to 2

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 ribs

Chest radiography for the adult patient usually uses a kilovoltage range of ____ to ___ kV.

110 to 125

Which of the following sets of exposure factors is recommended for a chest exam of a young pediatric patient?

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?

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 semi-axial projection, central ray 15 to 20 degrees cephalic