114 Chapter 2: Chest **SITUATIONAL QUESTIONS**
both LPO and RAO oblique positions will best demonstrate or elongate the left lung
PA and left lateral projections demonstrate a suspicious region in the L lung. radiologist ordered an oblique that will best demonstrate or "elongate" the L lung. which specific oblique projections will best elongate the L lung? (more than one will work)
ensure placement of correct marker on IR bc the heart and other thoracic structures may be transposed from right to left
a patient comes to the radiology department for a pre surgical chest examination. the clinical history indicates a possible situs inverses of the thorax. which positioning step or action must be taken to perform a successful chest examination?
inspiration and expiration PA projections and/or a lateral decubitus AP
a patient has a possible small pneumothorax. routine chest projections (PA and lat.) fail to show the pneumothorax conclusively. which additional projections could be taken to rule out this condition?
decrease the kV moderately (--)
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?
erect PA and lateral
a patient with a history of pleurisy comes to the radiology department. which radiographic series should be performed?
AP semi axial projection; CR angled 15-20 degrees cephalic to project the clavicles above the apices and to demonstrate clearly the possible tumor
a patient with a possible neoplasm in the R lung apex comes for a chest exam. the PA and lat do not clearly demonstrate the neoplasm bc of superimposition of clavicle over the apex. the patient is unable to stand or sit erect. which additional projection can be taken to demonstrate the neoplasm clearly and to eliminate the superimposition?
increase the kV slightly (+)
a patient with severe pleura effusion comes to the radiology department for a chest x-ray. automatic exposure control (AEC) will not be used. how should the tech alter the manual exposure settings for this patient?
determine which hemidiaphragm is more posterior or anterior ** this is bc the left can often be identified by visualization of the gastric air bubble or inferior heart shadow
a radiograph of a lateral projection of the chest shows he posterior ribs and costophrenic angles are separated more than 1/2 inch (1cm) indicating excessive rotation. describe a possible method for determining the direction of the rotation.
AP lordotic
a routine chest series indicates a possible mass beneath a patients right clavicle. the PA and lateral projections are inconclusive. what additional projections could be taken to rule out this condition?
AP lateral upper airway projections
a young child enters the ER with a possible foreign body in one of the bronchi of the lung. the foreign body, a peanut, cannot be seen on the PA and lateral projections of chest. which additional projections could the tech perform to locate the foreign body?
right lateral decubitus; in a patient with hemothorax (fluid), the side interest should be down
patient enters ER with a possible hemothorax in the R lung caused by a motor vehicle accident (MVA). the patient is able to sit or stand erect. which specific projection would best demonstrate this projection and why?