Bontrager chapter 2 self Test & Review Questions: Chest****
110-125
Chest radiography for the adult patient usually emplys a kilovoltage peak (kVp) of _________ to ________ kV.
True
Chest radiography is the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors. T or F?
Clavicle
Collar bone
should be able to see faint outlines of atleast middle and upper vertebrae and ribs through heart and other mediastinal structures
Describe the way optimum density of the lungs and mediastinal structures can be determined on a PA chest radiograph
presence of the liver on the right
Explain why the right lung is smaller than the left lung and the right hemidiaphragm is positioned higher than the left hemidiaphragm
False
Generally, you do not need to use radiographic grids for adult patients for PA or lateral chest radiographs. T or F?
greater than 1 cm
How much separation of the posterior ribs on a lateral chest projection indicates excessive rotation form a true lateral projection?
right bronchus, because it is larger in diameter and more verticle
If a person accidentally inhales a food particle, which bronchus is it most likely to enter, and why?
heart, great vessels, lung regions, hilar region
Optimal technical factor selection ensures proper penetration of the:
Scapula
Shoulder blade
Hilum
The area of each lung where the bronchi and blood vessels enter and leave is called the:
sternum, two clavicles, two scapulae, 12 pairs of ribs, and 12 thoracic vertebrae
The bony thorax consists of
T5
The carina (prominence or ridge) is located at the level of______ vertebrae
Hemothorax
The condition in which blood fills the potential space between the layers is called:
Vertebra prominens
The correct term for the seventh cervical vertebra is:
Costophrenic angle
The extreme, outermost lower corner of each lung is called the:
parietal layer
The outer layer of this membrane adhering to the inner surface of the chest wall ad diaphragm is the _______
scapulae
The shoulders need to be rolled forward for the PA projection to allow the _________ to move laterally and be clear of the lung fields
Alveoli
The small air sacs located at the distal ends of the bronchioles within the lung where oxygen and carbon dioxide gas exchange occurs are called:
Right and left bronchi
The trachea bifurcates and forms the:
1 1/2-2 inches (5 cm)
The traditional central ray centering technique for the chest it to place the top of the image receptor (IR) ____inches (____cm) above the shoulders
2nd inspiration
To ensure better lung inspiration during chest radiography, exposure should be made during the ______ inspiration.
symmetric appearance of sternoclavicular joints
What anatomic structures is examined to determine rotation on a PA chest radiograph?
air bronchogram
What is a common radiographic sign seen on a chest radiograph for a ptient with respiratory distress syndrome (RDS)?
Hilar pleura
What is not an aspect of the pleura?
125 kV, 72-inch SID
What is the best kV and SID level for adult chest radiography?
pleural effusion
What is the name of the condition characterized by fluid entering the pleural cavity?
70-85kV, short exposure time
What is the reccomended exposure factor for a chest examination of a young pediatric patient?
Dyspnea
What term is defined as shortness of breath?
hyposthenic and asthenic
What type of body habitus may cause the costophrenic angles to be cut off if careful vertical collimation is not used?
3 to 4 inches below the jugular notch
Where is the CR placed for an AP supine projection of the chest?
hypersthenic
Which body type of body habitus is associated with a broad and deep thorax?
right lateral
Which lateral projection would you perform left or right? Patient with no chest pain but recent history of pneumonia in right lung
Left lateral
Which lateral projection would you perform left or right? Patient with no chest pain or history of heart trouble ( Standard lateral projection)
Left lateral
Which lateral projection would you perform left or right? Patient with severe pains in left side of chest
pigg-o-stat
Which of the following devices should be used for the erect PA and lateral chest projections for an infant?
Left lateral decubitus
Which specific position would be used if a patient were unable to stand but the physician suspected the patient had fluid in the left lung?
Right lateral decubitus
Which specific position would be used if the patient were unable to stand but the physician suspected the patient had free air in the left pleural cavity?
To reduce chest rotation
Why are the shoulders pressed downward and toward the IR for a PA projection of the chest?
To remove scapulae from lung fields
Why are the shoulders rolled forward for a PA projection of the chest?
places heart closer to image receptor to reduce magnification of heart
Why is a PA chest preferred to an AP projection?
Prevents upper arm tissue and humerous from being superimposed over chest fields
Why is it important to raise the patient's arms above the head for lateral chest projections?
A left lateral better demonstrates the heart region, puts heart closer to image receptor, and reduces magnification of the heart
Why should a left lateral be performed unless departmental protocol indicates otherwise?
True
With most digital chest units, the question of the IR placement into either vertical or crosswise positions is eliminated because of the larger IR (True or False)?
tuberculosis
a contagious disease caused by an airborne bacterium
silicosis
a form of occupational lung disease
pneumothorax
accumulation of air in pleural cavity
empyema
accumulation of pus in pleural cavity
bronchitis
acute or chronic irritation of bronchi
hilum
central area in whch bronchi and blood vessels enter the lungs
atelectasis
collapse of all or portion of lung
pulmonary edema
condition most frequently associated with congestive heart failure
pleura
delicate, double walled-sac or membrane containing the lungs i
reduces distortion and magnification of heart and other chest structures
explain the primary purpose and benefit of performing chest radiography using a 72 inch (183 cm) source image receptor distance (SID)
costophrenic angles
extreme, outermost lower corners of the lungs
pleurisy
inflammation of pleura
Bronchiectasis
irreversible dilation of bronchioles
base
lower, concave portion of the lung
COPD
most common form is emphysema
caudad, sternum
o 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 _______
cystic fibrosis
one of the most commonly inherited diseases
Dyspnea
shortness of breath
epiglottis
structure that acts as a lid over the larynx to prevent foreign objects such as food particles from entering the respiratory system
hyoid
the _______bone is seen in the anterior portion of the next and is found just below the tongue or floor of the mouth
pericardium or pericardial sac
the heart is enclosed in a double-walled membrane called the______
visceral or pulmonary layer
the inner layer adhering to the surface of the lungs is the _______ or ________
pleural cavity
the potential space between the parietal and visceral layer is the ________
anteriorly
the trachea is located_______ to the esophagus
apex
upper, rounded portion of the lungs above the level of the clavicles
10
what is the minimum number of ribs that should be demostrated above the diaphragm on an adult PA chest x-ray with full inspiration?
causes abdominal organs to drop, diaphragm move down further, and allows lungs to more fully aerate
why do lungs tend to expand more with the patient in an erect position than in a supine position?
Jugular notch (AP) & Vertebral Prominens (PA)
2 anatomical landmarks used for locating the central ray (CR) for chest x-ray
nasopharynx, laryngopharynx, oropharynx
3 divisions of the structure located proximally to the larynx that serve as a common passageway for both food and air
ascending, arch, and descending
3 parts of the aorta
moves diaphragm down further, shows possible air or fluid, prevents engorgement and hypermia of pulmonary vessels
3 reasons why chest radiographs should be taken with the patient in the erect position
pharynx, bronchi, trachea, lungs
4 divisions of respiratory system
foreign body, atelectasis, fixation of diaphragm, small pneumothorax
4 possible pathologic conditions that suggest the need for both inspiration and expiration PA chest radiographs
thymus gland, heart and greater vessels, trachea, and esophagus
4 primary structures of Mediastinum
Crosswise (landscape)
A 14x17 inch Image Receptor (IR) should be aligned crosswise (landscape) or lengthwise (portrait) for a hypersthenic patient?
Lengthwise (portrait)
A 14x17 inch Image Receptor (IR) should be aligned crosswise (landscape) or lengthwise (portrait) for a hyposthenic patient?
Rotation into a LAO position
A PA chest radiography reveals that the left sternoclavicular joint is superimposed over the spine (in comparison with the right joint). What specific positioning error is involved?
Atelectasis
A condition in which all or a portion of the lung is collapsed:
Pulmonary edema
A condition in which excess fluid builds in the lungs as a result of obstruction of the pulmonary circulation is termed:
Raise upper limbs higher
A lateral chest radiograph demonstrates the soft tissue of the upper limbs is superimposed over the apices of the lungs. How can this situation be prevented?
asthenic
A narrow thorax that is shallow from the front to back but very long in the vertical dimension is characteristic of a(n)___________________body habitus.
Jugular notch
A notch, or depression, located on the on the superior portion of the sternum is called the:
Left lateral decubitus
A patient enters the ER with an injury to the chest. The ER physician suspects a pneumothorax may be present in the right lung. The patient is unable to stand or sit erect. Which specific position or projection can be performed to confirm the presence of pneumothorax?
left lateral decubitus
A patient with a history of pulmonary edema comes to the radiology department and is unable to stand. The physician suspects fluid in the left lung. Which specific projection should be used to confirm the diagnosis?
75 kV is too low. Should increase to 110-125 kV
A radiograph of a PA ad Left lateral projection of the chest reveals the mediastinum of the chest is underpenetrated. The technologist used the following factors for the radiograph: a 72 inch SID, an upright bucky, a full inspiration exposure, 75 kV and 600 mA and a 1/60 exposure time. Which one of thse factors is the most likely cause of the problem? and how can the technologist improve the image?
CR should be higher (T7), make sure image receptor is centered to the CR and the top of the collimation light border is 1 1/2 -2 inches above the shoulders or verterbra prominens
A radiograph of a PA projection of the chest reveals the top of the apices are cut off and a wide collimation border can be seen below the diaphragm. In what way can this be corrected during the repeat radiograph?
The lungs are underdeflated
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?
slight RAO position
A radiograph of a PA view of the chest reveals the sternoclovicular joints are not the same distance from the spine. The right SC joint is closer to the midline that is the left SC joint. What is the positioning error?
Carina
A specific prominence, or ridge, found at the point where the internal distal trachea divides into the right and left bronchi is called the:
Thyroid cartilage
Adam's apple
Parietal pleura, pleural cavity, pulmonary pleura
Aspects of pleura
False, sometimes anatomical structures are not always in the correct place. Ex. some people's heart may be on their right side,
Because the heart is always located in the left thorax, the use of anatomic side markers on a PA chest projection may not always be necessary. T or F?
True
Because they have shallower lung fields, the central ray is often centered higher for geriatric patients. T or F?
Jugular notch
Bony landmark used for centering of the AP chest projection?
Vertebral prominens
Bony landmark used for centering of the PA chest projection?
Sternum
Breastbone