CH 2 Bontrager
True/False
A grid is not recommended for an LPO projection of the adult chest
Vertebra promines, 8 inches, 20 cm for a male 7 Inches and 18 cm for a female patient.
A recommended central ray centering technique for a PA chest projection requires the technologist to palpate the __________ and measure down from that bony landmark ______ inches (______ cm) for a male and ________ inches and (_______ cm) for a female patient.
Pneumothorax
Air or gas that enter the space identified in D (Pleural cavity) results in a condition called ____________
engorgement, hyperemia
An erect chest PA radiograph aids the patient to achieve full inspiration and helps to prevent _______ and _______ of the pulmonary vessels.
True/False
Because they have shallower (superior-inferior dimension) lung fields, the central ray is often centered higher for geriatric patients.
True/False
CR centering for the PA chest projection on an obese patient is 1 to 2 inches (2.5 to 5 cm) lower than for a sthnic patient.
Scatter
Careful collimation during a chest radiograph will improve images quality by decreasing _____ radiation to the IR.
110-125 kV
Chest radiography for the adult patient uses a kilvoltage range of ________ to _____ kv
True/False
Chest radiography is the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors.
Should be able to see faint outlines of at least middle and upper vertebra and ribs through the heart and other mediastinal structures.
Describe the way optimum density (brightness) of the lungs and mediastinal structures can be determined on a PA chest radiograph
True/False
Echocardiography and electrocardiography are basically the same procedure.
Reduces distortion and magnification of the heart and other chest structures
Explain the primary purpose and benefit of performing chest radiography using 72-inch (183cm) source image receptor distance (SID).
The presence of the liver on the right.
Explain why the right lung is the smaller than the left lung and the right hemidiaphragm is positioned higher than the left hemidiaphragm. _____________
A. Lower, concave portion : Base B. Central area in which bronchi and blood vessels enter the lungs: Hilum (hilus) C. Upper, rounded portion above the level of the clavicles: Apex (apices) D. Extreme, outermost lower corner of the lungs: Costophrenic angles
Fill in the correct terms for the following portions of the lungs.
Left, 60 degrees
For certain studies of the heart, the ______ anterior oblique requires a rotation of _____________
A. Left B. Right C. Left
For patients with the following clinical histories, which lateral projection would you perform-- right or left? A. Patient with serve pains in left side of chest ____ B. Patient with no chest pain but recent history of pneumonia in right lung_______ C. Patient with no chest pain or history of heart trouble.
____+____ Left lung ____0____ Lung neoplasm ____+___ Severe pulmonary edma ____-____ Respiratory distress syndrome (RDS) or adult respiratory distress (ARDS), known as hyaline membrane disease (HMD) in infants ____+___ Reactive (secondary) tuberculosis ____-___ Advanced emphysema ____0____ Large pneumothorax ____0____ Pulmonary emboli ____0____ Primary tuberculosis _____0___ Advanced asbestosis
For the following types of pathologic indicate whether manual exposure factors would be increased (+), decreased (-), or generally remain the same (0) compared with standard chest exposure factors. ________ Left lung ________ Lung neoplasm ________ Severe pulmonary edma ________ Respiratory distress syndrome (RDS) or adult respiratory distress (ARDS), known as hyaline membrane disease (HMD) in infants ________ Reactive (secondary) tuberculosis ________ Advanced emphysema ________ Large pneumothorax ________ Pulmonary emboli ________ Primary tuberculosis ________ Advanced asbestosis
True/False
Generally, you do not need to use radiographic grids for adult patients for PA or lateral chest radiographs?
Greater than 1 cm 1/2 to 3/4 inch
How much separation of the posterior ribs on lateral chest projection indicates excessive rotation from a true lateral position? __________ (note: less separation than this is caused by the divergent x-ray.)
A. Adam's apple - Thyroid cartilage B. Voice Box - Larynx C. Breastbone - Sternum D. Shoulder - Scapula E. Clavicle
Identify the correct anatomic terms for the following structures.
A. Apex of left lung B. Trachea C. Carina D. Heart. E. Left costophrenic angle F. Right Costopgrenic angle G. Hilum
Identify the following labeled structures as seen on PA and lateral chest radiographs in Fig. 2.2
H. Apex of the lungs I. Hilum J. Heart K. Right and Left hemidiaphragm L. Right and Left costophrenic angles (superimposed)
Identify the following labeled structures as seen on PA and lateral chest radiographs in Fig. 2.3
A. Thymus gland B. Arch of aorta. C. Heart. D. Inferior Vena Cava E. Superior Vena Cava F. Thyroid gland G. Trachea H. Esophagus
Identify the following structures in Fig. 2.1
A. Left main stem Bronchus B. Descending Aorta C. T5 (TV) D. Esophagus E. Region of Carina F Right main stem bronchus G. Superior Vena Cava H. Ascending Aorta. I. Sternum
Identify the labeled parts on this computed tomography (CT) image (Fig 2.4) of a transverse section of the thorax at the level of T5, the fifth thoracic vertebra, which is also the level of the carina. (Hint B,G, and H are major blood vessels.)
A. The Right bronchus B. Why? It is larger in diameter and more vertical
If a person accidentally inhales food particles, which bronchus is it most likely to enter, and why?
True/False should be equal
In general for an average patient, more collimation should be visible on lower margin of the chest image than on the top for a PA or lateral chest projection
A. To allow diaphragm B. To show possible air and fluid levels in the chest. C. To prevent engorgement and hypermia of the pulmonary vessels
List and explain briefly the three reason chest radiographs should be taken with the patient in the erect position (when te patient condition permits).
A. Small pneumothorax B. Fixation or lack of normal diaphragm movement C. Presence of a foreign body. D. Distinguishing between
List four possible pathologic conditions that suggest the need for both inspiration and expiration PA chest radiographs.
A. Thymus Gland B. Heart and great vessels C. Trachea. D. Esophagus
List the four important structures located in the mediastinum.
A. Nasopharynx B. Oropharynx C. Laryngopharynx
List the three divisions of the structure located proximally (nearest) to the larynx that serve as a common passageway for both food and air.
True/False
Long hair may produce an artifact when imaging with digital radiographic systems.
F. One of the most common inherited disease J. Condition most frequently associated with congestive heart failure E. Dyspnea I. Accumulation of air in pleural cavity G. Accumulation of pus in pleural cavity L. A form of occupational lung disease K. A contagious disease caused by an air bone bacterium B. Irreversible dilation of bronchioles D. Most common form is emphysema C. Acute or chronic irritation of bronchi A. Collapse of all or portion of lung H. Inflammation of pleura
Match each of the following description of clinical indicators to its correct term. A. Atelectasis B.Bronchiectasis C.Bronchitis D. Chronic obstructive pulmonary disease E. Shortness of breath F. Cystic fibrosis G. Empyema H. Pleurisy I. Pneumothorax J. Pulmonary edema K. Tuberculosis L. Silicosis
True/False
Multi-detector CT can produce high-resolution images of the heart on one breath-hold.
Heart, Great vessels, lungs regions, Hilar region All of the above
Optimal Technical factor selections ensure proper penetration of the _____
Part A: Carina Part B: T5
Part A: What is a name of the prominence, or ridge, seen when looking down into the bronchus where it divides into the right and left bronchi? Part B: This prominence, or ridge, is approximately at the level of the ________ vertebra.
Hypersthenic patient Landscape Asthenic patient Portrait
Should the 35- X43-cm (14x17 inch) image receptor be aligned in portrait or landscape orientation for a PA chest projection of a hypersthenic pateint _____ ? For an asthenic patient_______?
True/False
Single-photon emission computed tomography (SPECT) is frequently used to diagnose myocardial infarction.
T7
The CR is placed at the level of the ___________ vertebra for a PA chest projection.
Hyoid bone
The _______ bone is seen in the anterior portion of the neck and is found just below the tongue or floor of the mouth.
A.Sternum B. two Clavicles C. two scapulae D. 12 pair of ribs E. 12 thoracic Vertebrae
The bony thorax consists of?
Pleura
The delicate, double-walled sac or membrane that contains the lungs is called the _______
second
The ensure better lung inspiration during chest radiography, exposure should be made during the _______ inspiration.
A.Pharynx B.Trachea C.Bronchi D.Lungs
The four divisions of the respiratory system?
Pericardial sac or Pericardium
The heart is enclosed in a double-walled membrane called _________________
True/False Greater width
The height, or vertical dimension, of the average-to-large person's chest is greater than the width, or horizontal dimension.
A.Vertebra Prominens B. Jugular Notch
The important bony landmarks of the thorax that are used for locating the central ray on a posteroanterior (PA) and anteroposterior (AP) chest projection are the:
Pulmonary or Visceral pleura
The layer adhering to the surface of the lungs is the _____________, or________________
Partietal Pleura
The outer layer adhering to the surface of the lungs is the ______________
Pleural Cavity
The potential space between these two layers ( both pulmonary and visceral pleura) is called the ________
Scapula
The shoulders need to be rolled forward for the PA projection to allow ___________ to move laterally and be clear of the lung fields
Ascending, arch, and descending aorta
The three parts of the aorta are the _________, _________, and __________
anteriorly
The trachea is located _____ to the esophagus
1 1/2 to 2 inches and 5cm
The traditional central ray centering technique for the chest is to place the top of the image receptor (IR) ______ inches (_______ cm) above the shoulders.
Caudad (+- 5 degrees) Sternum
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 ________
True/False
Ultrasound is not an effective modality to detect pleural effusion.
Lift the breast up and outward and then remove her hands as she leans agains the chest board (image receptor) to keep them in the position.
What are the recommended patient instructions when performing an erect PA chest on a female patient with large pendulous breasts?
Ruled out calcifications or masses beneath the clavicles
What circumstances or clinical indications suggest that an AP lordotic projection should be ordered?
Air bronchogram
What is a common radiograph sign seen on a chest radiograph for a patient with respiratory distress syndrome (RDS)?
Stitus inversus
What is another term for the condition termed visceral inversion?
10 rins
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?
Pleural effusion
What is the name of the condition characterized by fluid entering the pleural cavity?
Pneomothorax
What is the name of the condition characterized by free air entering the pleural cavity?
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, in which oxygen and carbon dioxide are exchanged in the blood?
AP semiaxial projection, central ray 15 to 20 degrees cephalad
What position/projection would be used for a patient who is too ill or weak to stand for an AP lordotic projection?
Hypersthenic
What type of the body habitus is located with a broad and deep thorax?
Level of C6-C7, midway between thyriod cartilage and jugular notch
Where is the central ray placed for a lateral projection of the upper airway?
RAO
Which anterior oblique projection wold best demonstrate the left lung-right anterior oblique (RAO) or left anterior oblique (LAO)?
Jugular notch
Which of the following bony landmarks is palpated for centering of the AP chest projection?
AP Lordotic
Which of the following chest projection/positions is recommended to detect calcification or cavitation within the upper left lung region beneath the clavicles?
A. Necklace B. Bra C. Religious medallion around neck D. Dentures E. Pants F. Hair fasteners G. oxygen lines
Which of the following object should be removed (or moved) before before chest radiography? (choose all that apply)
70 to 85 kV, short exposure time
Which of the following sets of exposure factors is recommended for a chest examination of a young pediatric patient?
Pigg-O-Stat
Which of the following sets of exposure factors is recommended for the erect PA and lateral chest projections for an infant?
D. Hyposthenic and asthenic
Which of the following types of body habitus may cause the costophrenic angles to be cut if careful vertical collimation is not used?
Extend the neck upward.
Which positioning tip will help prevent the patient's chin and neck from being superimposed over the upper airway and apices of the lungs for a PA chest radiograph?
LPO
Which posterior oblique projection demonstrate the left lung ---RPO or LPO?
Left lateral decubitus
Which specific position would be used if a patient were unable to stand by the physician suspected that the patient had fluid in the left lung?
Right lateral decubitus (affected side-up)
Which specific position would be used if the patient were unable to stand by the physician suspected that the patient had free air in the left pleural cavity?
Erect position allows abdominal organs to drop, allowing the diaphragm to move farther down and the lungs to aerate more fully.
Why do the lungs tends to expand more with the patient in an erect position than in a supine position?
Places the heart closer to the imagine receptor to reduce magnification of the heart
Why is a PA chest preferred to an AP projection?
Prevents upper arms soft tissues from being superimposed over upper 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.
Why should a left lateral be performed unless department protocol indicates otherwise?
True/False
With most digital chest units, the question of IR placement into either the portrait or the landscape position is eliminated because of the large IR.
Symmetric appearance and location of sternoclavicular joints
which of the following anatomic structures is examined to determine rotation on a PA chest radiograph?
Emphysema
which of the following is not a form of occupational lung disease?
