Procedures Ch.3 - thoracic viscera

Which of the following objects should be removed before a chest x-ray? 1. Necklace 2. Dentures 3. Pants 4. Hair fasteners

1. Necklace

Three chambers of the thoracic cavity:

1. Pericardial cavity 2. Right pleural cavity 3. Left pleural cavity

Which evaluation criterion pertains to the AP axial projection, Lordotic position radiograph of the chest?

1. The ribs should appear distorted 2. The clavicles should lie superior to the apices

Which of the following is NOT a valid reason to perform chest projections with the patient in the erect position? 1. To reduce patient dose 2. To demonstrate air/fluid levels 3. To allow the diaphragm to move down farther 4. To prevent hyperemia (swelling) of the pulmonary vessels

1. To reduce patient dose

How many ribs should be showing above the diaphragm on a PA chest radiograph on deep inspiration?

10

Which of the following is NOT an aspect of the pleura? 1. Parietal pleura 2. Hilar pleura 3. Pleural cavity 4. Pulmonary pleura

2. Hilar pleura

The right bronchus divides into _?_ branches and the left bronchus into _?_ branches.

3, 2

Where is the central ray placed for an AP supine projection of the chest?

3-4 inches below jugular notch

Which structure is not demonstrated within the mediastinum in PA projections of the chest? 1. Heart 2. Trachea 3. Diaphragm 4. Esophagus

3. Diaphragm

Which one of the following structures is NOT found in the mediastinum? 1. Thymus gland 2. Heart and great vessels 3. Epiglottis 4. Trachea

3. Epiglottis

The thyroid cartilage of the larynx is at the vertebral level of which cervical vertebra?

4-5

Using a lateral decubitus position for patients who are unable to stand upright best demonstrates which of the following pathologic conditions of the chest? 1. Rib fractures 2. Cardiomegaly 3. Collapsed lung 4. Air or fluid levels

4. Air or fluid levels

Which of the following structures would NOT be found in the mediastinum? 1. Heart 2. Trachea 3. Esophagus 4. Epiglottis

4. Epiglottis

The SID used for an AP projection of the upper airway is:

40"

The two lungs contain from _?_ to _?_ million alveoli

500 to 700

Preferred SID for radiography of the heart and lungs?

72"

A routine chest x-ray indicates a possible mass beneath a patients right clavicle. The PA and lateral projections are inconclusive. Which additional projections/positions could the tech take to diagnose this small tumor?

AP axial (Lordotic position)

Which projection of the chest best demonstrates lung apices free from superimposition with the clavicle?

AP axial projection, Lordotic position

What is the portion of the lung that lies above the clavicles called?

Apex

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

Asthenic

Which body habitus is associated with a: 1. Lung thin patients 2. Thorax is long & shallow from front to back 3. 10% of population

Asthenic

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

Asthenic

Main branches of the trachea:

Bronchi

In order to demonstrate the pulmonary apices with the patient in the supine position, the:

CR is directed 15-20 cephalic

What cells do we use for a lateral position?

Center cell

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 technologist alter the manual exposure settings for this patient?

Decrease the kV moderately

Which radiographic position requires that the patient be placed supine with the IR placed vertically against the patient's right side and a horizontal central ray directed to the center of the IR?

Dorsal decubitus

Flat diaphragms, elongated lungs, barrel chest appearance, and an increased retrosternal space are indicative of:

Emphysema

Located posterior to the trachea & extends from C6-T11

Esophagus

Which side of the chest is better visualized on a PA oblique projection of the chest?

Farther from the IR

Which pathologic condition of the lungs is best demonstrated with the AP chest, left lateral decubitus position?

Fluid levels in the left side or free air in the right side

When the patient is properly positioned for a PA oblique projection of the chest, the central ray will enter the body:

Halfway between the lateral surface of the elevated side and the spine

Primary organ in the mediastinum is the:

Heart

Which body habitus is associated with a: 1. Broad & deep thorax 2. Diaphragm is higher & lungs shorter 3. 5% of population

Hypersthenic

Which body habitus is associated with a: 1. A little thinner than sthenic 2. 35% of population

Hyposthenic

PA oblique projections are the preferred method for doing our oblique positions because:

It places the heart closer to the IR, decreasing magnification

What bony landmark is palpated for centering of the AP chest projection?

Jugular notch

Which of the following positions would be used to show air-fluid levels on a patient who could NOT be done erect?

Lateral decubitus

For which projection of the chest should the midsagittal plane be parallel with the IR?

Lateral projection

When the AEC is being used for the PA protection, which ionization chambers (photo cells) should be activated?

Left and right chambers

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 can be performed to confirm the presence of the pneumothorax?

Left lateral decubitus

Flap that protects the heart:

Lingula

Technical factors for chest:

Long scale contrast — high kVp Short exposure time High mA

The CR location for a Lordotic position of the chest is:

Mid-sternum

With reference to the IR, how are the midsagittal plane and the midcoronal plane positioned for the AP chest (left lateral decubitus position)?

Midsagittal: perpendicular; midcoronal: parallel

With reference to the IR, how are the midsagittal plane and the midcoronal plane positioned for the PA projection of the chest?

Midsagittal: perpendicular; midcoronal: parallel

For PA, we want to measure the amount of radiation in the lungs, so what cells are selected?

Outer

What are the basic positions/projections for a radiographic examination of the chest?

PA and left lateral

The AP oblique projection, RPO position of the chest corresponds to and essentially produces the same image as the:

PA oblique projection, LAO

Which structure serves as a common passageway for both food and air?

Pharynx

What should be used for the PA and lateral chest positions for a young pediatric patient?

Pigg-O-Stat

The numerous C-shaped cartilages which form the anterior and lateral borders of the trachea serve to:

Prevent collapse during respiration

How many degrees should the patient be rotated for PA oblique projections of the chest to evaluate the heart and great vessels?

RAO 45 degrees; LAO 55-60 degrees

How many degrees should the patient be rotated for PA oblique projections of the chest to evaluate the lungs?

RAO: 45 degrees; LAO: 45 degrees

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?

Raise upper limbs higher

Which primary bronchus is shorter and wider than the other and is also more vertical?

Right

A patient enters the emergency room with a possible hemothorax in the right lung caused by a motor vehicle accident (MVA). The patient is unable to stand or sit erect. Which specific position would BEST diagnose this condition?

Right lateral decubitus

A right lateral projection of the chest is utilized for visualization lesions involving:

Right lung

Due to its large diameter and more vertical placement, the most common location of foreign body blockage within the lungs is:

Right primary bronchus

For the PA projection of the chest, which positioning maneuver should be performed to best remove scapulae from lung fields?

Roll the elbows and shoulders forward

A PA chest radiograph reveals that the left sternoclavicular joint is superimposed over the spine (in comparison with the right joint). What specific positioning error is involved?

Rotation into a left anterior oblique position

The phase of respiration utilized when performing a soft tissue neck:

Slow inspiration during exposure

Which body habitus is associated with a: 1. Lower diaphragm 2. Thorax is narrow, depth is shallower 3. 50% of population

Sthenic

Which anatomic structure is examined to determine rotation on a PA chest radiograph?

Symmetric appearance of sternoclavicular joints

The carina is located at the vertebral level of:

T4-T5

PA and lateral chest radiographs are performed with the CR directed perpendicular to the level of:

T7

Which evaluation criterion pertains to the PA protection radiograph of the chest?

Ten posterior ribs should be visible above the diaphragm

Which evaluation criterion pertains to the lateral projection radiograph of the chest?

The ribs posterior to the vertebral column should be superimposed

Thorax extends from:

The thoracic aperture to the diaphragm

The bony thorax surrounds and protects the:

Thoracic viscera

Gives an angel wing appearance on infants:

Thymus gland

Why should chest radiographs be performed after the patient has suspended respiration after the second inspiration?

To better expand the lungs

Why would the chest most likely be demonstrated using two PA projections (in which the patient is seen in suspended inspiration and suspended expiration)?

To demonstrate a pneumothorax

Why should the chin be extended when doing either a PA or a lateral chest radiograph?

To demonstrate the lung apices

Why is the shortest possible exposure time necessary for chest radiography?

To eliminate heart motion

Why should chest radiographs be performed with a 72 inch SID?

To minimize magnification of the heart

Why are the elbows rolled toward the IR for a PA projection of the chest?

To remove the scapula from lung fields

Split at T4 - T5

Trachea

The correct term for the seventh cervical vertebrae is:

Vertebra prominens

The inner layer of pleura that attaches directly to the lung tissue is termed the:

Visceral pleura

The structures within the lung where oxygen and carbon dioxide gas exchange occurs are called:

alveoli

What is the name for the small air sacs located at the distal ends of the bronchioles?

alveoli

Where is the trachea situated in relationship to the esophagus?

anterior

A condition in which all or a portion of the lung is collapsed is:

atelectasis

A specific prominence, or ridge, found at the point where the internal distal trachea divides into the right and left bronchi is called the :

carina

The extreme, outermost lower corner of each lung is called the:

costophrenic angle

What is the lower, outer margin of the lung, at the junction of the ribs and diaphragm, called?

costophrenic angle

Which structure is not demonstrated within the mediastinum in PA projections of the chest?

diaphragm

What is the name of the cartilage that prevents food from entering the larynx during swallowing?

epiglottis

The separation of the lobes of the lungs is accomplished by long, narrow grooves called:

fissures

The condition in which blood fills the potential space between the layers of pleura is called:

hemothorax

The area of each lung where the bronchi and blood vessels enter and leave is called the:

hilum

What is the area called where the bronchi enter the lungs?

hilum

In which direction does the diaphragm move on inspiration?

inferiorly

A notch, or depression, located on the superior portion of the sternum is called the

jugular notch

What is the organ of voice called?

larynx

What is the name of the tongue-shaped process on the anterior-medial border of the left lung?

lingula

What is the name of the area between the two pleural cavities?

mediastinum

The lungs are composed of a light, spongy, elastic substance called:

parenchyma

Which set of conditions would allow the diaphragm to descend to its most inferior position?

patient erect, inspiration

What is the sac that encloses the lungs called?

pleura

The Lindblom method is used to demonstrate the:

pulmonary apices

Which pathologic condition of the lung involves the replacement of air with fluid in the lung interstitium and alveoli?

pulmonary edema

Which hemidiaphragm is usually located more superior?

right

The trachea bifurcates and forms the:

right and left primary bronchi

The thoracic cavity is enclosed with a shiny, slippery lining called the:

serous membrane

The xiphoid process is part of which of the following bones?

sternum

Which gland is large when a person is young and almost disappears as an adult?

thymus

Which structure forms the laryngeal prominence?

thyroid cartilage

Why are chest radiographs taken PA rather than AP?

to minimize heart magnification

Which radiographic position requires that the patient be placed prone?

ventral decubitus