Ch. 10 Chest 10/26/15

Question 1

The MSP is ____ to the image receptor for a lateral projection of the chest.

Answer 1

Parallel

Question 2

If the lungs appear short and broad with a high diaphragm with organs lying away from the mid-line the body habitus is ____.

Answer 2

Hypersthenic

Question 3

For a well inspired chest radiograph, there should be ____ ribs present within the air filled lungs.

Answer 3

10

Question 4

The space between the lungs that is bound anteriorly by the sternum and posteriorly by the vertebrae is referred to as the ____.

Answer 4

Mediastinum

Question 5

For an AP/PA projection of the chest, the ____ is parallel to the film.

Answer 5

MCP

Question 6

The CR should be directed to the vertebral level of ____ fir a PA projection of the chest.

Answer 6

T7

Question 7

Another term for the trachea is ____.

Answer 7

Windpipe

Question 8

The epiglottis is found on the top if this structure and will elevate when a person swallows to avoid food going down the wrong tract.

Answer 8

Larynx

Question 9

The term used to describe a 72” SID used for routine chest radiography is ____?

Answer 9

Teleroentgenogram

Question 10

Why is a left lateral position preferred for chest radiography rather than right?

Answer 10

Decrease magnification of the heart

Question 11

Inhalation and exhalation films are performed for the following 4 reasons:

Answer 11

1) There is suspicion of a Pneumothorax
2) Foreign bodies are inhaled
3) Diaphragm is fixed
4) Atelectasis

Question 12

Why is a double inspiration preferred for chest radiography?

Answer 12

More air is inhaled during the second breath and without strain than with the first breath.

Question 13

This organ is also called the voice box.

Answer 13

Larynx

Question 14

The trachea has ____ incomplete C-shaped cartilage like rings for rigidity.

Answer 14

16-20

Question 15

The left lung contains __a__ major lobes and the right lung contains __b__ major lobes.

Answer 15

a) 2

b) 3

Question 16

The most superior portion of the lungs is termed as the ____.

Answer 16

Apices

Question 17

The muscle that is located between the thoracic and abdominal cavities is called the ____.

Answer 17

Diaphragm

Question 18

Referring to the previous question, which half of this muscle is situated higher within the body and why?

Answer 18

The right half is situated higher to make room for the liver.

Question 19

Name the cartilage point where the Right and Left Bronchus divide.

Answer 19

Carina

Question 20

List 4 reasons to perform chest radiography in the upright position whenever possible.

Answer 20

1) Prevent engorgement of pulmonary vessels.
2) To allow the diaphragm to move to its lowest position.
3) Showing the maximum lung field.
4) Air/fluid levels seen if present.

Question 21

To identify rotation of a PA position chest radiograph, you should look for symmetry of these on the finished radiograph.

Answer 21

SC joints

Question 22

To identify rotation of a lateral position chest radiograph, you should look for ____ on the finished radiograph.

Answer 22

Superimposition of the ribs posterior to the vertebral column.

Question 23

The method name for an AP axial lordotic chest radiograph is called ____.

Answer 23

Lindblom

Question 24

Describe how to position the pt in Linblom Method.

Answer 24

Have pt lean backwards in a position of extreme lordosis and rest shoulders against bucky; may also place pt’s back against bucky and have pt walk feet forward about 1 ft, arching the back, flex elbows and place hands palm out on hips.

Question 25

If the pt is unable to achieve the previous method, what can be done in order to place the apices below the shadows of the clavicles on the finished radiograph.

Answer 25

AP Axial Projection- perform upright or supine, angle at 15-20 degrees cephalic to the center of the IR and manibrium.

Question 26

For a routine PA chest position, where should the top of he imaging plate be placed?

Answer 26

1 and 1/2 to 2 in above relaxed shoulders.

Question 27

Explain why it is important to have the pt elevate their arms for the lateral position of the chest?

Answer 27

To ensure they are out of the field of view.

Question 28

Explain how to remove the shadows of the scapulae from the lungs field when performing a PA/AP chest.

Answer 28

Hug bucky/ roll shoulders forward.

Question 29

What is the proper SID used when performing an AP single view or portable AP chest radiograph?

Answer 29

60"-72" recommended- Whg Hospital uses 50"

Question 30

Where should the film be placed when performing an AP Axial Lordotic view of chest and why?

Answer 30

3" above shoulders because image will be thrown up and so the apices won't be clipped.

Question 31

List 3 history questions specific to the chest radiography.

Answer 31

1) Are you having pain in your chest? If so, where? 2) How long has this been going on? 3) Having any coughing, shortness of breath, congestion, wheezing, etc.?

Question 32

List 3 pathologies specific to the chest cavity that you would list as previous conditions.

Answer 32

1) Pneumonia 2) Bronchitis 3) Emphysema

Question 33

What vertebral level is the carina?

Answer 33

T4-T5

Question 34

What is the name of for the 9 regions that divide the abdominal cavity?

Answer 34

Addison's Planes

Question 35

Where vessels enter a lung.

Answer 35

Hilum

Question 36

Inferior border of thoracic cavity.

Answer 36

Diaphragm

Question 37

Major airway tube.

Answer 37

Trachea

Question 38

Number of lobes in right lung.

Answer 38

3

Question 39

Side of lung where vessels enter.

Answer 39

Medial

Question 40

Double-walled, serous membrane sac.

Answer 40

Pleura

Question 41

Respiratory sacs.

Answer 41

Alveoli

Question 42

Area between lungs.

Answer 42

Mediastinum

Question 43

This lung has 2 lobes.

Answer 43

Left

Question 44

Inferior part of a lung.

Answer 44

Base

Question 45

Pertaining to the chest cavity.

Answer 45

Thoracic

Question 46

These branch from the trachea.

Answer 46

Bronchi

Question 47

Separates a lung in lobes.

Answer 47

Fissure

Question 48

What mediastinal structure consists of C-shaped cartilaginous rings?

Answer 48

Trachea

Question 49

Which structures branch from the distal end of the trachea?

Answer 49

Primary Bronchi

Question 50

Which structures are at the terminal end of the respiratory system?

Answer 50

Alveoli

Question 51

Name 3 portions of the pleura.

Answer 51

1) Inner layer- Visceral Pleura 2) Outer layer- Parietal Pleura 3) Space between layers- Pleural Cavity

Question 52

A collapse of all parts of a lung.

Answer 52

Atelectasis

Question 53

Collection of fluid in the pleural cavity.

Answer 53

Pleural Effusion

Question 54

Underaeration of the lungs due to lack of surfactant.

Answer 54

Hyaline Membrane (respiratory distress syndrome)

Question 55

Chronic infection of lung due to the tubercle bacillus.

Answer 55

Tuberculosis

Question 56

Replacement of air with fluid in the lung interstitium and alveoli.

Answer 56

Pulmonary Edema

Question 57

Pneumonia involving the bronchi and scattered throughout the lung.

Answer 57

Lobular (broncho-pneumonia)

Question 58

Condition of unknown origin often associated with pulmonary fibrosis.

Answer 58

Sarcoidosis

Question 59

Accumulation of air in the pleural cavity resulting in collapse of the lung.

Answer 59

Pneumothorax

Question 60

Pneumonia involving the alveoli of an entire lobe without involving the bronchi.

Answer 60

Lobar (bacterial pneumonia)

Question 61

Destructive and obstructive airway changes leading to an increased volume of air in the lungs.

Answer 61

Emphysema.

Question 62

Average build.

Answer 62

Sthenic

Question 63

Thin build.

Answer 63

Hyposthenic

Question 64

Extremely slender, lungs long and extended well above clavicles, diaphragm is low, organs near midline.

Answer 64

Asthenic

Question 65

The thoracic viscera consists of the lungs and the ____.

Answer 65

mediastinal structures

Question 66

The 6 radiography important mediastinal structures.

Answer 66

1) Heart 2) Great Vessels 3) Trachea 4) Esophagus 5) Lymphatics 6) Thymus

Question 67

Produces the hormone Thymosin which plays critical role in development of immune system. Primary control organ of the Lymphatic System.

Answer 67

Thymus

Question 68

7 structures that make up the Respiratory System.

Answer 68

1) Nose 2) Mouth 3) Pharynx 4) Larynx 5) Trachea 6) Bronchi 7) Alveoli (parenchyma)/ gas exchangers

Question 69

Organ of both Respiratory and Digestive systems; extends from base of skull to the esophagus; 3 divisions?

Answer 69

Pharynx 1) Nasopharynx 2) Oropharynx 3) Laryngopharynx

Question 70

Vertebral level of C4-C6; had 9 catilages; has epilgottis on top.

Answer 70

Larynx (voice box)

Question 71

Vertebral level C6-T4; has 16-20 incomplete cartilaginous rings; splits into 2 tubes called primary or main stem bronchi at T4.

Answer 71

Trachea

Question 72

Foreign bodies are most likely to pass into which Bronchus and why?

Answer 72

Right branch because it is more vertical and bigger diameter.

Question 73

____-portion of the left lobe that corresponds in position to the right middle lobe.

Answer 73

Lingula

Question 74

____-part of the lung located where ribs and diaphragm meet. Vertebral level T12.

Answer 74

Costerophrenic Angle

Question 75

If the exposure is made at exhalation, an increase of ____ is necessary for adequate penetration.

Answer 75

6-8 kV

Question 76

A grid tech is used in investigation of opaque areas within the lung fields to demonstrate the lung structures through the thickened ____.

Answer 76

pleural memebranes

Question 77

____- organs of these ppl are on the opposite side.

Answer 77

Transportation/ Situs Inversus

Question 78

Using 72" SID does what?

Answer 78

minimizes magnification of the heart shadows AND obtains a sharper outline of lung structures.

Question 79

____- should be moved up and lateral to remove shadows from obscuring the lungs.

Answer 79

LARGE pendulous breasts!

Question 80

____- non synchronous movement of a hemi diaphragm; one half is moving up while the other half is moving down.

Answer 80

Hiccups

Question 81

CR for PA Chest.

Answer 81

Perpendicular to IR and enter at T7

Question 82

If performing inspiration and expiration studies be sure that ____ on expiration radiograph.

Answer 82

at least one less rib is seen

Question 83

In an AP projection, CR is __1__ to the IR and the CR should enter __2__?

Answer 83

1) Perpendicular to IR and the long axis of the sternum. | 2) CR should enter approx. 3" below the jugular/manubrial notch (T7)

Question 84

In AP Axial Projection/ Lindblom Method (Iordotic position), the IR is __1__ to center of IR at level of __2__.

Answer 84

1) Perpendicular | 2) mid-sternum

Question 85

In AP Axial Projection/Lindblom Method (lordotic position), demonstrates the __1__ and the __2__ lie superior to the __3__.

Answer 85

1) Apices 2) Clavicles 3) Apices

Question 86

In the AP Axial Projection/Lindblom Method (lordotic position), the __1__ lie horizontally with the medial ends overlapping only the __2__ ribs.

Answer 86

1) Clavicles | 2) 1st or 2nd

Question 87

The AP Axial Projection/Lindblom Method (lordotic position) can also be asked to be performed as an ____.

Answer 87

Oblique-LPO or RPO; rotate body 30 degrees from AP with affected side toward centered IR.

Question 88

In PA Axial Position, the IR is centered at __1__. CR angled __2__ through T3. Shows __3__ in their entirety.

Answer 88

1) level of jugular notch (T2-T3) 2) 10-15 degrees 3) Apices

Question 89

For PA Oblique Projections (RAO/LAO Positions), the side of interest is generally the side __1__ from the IR. The CR enters at __2__.

Answer 89

1) Farthest | 2) T7

Question 90

On AP/PA Obliques, IR is 1 and a 1/2 to 2" above ____.

Answer 90

Vertebral Prominens or 5" above the jugular notch

Question 91

For AP Oblique Projections, the side of interest is generally the side __1__ to the IR. Center CR at level 3" below the __2__ (the CR will exit at T7)

Answer 91

1) Closest | 2) Jugular Notch

Question 92

Maximum area of ____ lung on PA Oblique LAO.

Answer 92

Right

Question 93

Maximum area of the ____ lung on PA Oblique RAO.

Answer 93

Left

Question 94

PA CHEST

Answer 94

1) IR is 1-1/2 to 2" above relaxed shoulders 2) CR T7 3) SC Joints asymmetrical 4) 10 posterior ribs

Question 95

LATERAL CHEST

Answer 95

1) IR is 1-1/2 to 2" about shoulders 2) CR enters on MCP at level T7 3) Superimposition of the ribs posterior to the vertebral column

Question 96

AP PROJECTION

Answer 96

1) IR is 1 1/2 to 2" above relaxed shoulders 2) CR enters approx. 3' below jugular notch (T7) 3) SC Joints asymmetrical

Question 97

AP AXIAL/ LINDBLOM METHOD (LORDOTIC POSITION)

Answer 97

1) IR is 3" about shoulders in lordotic positon 2) CR enters at midsterum 3) throws clavicles up 4) can also be LPO or RPO (30 degree angle from AP)

Question 98

PA AXIAL PROJECTION

Answer 98

1) IR with its center at the level of jugular notch (T2-3) 2) CR enters 10-15 degrees cephalic thru T3 3) Throws apices up 4) asymmetrical SC Joints

Question 99

AP AXIAL PROJECTION

Answer 99

1) center IR to MSP at level of T2 and adjust body with no rotation 2) CR enters 15-20 degrees cephalic thru Manubrium (T2) 3) throws clavicles up 4) SC Joints asymmetrical

Question 100

PA OBLIQUE PROJECTIONS (RAO/LAO)

Answer 100

1) 1 1/2- 2" above vertebral prominens 2) 45 degrees from PA 3) Side of interest is FARTHER away from IR 4) CR enters at T7 5) LAO (right lung) RAO (left lung)

Question 101

AP OBLIQUE PROJECTIONS (RPO/LPO)

Answer 101

1) 1 1/2- 2" above vertebral prominens 2) 45 degrees from AP 3) Side of interest is CLOSEST to IR 4) CR enters at level 3" below jugular notch (T7) 5) LPO (left lung) RPO (right lung)