Chapter 3 Flashcards
(44 cards)
1
Q
Thoracic Cavity characteristics
A
- bound by the walls of the thorax
- extends from the superior thoracic aperture to inferior thoracic aperture
- diaphragm separates thoracic cavity from abdominal cavity
2
Q
What does the thoracic cavity contain?
A
- lungs
- heart
- organs of the respiratory, cardiovascular, and lymphatic systems
- thymus gland
- inferior part of the esophagus
3
Q
What are the chambers of the thoracic cavity?
A
- single pericardial cavity (1)
- right and left pleural cavity (2)
4
Q
What is the mediastinum? What does it contain?
A
- the space between the two pleural cavities
- contain all thoracic structures expect the lungs and pleurae
5
Q
What does the respiratory system consist of?
A
- lungs
- mouth
- nose
- pharynx
- trachea
- bronchi
6
Q
Trachea Characteristics
A
- fibrous, muscular tissue
- lies anterior to esophagus
- filled with air in the x-ray
- divides at carina into right and left primary bronchi
7
Q
Right Primary Bronchus Characteristics
A
- shorter, wider, and more vertical
- foreign bodies are more able to enter
8
Q
Alveoli Characteristics
A
- each alveolar duct ends with alveolar sacs
- oxygen and CO2 is exchanged by diffusion
- millions of alveoli in each lung
9
Q
Lungs Characteristics
A
- apex reaches above the clavicles
- rests obliquely on diaphragm
- moves inferiorly during inspiration and superiorly during expiration
- inner layer is the visceral pleura
- outer layer is the parietal pleura
10
Q
Thyroid Gland Characteristics
A
- consists of two lateral lobes
- connected at their lower thirds by the isthmus
- isthmus lies in front of the upper part of the trachea
11
Q
Parathyroid Glands Characteristics
A
- small ovoid bodies
- two on each side, superior and inferior
12
Q
Pharynx Characteristics
A
- located in front of vertebrae
- located behind nose, mouth, and larynx
- serves as a passage for air and food
13
Q
Larynx Characteristics
A
- organ of voice
- the laryngeal prominence = adam’s apple
14
Q
What are the structures in the mediastinum?
A
- heart
- great vessels
- trachea
- esophagus
- thymus
- lymphatics
- nerves
- fibrous tissues
- fat
15
Q
What are the general procedural guidelines for a chest x-ray?
A
- patient preparation
- general patient position
- IR and collimation size
- SID
- ID markers
- radiation protection
- patient instructions
16
Q
How do you prepare a patient for a chest x-ray?
A
- remove clothing and artifacts from anatomy of interest
- secure all belongings in a designated manner and location
17
Q
What is the general patient position for a chest x-ray?
A
- ambulatory patients: upright or seated erect
- nonambulatory patients:
- determine whether air fluid levels are critical to diagnosis
- may have to substitute a decubitus if patient can’t be upright
18
Q
What is the IR and collimation size for a chest x-ray?
A
- lengthwise
- 43cm x 35cm
19
Q
What is the SID for a chest x-ray? Why?
A
- 72in
- to minimize magnification of heart
20
Q
How should you shield a patient during a chest x-ray?
A
lead shield between between x-ray tube and patient’s pelvis
21
Q
What are the 4 reasons to do inspiration and expiration for chest x-rays?
A
- demonstrates pneumothorax
- diaphragm movement
- presence of foreign body
- atelectasis (collapsed lung)
22
Q
What are the essential projections for a chest x-ray?
A
- AP
- PA
- lateral (right and left)
- AP oblique (RPO and LPO)
- PA oblique (RAO and LAO)
- AP axial
23
Q
What is important to remember when doing a PA chest x-ray?
A
- upright either standing or sitting
- SID is 72in
- chest is on the IR
- top of the IR is 1 1/2 - 2 inches above the shoulder
- CR enters midsagittal plane and level of T7, is perpendicular to IR, lines up to the spine
- exposure is made after breathing in and holding
- clavicles appear less straight
24
Q
What structures are shown in the PA chest x-ray?
A
- air filled trachea
- lungs
- diaphragm
- costophrenic angles
- heart
- aortic arch
- clavicles
- scapulae outside the lung fields
- ribs
25
Explain the procedure of a PA chest x-ray when it is a cardiac study with barium
* barium is thicker than the barium used for the stomach so it goes down slower
* patient holds barium in their mouth until time of exposure
* patient takes a deep breath and then swallows barium, exposure is made at this time
26
What is important to remember when doing a lateral chest x-ray?
* upright either standing or sitting
* side closest to IR is side on the image and names the type of lateral
* left lateral is used to minimize magnification
* top of the IR is 1 1/2 - 2 inches above the shoulder
* midsagittal plane is parallel to IR
* patient shouldn't be leaning sideways or bending forward
* CR enters midcoronal plane
* exposure is made after breathing in and holding
27
What are the structures shown in a lateral chest x-ray?
* heart
* aorta
* left-sided pulmonary lesions (left lateral)
* right-sided pulmonary lesions (right lateral)
* posterior ribs
* sternum
* trachea
* esophagus
* hilar region
* diaphragm
* costophrenic angles
28
What is important to remember when doing a PA oblique chest x-ray?
* upright either standing or sitting
* top of the IR is 1 1/2 - 2 inches above vertebra prominenes (C7)
* side of interest is farther away
* LAO side of interest: right
* RAO side of interest: left
* CR is perpendicular, enters at level of T7 (scapula)
* exposure is made after breathing in again and holding
* SID is 72 inches
29
What structures are seen in a PA oblique chest x-ray?
LAO:
* maximum area of right lung field
* thoracic viscera
* anterior portion of left lung
* trachea
* heart
* aorta
RAO
* maximum area of left lung
* thoracic viscera
* anterior portion of right lung
* trachea
* when filled with barium the esophagus
30
When doing a cardiac series for a PA oblique projection, what is the angle of the oblique?
55 to 60 degrees
31
What is important to remember when doing a AP oblique projection?
* upright either standing or sitting
* top of the IR is 1 1/2 to 2 inches above the vertebra prominens
* side of interest is close to IR
* RPO side of interest: right
* LPO side of interest: left
* CR is perpendicular to IR
* CR enters 3 inches below jugular notch (T2)
* exposure is done after breathing in again and holding
* SID is 72inches
32
What are the structures shown in a AP Oblique projection?
* lungs
* trachea
* bronchus
* carina
* vertebral column
* heart
* diaphragm
* costophrenic angle
33
What is important to remember when doing a AP chest x-ray?
* supine if the patient is too sick or upright
* top of the IR is 1 1/2 - 2 inches above the shoulders
* might have to angle the tube caudad no more than 10 degrees
* get as much distance as possible
* 60 SID okay, but write it down
* clavicles are straighter
* if patient condition is okay, do the same position as PA chest
* CR is perpendicular to IR and enters 3inches below jugular notch
* exposure is made after breathing in again and holding
34
What structures are seen in a AP chest x-ray?
* horizontal clavicles
* magnified heart and vessels
* shorter lungs
* trachea
35
What is important to remember when doing a AP Axial projection in the lordotic position?
* upright and ~1ft in front of the grid
* top of the IR is 3inches above the shoulders
* patient is leaning back until shoulders rest on grid
* angle patient 15 to 20 degrees, CR is not angled
* exposure done after breathing in again and holding
* CR enters 3 to 4 cm below jugular notch
36
What are the structures shown in the AP Axial Projection in the Lordotic Position?
* entire apices
* clavicles above apices and horizontal
37
What is important to remember when doing a AP axial projection?
* upright or supine
* CR enters T2 and is angled 10 to 20 degrees cephalically and is perpendicular to IR
* collimation is 24 x 30 cm
38
What structures are shown in the AP Axial projection?
apices below clavicles
39
What is important to keep in mind when doing a PA Axial projection?
* upright, seated or standing
* IR size: 24 x 30 cm and is centered at the level of the jugular notch
* CR is 10 to 20 degrees cephalad
* collimation is 24 x 30
* patient position is the same as AP chest
40
What structures are shown in PA Axial Projection?
apices above the clavicles
41
What is important to remember when doing a AP or PA lateral decubitus position chest x-ray?
* patient is lying either on their right or left side
* to demonstrate fluid, patient should lie on their affected side
* to demonstrate air, patient should lie on their unaffected side
* top of the IR is 1 1/2 - 2inches above shoulders
* place marker on whatever side is up and annotate whatever side is down
* elevate patient body 2 to 3 inches if lying on affected side
* extend arms over head
* anterior or posterior side against the IR
* CR is horizontal and perpendicular to the center of the IR and enters 3 inches below jugular notch for AP
CR is horizontal and perpendicular to the center of IR and below T7 for PA
* exposure is done after breathing in again and holding
42
What structures are shown in AP or PA lateral decubitus positions?
* fluid position
* affected side from apex to costophrenic angle
43
What is important to remember when doing lateral ventral or dorsal decubitus positions?
* patient is prone or supine and elevated 2 to 3 inches
* top of the IR is at level of thyroid cartilage
* affected side is against the vertical grid
* CR is horizontal and perpendicular to IR
* dorsal decubitus: CR enters 3-4 inches below jugular notch
* ventral decubitus: CR enters at T7
* exposure is made after breathing in again and holding
44
What structures are shown in the lateral ventral or dorsal decubitus positions?
* shows a change in position of fluid
* reveals pulmonary areas that are obscured by the fluid in standard projections
