intermediate chest, sternum and soft tissue neck

Question 1

what does MI, AP, PTX, TATT, CABG, ARDS, CF, PPM, FB, CXR stand for

Answer 1

• myocardial infarction
• anterior posterior
• pneumothorax
• tired all the time
• coronary artery bypass grraft
• acute respiratory distress syndrome
• cystic fibrosis
• permanent pace maker
• foreign body
• chest xray

Question 2

what does CVP, SOB, SOBOE, AF, PE, LVF, COPD, ABX, ECG, BP stand for

Answer 2

• central venous pressure
• shortness of breath
• shortness of breath on exertion
• atrial fibrilation
• pulmonary embolism
• left ventricular failure
• coronary obstructive pulmonary disease
• antibiotics
• electrocardiogram
• blood pressure

Question 3

what is the standard chest xray

Answer 3

PA erect chest

Question 4

where do you centre for a chest xray

Answer 4

level of t7

• 7-10 cm below sternal notch

Question 5

what should you see on a chest xray

Answer 5

• apices and upper airways
• soft tissue borders
• collimate to ac joint
• 12th ribs

Question 6

in what case would you require additional annotation on a chest xray

Answer 6

anything besides a PA erect chest will require annotation

Question 7

how are fluid levels affected based on if a patient is supine or erect

Answer 7

• when erect, clear horizontal fluid level is seen
• when supine, the fluid is spread across the whole chest and no fluid level is seen

Question 8

if a patient cannot get into position for a lordotic chest xray, what ,must be done

Answer 8

• angle tube 30-45 degrees cranially for AP
  or
• angle tube 30-45 degrees caudally for PA

Question 9

what type of arrested respiration is needed for a lateral sternum xray

Answer 9

arrested inspiration

Question 10

what should be seen on a lateral sternum xray

Answer 10

• whole sternum
• manubrium (upper part of sternum) free of superimposition by soft tissue of shoulders
• sternum free of superimposition by ribs
• lower portion of sternum unobscured by breasts of female patient
• bone trabecular detail and surrounding soft tissue

Question 11

what are the 3 sections of the pharynx

Answer 11

• nasopharynx
• oropharynx
• laryngopharynx

Question 12

describe the regions in which the pharynx reaches superiorly, inferiroyl, anteriorly and posteriorly

Answer 12

• superiorly = base of skull
• inferiroly = oesphageous (continuous)
• anteriorly = tongue and soft palate
• posteriorly = c1-c6

Question 13

what is the larynx

Answer 13

The area of the throat containing the vocal cords and used for breathing, swallowing, and talking

Question 14

how many cartilages is the larynx composed of

Answer 14

5

Question 15

what landmark is the larynx found

Answer 15

c3-c6

Question 16

how does the the larynx act to prevent food entering the trachea

Answer 16

• raises itself and moves anteriorly
  hence allowing the epiglottis covering the trachea and preventing food entering

Question 17

what are the associated structures of the larynx superiorly, inferiorly, anteriorly, posteriorly and laterally

Answer 17

superiorly - hyoid bone
inferiorly - trachea (continuous)
anteriorly - neck muscles
posteriorly - oesophagus
laterally - lobes of thyroid

Question 18

describe the tissue structure of the pharynx

Answer 18

• outermost layer of pharynx = constrictor muscles
• middle layers = fibrous tissue attaching pharynx to base of skull (thickens posteriorly)
• innermost layer = epithelial cell/ mucous membrane (upper pharynx is layered with ciliated cells)
  (ciliated cells have goblet cells which secret mucous to trap dust etc and sweep it externally)

(lower 2 3rd of pharynx has stratified cells)

Question 19

which vein does the vascular structure of the pharynx drain into

Answer 19

• internal jugular vein

Question 20

what is found on the posterior wall of the nasopharynx

Answer 20

phalangeal tonsils

Question 21

which tonsils are found in the oropharynx

Answer 21

palatine tonsils

Question 22

what forms the Adams apple

Answer 22

the midline prominence of the thyroid cartilage

Question 23

what structure produced the voice box

Answer 23

• the signet shaped cricoid cartilage
• thin part facing anteriorly thick part posteriorly
• epiglottis acts as the lid

Question 24

what cartilage keeps the vocal cords in place

Answer 24

the paired arytenoid cartilage

Question 25

what are 5 things to look out for on soft tissue neck xray

Answer 25

• cervical spine
• foreign bodies
• swelling
• masses
• fractures of larynx and hyoid bone

Question 26

what similar xray is used for a soft tissue neck xray

Answer 26

• same positioning as for lateral cervical spine

Question 27

the valsasalva manoeuvre is used for soft tissue neck xray, what is this

Answer 27

blowing out but not exhaling (to puff your cheeks)

Question 28

why is the valsalva manoeuvre sued for soft tissue neck xray

Answer 28

• demonstrates all soft tissue to a maximum

Question 29

what is the only complete cartilaginous ring of the trachea

Answer 29

cricoid cartilage

Question 30

what is subcutaneous emphysema

Answer 30

• abnormal air in the soft tissue of the neck