Procedure - Thorax & Abdomen Flashcards
(152 cards)
1
Q
How many ribs should you seen on a fully inspiration CXR
A
10 ribs above diaphragm
2
Q
Where should CR be directed for a PA CXR?
a. MCP at T7
b. MSP at T7
c. at level of scapular spine
d. at level of 12th rib
A
B
3
Q
T7 corresponds to a horizontal plane through _________ of scapular
A
inferior angles
4
Q
What is the primary indicator of full inspiration on the following radiograph?
a. visualization of posterior ribs through heart shadows
b. minimum of 10 posterior ribs above diaphragm
c. minimum of 10 anterior ribs above diaphragm
d. fine vascular markings are visible within lungs
A
B
5
Q
CR entrance point for lateral CXR? be specific
A
midcoronal plane at level of T7
6
Q
What should be visualized on a lateral CXR? (4)
A
apices
costophrenic angles
posterior ribs
sternum
7
Q
Why 72” SID for CXR
A
compensate for increased OID bw heart and IR AND reduce the magnification of heart
8
Q
for PA CXR, how should the IR be positioned in relation to patient;s shoulder?
a. 1.5-2” above shoulder
b. 2” below shoulder
c. directly at level of shoulders
A
A
9
Q
Lordotic position mainly shows which anatomy of the lungs
A
apices
10
Q
For Lordotic position, how should the IR positioned in relation to the patient;s shoulder
A
3” above shoulder
11
Q
what is the CR for lordotic CXR
A
mid-sternum
12
Q
for AP CXR on a stretcher, what is the SID and angulation
A
SID: 72”
angulation: caudal to match IR
13
Q
For AP lordotic CXR, CR should be directed:
a. 1-2” below jugular notch
b. 2-3” below jugular notch
c. 3-4” below jugular notch
d. 4-5” below jugular notch
A
C
14
Q
AP axial projection of the chest refers to which position
A
lordotic
15
Q
for lordotic, patient is instructed to lean backward how many degrees
a. 5
b. 5-10
c. 10-15
d. 15-20
A
D
16
Q
When performing an AP upright CXR when pt is on stretcher, technologist must ensure angle of tube matches angle of ___
a. IR
b. pt’ chest
A
A
17
Q
Why is it important to make sure CR matches the angle of the IR
A
prevent grid cutoff and processing errors
18
Q
what is SID for lordotic CXR
a. 72”
b. 40”
A
72”
19
Q
When positioning pt for a lateral chest on a stretcher, which side of the pt should be placed against the IR?
a. RT side
b. LT side
c. Either side
d. depend on pathology
A
B
20
Q
how many posterior ribs will be demonstrated above diaphragm in a correctly AP portable CXR
a. 8-9
b. 9-10
A
A
21
Q
What is the preferred position for AP CXR when pt cannot stand
a. supine
b. semi erect
c. lateral decub
A
B
22
Q
To ensure AP mobile CXR is free of rotation, what structures should appear symmetrical
a. ribs and clavicle
b. sternum and xiphoid process
c. lung apicec & costophrenic angles
A
A
23
Q
SID for lateral Soft Tissue Neck
A
72”
24
Q
CR for lateral soft tissue neck
A
laryngeal prominence
25
SID for AP Soft Tissue Neck
40"
26
Breathing instruction for AP soft tissue neck
a. slow deep inspiration
b. suspend after inspiration
A
27
CR for AP soft tissue neck
a. 1" superior to jugular notch
b. 0.5" superior to jugular notch
c. 2" inferior to jugular notch
A
28
what is the correct marker and correct marker placement used to indicate the left side of pt for an L lateral soft tissue?
a. left marker placed posteriorly
b. left marker placed anteriorly
B
29
what is the optimal vertical collimation for a lateral soft tissue neck
12"
30
Which of the following is the carina associated with?
a. superior wall of aortic arch
b. horizontal fissure of lung
c. hilum of lung
d. bifurcation of trachea
D
31
Trachea is split into ___
L & R bronchi
32
Which of the following statement is accurate in reference to lung's vascular marking on PA CXR
a. vascular marking are only visible when there is pulmonary pathology
b. vascular marking appear thinner in superior portions of the lungs
c. caliber of vascular marking should be same from superior to inferior lung
d. vascular marking are only visible in hilar region near the heart
B
33
vascular markings are most prominent at the _____ regions
hilar
34
vascular markings appear thicker in ___ lung zones
a. inferior
b. superior
A
35
vascular markings appear thinner in ____ lung zones
a. inferior
b. superior
B
36
A pathological condition in which air or gas enters the pleural space:
a. pneumothorax
b. pleural effusion
c. emphysema
A
37
which conditions would demonstrate as the absence of diaphragm contour and blunting of costophrenic angles
a. emphysema
b. pleural effusion
c. pneumothorax
d. atelectasis
B
38
when evaluating PA CXR, radiologist note absence of lung markings and pleural line on pt's right side. which conditions cause this appearance?
a. pneumonia
b. pneumothorax
c. pleurisy
d. croup
B
39
40
Why is it better to do PA chest in erect position
Detect air/fluid level
Diaphragm is lowered
Full lungs are shown
41
Why is it better to do PA over AP for chest
Lower OID for lungs & heart
42
43
What is Lithotomy position?
Legs are higher than head
44
Why 72" SID for chest x-ray
-Increased SID
-avoid magnification of heart
-capture bilateral lungs
-less divergence of x-ray beam = less distortion
45
3 body landmarks for CXR
1. vertebral prominen
2. jugular notch
3. xiphoid tip
46
Vertebral prominen is at
C7
47
Jugular notch is at
T2
48
Xiphoid tip is at
T9/10
49
What is the tissue that make up the lungs
parenchyma
50
How do you know the exposure is good for PA chest
-no motion
-sharp outline of ribs
-visualization of vascular marking
51
The heart appears larger as a result of _____
shorter SID
increased OID
52
[CHEST CXR] What is the kVP for pediatric pt? Why?
70-80
they have low body mass
53
[CXR]
To indicate there are no rotation, the separation of posterior ribs should be ____
no more than 1/4 to 1/2"
54
Pneumothorax is detected on the right side of the lung, which position should the patient be placed in?
L lateral decub because the affected RIGHT lung should be up for us to see air.
55
Hemothorax is detected in the left side of the lung, which position should the patient be placed in?
L lateral decub because the right side needed to be away from the mediastinum
56
[CXR]
LPO corresponds to which position? Why?
RAO
Both see L lung best
57
[CXR] RPO corresponds to which position? Why?
LAO
Both see R lung best
58
Which positions can see the right lung best?
LAO
RPO
59
Which positions can see the left lung best?
RAO
LPO
60
For ___ oblique, lung will be closest to IR
posterior
61
[CHEST CXR] Which oblique position will cause the lung field to be shorter
POSTERIOR because the diaphragm is being magnified
62
[CXR] why posterior oblique results in larger heart and great vessels
farther away from the IR
63
Why lung is shorter and why
Right lung because liver located in RUQ of abdomen which pushes up on RT hemidiaphragm
64
Costophrenic angle is where ____
diaphragm meets ribs
65
Cardiophrenic angle located in ____
LT ventricle
RT atrium
66
Hilum is where ____ (4) enter & leaves lungs
bronchi
blood
lymph vessels
nerve
67
The difference b/w these disease:
1. Empyema
2. Hemothorax
What are the positions for any type of pleural effusion ?
1. fluid is pus
-caused by chest wound, ruptured lung abscess, obstruction of bronchi
2. fluid is blood
-RT: caused by heart failure
-LT: trauma, pancreatitis, pulmonary infarct, subphrenic abscess
erect PA
lateral decub with affected side DOWN
68
____ is an accumulation of air in pleural space that can cause ____. Results in ___ (2)?
Pneumothorax
collapse of lung
==> SOB & chest pain
69
70
Parietal pleura lines ___
inner surface of chest wall & diaphragm
71
What pleura cover surfaces of lungs
visceral
72
What is the primary muscle for breathing
diaphragm
73
what are the 3 openings in the diaphragm
IVC
Esophagus
Aorta
74
Bronchi on the left or right is more prone to foreign bodies? why?
Right because of larger diameter
75
What is the recommended source-to-image distance SID for a lateral
erect radiograph of the sternum?
72 inches (183 cm)
76
What is the recommended source-to-image distance SID for a
posteroanterior PA oblique sternum, right anterior oblique RAO
position?
30 inches (76 cm)
77
Which of the following is the correct breathing instruction for a lateral projection of the sternum?
a. Normal breathing
b. Suspend on deep expiration
c. Suspend on deep inspiration
d. Shallow breathing
C
78
For a lateral sternum radiograph, the central ray is directed at the:
a. Midline of the jugular notch
b. Lateral border of the midsternum
c. T7 vertebra
d. Level of the clavicles
b. Lateral border of the midsternum
79
Which of the following is the correct central ray entrance point for a posteroanterior PA sternum projection, right anterior oblique RAO
position?
a. Midcoronal plane at the level of T7
b. Midsagittal plane at the level of T7
c. Enters the dependent side 1 inch 3 cm) lateral to the spine at the level of
T6
d. Enters the elevated side 1 inch 3 cm) lateral to the spine at the level of T7
D
80
which vertebra corresponds to the level of inferior angle of scapula
T7
81
7
82
where is the midpoint of sternum in RAO position
1" from MSP
83
where is the midpoint of sternum in Lateral position
T7
84
Which three of the following are considered correct patient positioning for a lateral sternum radiograph? (Select three)
a. Prone on the table
b. Supine on the table
c.Standing or sitting at the upright bucky
d. Laying laterally on the table
B C D
85
What is the appropriate degree of rotation for a posteroanterior PA
oblique sternum, right anterior oblique RAO position?
15-20
86
Which two of the following patient positions are appropriate when
positioning for a posteroanterior PA) oblique sternum, right anterior oblique RAO) position?
Prone on the table
Standing or sitting at the upright bucky
87
Which of the following is the correct breathing instruction for a posteroanterior PA oblique sternum, right anterior oblique RAO
position?
shallow breathing or suspend on expiration
88
What does the bony thorax consists of ? (3)
1 sternum
12 thoracic vertebrae
12 rib pairs
89
What is the purpose of bony thorax
protects respiratory & mediastinum
90
What are the 3 parts of the sternum
1. manubrium
2. body
3. xiphoid tip
91
Which structure is located at T2-3
Jugular notch
92
What does the body of sternum articulate with
manubrium
93
What is the articulation angle of the body to the manubrium called?
sternal angle
94
Location of sternal angle
T4-5
95
What structure provide anterior articulation of the cartilage of the rib
facet of the body of the sternum
96
There are no bony articulation of the rib ____
a. anteriorly
b. posteriorly
A
97
Ribs articulate with bony joint ____
a. anteriorly
b. posteriorly
B
98
Which structure articulate laterally to the jugular notch?
medial end of clavicle
99
SC joint is the formation of ____ & _____
medial end of clavicle and clavicular notch
100
How many ribs articulate with the sternum
7
101
Ribs articulate with the sternum through ____
costocartilage
102
Why does costocartilage show up as a gap on radiograph?
cartilage is not dense enough for Xray attenuation
103
What are other names for jugular notch
suprasternal & manubrial notch
104
The 1st pair of ribs articulate with which part of the sternum
manubrium
105
the 2nd pair of ribs articulate with the ____ of the sternum
sternal angle
106
___ through ___ pair of ribs connect directly to the body of sternum through costocartilage
3rd - 7th
107
___ through ____ pair of ribs connect to costocartilage 7, which then connects to sternum
8th-10th
108
Routine for sternum. Which routine is usually preferred?
RAO
Lateral
Lateral
109
[Sternum] kVp?
70-80
110
Why RAO sternum over LAO sternum
Rotate sternum away from vertebrae and superimpose the heart
111
Why is it important for the sternum to superimpose the heart when imaging
increase density of sternum --> better attenuation --> more visualization of sternum
112
for a bigger patient, would you need a higher or lower obliquity for RAO Sternum
lower (15)
113
Patient with a shallow or thin chest would need ____ rotation than a patient with a deep chest
MORE
114
[Sternum] If patient is unable to stand for RAO, what is the alternate position?
SUPINE LPO with CR angled 15-20 across right side of patient
115
Lateral Sternum
For erect, arms ____
For recumbent, arms ____
What is the purpose?
Back
Up
Avoid superimposition of humerus over sternum
116
How many ribs are considered "true" ribs
7
117
True ribs are direct ____ attachment
anterior
118
How many ribs are considered "false" ribs
5
119
_____ ribs have no anterior attachment
False & Floating
120
Rib 8-10th have ____ that join together at rib ____ connects to sternum
costocartilage
7
120
does floating ribs have costocartilage?
NO
121
Which ribs do not connect to the sternum?
a. floating
b. true
c. false
d. all ribs are connect to sternum
A
122
If floating ribs are not connect to sternum, what does it connect to?
T12
123
Which structures of the ribs are located posteriorly
Head
Neck
Tubercle
124
Head of ribs articulate with _____
vertebral body
125
what is the internal structure of rib
costal groove
126
what does costal groove house
artery, vein, nerve
127
What could happened if there is a rib fracture
1. HEMOTHORAX (puncture of parietal pleural surround the lungs. The veins inside the costal groove severed and leaks into the pleural )
2. PNEUMOTHORAX (puncture causing air leakage)
128
Tubercle of ribs articulate with ____
transverse process of a vertebra
129
On a radiograph, the part of ribs that most superior is ___, and most inferior is ____
posterior end (vertebral end)
Anterior end
130
What is a joint between costocartilage and ribs
costochondral
131
What is a joint between costocartilage & sternum
sternocostal
132
What is a joint between costocartilages?
interchondral
133
Interchondral joint is between the ___ of which ribs
costalcartilage / 6-10
134
Sternocostal joint is between ___ & ___ ribs
1-7
135
What is the joint between head of ribs and vertebral body
costovertebral joint
136
Costovertebral joint is between ___ & ____
head of ribs
vertebral body
137
What is the joint between tubercle to transverse process
costotransverse
138
Costotransverse joint is between __ & ___
tubercle & transverse process
139
Costotransverse joint are found on which ribs
1 - 10
140
Which joint does 11th & 12th rib don't have?
costotransverse
141
Routines for RIB
PA chest
AP Above Diaphragm
AP Below Diaphragm
RPO/LPO
142
kVp for RIB
75-85
143
AP Above Diaphragm can be done for ____
a. bilateral
b. unilateral
c. both
C
144
AP below diaphragm can be done for ____
a. bilateral
b. unilateral
c. both
A (unless otherwise noted)
145
RPO/LPO ribs can be done for ____
a. bilateral
b. unilateral
c. both
B
146
[RIB] if the right side is affected, which position will elongate the right side
RPO
147
[RIB] if the right side is affected, which position will shorten the right side
LPO
148
[RIB] if the left side is affected, which position will elongate the left side
LPO
149
What should be included in a diagnostic dorsal decubitus abdomen radiograph (select all that applied)
a. superimposed ilia
b. kidneys
c. domes of diaphragm
d. pedicles of L spine
A C D
150
which of the following is the most distal part of the small bowel
a. jejunum
b. cecum
c. ileum
d. duodenum
illeum
151
which organ is positioned transversely across upper abdomen
a. pancreas
b. stomach
c. spleen
d. kidneys
A
