Radiologic Positioning - Chest - Full Deck Flashcards

1
Q

3 divisions of Chest Anatomy

A

Mediastinum
Respiratory system
Bony thorax

Acronym: MR. B

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2
Q

5 parts of Bony Thorax

A

Sternum
Clavicles
Ribs - 12 pairs
Thoracic vertebrae - 12
Scapulae

Acronym: South Carolina Ribs Taste Sweet

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3
Q

Vertebra Prominens location

A

C7

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4
Q

3 parts of Sternum

A

Manubrium
Body
Xiphoid process

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5
Q

Xiphoid Process

A

Inferior aspect of sternum
Approximate level of anterior diaphragm
At T9-T10

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6
Q

Jugular notch

A

Dip between clavicles above the manubrium
At T2/T3

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7
Q

Location of Mid-thorax

A

T7

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8
Q

4 divisions of Respiratory System

A

Pharynx
Trachea
Bronchi
Lungs

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9
Q

Trachea is anterior or posterior to the esophagus

A

Anterior

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10
Q

Esophagus is anterior or posterior to the trachea

A

Posterior

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11
Q

Larynx location

A

Between C3 and C6

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12
Q

Laryngeal prominence is known as _______

A

Adam’s apple

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13
Q

Laryngeal prominence is part of what cartilage?

A

Thyroid cartilage

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14
Q

Epiglottis

A

Lid covering laryngeal opening during swallowing

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15
Q

Trachea location

A

Between C6 and T4/T5

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16
Q

Carina location

A

T5

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17
Q

Right bronchus has ___ branches

A

3

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18
Q

Left bronchus has ___ branches

A

2

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19
Q

Right lung has ___ lobes

A

3

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20
Q

Left lung has ___ lobes

A

2

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21
Q

Outer layer of Pleura

A

Parietal

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22
Q

Inner layer of Pleura

A

Visceral

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23
Q

Mediastinum

A

Medial portion of thoracic cavity between lungs
Trachea
Thymus gland
Esophagus
Heart & great vessels

Acronym: Tracy Tickles Each Heart

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24
Q

4 structures of Mediastinum

A

Trachea
Esophagus
Thymus gland
Heart and great vessels

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25
Q

Location of Xiphoid Process

A

T9 - T10
Anterior diaphragm

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26
Q

Boundary between Oropharynx and Nasopharynx

A

Uvula

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27
Q

From what part of anatomy is larynx suspended?

A

Hyoid bone

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28
Q

Thyroid gland

A

Located anteriorly and inferior to larynx
Divided into right and left lobes
Radiosensitive
Stores metabolism hormones

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29
Q

Right Bronchus

A

3 branches
Wider, shorter, more vertical than left bronchus

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30
Q

Which bronchus is more likely for obstruction?

A

Right

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31
Q

Left Bronchus

A

2 branches
Narrower, longer, more curvy than right bronchus

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32
Q

Carina

A

Juncture of trachea where it splits into right and left bronchi
Location at T5

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33
Q

Secondary Bronchi

A

Right main bronchus separates into 3 secondary bronchi
Left main bronchus separates into 2 secondary bronchi
Each secondary bronchi enters a separate lobe of lung

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34
Q

Secondary Bronchi divides into smaller branches called _______

A

Bronchioles

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35
Q

Terminal Bronchioles

A

Final, smallest bronchioles

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36
Q

Alveoli

A

Air sacs at end of terminal bronchioles
Where O2 and CO2 exchange occurs

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37
Q

Thoracic viscera

A

Lungs and organs of mediastinum

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38
Q

Viscera means ____

A

Organs

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39
Q

Parenchyma

A

Lung tissue
Light sponge-like elastic material
Allows for expansion/contraction

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40
Q

Pleura

A

Doubled wall sac surrounding lungs

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41
Q

Parietal Pleura

A

Outer layer of pleura
Covers inner surface of chest wall

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42
Q

Visceral Pleura

A

Inner layer of pleura
Covers surface of lungs

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43
Q

Pleural Cavity

A

Space inside pleura
Between parietal and visceral pleura

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44
Q

Pleurisy

A

Inflammation of pleura

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45
Q

Pneumothorax

A

Air accumulation in pleural space
Creates pressure against lung and possible lung collapse

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46
Q

Hemothorax

A

Blood accumulation in pleural space

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47
Q

Apex of Lung

A

Rounded upper area above clavicles

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48
Q

Base of Lung

A

Concave portion that rests on diaphragm

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49
Q

Diaphragm

A

Muscle that separates thorax from abdomen
Moves downward - breathe in
Moves upward - breathe out

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50
Q

Why is diaphragm higher on the right than the left?

A

Presence of liver

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51
Q

Costophrenic Angle

A

Extreme outer-most corner of each lung

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52
Q

Hilum

A

Central root area where bronchi, blood & lymph vessels, nerves enter/leave the lung

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53
Q

Thymus Gland

A

Located behind upper sternum
Anterior to and just above heart
Aids with immune system
Gradually disappears in the adult

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54
Q

Great Vessels of the Heart

A

Superior vena cava
Inferior vena cava
Aorta
Pulmonary arteries & veins

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55
Q

Superior Vena Cava

A

Returns blood to heart from upper half of body

56
Q

Inferior Vena Cava

A

Returns blood to heart from lower half of body

57
Q

Aorta

A

Largest artery
Carries oxygenated blood to body
Ascending aorta
Aortic arch
Descending aorta

58
Q

Pulmonary Arteries & Veins

A

Supply blood to/from the lungs

59
Q

Hypersthenic

A

Wider physique
5% of poplulation

60
Q

Sthenic

A

Average physique
50% of population

61
Q

Hyposthenic

A

Skinny physique
35% of population

62
Q

Asthenic

A

Tall and skinny physique
10% of population

63
Q

True/False Pharynx is common passageway for food & respiration

A

True

64
Q

Laryngeal Prominens is a.k.a. _____

A

Adam’s apple

65
Q

Is epiglottis a mediastinal structure?

A

No

66
Q

kVp range for adult chest X-ray

A

110 to 125 kVp

67
Q

Atelectasis

A

Collapse of the lung
Caused by obstruction, pneumothorax, pleural effusion

68
Q

How is rotation evident in PA chest X-ray?

A

Asymmetry of SC joints

69
Q

How is rotation evident in lateral chest X-ray?

A

Posterior ribs not superimposed

70
Q

CR location for PA chest

A

T7
7-8 inches below vertebra prominens

71
Q

CR location for AP chest X-ray

A

3-4 inches below jugular notch

72
Q

Collimation borders guidelines

A

Collimation borders above lung apices and below costophrenic angles should be equal

73
Q

How many posterior ribs visible above diaphragm for PA chest?

A

10

74
Q

Immobilization technique for pediatric patient

A

Pigg-O-Stat

75
Q

CR location for lateral chest X-ray

A

1 inch below from PA T7 location
Why? Bc increase in OID causes divergent X-ray to cutoff costophrenic angles

76
Q

AP Semierect

A

Heart may appear larger
Air-fluid levels not well defined
Usually not a complete inspiration
8-9 ribs

77
Q

AP Lordotic

A

Horizontal CR to midsternum

78
Q

AP Semiaxial Lordotic

A

Alternative to AP Lordotic - if patient can’t stand
Recumbent supine position
CR 15-20 degrees cephalad to midsternum

79
Q

Lordotic - clavicles are above or below apices?

A

Above

80
Q

Lateral Upper Airway X-ray

A

CR at C6-7
Slow, deep inspiration to show air-filled trachea

81
Q

AP Upper Airway X-ray

A

CR at T1-2
AML - acanthiomeatal line perpendicular to IR

82
Q

Which 3 topographic landmarks are used for chest positioning?

A

Vertebra prominens - C7
Jugular notch - between T2/T3
Xiphoid tip - between T9/T10

83
Q

Xiphoid Process is inferior or superior to Sternum?

A

Inferior

84
Q

Xiphoid Process is inferior or superior to Vertebral Prominens?

A

Inferior

85
Q

When you breathe in, diaphragm moves ____ and when you breathe out, diaphragm moves ____

A

Downward - breathe in
Upward - breathe out

86
Q

Epiglottis projects downward or upwards behind the tongue?

A

Upwards

87
Q

During swallowing, epiglottis flips ____ and covers laryngeal opening and prevents food/fluid from entering ____

A

Down
Larynx

88
Q

3 divisions of Pharynx

A

Nasopharynx
Oropharynx
Laryngopharynx

89
Q

Uvula

A

Inferioposterior aspect of soft palate
Separates nasopharynx and oropharynx

90
Q

4 parts of respiratory system PROPER?

A

Larynx
Trachea
Bronchi
Lungs

Note: Respiratory system includes Pharynx. Respiratory system proper includes Larynx.

91
Q

Hyoid bone, voice box and Adam’s apple are located in this area

A

Larynx

92
Q

Why does right lung have 3 lobes vs. left lung 2 lobes?

A

Heart is on the left side

93
Q

Body habitus for PA chest taken crosswise?

A

Hypersthenic

94
Q

Body habitus for narrow thorax and shallow from front to back but very long in dimension?

A

Asthenic

95
Q

When performing expiration Chest X-ray, need to label expiration?

A

Yes, always label expiration Chest X-ray

96
Q

True/False Heart is magnified in Left Lateral Chest X-Ray.

A

False

97
Q

COPD

A

Chronic Obstructive Pulmonary Disease
Difficulty emptying lungs of air
Severe cases become emphysema

98
Q

PTX

A

Pneumothorax

99
Q

Patient in wheelchair for chest X-rays. Patient cannot stand due to dizziness. What do you do?

A

Assess patient.
Inform patient about standing.
Determine if patient can stand.
If not, consult technologist nearby.

100
Q

CXR

A

Chest X-Ray

101
Q

Patient w/right sided chest pain. Order is for CXR. You notice pneumothorax on PA chest. What should you do?

A

Alert the tech
Follow department protocol
Have tech contact doctor

102
Q

When performing PCXR, patient refuses to remove multiple necklaces. What should you do?

A

Inform patient that chains can be put into mouth out of the way of X-ray

103
Q

PCXR

A

Portable chest X-ray

104
Q

You take an ER patient who refuses X-rays. What should you do?

A

Inform patient of doctor ordered X-ray
Patient has right to refuse
Document refusal and consult w/ tech

105
Q

Pediatric patient needs CXR.
Patient not holding still.
What should you do technique wise?

A

Use 800 mA and .01sec to reduce motion

106
Q

True/False You must use 110kV on portable CXR due to heart magnification and no grid.

A

False

107
Q

Aspiration

A

Foreign objects swallowed into air passages of bronchial tree

108
Q

Epiglottitis

A

Life threatening condition, most common in children ages 2-5

109
Q

Number of full inspirations to fully expand lungs in both PA & Lateral CXR

A

2

110
Q

On Lateral CXR, which plane is parallel to IR?

A

Midsagittal

111
Q

On Lateral CXR, which plane is perpendicular to IR?

A

Midcoronal

112
Q

On decubitus chest X-ray, do you need to include the side down?

A

Yes

113
Q

Where is the centering location for Lateral Upper Airway X-ray

A

Level of C6 or C7

114
Q

Exposure for Lateral Upper Airway should be made during ________

A

Slow, deep inspiration

115
Q

AP bedside Chest X-ray, the CR is angled _____ to be _____ to long axis of sternum

A

Angled cephalad
Perpendicular to long axis of sternum

116
Q

Beam for decubitus Chest X-ray is _____ and centered at _____

A

Horizontal
Level of T7

117
Q

Artifact

A

Foreign object in chest area

118
Q

Orientation of PA Chest X-ray cassette for hypersthenic patient

A

Crosswise (landscape)

119
Q

kVp for portable Chest X-rays

A

80-90 kVp

120
Q

Reason for using high kVp (110-125)

A

Penetrate heart
Produce low contrast (long scale)
Produce many shades of gray
Reduces attenuation

121
Q

Technique factors for Chest X-ray

A

High kVp (110-125)
High mA
Short exposure time
Grid

122
Q

Pediatric Chest X-rays on infant

A

AP Supine
Lateral Chest X-ray
Low kVp
Very short exposure time

123
Q

When both inspiration and expiration Chest X-rays are done, do both need to be labeled “inspiration” and “expiration”?

A

Yes

124
Q

Reasons for expiration images

A

Identify pneumothorax
Identify location of foreign body
Determine if opacity is in lung or rib
See if diaphragm is moving correctly

125
Q

3 dimensions of Expiration vs. Inspiration

A

Vertical
Transverse
AP diameter

126
Q

Reasons for Erect Chest X-ray

A

Diaphragm can move further down - more complete inspiration
Air & fluid levels can be visualized
Minimizes engorgement of pulmonary blood vessels

127
Q

PA vs. AP Chest X-ray for heart diagnosis

A

Heart is located close to anterior chest wall
If taken AP, heart is magnified (OID increased)
Complicates diagnosis of cardiac enlargement

128
Q

Lateral chest positioning - why left vs. right side?

A

Left lateral chest X-ray
Heart is on left side, so OID is reduced, heart is more accurate size

129
Q

Structures visualized on lateral chest

A

Right & left hemi-diaphragm
Lungs, superimposed
Entire posterior costophrenic angle
Heart
Aorta

130
Q

Lung dimensions & IR placement

A

Width of average PA/AP chest is greater than its height
Most IRs are placed crosswise
Discretion is used based on body type

131
Q

Evaluation of PA Chest X-ray

A

All required anatomy is included
Clavicles - equidistant
No rotation of chest
Exposure index or S number is within range

132
Q

Appearance of Lateral Chest X-ray that is rotated

A

Ribs are visible behind the chest

133
Q

Thoracentesis

A

Aspiration of fluid between lungs and chest cavity with a needle

134
Q

Aspiration of fluid

A

Draw in or out using a sucking motion

135
Q

_____ may be used to locate pleural effusion and for guidance when needle is used to aspirate the fluid

A

Ultrasound

136
Q

Emphysema

A

Lungs lose elasticity
Lungs become radiolucent, require less mAs
Lung dimensions become longer

137
Q

Pneumonia

A

Accumulation of fluid in certain lung sections
Often appears in single or several lobes
Area would be whiter (or brighter)