Chest Positioning
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| Why is the patient placed in an upright position when x-raying the heart and lungs? | To prevent engorgement of the pulmonary vessels and to allow gravity to depress diaphragm.
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| Which lateral chest image (left or right) is most commonly used? | Left
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| In a PA projection of the chest, the central ray is directed to what level? | T7
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| During x-ray of the lungs, the diaphragm moves to its lowest position when? | Erect inspiration
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| Rotation on a PA chest x-ray can be detected by evaluating what? | Sternoclavicular joints
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| How many ribs should be seen on an adult chest x-ray? | 10
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| When performing a frontal projection of the chest, why is the PA projection preferred? | It places the heart closest to the IR
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| Why is the right side of the lung base higher than the left? | Because of the presence of the liver.
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| Is the posterior aspect of the ribs higher than the anterior aspect? | Yes
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| How many degrees should a patient be rotated for a PA oblique projection of the chest evaluating the lungs? | 45 degrees
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| Where should the CR be directed/centered for a lateral projection? | Perpendicular to the midline of the IR, at the level of T7.
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| Where is the midsagittal plane placed for a lateral projection? | The MSP should be parallel with the plane of the IR.
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| What body plane should be perpendicular and centered to the midline of the IR? | Midcoronal
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| With a PA Oblique projection, which side (the one closer or farther) is generally the side of interest? | The one farthest from the IR.
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| Which side of the chest (left or right) is of primary interest with the PA oblique projection, RAO? | Left side
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| When performing the PA oblique projection, RAO position, how many degrees should the patient be rotated? | 45 degrees
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| When performing the PA oblique projection, LAO position, how many degrees should the patient be rotated? | 55 to 60 degrees
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| Which AP oblique projection produces an image similar to that produced by the PA oblique projection, RAO position? | AP oblique projection, LPO position
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| In a AP Axial (Lordotic) projection, which portion of the lung is generally the area of interest? | Apex
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| In a AP Axial (Lordotic) projection, where should the CR enter the patient? | Midsagittal plane, on the midsternum.
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| What is the general purpose for using a lateral decubitus position? | To demonstrate air or fluid levels in the thorax.
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| If a patient has fluid on right side of thorax, which lateral decubitus position should be used? | Right lateral recumbent
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| Which side of the thorax will best demonstrate free air when the patient is in the left lateral decubitus position? | Right
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| What positions are used to demonstrate air and fluid levels in a supine or prone position? | Ventral and dorsal decubitus
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| For a dorsal decubitus position projection, what position is the patient placed in? | Supine
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| For a ventral decubitus position projection, what position should the patient be placed in? | Prone
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| Where is the CR entered on a patient for the dorsal decubitus projection? | Midcoronal plane, approximately 3-4 inches distal to jugular notch
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| Where is the CR entered on a patient for the ventral decubitus projection? | Midcoronal plane at level of T7
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| Which structure is not demonstrated within the mediastinum in PA projections of the chest? | Diaphragm
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| Why should chest x-rays be performed with a 72-inch SID? | To minimize magnification of the heart.
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| Why should chest x-rays be performed after the patient has suspended respiration after the second inspiration? | To better expand the lungs.
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| With reference to the IR, how are the MSP and the MCP positioned for a chest PA projection? | MSP: perpendicular; MCP: parallel
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| For a chest PA projection, what maneuver should be performed to remove scapulae from lung fields? | Rotate the shoulders forward
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| For which chest projection should the MSP be parallel with the IR? | Lateral projection
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| Regarding the IR, how are the MCP and MSP positioned for the lateral projection of the chest? | MCP: perpendicular; MSP: parallel
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| Which chest projection demonstrates lung apices free from superimposition with the clavicles? | AP axial projection, lordotic position (Lindblom method)
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| How many degrees should patient be rotated for PA oblique projections of the chest to evaluate the lungs? | RAO: 45 degrees; LAO: 45 degrees
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| Using the lateral decubitus position for patients unable to stand best demonstrates which pathologic condition of the chest? | Air or fluid levels
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| Regarding IR, how are the MSP and the MCP positioned for the AP chest (left lateral decubitus position)? | Midsagittal: perpendicular; midcoronal; parallel
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| Which pathologic condition of the lungs is best demonstrated with the AP chest, right lateral decubitus position? | Free air in the left side or fluid levels in the right side?
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| Which pathologic condition of the lungs is best demonstrated with the AP chest, right lateral decubitus position? | Free air in the left side or fluid levels in the right side.
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| Which x-ray position requires that the patient be placed prone? | Ventral decubitus
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| Which evaluation criterion pertains to the AP axial projections, lordotic position radiograph of the chest? | The clavicles should lie superior to the apices.
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| Which decubitus would be performed for a patient with fluid on the left side? | Left lateral decubitus
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| Which x-ray position requires the patient to be placed supine? | Dorsal Decubitus
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| To demonstrate free air in the thoracic cavity on patient's left side, what position is used? | Right Lateral decubitus
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| During an upright PA chest x-ray, why is the patient asked to flex their arms and rest the back of their hands on the hips? | To rotate the scapulae laterally, avoiding superimposing the lungs.
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