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Chest and Abdomen
SJC S1U3 Zerbe
| Come on... | You got this! |
|---|---|
| The vertebral prominens is at the level of | C7/T1 |
| The jugular notch is level with | T2/T3 |
| The xyphoid tip is level with | T9/T10 |
| The mid thorax is at the level of | T7 |
| What separates the thoracic cavity from the abdominal cavity | Diaphragm |
| The thoracic Cavity includes: | •Lungs •Heart •Respiratory Organs •Cardiovascular System •Lymphatic system •Esophagus •Thymus Gland |
| What is the parietal pleura? | That serous membrane attached to the wall of the cavity |
| What is the visceral pleura? | The serous membrane that covers the organs of the thoracic cavity? |
| What is the Pleural Cavity? | The space or potential space between these two membranes |
| What is a pneumothorax? | When the lung collapses or when air collects between the two layers |
| What is the epiglottis? | thin, lid-like flap of cartilage tissue covered with a mucous membrane, attached to the root of the tongue, and guards the entrance of the glottis, the opening between the vocal cords. |
| Where does the trachea lie in relation to the esophagus? | Anteriorly |
| What is the name of the hook-like process on the last tracheal cartilage? | Carina |
| After entering the hilum, each primary bronchus divides. How many primary branches are there in the right lung? | 3 |
| The lungs are composed of a light, spongy, elastic substance called the | parenchyma |
| After entering the hilum, each primary bronchus divides. How many primary branches are there in the left lung? | 2 |
| The part of the lung that extends above the clavicle is termed the: | Apex |
| The right lung is about how much shorter than the left? | 1” Due to the liver location under the right lung |
| What is the name of the double-walled serous membrane sac that encloses the lung? | pleura |
| What is the area between the Right and Left Pleural Cavities? | The Mediastinum |
| The mediastinum includes? | •Heart •Great vessels •Trachea •Esophagus (digestive system) (in posterior mediastinum between the spine and trachea) •Thymus •Lymphatics •Nerves •Fibrous tissue •Fat |
| Where does the esophagus lie in relation to the trachea? | Posteriorly (between the trachea and spine) |
| List the structures of the bronchial tree in order from the carina to the terminal bronchials: | •Primary Bronchi •Secondary bronchi •Teritiary Bronchi •Bronchioles •Terminal bronchioles •Alveolar ducts •Alveolar sacs •Alveoli |
| Where does oxygen and carbon dioxide exchange take place within the lungs? | Alveoli |
| The right lung has how many lobes and deep fissures? | 3 lobes, 2 deep fissures |
| The left lung has how many lobes and deep fissures? | 2 lobes, 1 deep fissure |
| The broadened inferior portion of each lung that rests on diaphragm is termed the: | Base |
| The most inferior portion of each lung that is formed by a deep recess of the parietal pleura upon inspiration is termed the: | Costophrenic angles |
| The depression within the mediastinal surface allowing for passage of the bronchi and pulmonary vessels, lymph vessels and nerves is termed the: | Hilum |
| The medistinum is surrounded by what structures? | •Sternum anteriorly •Vertebrae posteriorly •Right and Left pleural cavities laterally |
| What is the most optimal position of the patient for examinations of the heart and lungs? | upright |
| Why is the most optimal position of the patient for examinations of the heart and lungs the upright position? | •To reduce Engorgement of the pulmonary vessels •Drops diaphragm to its lowest level •Air fluid level visualization •Allows for full inspiration |
| Why is the left lateral chest position the most commonly used for lateral radiographs of the chest? | To place the heart neared to the IR and reduce magnification |
| For what reasons would and inspiration and an expiration chest be warranted? | •Pneumothorax •Diaphragmatic excursion •Foreign body location •Atelectasis |
| When a foreign body is aspirated, where is more likely to lodge? | Rt main bronchus: its more vertical and has a greater diameter |
| What is the preferred distance for chest radiography? | ____72”_____ •Longer distance reduces magnification of the heart **Remember: the more SID you have, the less magnification you have. Also, less magnification gives better recorder detail** |
| What is the preferred kVp range for chest radiography? | 100-130 kVp |
| Grids are recommended for chest radiography when using kVp ranges above: | 100 |
| Reasons for 72” SID for chest radiography: | Decreased magnification of heart Increased recorded detail of thoracic structures |
| How far above the relaxed shoulders should the IR be positioned for PA and lateral chest radiographs? | 1½ to 2 inches |
| Where are the hands placed for a PA projection of the chest? | back of the hands on the hips With shoulders rolled forward to move the scapula out of the lungs |
| What is the CR angle for a PA chest radiograph? | 0 degrees, the CR is perpendicular |
| What is the optimal respiration phase for a PA or lateral chest radiograph? | full inspiration—second breath |
| How many ribs should be visible above the diaphragm on a PA chest radiograph? | 10 |
| The midcoronal plane is __________ to the plane of the IR for the PA Chest? | Parallel |
| The midsagittal plane is _________to the IR for the PA Chest? | Perpendicular and centered |
| Where is the CR location for a PA projection chest? | T7 on the MSP |
| How are the arms and shoulders to be positioned fro a PA projection Chest. | •Elbows flexed to place dorsal hand surface on postierior hips below costophrenic angles •Shoulder rolled forward to pull scapulae out of lung field •Shoulder depressed to place clavicles in same horizontal plane |
| Which plane must be accurately parallel with the IR to prevent distortion of the thoracic structures during a lateral chest radiograph? | midsagittal plane |
| Which plane is perpendicular to the IR when doing the lateral projection of the chest? | MCP |
| What is the CR location and direction for the Lateral Chest? | Perpendicular at the Level of T7 on the MCP |
| How many degrees of body rotation are required for routine AP or PA oblique chest radiography? | 45 degrees |
| Where should the top of the IR be positioned for a PA oblique projection of the lungs? | 1½ -2 inches above the vertebral prominens |
| For AP oblique projections of the chest, the side of interest is generally: | the side closest to the IR |
| For PA oblique projections of the chest, the side of interest is generally: | the side farthest from the IR |
| If an oblique projection was needed to see a left sided lesion, which oblique(s) could demonstrate this best: | RAO or LPO |
| What is the recommended SID for a supine AP chest radiograph? | 72”, although 72” is recommended it is not always possible due patient condition or room set up |
| Each lung is divided into specific segments called: | lobes |
| Where should the top of the IR be positioned for a supine AP chest radiograph? | 1½ -2 inches above the relaxed shoulders |
| CR location and direction for the AP Chest? | Perpendicular to the sternum and 3 inches below the jugular notch on the MSP (exits the level of T7) |
| How far above the top of the shoulders should the IR be positioned for any decubitus position of the chest? | 1½ -2 inches above the shoulders |
| The Lindblom method is used to demonstrate the: | pulmonary apices |
| What is the CR angle for the Lindblom method (lordotic position) of demonstrating the pulmonary apices? | 0º If the patient can do the lordotic position the CR is perpendicular to the IR |
| How far should the patient stand in front of the grid device for the lordotic position? | 1 foot |
| If the patient cannot be placed in the lordotic position for radiography of the pulmonary apices, what is the CR angle that can be used to project the clavicles above the apices? | 15º-20º cephalad |
| How is the CR positioned for an x-ray projection done with the patient placed in a decubitus position? | horizontal |
| How long should the patient remain in position before making the exposure when performing a projection in the lateral or dorsal decubitus position? | 5 min |
| If the lateral decubitus position is used to demonstrate fluid in the pleural cavity, which side must the patient lie on? | affected side |
| If the lateral decubitus position is used to demonstrate air in the pleural cavity, which side must the patient lie on? | unaffected side |
| Decsribe CR location for an AP projection Chest? | Perpendicular to the sternum at a level @3” below the jugular notch on the MSP |
| Describe the orientation of the CR when doing an AP projection in the RT or LT lateral decubitus position? | Horizontal entering at a level 3” below the jugular notch (at T7 when doing PA) |
| projection (lindblom metho | Perpendicular to the center of the IR at the level of the midsternum |
| How should the arms be positioned for the lordotic position for the lung apices? | Flex elbows and place dorsal surface of hands against posterior hips to roll shoulders forward |
| The serous membrane that lines the abdominopelvic walls is called the: | peritoneum |
| Which organ is included in both the respiratory and digestive systems: | Pharynx |
| What is the Prietal peritonaeum? | outer layer; on abdominal wall |
| Which organs are contained in the abdominal cavity? | •From diaphragm to superior bony pelvis •Stomach •Small intestine •Large intestine •Liver •Gallbladder •Spleen •Pancreas •Kidneys and proximal ureters |
| Which organs are in the pelvic cavity? | •Within margins of bony pelvis •Distal portion of large intestine •Sigmoid •rectum •Urinary bladder •Reproductive organs |
| What is the visceral peritoneum? | The inner layer of the serous membrane that actually surrounds the organs themselves and creat folds called mesentary and omentum |
| What is the peritoneal cavity? | is the space between the two (parietal and visceral) |
| What fills the peritoneal cavity? | Organs and serous fluid to reduce friction between moving organs |
| Double fold of peritoneum that loosely connecting the small intestine to the posterior abdominal wall | mesentary |
| Specific type of double fold of peritoneum extending from the stomach to another organ | Omentum |
| What are the 3 major muscles in the abdominal cavity? | Diaphragm and RT and LT Psoas muscles |
| What are the Psoas Muscles? | Muscle of the lower back that orginate at the spine and end at either the femur (major) or bony pelvis (minor) |
| The inferior costal margin is at the level of: | L2/L3 |
| The iliac crest is at the level of: | L4/L5 |
| The greater trochanter of the hip is level with the: | Symphysis Pubis |
| T/F: A grid should be utilized for abdominal radiography. | True |
| List steps that should be taken to eliminate motion for abdominal radiography: | Make patient comfortable as possible to prevent muscle contraction Explain breathing instructions before exposure Wait 1-2 seconds after respiration phase has stopped before exposing to give viscera time to stop moving Short exposure time (peristalsis) |
| What is a KUB? | An AP/PA projection of the abdomen. Meaning “kidneys, ureter, and bladder” |
| The most commonly performed abdominal examination is referred to as a: | KUB |
| Where is the center of the IR positioned for an AP abdominal radiograph done in the supine position? | iliac crests (L4/L5) |
| What is the respiration phase for an AP abdominal radiograph done in the supine position? | expiration |
| The CR for an AP Projection Supine Abdomen should be: | Perpendicular at the level of the iliac crests |
| What plane should be perpendicular and centered to the IR for the AP projection supine Abdomen | Midsagittal plane |
| Shielding for AP supine abdomen: | Males only (shielding females will cover pelvic anatomy) |
| Respiration phase for abdominal radiography: | Suspended on expiration Waiting 1-2 seconds after to allow viseral movement to stop |
| If a patient is unable to stand for an upright AP abdominal radiograph to demonstrate “free air”, which position should be used? | left lateral decubitus |
| If a patient is unable to stand for an upright AP abdominal radiograph or turn on their side for a lateral decubitus to demonstrate free air, which position should be used? | Dorsal Decubitus |
| Where is the center of the IR positioned for an AP abdominal radiograph to include the diaphragm done in the upright position? | 2 to 3” inches above the iliac crests to include the diaphragm (top of IR at the Axilla) |
| What is the respiration phase for an AP or PA abdominal radiograph done in the upright position? | Suspended at the end of expiration |
| It is often necessary to demonstrate small amounts of intraperitoneal gas in patients with an acute abdomen. How long should the patient lay in the left lateral position before the radiograph is made? | Ideally, 10-20 minutes At least 5 for large Pneumoperitoneum And 20 for small |
| Which plane should be perpendicular and centered to the IR for upright AP/PA abdominal radiography? | Midsagittal |
| Which abdominal projections require a horizontal beam? | AP/PA projection upright AP/PA projection Left lateral decubitus Lateral projection dorsal decubitus |
| Which plane is placed perpendicular to the long axis of the grid for a lateral projection of the abdomen? | midcoronal |
| Where is the center of the IR positioned for a lateral projection of the abdomen done in the dorsal decubitus position to include the diaphragm? | 2 to 3 inches superior the iliac crests |
| CR location for a lateral projection dorsal decubitus position abdomen to include the diaphragm? | Horizontal, entering midcoronal plane 2 to 3” above the iliac crest |
Created by:
paigeduh
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