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Image Analysis AP2
Portable Chest
| Question | Answer |
|---|---|
| Two main types of COPD | Chronic Bronchitis and Emphysema |
| Clinical Indications for a Chest X-ray | COPD, Pneumonia, Pulmonary Edema, TB, Asbestosis, Respiratory Distress, Pleurisy, Pneumothorax, Hemothorax, Atelectasis, Pleural Effusion, Emphysema |
| Caused by long-term exposure to substances that irritate and damage the Lungs | Chronic Obstructive Pulmonary Disease (COPD) |
| Inflammation (infection) of the Lung resulting in accumulation of fluid within a segment of the Lung | Pneumonia |
| Caused by Congestive Heart Failure, Heart is unable to pump blood efficiently, which then backs up into the veins and ultimately the Alveoli | Pulmonary Edema |
| Collection of air or gas in the Chest or Pleural Space that causes part or all of a Lung to collapse | Pneumothorax |
| A pleural effusion containing blood in the pleural cavity | Hemothorax |
| A collapse of Lung tissue affecting part or all of one Lung | Atelectasis |
| Too much fluid collecting in the Pleural Space | Pleural Effusion |
| Chronic Respiratory Disease, over-inflation of the Alveoli in the Lungs - Barrel shaped Chest - Diaphragm flattened with loss of Costophrenic Angles | Emphysema |
| Short venous catheter left in the vein for long periods, used for IV medications | Heparin Lock |
| Small needle with plastic wings to aid in positioning, short term only | Butterfly |
| Needle with a flexible plastic sheath which stays in vein after needle is introduced and withdrawn | Angiocath |
| Straight Catheter for temporary use - Red Robinson | Non-Retension |
| Foley Catheter for prolonged indwelling use, balloon attached | Retention |
| Plastic or rubber tube placed through the nasopharynx into the Stomach for suction, feeding, to aspirate stomach, or diagnostic purposes | NG Tube |
| Tube that assists in ventilation and isolates the Trachea to control the airway; avoids gastric distention and provides a direct route for suctioning - placement location? | Endotracheal Tube - 3-5 cm above the Carina |
| Measures central venous pressure, maintains and monitors intravascular blood volume - line placement? | Central Venous Catheter (CVC) - within the Superior Vena Cava |
| For long-term venous access and to administer medications such as chemotherapy or antiobiotics - line placement? | Peripherally Inserted Central Catheter (PICC) - in the Superior Vena Cava or Axillary Vein |
| Pulmonary artery catheter to monitor hemodynamic status of critically ill patients; helps to differentiate cardiac from non-cardiac pulmonary edema - line placement? | Swan-Ganz Catheter - about 2 cm from the Hilum in either the Right or Left Pulmonary Artery |
| implanted venous access device for patients who need frequent or continuous administration of chemotherapy; implanted under the skin in the upper chest - line placement? | Port-a-Cath - in the Internal Jugular Vein |
| Placed in the Common Bile Duct after Gallbladder Surgery - T shaped | T-Tube |
| When is the Portable Chest X-ray performed? | When patient is unable to stand or sit upright against the Upright Bucky (Dpmt, ER, or patient floor) |
| How is the SID determined for a Portable Chest X-ray? | Whether Semi-upright or Supine is performed |
| SID for the Semi-upright position and why? | as long as the equipment allows (as close to 72 inches as possible) to avoid magnification |
| CR location for the portable chest? | Perpendicular to midsternum, midline IR at the level of Midthorax |
| Patient centering for a portable chest? | Midsaggital Plane to midline IR |
| Image Receptor placement? | Crosswise behind patient's back - 2 inches above the shoulders - equal amount of IR on either side of patient |
| X-ray tube placement for a portable chest x-ray? | parallel to the patient's Sternum, Caudad to match the angle of the patient |
| Breathing instruction for a portable Chest? | Expose on Inspiration |
| What is annotated on a portable chest x-ray? | AP Semi-upright portable, time of day, and exposure factors |
| Differences in the AP image vs. the PA? | 1. The Heart will appear magnified and engorged due to being farther away from the Image Receptor (increased OID) 2. Clavicles projected higher and more horizontal on the AP 3. If not fully upright with a horizontal beam, air/fluid levels |
| If CR is not placed perpendicular to the Sternum or not angled enough? | Clavicles will be projected above the Apices of the Lungs, Ribs lie in a Horizontal Plane, there will be distortion of the Thoracic organs |
| Image Analysis for portable Chest? | -entire Lung field Apices to the Costophrenic Angles -Air filled Trachea midline of image -10 Ribs demonstrated above Diaphragm -Scapula removed from Lung field -Lung and Hilar markings on either side of thoracic spine |
| Sufficient Exposure factors demonstrated by? | -Faint shadow of thoracic spine behind Heart Shadow -no motion evidenced by sharp outlines of rib margins, diaphragm and Heart Borders -long scale contrast visualized by vascular markings within Lung field -chin soft tissue not overlying Apices of Lung |
| Elongation and Foreshortening of the part being imaged is called? | Distortion |
| What type of Distortion is Elongation and Foreshortening? | Shape and Size |
| How to correct Distortion on an image? | Center anatomy to IR and CR to part |
| enlargement of a part is called what? | Magnification |
| What controls magnification? | Distance controls magnification, OID and SID |
| How to correct magnification on an image? | Increase SID and decrease OID |
| What is Quantum Mottle on an image? | Noise on the image - grainy appearance - insufficient mAs |
| How to correct Quantum Mottle on an image? | increase mAs |
| appears as blur on an image? | Motion |
| Two types of motion? | Voluntary and Involuntary |
| How to correct Voluntary motion on an image? | Exposure time reduction, immobilization, synchronize exposure with patient motion |
| How to correct Involuntary motion on an image?q | Communication with patient, create trust and patient cooperation, breathing techniques |
| What is mAs? | Quality on an image; Density |
| What is kVp? | Quantity on an image - Contrast |
| What does Focal Spot control on an image? | Radiographic sharpness |
| What reduces chance of motion? | High mAs and low exposure time |
| What is overexposure on an image? | Appears as black on an image, lacks contrast |
| How to correct overexposure? | Subtract 15% contrast, windowed lower, adjust brightness |
| How does Underexposure appear on an image? | appears white |
| How to correct Overexposure? | Add 15% kVp - cannot improve underexposed image |
| The Pharynx (throat): 1. _____ inches in length 2. extends from _____ _____ at base of skull to _____-_____ where it becomes continuous with Esophagus 3. Common to what? | 1. 5 2. Sphenoid Bone; C6-C7 |
| The Larynx (Vocal Chords): 1. ____ to ____ inches in length 2. extends from ____-____ 3. Suspended by? 4. Contains the _____ and _____ 5. Consists of ___ pieces of Cartilage, Thyroid ____ and Cricoid ___ | 1. 1 1/2 to 2 2. C3-C6 3. ligaments from the Hyoid Bone (C3) 4. Glottis and Epiglottis 5. 9; C4-C5; C6 |
| The Trachea (Windpipe): 1. ____ by ____ inch in diameter 2. extends from its junction with the _____ (C6) to level of ____-____ 3. ____-_____ C-shaped rings of cartilage to keep from collapsing 4. carries particles/secretions away from Lungs? | 1. 4 1/2 by 1 2. Larynx; T4-T5 3. 16-20 4. Ciliated |
| A bony spur of cartilage at the inferior margin of the Trachea? | Carina |
| Level that the Carina bifurcates into the Right and Left Main Stem Bronchus? | T5 |
| Where do Foreign bodies lodge more frequently and why in the Main Stem Bronchus? | The Right Main Stem Bronchus because if is shorter, wider, and more vertical |
| What is the Lung made of and why? | Parenchyma (spongy elastic material) - allows Lungs to expand and contract |
| A slit in the Lungs where two primary tubes enter? | Hilum |
| How many Lobes, Bronchi and Fissures in the Left Lung? | 2 Lobes (upper or Superior and Lower or Inferior), 2 corresponding Bronchi, and 1 Fissure (oblique) |
| How many Lobes, Bronchi and Fissures in the Right Lung? | 3 Lobes (Upper or Superior, Middle, and Lower or Inferior), 3 corresponding Bronchi, and 2 Fissures (Horizontal and Inferior) |
| Characteristics of the Left Lung? 1. 2. 3. | 1. Cardiac Notch on Medial side to accommodate the Heart 2. Longer than the Right 3. Less volume due to less Lobes |
| Characteristics of the Right Lung? 1. 2. | 1. 1 inch shorter than the left due to space occupied by the Liver 2. Broader than the Left Lung |
| Structures of the Mediastinum? | All of the Thoracic Organs except the Lungs: Trachea, Esophagus, Bronchi, Thymus Gland, Heart, Great Vessels |
| Great Vessels of the Mediastinum? | Superior and Inferior Vena Cava, Aorta, Pulmonary Arteries, Pulmonary Veins |
| Brings blood back to the Heart from the Body? | Superior and Inferior Vena Cava |
| Largest Artery in the Body? | Aorta |
| Brings deoxygenated blood to the Lungs from the Heart | Pulmonary Arteries |
| Brings oxygenated blood from the Lungs to the Heart? | Pulmonary Veins |
| Respiratory Cycle | Oxygen (Air) enters Nose and Mouth (inhale) → Pharynx → Larynx "Windpipe or Voicebox" → Trachea → Left and Right Main Stem Bronchi → Bronchioles → The Alveoli (O2 and CO2 exchange takes place) |
Created by:
teresachristensen
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