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Ch. 3
Merrill's chapter 3
| Question | Answer |
|---|---|
| for radiographic purposes the neck is divided into _______ and _______ portions | posterior, anterior |
| which structures are located in the anterior neck: thyroid gland cervical vertebrae trachea esophagus | thyroid gland, trachea, esophagus |
| the structure of the upper neck that serves as a passage for both food and air and is common to the respiratory and digestive systems is the _____ | pharynx |
| the portion of the pharynx located above the soft palate is the _______ | nasopharynx |
| the portion of the pharynx located from the soft palate to the hyoid bone is the _____ | oropharynx |
| the organ of voice is the ______ | larynx |
| Which cavity contains the heart and lungs? | thoracic |
| which structure separates the thoracic cavity from the abdominal cavity | diaphragm |
| which part of the thoracic cavity contains all thoracic organs except the lungs and pleura? | mediastinum |
| which bony structure forms the anterior border of the mediastinum | sternum |
| which mediastinal structure consists of c shaped cartilaginous rings? | trachea |
| what area of the trachea divides into two lesser tubes? | carina |
| which structures branch from the distal end of the trachea? | primary bronchi |
| which primary bronchus is shorter and wider than the other? | the right |
| what thoracic structure are the organs of respiration? | the lungs |
| what is the name of the medial aspect of each lung in which the primary bronchus enters? | hilum |
| what is the name of the superior portion of each lung? | apex |
| which structures are at the terminal end of the respiratory system? | alveoli |
| how many lobes are found in the right lung? the left lung? | 3, 2 |
| which lung is shorter and broader than the other? | the right lung because of it's close proximity to the liver and heart |
| name the 3 portions of the pleura | inner layer - visceral pleura outer layer - parietal pleura space between layers - pleural cavity |
| atelectasis | a collage of all or part of a lung |
| sarcoidosis | condition of unknown origin often associated with pulmonary fibrosis |
| emphysema | destructive and obstructive airway changes leading to an increased volume of air in the lungs |
| tuberculosis | chronic infection of the lung caused by the tubercle bacillus |
| pneumothorax | accumulation of air in the pleural cavity resulting in the collapse of the lung |
| pleural effusion | collection of fluid in the pleural cavity |
| pulmonary edema | the replacement of air with fluid in the lung interstitium and alveoli |
| lobar (bacterial pneumonia) | pneumonia involving the alveoli of the entire lobe without involving the bronchi |
| lobular (bronchopneumonia) | pneumonia involving the bronchi and scattered distress throughout the lung |
| hyaline membrane (respiratory syndrome) | under aeration of the lungs caused by a lack of surfactant |
| List pathologic conditions in which radiography of the soft tissue neck is performed? | to demonstrate foreign bodies, swelling (especially epiglottitis) masses (intrinsic and extrinsic to airway), and fractures of the larynx and the hyoid bone |
| radiographs are most commonly made of the upper airway, from the ____ to the ___ | superior oropharynx and proximal trachea |
| when performing the AP projection of the soft tissue neck, at what level do you direct the cr for the upper airway? | at the level of laryngeal prominence |
| when performing the AP projection of the soft tissue neck, at what level do you direct the cr for the larynx and superior mediastinum? | at the level of the manubrium |
| describe the breathing instructions when perform AP and Lat projections of soft tissue neck | slow inspiration to ensure the trachea is filled with air |
| what are the collimation light field parameters when performing AP and Lat projections of the soft tissue neck | 12in (30cm) L wise and 1in (2.5cm) beyond the skin line of the anterior and posterior surfaces but not greater than 10in (24cm) |
| when performing the Lat projection of soft tissue neck direct the cr _____ through the _____ plane at the level of the _____ for the upper airway | horizontal, mcp, laryngeal prominence |
| when performing the Lat projecting of the soft tissue neck direct the cr at the level of the _________ through a point midway between the ______ and the ______ plane for trachea and superior mediastinum | jugular notch, jugular notch, mcp |
| what is the recommended SID in reference to PA projection. why? | 72in, to reduce magnification of thoracic structures |
| 3 reasons pt should be upright whenever possible in reference to PA projection? | to allow diaphragm to reach lowest level, prevent engorgement of pulmonary vessels, demonstrate air and fluid levels |
| which body plane should be perpendicular and centered to the midline of the IR in reference to PA projection | midsagittal |
| how should the pt hands be positioned in reference to PA projection | rest the backs of the hands low on the hips below the level of costophrenic angles. this maneuver rotates the scapulae laterally so that they do not superimpose the lungs |
| with reference to the pt where should the upper border of the IR/ collimated field be placed in reference to PA projection? | about 1.5-2in (3.8-5cm) above the top of the shoulders |
| what is the purpose of depressing the shoulders in reference to PA projection? | to keep the clavicles below the apices of the lungs |
| what special position instructions may be given to a women with large pendulous breasts to avoid superimposing the lower part of the lungs fields in reference to PA projection? | instruct the pt to pull her breasts upward and laterally |
| what would happen if a pt were to remove 1 shoulder from contact with the grid device before exposure in reference to PA projection? | the sternal ends of the clavicles would no longer be equidistant from the vertebral column |
| 2 reasons why exposures can be made after both inspiration and expiration in reference to PA projection | to demonstrate pneumothorax or to check for a foreign body |
| to demonstrate the heart why should the exposure be made after normal inspiration rather than deep inspiration in reference to PA projection? | to prevent distortion (elongation) of the heart caused by a full inferior movement of the diaphragm |
| which thoracic structures are primary interest with L lat projection | heart and L lung |
| which thoracic structure is of primary interest when performing R lat projection | R lung |
| what body plane should be perpendicular and center to the midline of the IR in reference to lat projection | midcoronal |
| describe how the pt arms should be positioned in reference to lat projection | extend arms directly up, flex elbows, forearms resting on elbows hold the arms in the position |
| what purpose might an IV medication stand serve when the pt is positioned in reference to lat projection? | a pt who is unsteady may use the IV stand for support |
| T/F a lat projection image of the chest should be viewed so the side of the pt where the cr entered is nearer the viewer? | true |
| T/F the pt heart will appear larger in the R lat projection image as opposed to L lat projection image? | true |
| what is the musculomembranous tubular structure located in front of the vertebra and behind the nose mouth and larynx | pharynx |
| which structure of the neck is approx 1.5in in length and is situated below the root of the tongue and in front of the laryngealpharynx | larynx |
| which structure forms the laryngeal prominence? | thyroid cartilage |
| which structure prevents leakage into the larynx during swallowing? | epiglottis |
| what is the most superiorly located structure of the neck? | pharynx |
| what is the name of the area between the 2 pleural cavities | mediastinum |
| which structure is not demonstrated within the mediastinum in PA projections of the chest | diaphragm |
| when performing AP projection of soft tissue neck at what level do you direct the cr for the larynx and superior mediastinum | manubrium |
| with reference to the IR how are the msp and mcp position for the PA projection of chest | msp - perpendicular mcp - parallel |
| for PA projection of chest which positioning maneuver should be performed for best removal of scapulae from lung fields | rotate shoulders forward |
| 2 essential projections for heart and lungs routinely used for chest exams | PA and Lateral |
| sized of collimated field for PA chest | 14x17in |
| key pt/part positioning points for pa chest | upright, facing vertical grid |
| anatomical landmarks in relation to IR for pa chest | MSP perpendicular, MCP parallel |
| CR orientation and entrence point for pa chest | perpendicular; enters msp at level of T7 |
| size of collimated field for lat chest | 14x17in |
| key pt/part positioning points for lat chest | upright left lateral position |
| anatomic landmarks and relation to IR for lat chest | MCP perpendicular and MSP parallel |
| cr orientation and entrance point | perpendicular; enters mcp at level of T7 |
| which side is generally the side of interest in reference to PA oblique projections | the one farther from the IR |
| which side of the chest is of primary interest with PA oblique proj, rao position | left |
| with reference to the pt, where should the upper border of the ir be placed in reference to PA oblique projections | 1.5-2in above the vertebral prominens |
| when performing pa oblique proj, rao position, how many degrees should pt be rotated | 45 degrees |
| what determines how many degrees pt should be rotated for pa oblique lao position | the desired structures to be demonstrated (more rotation when the heart is of primary interest) |
| when performing pa oblique lao position, to demonstrate lungs how many degrees pt rotated? | 45 degrees |
| when performing pa oblique lao position, to demonstrate the heart and great vessels, how many degrees pt rotated? | 55-60 degrees |
| with reference to pt respiration when should the exposure be made in reference to PA oblique projs | after second full inspiration |
| to what level of the pt should the cr be directed in reference to PA oblique projections | T7 |
| which PA oblique projection provides the best view of left atrium and entire left branch of bronchial tree | right pa oblique projection (RAO position) |
| T/F when viewing PA oblique chest images (LAO), the left lung should be partially superimposed by the spine? | true |
| T/F when viewing PA oblique chest images, the pts left side should be toward the viewers right side | true |
| T/F the heart and mediastinal structures should be clearly demonstrated within the lung field of the elevated side in oblique images of 45 degrees of body rotation | truw |
| which side is generally the side of interest in reference to AP oblique proj | the one closer to IR |
| which AP oblique img demonstrates the max area of the L lung | LPO |
| what is minimum recommended SID for ap oblique proj | 72in |
| Which ap oblique proj produces an image very similar to that produced by pa oblique projection, RAO position | AP oblique proj, LPO position |
| how many degrees pt rotated for ap oblique proj | 45 degrees |
| how far above top of shoulders should upper border of ir placed for ap oblique proj | 1.5-2in |
| to what level should cr be directed for ap oblique proj | 3 in below jugular notch |
| recommended Sid for ap proj | 72 in or 60 in depending on equipment limitations |
| what body plane centered to midline of ir for ap proj | MSP |
| with reference to pt where should ir be placed for ap proj | upper boarder of ir 1.5-2 in above relaxed shoulders |
| if pt condition permits, how should arms and shoulders be positioned for ap proj | elbows flexed, pronate the hands and place them on the hips to draw scapulae laterally |
| why should pt perform recommended breathing instructions for ap proj | to ensure maximum expansion of lungs |
| to what level on pt should cr be directed for ap proj | 3in below jugular notch |
| how do heart and great vessels appearance differ in ap proj vs pa proj | more magnified |
| how do lungs appearance differ in ap proj vs pa proj | shorter |
| how do clavicles appearance differ in ap proj vs pa proj | projected higher |
| how do ribs appearance differ in ap proj vs pa proj | assume a more horizontal appearance |
| in lordotic position, which portion of lung is generally the area of primary interest | apex |
| describe how pt positioned in lordotic position | pt standing and facing X-ray tube, 1 foot in front of vertical grid device and lean backward, placing upper back in contact w grid device. elbows flexed posterior surface of hands on hips to rotate shoulders forward better |
| where cr enter pt in lordotic position | on msp on midsternum |
| if pt cannot get into lordotic position, how is cr directed to demonstrate apices | 15-20 degrees cephalad |
| general purpose for using lat decube position | to demonstrate air or fluid levels in thorax |
| T/F the pt can be positioned upright in lat decube position | false |
| T/F the IR must be placed vertically against pt in lat decube position | true |
| T/F the cr must be directed horizontally in lat decube position | true |
| T/F the affected side should be up to demonstrate fluid level in lat decube position | false |
| T/F both sides should be seen in their entirety in lat decube position | false (only affected side need to be entirely seen |
| to demonstrate fluid in right thorax, pt must be positioned in a | right lateral decube |
| which side of the thorax best demonstrates free air when the pr is in the left lat decube position | right |
| for dorsal decube position proj, pt must be placed in _____ position | supine |
| for ventral decube position proj, the pt must be placed in ____ position | prone |
| for decube positions, in addition to being perpendicular to IR, the cr must also be directed ______ | horizontally |
| how much should thorax be elevated for decube positions | 2-3 in |
| how long should pt remain in position for decube positions | 5 min to allow fluid to settle and air to rise |
| describe how pt arms positioned in decube positions | extend the arms well above the head |
| with reference to pt, how and where should the IR/collimated field be place in decube position | vertically, with the top of the ir/collimated field at the level of the thyroid cartilage |
| where should cr enter pt in decube positions | on MCP, ~3-4in distal to jugular notch for dorsal decube, and T7 for ventral decube |
Created by:
sschulz24
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