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Questions and Answers
What is the recommended source-to-image distance (SID) to minimize magnification of the heart in chest radiography?
What is the recommended source-to-image distance (SID) to minimize magnification of the heart in chest radiography?
- 72 inches (correct)
- 60 inches
- 84 inches
- 48 inches
Why is a high kilovoltage peak (kVp) typically used in chest radiography?
Why is a high kilovoltage peak (kVp) typically used in chest radiography?
- To penetrate and visualize all thoracic anatomy (correct)
- To increase the contrast of pulmonary vascular markings
- To reduce the exposure time to the patient
- To enhance the color of the radiograph
What is the purpose of using a grid in chest radiography?
What is the purpose of using a grid in chest radiography?
- To increase the exposure time
- To visualize the heart more clearly
- To show lung structures through thickened pleural membranes (correct)
- To reduce patient exposure to radiation
What should be ensured regarding female patients before a chest radiograph?
What should be ensured regarding female patients before a chest radiograph?
In which position should patients ideally be examined for a chest radiograph?
In which position should patients ideally be examined for a chest radiograph?
What is the primary reason for ensuring gonadal shielding during radiography?
What is the primary reason for ensuring gonadal shielding during radiography?
What size image receptor is recommended for each chest image on an adult?
What size image receptor is recommended for each chest image on an adult?
What is the expected position of air and fluid in a chest radiograph?
What is the expected position of air and fluid in a chest radiograph?
What is the primary function of the serous membrane covering the lungs?
What is the primary function of the serous membrane covering the lungs?
Which of the following accurately describes the structure of the left lung?
Which of the following accurately describes the structure of the left lung?
What distinguishes the right lung from the left lung?
What distinguishes the right lung from the left lung?
What is the role of the pleural cavity?
What is the role of the pleural cavity?
During which respiratory action do the lateral margins of the lungs descend?
During which respiratory action do the lateral margins of the lungs descend?
How are the lung lobes arranged relative to one another?
How are the lung lobes arranged relative to one another?
What anatomical feature allows the hilum to accommodate specific structures?
What anatomical feature allows the hilum to accommodate specific structures?
What defines the visceral pleura?
What defines the visceral pleura?
What should the central ray be positioned perpendicular to during an examination of the thoracic viscera?
What should the central ray be positioned perpendicular to during an examination of the thoracic viscera?
What is the recommended distance for the source-to-image distance (SID) in lateral chest projections?
What is the recommended distance for the source-to-image distance (SID) in lateral chest projections?
What should be adjusted when collimating for a PA chest projection?
What should be adjusted when collimating for a PA chest projection?
Which structure is not typically shown in a PA projection of thoracic viscera?
Which structure is not typically shown in a PA projection of thoracic viscera?
For a patient with hypersthenic body habitus, how should the IR be positioned for the chest projection?
For a patient with hypersthenic body habitus, how should the IR be positioned for the chest projection?
What is the significance of having the patient rotate their shoulders forward during the procedure?
What is the significance of having the patient rotate their shoulders forward during the procedure?
Which of the following criteria should be evaluated for a PA chest projection?
Which of the following criteria should be evaluated for a PA chest projection?
What is the primary reason for using the left lateral chest position in radiography?
What is the primary reason for using the left lateral chest position in radiography?
Which of these features may appear more prominent in a PA chest projection taken at the end of expiration?
Which of these features may appear more prominent in a PA chest projection taken at the end of expiration?
Where is the epiglottis located in relation to the laryngeal entrance?
Where is the epiglottis located in relation to the laryngeal entrance?
Which of the following is an important criterion for the PA projection?
Which of the following is an important criterion for the PA projection?
What should be examined to check for rotation in a lateral chest radiograph?
What should be examined to check for rotation in a lateral chest radiograph?
What forms the laryngeal prominence commonly known as the Adam's apple?
What forms the laryngeal prominence commonly known as the Adam's apple?
Which structure is described as lying in front of the vertebral column?
Which structure is described as lying in front of the vertebral column?
When is the best time to obtain radiographs of the heart to prevent distortion?
When is the best time to obtain radiographs of the heart to prevent distortion?
What is the primary goal in instructing the patient to raise their arms during a lateral chest projection?
What is the primary goal in instructing the patient to raise their arms during a lateral chest projection?
What is the primary function of the thymus gland?
What is the primary function of the thymus gland?
What technique is commonly used to assess the presence of pneumothorax in a patient?
What technique is commonly used to assess the presence of pneumothorax in a patient?
What happens to the thymus gland after puberty?
What happens to the thymus gland after puberty?
What effect does deep inspiration have on the diaphragm and the heart?
What effect does deep inspiration have on the diaphragm and the heart?
What comprises the contents of the mediastinum?
What comprises the contents of the mediastinum?
What factor is considered when determining exposure factors for thoracic radiographs?
What factor is considered when determining exposure factors for thoracic radiographs?
What is the recommended patient position to prevent engorgement of pulmonary vessels during a chest exam?
What is the recommended patient position to prevent engorgement of pulmonary vessels during a chest exam?
Which imaging technique is often employed to assess esophageal anatomy?
Which imaging technique is often employed to assess esophageal anatomy?
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Study Notes
Structure of the Lungs
- Lungs consist of light, spongy, highly elastic parenchyma, covered by serous membrane.
- They occupy space within the thoracic cage, with a rounded apex above the clavicles and a broad base resting on the diaphragm.
- Right lung has two fissures creating three lobes; the left lung has one horizontal fissure creating two lobes.
- The base of the lungs is lower posteriorly than anteriorly, and lateral surfaces conform to the diaphragm.
Respiratory Anatomy
- Hilum of each lung is where bronchi, pulmonary blood vessels, lymph vessels, and nerves enter.
- The left lung features a cardiac notch, accommodating the heart's shape.
- Each lung is enclosed in a double-walled pleura: visceral pleura adheres directly to the lung surface; parietal pleura lines the thoracic cavity wall.
Mediastinal Components
- Mediastinum is the area between the sternum and spine flanked by the lungs, containing the heart, great vessels, trachea, esophagus, thymus, lymphatics, and nerves.
- Thymus gland produces thymosin, crucial for immune system development, reaching its largest size at puberty before atrophying.
Chest Imaging Techniques
- Upright positions preferred in imaging to prevent pulmonary vessel engorgement and allow proper diaphragm placement.
- Left lateral position commonly used to reduce heart magnification.
- Avoid rotation in PA projections for accurate heart shadow representation.
PA Projection Preparation
- Patient should wear a gown with the back open; remove jewelry and other items from the waist up.
- Ensure equal weight distribution on feet and proper shoulder depression for accurate positioning.
- Central ray targeted to T7, with precise collimation to avoid unnecessary exposure.
Breathing Instructions
- Normal respiration leads to expansion of the thorax; imaging should capture heart at end of normal inspiration to minimize distortion.
- Special exposures taken for conditions like pneumothorax at full inspiration and expiration to reveal free air in the pleural cavity.
Technical Factors in Imaging
- High kilovoltage peak (kVp) recommended to ensure adequate penetration of thoracic anatomy.
- Use an SID of 72 inches to minimize heart magnification and enhance spatial resolution.
- Radiation protection measures include gonadal shielding and proper collimation to restrict the beam.
Evaluation Criteria for Imaging
- Characteristics of PA projections include visibility of the trachea, lungs, diaphragmatic domes, heart, and aortic arch.
- Evaluation criteria should ensure clear depiction of all pertinent thoracic structures for diagnosis accuracy.
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