Podcast
Questions and Answers
What is the required kVp range for a PA Chest radiograph?
What is the required kVp range for a PA Chest radiograph?
- 110-120 kVp
- 90-110 kVp (correct)
- 80-90 kVp
- 60-70 kVp
At what central ray level should it be positioned for a PA Chest view?
At what central ray level should it be positioned for a PA Chest view?
- T5 vertebra level
- T3 vertebra level
- T7 vertebra level (correct)
- T10 vertebra level
What is the appropriate distance from the x-ray tube to the IR for a PA Chest radiograph?
What is the appropriate distance from the x-ray tube to the IR for a PA Chest radiograph?
- 160 cm
- 180 cm (correct)
- 200 cm
- 150 cm
What is the estimated mAs setting when using both lateral cells of AEC for a PA Chest?
What is the estimated mAs setting when using both lateral cells of AEC for a PA Chest?
Which of the following collimation guidelines is correct for a PA Chest radiograph?
Which of the following collimation guidelines is correct for a PA Chest radiograph?
Which of the following indicates proper alignment for a PA Chest image?
Which of the following indicates proper alignment for a PA Chest image?
What is the primary reason for using high kVp in PA Chest radiographs?
What is the primary reason for using high kVp in PA Chest radiographs?
When preparing a patient for a PA Chest radiograph, which artifact should be removed to ensure the best image quality?
When preparing a patient for a PA Chest radiograph, which artifact should be removed to ensure the best image quality?
What is the central ray location when performing a lateral thumb positioning?
What is the central ray location when performing a lateral thumb positioning?
What is the required tube angle for the lateral thumb procedure?
What is the required tube angle for the lateral thumb procedure?
What is the recommended mAs setting for the lateral thumb X-ray?
What is the recommended mAs setting for the lateral thumb X-ray?
Which of the following is essential for proper collimation in a lateral thumb X-ray?
Which of the following is essential for proper collimation in a lateral thumb X-ray?
What is the recommended kVp for the lateral thumb procedure?
What is the recommended kVp for the lateral thumb procedure?
When positioning for an AP thumb procedure, which anatomical structure is the focus of the central ray?
When positioning for an AP thumb procedure, which anatomical structure is the focus of the central ray?
What is a critical factor to ensure when performing the lateral thumb X-ray regarding patient positioning?
What is a critical factor to ensure when performing the lateral thumb X-ray regarding patient positioning?
What is the appropriate distance from the x-ray source for lateral thumb positioning?
What is the appropriate distance from the x-ray source for lateral thumb positioning?
What is the correct positioning of the patient for a lateral chest X-ray?
What is the correct positioning of the patient for a lateral chest X-ray?
At what level should the central ray be positioned for a lateral chest X-ray?
At what level should the central ray be positioned for a lateral chest X-ray?
What is the appropriate kVp range for a lateral chest X-ray?
What is the appropriate kVp range for a lateral chest X-ray?
For a lateral chest X-ray, what is the estimated mAs using the central cell of AEC?
For a lateral chest X-ray, what is the estimated mAs using the central cell of AEC?
What is a key criterion for identifying successful collimation in a lateral chest X-ray?
What is a key criterion for identifying successful collimation in a lateral chest X-ray?
What distance should be maintained from the X-ray tube for a lateral chest image?
What distance should be maintained from the X-ray tube for a lateral chest image?
In a standard AP abdomen X-ray, what should be the central ray alignment?
In a standard AP abdomen X-ray, what should be the central ray alignment?
For an adult AP abdomen X-ray, what is the recommended kVp range?
For an adult AP abdomen X-ray, what is the recommended kVp range?
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Study Notes
PA Chest
- Posture: Erect, facing upright bucky
- Positioning: Shoulders rolled forward, head straight
- Tube Angle: Straight (perpendicular to anatomy)
- Central Ray: Mid-sagittal plane at level of T7 (inferior angle of scapulae)
- Distance: 180cm
- Collimation: Include lung apices to costophrenic angles, laterally to skin border
- IR (Receptor): 35x43cm Portrait or Landscape
- kVp: Adult 90-110 kVp
- mAs: Both lateral cells of AEC Estimate: 1.2 mAs
- Grid: Yes
- Instructions: Breath in and hold your breath
- Breathing: Suspended (inspiration)
- Notes: Remove artifacts (zippers, bra, jewelry). Patient should be in gown.
PA Chest Criteria
- Collimation: Include from the apices to costophrenic angles. Include the anterior and posterior soft tissues
- Alignment: No rotation. Clavicles should be equidistant from sternum. Correct angulation places medial ends of clavicles at level of T3 vertebra
- Anatomy: Lungs, including apices, tracheal air shadow, heart, great vessels, diaphragm, costophrenic angles, bony thorax
- Density: Vertebral bodies of thoracic spine just visible through cardiac shadow
- Contrast: Lung detail clearly visualised. Soft tissue borders should be seen.
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: High kVp ensures an increased grayscale on the radiograph. Poor inspiratory efforts alter cardiothoracic ratio. One should be able to visualise the first four thoracic vertebral bodies, seven anterior ribs, and 10 posterior ribs.
- Lordotic view: May be performed to define apical lesions or middle lobe infiltrates.
- Full expiration PA Chest: Accentuates the visceral–parietal pleural interspace, useful in suspected pneumothorax.
Lateral Chest
- Posture: Erect
- Positioning: Left side to upright bucky, hands on head
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: Mid-coronal plane at level of T7 (inferior angle of scapulae)
- Distance: 180cm
- Collimation: Include lung apices to costophrenic angles, laterally to skin border
- IR (Receptor): 35x43cm Portrait
- kVp: 90-110 kVp
- mAs: Central cell of AEC Estimate: 4 mAs
- Grid: Yes
- Instructions: Breath in and hold your breath
- Breathing: Suspended (inspiration)
- Notes: Remove artifacts (zippers, bra, jewelry). Patient should be in gown.
Lateral Chest Criteria
- Collimation: Include from the apices to costophrenic angles. Include the anterior and posterior soft tissues
- Alignment: No rotation. Posterior ribs superimposed
- Anatomy: Lungs, trachea, heart, great vessels, diaphragm, posterior costophrenic angles, bony thorax
- Density: Vertebral bodies of thoracic spine just visible through cardiac shadow
- Contrast: Lung detail clearly visualised. Soft tissue borders should be seen.
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Left lateral position reduces cardiac magnification as the heart is close to the image receptor.
AP Abdomen
- Posture: Supine
- Positioning: Pt on back, on xray table or trolley. No rotation, with shoulders and hips equidistant from table/trolley
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: Mid-sagittal plane at level of iliac crests
- Distance: 100-110cm
- Collimation: Include lung apices to costophrenic angles, laterally to skin border
- IR (Receptor): 35x43cm Portrait (landscape may be required in bariatric patients to include all relevant anatomy)
- kVp: Adult 75-80 kVp
- mAs: Lateral cells of AEC Estimate: 30-35+ mAs
- Grid: Yes
- Instructions: Breath in, breath out and hold it. Hand pronated, then arch fingers slightly to rotate thumb into lateral position
Lateral Thumb
- Posture: Supine
- Positioning: Hand pronated, then arch fingers slightly to rotate thumb into lateral position
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: 1st MCP Joint
- Distance: 100-110cm
- Collimation: Four sides of collimation seen to include skin edges of thumb
- kVp: 50kVp
- mAs: 2mAs
- Grid: No
- Instructions: Hold still
- Breathing: N/A
- Notes: Remove artifacts (jewelry)
Lateral Thumb Criteria
- Collimation: Include all of digit of interest including skin edges
- Anatomy: Tip of thumb to trapezium
- Density: Cortical outline and bony trabecular pattern adequately demonstrated
- Contrast: Soft tissue and bony interfaces visualised
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Ensure finger is parallel to the image detector to ensure joint spaces are open. Hand is free of motion artifact
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