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Questions and Answers
What is a common cause of confusion in identifying lung lesions on radiographs?
What is a common cause of confusion in identifying lung lesions on radiographs?
Which side of the thoracic cavity is occupied more due to the anatomical position of the heart?
Which side of the thoracic cavity is occupied more due to the anatomical position of the heart?
What is the significance of the fissures in the lungs?
What is the significance of the fissures in the lungs?
At what vertebral level does the trachea divide into the right and left main bronchi?
At what vertebral level does the trachea divide into the right and left main bronchi?
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Which of the following statements is true about the right main bronchus?
Which of the following statements is true about the right main bronchus?
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What is the primary reason the right dome of the diaphragm is higher than the left?
What is the primary reason the right dome of the diaphragm is higher than the left?
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What is the position of the patient's feet during the orientation for a larger cassette?
What is the position of the patient's feet during the orientation for a larger cassette?
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What structure is seen as a radiolucent air-filled region in the upper thorax on radiographs?
What structure is seen as a radiolucent air-filled region in the upper thorax on radiographs?
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What is likely to obscure lung tissue on standard thoracic radiographs?
What is likely to obscure lung tissue on standard thoracic radiographs?
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Where is the X-ray beam directed when performing a PA chest radiograph?
Where is the X-ray beam directed when performing a PA chest radiograph?
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Which of the following is a sign of an ideal PA chest radiograph?
Which of the following is a sign of an ideal PA chest radiograph?
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What effect does patient rotation have on a PA chest radiograph?
What effect does patient rotation have on a PA chest radiograph?
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Which position is recommended for the patient's arms during a PA chest radiograph if the basic arm position cannot be adopted?
Which position is recommended for the patient's arms during a PA chest radiograph if the basic arm position cannot be adopted?
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Which structure can be used to locate the T7 spinous process before pushing the shoulders forward?
Which structure can be used to locate the T7 spinous process before pushing the shoulders forward?
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What preparation should be undertaken before performing a PA chest radiograph?
What preparation should be undertaken before performing a PA chest radiograph?
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What is the required lung field visibility for an ideal PA chest radiograph?
What is the required lung field visibility for an ideal PA chest radiograph?
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What is the primary benefit of the postero-anterior (PA) projection compared to the antero-posterior (AP) projection?
What is the primary benefit of the postero-anterior (PA) projection compared to the antero-posterior (AP) projection?
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Under which condition is a decubitus technique most likely preferred?
Under which condition is a decubitus technique most likely preferred?
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What impact does overexposure of images have on the visibility of lung details?
What impact does overexposure of images have on the visibility of lung details?
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During a radiographic examination, what patient position ensures maximum air-filled lung visualization?
During a radiographic examination, what patient position ensures maximum air-filled lung visualization?
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Which of the following statements about lung imaging is true?
Which of the following statements about lung imaging is true?
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What is a noted effect of using underexposed images in lung examinations?
What is a noted effect of using underexposed images in lung examinations?
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What factor primarily governs the choice between erect and decubitus positioning in radiographic examinations?
What factor primarily governs the choice between erect and decubitus positioning in radiographic examinations?
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What is the purpose of arresting deep inspiration during image acquisition?
What is the purpose of arresting deep inspiration during image acquisition?
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What are the primary reasons for requesting plain radiography in relation to the larynx?
What are the primary reasons for requesting plain radiography in relation to the larynx?
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What is the recommended patient position for anteroposterior (AP) projection of the larynx?
What is the recommended patient position for anteroposterior (AP) projection of the larynx?
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Where should the image receptor be centered for correct positioning during radiography of the larynx?
Where should the image receptor be centered for correct positioning during radiography of the larynx?
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How should the X-ray beam be directed during the anteroposterior projection of the larynx?
How should the X-ray beam be directed during the anteroposterior projection of the larynx?
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During the lateral projection, how should the patient's jaw be positioned?
During the lateral projection, how should the patient's jaw be positioned?
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What is the correct method for the patient to prepare before exposure during lateral projection?
What is the correct method for the patient to prepare before exposure during lateral projection?
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What range should the collimated beam include during anterior-posterior projection?
What range should the collimated beam include during anterior-posterior projection?
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Which imaging modalities may be required for the full evaluation of other disease processes beyond plain radiography?
Which imaging modalities may be required for the full evaluation of other disease processes beyond plain radiography?
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Study Notes
Radiographic Techniques of the Thorax: Larynx
- Plain radiography is used to locate soft tissue swellings, assess their effects, and identify foreign bodies or laryngeal trauma.
- Tomography, CT, and MRI may be used for a full evaluation of disease processes.
- Two projections are typically taken, an anteroposterior (AP) and a lateral.
Anteroposterior (AP) Projection (Fig. 7.1a)
- Patient lies supine with the median sagittal plane aligned with the central long axis of the couch.
- Chin is raised to show soft tissues below the mandible.
- Image receptor is centered at the level of the 4th cervical vertebra.
- X-ray beam is directed 10° cranially and centered in the midline at the level of the 4th cervical vertebra.
- Beam is collimated to include the area from the occipital bone to the 7th cervical vertebra.
Lateral Projection (Fig. 7.2a)
- Patient stands or sits with a shoulder against the cassette or Bucky.
- Median sagittal plane of the trunk and head are parallel to the image receptor.
- Jaw is raised slightly to separate the angles of the mandible from the upper cervical vertebrae.
- A point 2 cm posterior to the angle of the mandible should align with the vertical central line of the image receptor.
- The image receptor is centered at the level of the thyroid cartilage.
- Before exposure, the patient depresses their shoulders to project structures below the 7th cervical vertebra.
- Exposure is made on forced expiration.
- Collimated horizontal central ray is centered below the mastoid process at the level of the thyroid cartilage through the 4th cervical vertebra.
- Soft tissues should be demonstrated from the skull base to C7 to clearly visualize the laryngeal cartilages and possible foreign bodies.
Lungs
- Radiographic examination of the lungs is used to assess a wide range of medical conditions, including primary lung disease and pulmonary effects of other diseases.
- Changes in lung parenchyma appearance may vary based on the disease's nature and extent.
Positioning
- Erect or decubitus positioning is chosen based on the patient's condition.
- Most patients are positioned erect; immobile or severely ill patients are positioned supine or semi-erect.
- Erect positioning simplifies the procedure due to the gravitational effects on abdominal organs, allowing better visualization of the lung tissue and fluid levels, especially when using a horizontal central ray.
Posteroanterior (PA) Projection
- The PA projection is favored over AP due to easier arm positioning, resulting in a reduced heart magnification, and reduction in breast tissue compression.
- The mediastinum and heart shadows may obscure parts of the lung fields, making a lateral radiograph sometimes necessary.
Respiration
- Images are acquired during arrested deep inspiration to visualize air-filled lungs.
- AP magnification makes assessing heart size and apical region difficult, as well as the mediastinum.
Exposure
- Overexposure reduces the visibility of lung parenchymal details and hides consolidations.
- Underexposure can falsely highlight normal markings as disease.
- Inadequate exposure may obscure central areas and potentially hinder the diagnosis of mediastinal abnormalities.
Soft-tissue Artifacts
- Soft tissue artifacts can cause misinterpretations.
- The normal nipple, skin lesions, and breast tissue/masses can mimic lung lesions.
- Clothing folds and creases (especially in thin patients) can create linear artifacts.
Radiographic Anatomy
- Lungs are positioned in the thoracic cavity on either side of the mediastinum.
- The diaphragm separates the lungs from the abdomen.
- The right lung is larger than the left due to heart position.
- Rib, clavicle, and heart positions obscure certain lung tissue on the PA radiograph, but other projections can showcase more.
- The right and left lungs are divided into upper, middle, and lower lobes, separated by fissures that are most visible in PA radiographs when parallel with the beam.
Trachea and Bronchi
- The trachea is centrally located in the upper chest, splitting into the right and left main bronchi at the 4th thoracic vertebra.
- The right main bronchus is wider and more vertical than the left, influencing foreign body inhalation.
- Bronchi subdivide into progressively smaller bronchioles, then alveolar air spaces, increasing in density.
- Hilar regions (the points where the pulmonary arteries and veins branch) present as areas of increased radio-opacity.
- Lung markings are a visualization of the pulmonary vessels, and decrease in size as they branch away from the hilum.
Patient Preparation and Notes
- Patient preparation is crucial by removing any radiopaque items and ensuring proper positioning.
- Patients with chest tubes/underwater-sealed bottles require careful handling to prevent displacement; the bottle should not be placed above chest level.
- PA side markers are used for accurate image identification. Misidentification of cases like dextrocardia needs care.
- Long hair should be removed from the image area.
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Description
This quiz focuses on the radiographic techniques used for evaluating the larynx, including plain radiography, tomography, CT, and MRI. It details the procedures for anteroposterior and lateral projections, including patient positioning and beam alignment. Test your knowledge on essential imaging techniques for laryngeal assessment.
