Respiratory System: The Trachea

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Questions and Answers

What is the correct location for the Endotracheal tube?

In the Superior Vena Cava

At the Carina

2 cm above the Carina

3-5 cm above the Carina (correct)

Where should the tip of a Central Venous Catheter (CVC) lie?

Near the heart valves

Within the Superior Vena Cava (correct)

In the right Atrium

At the Aorta

What is the primary use of a Peripherally inserted Central Catheter (PICC)?

Direct delivery of oxygen

Emergency airway management

Monitoring cardiac output

Long-term venous access (correct)

What is the main purpose of a Swan-Ganz Catheter?

To monitor hemodynamic status Signup and view all the answers

Where is the tip of a Port-a-Cath typically placed?

In the Internal Jugular Vein Signup and view all the answers

What is the primary function of a Chest Tube?

To remove excess air, fluid, or blood from the pleural space Signup and view all the answers

Where is a pacemaker typically implanted?

Subcutaneously in the left anterior chest wall Signup and view all the answers

What condition do pacemakers primarily treat?

Arrhythmias Signup and view all the answers

What is the primary function of the ciliated cells lining the trachea?

To carry foreign particles and excessive mucous away from the lungs Signup and view all the answers

At what level does the bifurcation of the trachea occur?

T5 Signup and view all the answers

Which bronchus is typically shorter, wider, and more vertical?

Right Main Stem Bronchus Signup and view all the answers

How many Secondary Bronchi are found in the Left Lung?

2 Signup and view all the answers

What effect might bronchospasm have on the bronchioles?

They close off, potentially triggering an Asthma Attack Signup and view all the answers

What is a Bronchogram used to visualize?

The bronchial tree using radiopaque contrast medium Signup and view all the answers

Which anatomical structure are the Alveoli part of?

Bronchioles Signup and view all the answers

What type of blood do Alveoli receive from the Pulmonary Arteries?

Deoxygenated blood Signup and view all the answers

What should be positioned at the center of the upright Bucky for a lateral projection?

The patient's Midaxillary line Signup and view all the answers

When adjusting for hyposthenic and asthenic patients, where should the Bucky be moved?

Lower the Bucky 1 inch from the PA Projection Signup and view all the answers

What is crucial to include for all radiographic images concerning medicolegal aspects?

Patient identification and anatomic side marker Signup and view all the answers

What is the proper method to expose the image for a chest X-ray?

Expose on inspiration Signup and view all the answers

For a PA projection of the chest, which anatomical structures should be included in the imaging?

Air-filled trachea, apices of lungs, and clavicles Signup and view all the answers

What is a necessary adjustment to the AEC control panel for a lateral chest X-ray?

Set to the Center Chamber Signup and view all the answers

What indicates that the chest X-ray exposure was made on full inspiration?

10 ribs demonstrated above the diaphragm Signup and view all the answers

Where should the left anatomic side marker be placed for a lateral projection?

On the outside of Upright Bucky in the light field Signup and view all the answers

What is the appropriate positioning of the Image Receptor for a PA Projection in most patients?

1-2 inches above the shoulders Signup and view all the answers

When collimating the X-ray beam, what should be visible on either side of the patient?

A light shadow Signup and view all the answers

How should the gonadal shielding be placed for effective protection?

At waist level facing the X-ray tube Signup and view all the answers

What central ray adjustment is recommended for hypersthenic patients during a PA Projection?

Place the Image Receptor 1 inch higher than the standard position Signup and view all the answers

What does the textbook recommend for centering the Central Ray based on the Vertebral Prominens?

An 8 inch hand spread for males and a 7 inch for females Signup and view all the answers

What is the correct arrangement of the patient for the Left Lateral Projection?

Left side against the bucky, weight evenly distributed Signup and view all the answers

What should be avoided to ensure proper positioning during the Lateral Projection?

Leaning into the bucky Signup and view all the answers

During a Lateral Projection, where should the top of the Image Receptor be positioned?

1 inch above the shoulders Signup and view all the answers

What is the proper positioning of the patient’s arms during the left lateral decubitus X-ray?

Arms should be raised above the head, away from the lung field Signup and view all the answers

Where should the top of the Image Receptor be positioned during the left lateral decubitus procedure?

2 inches above the patient’s shoulders Signup and view all the answers

What is the appropriate direction for the Central Ray during a left lateral decubitus X-ray?

Perpendicular to midline of the Image Receptor Signup and view all the answers

Which of the following should be clearly visualized in an acceptable left lateral decubitus image?

Thoracic vertebrae behind the heart shadow Signup and view all the answers

What must you consider when adapting the exam for a patient unable to stand?

The adjustments must be documented on the image Signup and view all the answers

How should the patient’s chin be positioned during the PA projection for a cart patient?

Elevated Signup and view all the answers

For hypersthenic males being imaged, what should be done to ensure the entire lung field is captured?

Incorporate 1 cross-wise or 2 lengthwise image receptors Signup and view all the answers

What positioning should be avoided to ensure clear imaging of the lung fields?

Placing arms across the chest Signup and view all the answers

Study Notes

Trachea and Main Stem Bronchi

The Trachea is a fibrous, muscular tube reinforced by 16-20 C-shaped cartilage rings preventing collapse during inspiration.
Lined with ciliated cells that help clear foreign particles and excess mucus toward the lungs.
At the inferior margin is the Carina, a bony spur that bifurcates the trachea into the Right and Left Main Stem Bronchi at the T5 level.
The Right Main Stem Bronchus is shorter, wider, and more vertical than the Left, making it more common for foreign bodies to lodge there.

Secondary Bronchi and Bronchioles

Main Stem Bronchi branch into Secondary Bronchi supplying each lung lobe: 3 for the Right Lung and 2 for the Left Lung.
Secondary Bronchi further divide into Bronchioles, which spread throughout the lungs and are visible as lung markings on chest images.
Bronchioles' walls contain smooth muscle and can spasm, leading to asthma attacks.

Alveoli and Gas Exchange

Bronchioles terminate in Terminal Bronchioles that connect to Alveoli, the primary site for gas exchange of oxygen and carbon dioxide.
Alveoli receive deoxygenated blood from Pulmonary Arteries and consist of Alveolar Ducts and Sacs.

Radiographic Procedures

A Bronchogram is a specialized imaging procedure that utilizes radiopaque contrast to visualize the bronchial tree.
For PA projection, place the Image Receptor 1-2 inches above the shoulders to target approximately T7.
Lateral projections involve positioning the patient’s left side against the bucky to minimize magnification of the heart.

Imaging Technique Adjustments

Adjust image receptor location based on patient habitus:
- Hypersthenic: 1 inch higher for PA projections.
- Hyposthenic/Asthenic: Lower the Bucky 1 inch from PA projection.
Ensure proper exposure and identification markings on all radiographic images.

Post Examination Procedures

Patients should be instructed to wait in the designated area until image analysis is complete.
Relevant data must be entered into the computer system, and the examination charged to the patient's account.

Line Placement for Medical Devices

Correct positioning for common tubes and catheters is crucial:
- Endotracheal Tube should be 3-5 cm above the Carina to secure the airway.
- Central Venous Catheter (CVC) should lie within the Superior Vena Cava for accurate hemodynamic monitoring.
- PICC line tip should rest in the Superior Vena Cava or Axillary Vein for optimal long-term access.
- Swan-Ganz Catheter's tip should be approx. 2 cm from the Hilum in the pulmonary artery.

Chest Tubes and Pacemakers

Chest tubes are flexible tubes inserted to remove air (pneumothorax), fluid (pleural effusion), blood (hemothorax), or pus (empyema) from the pleural space.
Pacemakers are implanted devices that utilize electrical impulses to regulate the heart's rhythm in patients with cardiac conduction problems and are typically placed in the left anterior chest wall.

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Description

Explore the structure and function of the trachea in the respiratory system. This quiz covers important features including the cartilage rings, ciliated cells, and the carina. Test your knowledge on how the trachea contributes to effective breathing.