Positioning Ch.2 workbook

The two important bony landmarks of the thorax that are used for locating the central ray on a PA and AP chest projections are-

Vertebra prominent and Jugular notch

The four divisions of the respiratory system are

Pharynx

Trachea

Bronchi

Lungs

Adam’s apple is the

Thyroid cartilage

Shoulder blade is the

Scapula

Voice box is the

Larynx

Breast bone is the

Sternum

Collarbone is the

Clavicle

What are the three divisions of the structure located superior to the larynx that serves as a common passageway for both food and air?

Nasopharynx

Oropharynx

Laryngopharynx

What is the name of the structure that acts as a lid over the larynx to prevent foreign objects such as food particles from entering the respiratory system

Epiglottis

If a person accidentally inhaled a food particle, it is likely to enter the

Right bronchus Because it is larger in diameter and more vertical

What is the name of the prominence or ridge seen when looking down into the trachea where it divides into the right and left bronchi

Carina

What is the term for the small air sacs located at the distal end of the bronchioles in which oxygen and carbon dioxide are exchanged in the blood

Alveoli

The outer layer of the membrane adhering to the inner surface of the chest wall and diaphragm is

Parietal pleura

The inner layer adhering to the surface of the lungs is the pulmonary or

Visceral pleura

Why is the right lung smaller than the left lung and the right hemidiaphragm and is positioned higher than the left hemidiaphragm

Presence of liver on right

What are the four important structures located in the mediastenum

Thymus gland

Heart and great vessels

Trachea

Esophagus

The heart is enclosed in a double wall membrane called the

Pericardial sac

What are the three parts of the aorta?

Ascending

Arch

Descending aorta

Which type of body habitats is associated with a broad and deep thorax

Hypersthenic

What type of body habitats may cause the costophrenic angles to be cut off if careful vertical collimation is not used

Hyposthenic and asthenic

Minimum number of ribs that should be demonstrated above the diaphragm on a PA radiograph of an average adult chest with full inspiration

10 ribs

What should be removed before a chest radiography

Necklace

Bra

Hair fasteners

Oxygen lines

Religious medallion around neck

True or false, Long hair may produce an artifact when imaging with digital radiographic systems

True

True or false, Chest radiography is the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors

True

Chest radiography for the adult patient usually uses a kilo voltage range of

110 to 125 kVp

True or false, Generally, you do not need to use radiographic grids for adult patients for PA or lateral chest radiographs

False

True or false, Because the heart is always located in the left thorax the use of anatomic side markers on a PA chest projection may not be necessary

False

What is another term for the condition term visceral inversion?

Situs inversus

What device should be used for the erect PA and lateral chest projections for an infant

Pigg-o-stat

What set of exposure factors is recommended for a chest examination of a young pediatric patient

70 to 85 KVP, short exposure time

True or false, Because they have shallow lung fields, the central ray is often centered higher for geriatric patients

True

True or false, CR centering for the PA chest projections on a bariatric patient is 1-2 inches lower than that for a sthenic patient.

False

To ensure better lung inspiration during chest radiography exposure should be made during the

Second inspiration

Why do we use a 72 inch source image receptor distance?

Because it reduces distortion and magnification of heart and other chest structures

Why do the lungs tend to expand more with the patient in an erect position than in a supine position?

Erect position allows, abdominal organs to drop, allowing diaphragm to move farther down and lungs to aerate more fully

What anatomic structures Is examined to determine rotation on a PA chest radiograph

Symmetric appearance and location of sternoclavicular joints

Why is it important to raise the patient’s arms above the head for lateral chest projections?

It prevents upper Arm soft tissues from being superimposed over upper chest field

The traditional central ray centering technique for the chest is to place the top of the IR how many inches Above the shoulders

1 1/2 inches or 2 cm above the shoulders

Recommended central ray centering technique for a PA chest projection projection requires the technologies to palpate what?

Vertebra prominent

Should the 14 × 17 IR be aligned in portrait or landscape orientation for a PA chest projection of a hyposthenic patient

Portrait

Should be 14 × 17 IR be aligned in portrait or landscape orientation for a asthenic patient

Landscape

what Bony landmarks are Palpated for centering the AP chest projections

Jugular notch

True or false, With most digital chest units, the question of IR placement into either the portrait or the landscape position is eliminated because of the larger IR

True

True or false, In general for an average patient, more collimation should be visible on the lower margin of the chest image then on top for a PA or lateral chest projection

False

True or false, The height or vertical dimension of the average two more broad individual’s chest is greater than the width or horizontal dimension

False

True or false, Multi slice CT can produce high resolution images of the heart on one breath hold

True

True or false, Single photon emission computed tomography is frequently used to diagnose myocardial infarction

True

True or false, Diagnostic medical sonography is not an effective modality to detect plural effusion

False

True or false, Echocardiography and electrocardiography are basically the same procedure

False

What is one of the most common inherited diseases?

Cystic fibrosis

Condition most frequently associated with congestive heart failure

Pulmonary edema

What is dyspnea?

Shortness of breath

Accumulation of air and plural cavity

Pneumothorax

A form of occupational lung disease

Silicosis

A contagious disease caused by an airborne bacterium

Tuberculosis

Irreversible dilation of bronchioles

Bronchiectasis

Most common form of emphysema

Chronic obstructive pulmonary disease (COPD)

Acute or chronic irritation of bronchi

Bronchitis

Collapse of all or portion of lung

Atelectasis

Inflammation of pleura

Pleurisy

What is a common radiographic seen on a chest radiograph for a patient with respiratory distress syndrome? (RDS)

Air bronchogram sign

Pathologic conditions indicating whether manual exposure factors would be increased, decreased, or remain the same compared with standard chest exposure factors

Left lung atelectasis +

Lung neoplasm o

Severe pulmonary edema +

RDS Known as highline membrane disease in infants +

Reactivation tuberculosis +

Advanced emphysema -

Large pneumothorax o

Pulmonary emboli o

Primary tuberculosis o

Advanced asbestosis

Which of the following is not a form of occupational lung disease

Emphysema

What chest projection/position is recommended to detect calcification or cavitation within the upper lung region beneath the clavicle

AP lordotic

The CR is placed at what level of the vertebra for an adult PA chest projection

T7

Shoulders need to be rolled forward for the PA projection to Allow what to move laterally and be clear of the lung field

Scapulae

Why should a left lateral be performed?

Left lateral better demonstrates the heart region

How much separation of the posterior ribs on a lateral chest projection indicates excessive rotation from a true lateral position

> 1cm

What is the name of the condition characterized by fluid entering the plural cavity?

Plural effusion

Which specific position would be used if a patient were unable to stand, but the physician suspected that the patient had fluid in the Left lung

Left lateral decubitus

What is the name of the condition characterized by free air entering the plural cavity?

Pneumothorax

Which specific projection would be used if the patient were unable to stand, but the physician suspected that the patient had free air in the left plural cavity

Right lateral decubitus

What circumstances or clinical indications suggest that an AP lordotic projection should be ordered

Roll out calcifications or masses beneath the clavicles

What position/projection would be used for a patient who is too ill or too weak to stand for an AP lordotic projection

AP axial projection central ray 15 to 20° cephalad

Which anterior oblique projection would best elongate the left thorax

RAO

Which posterior oblique projection would best elongate the left thorax

LPO

For certain studies of the left anterior oblique requires a rotation of

60°

True or false, A grid is not recommended for an LPO projection of the adult Chest

False

Careful collimation during the chest radiograph will improve image quality by decreasing what

Scatter radiation to the IR

True or false, If your facility uses a virtual grid, a physical grid is still needed

False

How can the tech technologies improve the image when making the repeat exposure

Increase KVP and Lower mAs

A radiograph of a PA projection of the chest demonstrates the top of the Pisces is cut off and a wide collimation border can be seen below the diaphragm. How can this be corrected during the repeat radiograph?

Sent the central ray and the top collation light border is at vertebra prominent

A patient with the clinical history of advanced emphysema comes to the radiology department for a chest x-ray. AEC will not be used. How should the technologist alter the manual exposure settings for this patient?

Decrease the KVP moderately (- -)

A patient with severe plural effusion comes to the radiology department for a chest x-ray, AEC Will not be used how should the technologist alter the manual exposure settings for this patient?

Increase the KVP slightly (+)

A patient with a history of pleurisy comes to the radiology department, which of the following radiographic series should be performed

Erect, PA and lateral