Chest Radiography Lab Review

Flashcards covering key concepts from chest radiography lecture notes, including positioning, technical factors, anatomical landmarks, and special projections.

What are the four main reasons to prefer erect chest imaging?

To visualize air fluid levels, free air under the diaphragm, better assessment of the thoracic cavity (organs fall), and less cardiac congestion for a clearer heart outline.

For routine PA chest imaging, how should the patient's feet be spaced and what about their weight distribution?

Feet about shoulder width apart with equal weight on both feet.

When positioning for a PA chest X-ray, how far above the relaxed shoulders should the upper border of the image receptor be?

One and a half to two inches.

What patient maneuver helps roll the shoulders forward and scapulae out of the lung field during a PA chest X-ray?

Placing the back of their hands on their hips.

What is the typical SID used for chest imaging and why?

72 inches SID to minimize magnification due to OID of structures and the Bucky.

Where is the central ray centered for PA and lateral chest imaging?

At the level of T7.

How can the centering point for a chest X-ray be estimated using anatomical landmarks?

About seven inches inferior to the vertebral prominence for females, eight inches for males, or at the level of the inferior angle of the scapula.

What is the typical kV range for chest imaging when using AEC?

110 to 120 kV.

What are the standard breathing instructions for a routine chest X-ray?

Hold breath on the second inspiration (take a deep breath, blow it out, then take another deep breath and hold).

What breathing instruction is used for a rule out pneumothorax order?

Suspended expiration.

What is a good indicator of a patient having a full inspiration on a PA chest radiograph?

Being able to see the tenth rib in its entirety, visible above the diaphragm.

On a PA radiograph, which portion of the ribs (anterior or posterior) appears more crisp and less magnified?

The anterior portion, as it is closer to the receptor.

How can rotation of the patient's trunk or body be assessed on a chest radiograph?

By examining the sternoclavicular (SC) joints to see how far one end of the clavicle is from the midline compared to the other.

What anatomical structure marks the bifurcation of the trachea?

The carina (bronchial bifurcation).

What are the costophrenic angles?

The angles of the lungs closer to the ribs.

What are the cardiophrenic angles?

The angles of the lungs near the heart.

Why is a true left lateral position preferred for lateral chest imaging?

To keep the heart closer to the image receptor and reduce magnification.

When centering for a lateral chest, what anatomical region should be used instead of breast tissue, especially in females?

The thorax itself, as breast tissue is not the object of examination.

What is the significance of the 'divergence of the beam' in a lateral chest radiograph?

It can cause the lung bases to appear slightly offset, which is normal and not indicative of patient tilt.

For a lateral chest X-ray using AEC, which ionization chamber should be selected?

The center chamber.

In a lateral chest radiograph, which hemidiaphragm (left or right) typically appears more defined and why?

The left hemidiaphragm, because it is closer to the image receptor.

What is retrocardiac space?

The space located behind the heart.

In cases where a patient cannot stand for a chest X-ray, what alternative position might be used?

Supine AP chest imaging.

When performing a supine AP chest X-ray, where is the central ray typically centered?

About three inches inferior to the jugular notch.

Why is mobile AP chest imaging not the preferred method for routine chest X-rays?

It causes magnification to the heart structure because it is done AP versus PA.

What is an important consideration when dealing with wires or medical equipment on a patient's chest during mobile imaging?

Move as much of the equipment out of the way as possible to prevent obscuring anatomy.

What is the most common reason for performing an AP lordotic chest X-ray?

To rule out tuberculosis or an apical lesion (tumor) in the apices of the lung.

How does an AP lordotic chest position change the visualization of lung apices?

It throws the clavicles up and out of the way, allowing for a clearer view of the upper lung portions.

What are the indications for performing a decubitus chest X-ray?

Fluid accumulation, often done bilaterally, pre or post thoracentesis, or for challenging patients unable to stand.

When performing a decubitus chest X-ray for fluid accumulation, which side should be placed down?

The affected side (the side with suspected fluid accumulation).

How long should a patient remain in a decubitus position before exposure to allow fluid to settle?

Approximately five minutes.

Why is it important to use a sponge under the thoracic cavity for decubitus chest imaging?

To build up the patient off the bed, preventing the bed from appearing in the image and blocking lateral lung tissue.

How is a decubitus chest X-ray named?

By the side that is down (e.g., right lateral decubitus means the right side is down).

In marking a decubitus chest X-ray, which side is typically marked?

The side that is up, along with a decubitus marker.

What is the priority in a decubitus chest X-ray?

The side that is down, as it is where all fluid will fall due to gravity.