MOD 2 RAD 111 STUDY GUIDE #2

• FOREIGN BODIES

• SWELLING (EPIGLOTTIS)

• MASSES (INTRINSIC/ EXTRINSIC TO AIRWAY

• FRACTURES OF LARYNX/ HYOID BONE

• CERVICAL SPINE/ SOFT TISSUES OF ANTERIOR NECK

SOFT TISSUE NECK EVALUATION

• 10 X 12 LENGTHWISE

• 1 INCH FROM ANTERIOR/ POSTERIOR SURFACES

• 12 INCH LENGTHWISE

LATERAL SOFT TISSUE NECK

• 10 × 12 LENGTHWISE

• 1 INCH BEYOND SKIN LINE

LATERAL SOFT TISSUE NECK

• MSP PARALLEL TO MIDLINE

• ROTATE SHOULDERS POSTERIORLY (NO BLOCKING MEDIASTINUM)

LATERAL SOFT TISSUE NECK

• CENTRAL RAY HORIZONTAL TO MCP

• LEVEL AT LARYNGEAL PROMINENCE/ JUGULAR NOTCH

LATERAL SOFT TISSUE NECK

RESPIRATION: SLOW INSPIRATION

LATERAL SOFT TISSUE NECK

STRUCTURES SHOWN:

• AIR FILLED UPPER AIRWAY

• TRACHEA

• SUPERIOR MEDIASTINUM

LATERAL SOFT TISSUE NECK

EVALUATION CRITERIA:

• PHARYNX TO PROXIMAL TRACHEA (UPPER AIRWAY)

• MIDCERVICAL- MIDTHORACIC (TRACHEA AND SUPERIOR MEDIASTINUM)

LATERAL SOFT TISSUE NECK

NO ROTATION:

• SUPERIMPOSED MANDIBULAR RAMI

• SUPERIMPOSED ZYGAPOPHYSEAL JOINTS

LATERAL SOFT TISSUE NECK

BONY TRABECULAR DETAIL AND SOFT TISSUE

LATERAL SOFT TISSUE NECK

CENTRAL RAY:

• C6-C7

RESPIRATION:

• SLOW/ DEEP INSPIRATION

LATERAL UPPER AIRWAY

EVALUATION CRITERIA:

• AIR FILLED TRACHEA AND LARYNX

• SHOULDERS NOT SUPERIMPOSED OVER TRACHEA

• COLLIMATION EVIDENT

• EXPOSURE FACTORS

LATERAL UPPER AIRWAY

COLLIMATION:

• 12 INCHES LENGTHWISE

• 1 INCH BEYOND SKIN LINE

AP SOFT TISSUE NECK

PATIENT POSITION:

• UPRIGHT/ SUPINE

PART POSITION:

• MSP PERPENDICULAR TO MIDLINE GRID

• SHOULDERS = TRANSVERSE

AP SOFT TISSUE NECK

CENTRAL RAY:

• MSP PERPENDICULAR

• LEVEL TO LARYNGEAL PROMINENCE/ MANUBRIUM

AP SOFT TISSUE NECK

CENTRAL RAY:

• T1- T2

• AML PERPENDICULAR TO IR

AP UPPER AIRWAY

CENTRAL RAY:

• 15-20 DEGREES CEPHALAD

SEMIAXIAL AP

EVALUATION CRITERIA:

• NO MOTION

• NO ROTATION

• EXPOSURE FACTOR

• CLAVICLES ABOVE APICES

SEMIAXIAL AP

ANOTHER NAME FOR LORDOTIC

LINDBLOM

PATIENT POSITION:

• UPRIGHT

• APPROXIMATELY 1 FT IN FRONT

• IR 3 INCHES ABOVE SHOULDERS

AP AXIAL CHEST LORDOTIC

PART POSITION:

• MSP MIDLINE

• LEAN SHOULDER BACKWARDS

• CORONAL PLANE THORAX 15-20 DEGREES VERTICAL

AP AXIAL CHEST LORDOTIC

• HORIZONTAL CR MIDSTERNUM

• MSP MIDSTERNUM 3-4 INCHES BELOW JUGULAR NOTCH

AP CHEST AXIAL LORDOTIC

STRUCTURES SHOWN:

• LUNG APICES

• INTERLOBAR EFFUSIONS

AP AXIAL CHEST LORDOTIC

EVALUATION CRITERIA:

• CLAVICLES SUPERIOR APICES

• STERNAL ENDS OF CLAVICLES EQUIDISTANT FROM VERTEBRAL COLUMN

AP AXIAL CHEST LORDOTIC

• TO EVALUATE CHANGES THAT INDICATE PATHOLOGY

VASCULAR LUNG MARKINGS

WHEN SHOULD EXPOSURE BE TAKEN FOR MAXIMUM LUNG AERATION IN CONSCIOUS PATIENT

AFTER FULL SECOND INSPIRATION

RECOMMENDED POSITION FOR AMBULATORY PATIENTS DURING CHEST RADIOGRAPHY

UPRIGHT/ ERECT

RECOMMENDED SID FOR CHEST RADIOGRAPHY

AT LEAST 72 INCHES

• REDUCE SCATTER

• IMPROVE IMAGE CLARITY ESPECIALLY IN THICKER PATIENTS

GRIDS

AEC STANDS FOR

AUTOMATIC EXPOSURE CONTROL

• STOPS EXPOSURE WHEN ENOUGH RADIATION HAS REACHED IR

• USES SENSORS TO MEASURE RADIATION AUTOMATICALLY

AUTOMATIC EXPOSURE CONTROL

BREATHING INSTRUCTIONS FOR PATIENT DURING CHEST X-RAY

HOLD BREATH ON SECOND INSPIRATION

EVALUATION CRITERIA:

• NO ROTATION

• SCAPULAE REMOVED FROM LUNGS

• FULL INSPIRATION

• NO MOTION

• EQUAL COLLIMATION

PA CHEST

RECOMMENDED kVp RANGE FOR ADULT CHEST IMAGING

110 - 125 kVp

WHAT SHOULD BE DONE IF NON-AMBULATORY PATIENT CANT SIT UPRIGHT FOR CHEST X-RAY

SUBSITUTE DECUBITUS POSITION TO DIAGNOSE AIR FLUID LEVELS

WHY USE HAND SPREAD METHOD IN CHEST POSITIONING

• DETERMINES CORRECT CR PLACEMENT BASED ON HAND MEASUREMENT

WHAT IS THE PURPOSE OF TAKING TWO RADIOGRAPHS DURING CHEST IMAGING

• PNEUMOTHORAX

• DIAPHRAGM MOVEMENT

• FOREIGN BODY

• ACTELASIS

UPRIGHT STANDING/ SEATED/ WHAT X-RAY IS TAKEN

LATERAL CHEST X- RAY

EVALUATION CRITERIA:

• NO ROTATION

• ARMS RAISED HIGH

• CR CENTERED MID-LUNGS

LATERAL CHEST

SERVES AS LANDMARK FOR CR PLACEMENT IN PA-CHEST X-RAYS

VERTEBRA PROMINENS

• ENTIRE LUNGS INCLUDED

• SCAPULAE REMOVED FROM LUNGS

• NO MOTION

THIS PROJECTION IS A…..

PA CHEST

WHAT ADJUSTMENTS SHOULD BE MADE FOR BARIATRIC PATIENTS DURING IMAGING

CR/ TECHNICAL FACTORS

WHERE IS TOP OF IR POSITIONED FOR LATERAL CHEST (INCHES)

1 1/2 - 2 INCHES ABOVE SHOULDERS

PART POSITION FOR TRUE LATERAL CHEST X-RAY (MSP/ MCP)

• MSP PARALLEL TO IR

• MCP PERPENDICULAR TO IR

WHERE IS CR CENTERED FOR LATERAL CHEST

T7 MCP

WHAT SHOULD BE ENSURED REGARDING PATIENTS POSITION DURING LATERAL CHEST

• NO ROTATION

• PATIENT SHOULD NOT LEAN SIDEWAYS/ BEND FORWARD

EVALUATION CRITERIA:

• ARMS/ SOFT TISSUES NOT OVERLAP LUNGS

• HILUM CENTERED

• RIBS SUPERIMPOSED POSTERIORLY TO VERTEBRAL COLUMN

• TRACHEA IN MIDLINE

LATERAL CHEST

CR CENTERING FOR AP CHEST

• PERPENDICULAR T7

• 3 INCHES BELOW JUGULAR NOTCH

STRUCTURES SHOWN IN AP CHEST

• LUNGS

• GREAT VESSELS/ HEART

WHAT POSITION IS USED TO DEMONSTRATE AIR/ FLUID LEVELS IN PLEURAL SPACES

LATERAL DECUBITUS

CR FOR LATERAL DECUBITUS POSITION

HORIZONTAL/ PERPENDICULAR TO IR

POSITION FOR AP LORDOTIC

UPRIGHT/ APPORXIMATELY 1 FT IN FRONT OF GRID

STRUCTURES SHOWN IN AP LORDOTIC

LUNG APICES/ INTERLOBAR EFFUSIONS

EVALUATION CRITERIA:

• CLAVICLES HORIZONTALLY ABOVE APICES

• NO ROTATION

AP LORDOTIC

PATIENT POSITION FOR LATERAL SOFT TISSUE NECK

SEATED/ STANDING IN LATERAL POSITION

CR POSITIONING FOR LATERAL SOFT TISSUE NECK

• HORIZONTAL MCP

• LARYNGEAL PROMINENCE

STRUCTURES SHOWN FOR AP SOFT TISSUE NECK

• AIR FILLED TRACHEA

• SUPERIOR MEDIASTINUM

EVALUATION CRITERIA:

• NO ROTATION

• EQUIDISTANT SPINOUS PROCESSES TO PEDICLES

AP SOFT TISSUE NECK

CR LEVEL FOR AP UPPER AIRWAY

T1- 2

CR FOR DORSAL DECUBITUS POSITION

• HORIZONTAL/ PERPENDICULAR TO IR

• T7

POSITION FOR VENTRAL DECUBITUS PROJECTION

• PRONE/ SUPINE

• 2 TO 3 INCHES