Ch 3 (volume 1) Thoracic Viscera: Chest and Upper Airway

Found in each lobe

segment

where vessels enter a lung

hilum

superior portion of the lung

apex

inferior border of thoracic cavity

diaphragm

respiratory organ

lungs

major airway tube

trachea

number of lobes in the right lung

three

side of lung where vessels enter

medial

double-walled, serous membrane sac

pleura

respiratory sacs

alveoli

anterior bony wall of the mediastinum

sternum

area between the lungs

mediastinum

mediastinal organ

heart

mediastinal blood vessel

aorta

this lung has two lobes

left

inferior part of a lung

base

pertaining to the chest cavity

thoracic

these branch from the trachea

bronchi

separates a lung into lobes

fissure

For radiographic purposes, the neck is divided into ____________ and ______________ portions

posterior and anterior

Structures located in the anterior neck

thyroid gland

trachea

esophagus

The structure of the upper neck that serves as a passage for both food and air and is common to the respiratory and digestive systems is the __________

pharynx

The portion of the pharynx located above the soft palate

nasopharynx

The portion of the pharynx located from the soft palate to the hyoid bone

oropharynx

THe organ of voice is the

larynx

Which cavity contains the heart and lungs?

thoracic cavity

Which structure separates the thoracic cavity from the abdominal cavity?

diaphragm

Which part of the thoracic cavity contains all thoracic organs except the lungs and pleurae?

mediastinum

Which bony structure forms the anterior border of the mediastinum?

sternum

What mediastinal structure consists of C-shaped cartilaginous rings?

trachea

What area of the trachea divides into two lesser tubes?

carina

What structures branch from the distal end of the trachea?

primary bronchi

Which primary bronchus is shorter and wider than the other?

Right

What thoracic structures are the organs of respiration?

lungs

What is the name of the medial aspect of each lung in which the primary bronchus enters?

hilum

What is the name of the superior portion of each lung?

Apex

Whic structures are at the terminal end of the respiratory system?

alveoli

How many lobes are in the right lung? and left lung?

Right has three

Left has two

Which lung is short and broader than the other. Explain Why

Right because of its close proximity to the liver and heart

Name the three portions of the pleura

visceral pleura - inner layer

parietal pleura - outer layer

pleural cavity - space between layers

inspiration of a foreign material into the airway

apsiration of a foreign body

collapse of all or part of the lung

atelectasis

chronic dilation of the bronchi and bronchioles associated with secondary infection

bronchiectasis

inflammation of the bronchi

bronchitis

chronic condition of persistent obstruction of bronchial airflow

chronic obstructive pulmonary disease

disorder associated with widespread dysfunction of the exocrine glands, abnormal secretion of sweat and saliva, and accumulation of thick mucus in the lungs

cystic fibrosis

Destructive and obstructive airway changes leading to an increased volume of air in the lungs

emphysema

inflammation of the epiglottis

eliglottitis

inflammation of the lung caused by a fungal organism

fungal disease

infection caused by the yeastlike organism Histoplasma capslatum

histoplasmosis

Condition of the lung marked by formation of granulomas

granulomatous disease

condition of unknown origin often associated with pulmonary fibrosis

sarcoidosis

chronic infection of the lung caused by the tubercle bacillus

tuberculosis

under-aeration of the lungs caused by lack of surfactant

hyaline membrane disease of respiratory distress syndrome

transfer of a cancerous lesion from one area to another

metastasis

collection of fluid in the pleural cavity

pleural effusion

lung diseases resulting from inhalation of industrial substances

pneumoconiosis

inflammation caused by inhalation of industrial substances

anthracosis or coal miner lung or black lung

inflammation cased by inhalation of asbestos

silicosis

acute infection in the lung parenchyma

pneumonia

pneumonia caused by aspiration of foreign particles

aspiration

Accumulation of air in the pleural cavity resulting in collapse of the lung

pneumothorax

Replacement of air with fluid in the lung interstitium and alveoli

pulomnary edema

new tissue growth where cell proliferation is uncontrolled

tumor

List pathologic conditions in which radiography of the soft tissue neck is performed

to demonstrate foreign bodies, swelling, masses, and fractures of the larynx and hyoid bone

Radiographs are most commonly made of the upper airway from the _____________________________ to the _____________________________

superior orophraynx

proximal trachea

When performing the AP projection of the soft tissue neck, at what level do you direct the central ray for the upper airway?

direct the central ray at the level of the laryngeal prominence for upper airway

When performing the AP projection of the soft tissue neck, at what level do you direct the central ray for the larynx and superior mediastinum

direct the central ray at the level of the manubrium for larynx and superior mediastinum

Describe the breathing instructions when performing the AP and lateral projections of the soft tissue neck.

Slow inspiration to ensure the trachea is filled with air

What are the collimation light field parameters when performing AP and lateral projections of the soft tissue neck?

12x1

When performing the lateral projection of the soft tissue neck, direct the central ray _____________ through the _______ plane at the level of the ____________________ for the upper airway

horizontal

MCP

laryngeal prominence

WHen performing the lateral projection of the soft tissue neck, direct the central ray at the level of the _______________ through a point midway between the ______________ and the _________ plane for the trachea and superior mediastinum

jugular notch

jugular notch

MCP

Why is it preferable to have the patient upright for chest x-rays?

to allow the diaphragm to reach its lowest level to prevent engorgement of the pulmonary vessels

Which body plane should e perpendicular and centered to he midline of the IR in an upright PA chest?

midsagittal

With reference to the patient, where should the upper border of the IR/collimated field be placed?

About 1.5 to 2 inches above the top of the shoulder

What is the purpose of depressing the shoulders?

to keep the clavicles below the apices

why should the shoulders be rotated forward? (PA projection)

to move the scapulae laterally away from the lung fields

What special positioning instructions may be given to a woman with large, pendulous breasts to avoid superimposing the lower part of the lung fields?

instruct the patient to pull her breasts upward and laterally

If a patient were to remove one shoulder from contact with the grid device before the exposure, which of the following image effects would occur?

The sternal ends of the clavicles would no longer be equidistant from the vertebral column

List two reasons why exposures can be made after both inspiration and expiration?

To demonstrate pneumothorax or to check for foreign bodies

To demonstrate the heart, why should the exposure be made after normal inspiration rather than deep inspiration?

to prevent distortion of the heart by a full inferior movement of the diaphragm

How many posterior ribs should be demonstrated above the diaphragm with proper full inspiration?

10

eight evaluation criteria that indicate a patient was properly positioned for a PA chest projection

The trachea should be visible in the midline

The heart and diaphragm should show sharp outlines

Ten posterior ribs should be seen above the diaphragm

The scapulae should be projected outside the lung fields

The exposure should clearly demonstrate the lung fields

The entire lung fields from the apices to the costophrenic angles should be seen

No rotation; the sternal ends of the clavicles should be equidistant from the vertebral column

A faint shadow of the ribs and superior thoracic vertebrae should be seen through the heart shadow

Which thoracic structures are of primary interest with the left lateral projection?

Heart and left lung

Which thoracic structure is of primary interest when performing a right lateral projection?

Right lung

True or false. A lateral projection image of the chest should be viewed so that the side of the patient where the central ray entered is nearer the viewer.

True

True or false. The patient's heart will appear larger in the right lateral projection image than in the left lateral projection image.

True

Nine evaluation criteria that indicate the patient was properly positioned for a lateral projection.

The heart and diaphragm should be seen in sharp outline

The sternum should be seen in lateral view without rotation

Penetration of lung fields and heart should be clearly seen

The ribs should be superimposed posterior to the vertebral column

Neither the arm nor its soft tissues overlaps the superior lung fields

The hilum should be seen in the approximate center of the image

The thoracic intervertebral spaces should be open (except in patients with scoliosis)

The costophrenic angles and lower apices of lungs should be clearly demonstrated

The long axis of lung fields should be demonstrated in the vertical position without forward-backward leaning.

True or false. When viewing PA oblique chest images the patients left side should be toward the viewer's right side.

True

True or false. When viewing PA oblique chest images (LAO position) the left lung should be partially superimposed by the spine.

True

True or false. The heart and mediastinal structures should be clearly demonstrated within the lung field of the elevated side in oblique images of 45 degrees of body rotation.

True

which AP oblique projection produces an image very similar to that produced by the PA oblique projection RAO position?

AP oblique projection, LPO position

Six evaluation criteria that indicate the patient was properly positioned for an AP projection

The trachea should be seen in the midline

The lung fields should be seen from the apices to the costophrenic angles

The sternal ends of the clavicles should be equidistant from the vertebral column

A faint image of the ribs and thoracic vertebrae should be seen through the heart shadow

The clavicles will lie more horizontal and will obscure more of the apices than in AP projections

The distance from the vertebral column to the lateral border of the ribs should be equidistant on both sides

Pulmonary vascular markings should b visible from the hilar regions to the periphery of the lungs

What part of the lung is generally the area of primary interest when using the lordotic position?

apex

Five evaluation criteria that indicate the patient was properly positioned for an AP axial projection

The clavicles should lie superior to the apices

The apices and lungs should be included in their entirety

The sternal ends of the clavicles should be equidistant from the vertebral column

The ribs should appear distorted with their anterior and posterior portions somewhat superimposed

The clavicles should be lying horizontal, with their sternal ends overlapping only the first or second ribs

What is the general purpose for using a lateral decubitus position?

To demonstrate air or fluid levels in the thorax

True or false. The patient can be positioned upright in a lateral decubitus position.

False

True or false. The affected side in a lateral decubitus should be up to demonstrate fluid level

False

To demonstrate fluid in the right thorax, the patient must be positioned in a:

right lateral decubitus position

which side of the thorax best demonstrates free air when the patient is in the left lateral decubitus position?

Right