DMI 131 (THORACIC)

Bony thorax

Consists of the Sternum (breastbone), Manubrium, body, Xiphoid Process, Clavicles (collarbones), Scapula ( shoulder blades), 12 pairs of ribs, 12 thoracic vertebrae

Manubrium

Sternum

breast bone located in the center of the chest. Composed of three pieces: Manubrium, body, and xiphoid process

Xiphoid process (T9-T10)

pointy bone projection at the end of the sternum ( also known as the xiphoid tip)

Clavicles ( collarbones)

Scapula (shoulder blades)

12 pairs of ribs

Thoracic vertebrae

Vertebrae Prominens ( C7)

7th cervical vertebra. Bony bump at the base of the back of the neck that is felt when you bend your head forward

Jugular notch ( T2-T3)

Located on the manubrium, right in the middle between your clavicles. Can feel it at the base of your neck.

Sternal Angle ( T4-T5)

body meets manubrium

Inferior rib angle (L2-L3)

Lowest costal margin, below sternum

Apex

rounded upper area above the clavicles

Costophrenic angle

outermost corner of each lung

Hilum

central area where bronchi, blood vessels, lymph vessels, & nerves enter. ( theres a left and right)

Mediastinum

Middle portion of the thoracic cavity between the lungs. Four structures here: thymus gland, heart and great vessels, trachea ( anterior), esophagus ( anterior)

T7

approximately at the level of the inferior angle (bottom tip) of the scapula when the arms are down

Why inspirate? ( breathe in)

Fills lungs with air, making them bigger/longer, pushes diaphragm downward, letting you see lungs more clearly

Hemidiaphragm

Carina

Sternoclavicular junction

where your Sternum meets your clavicular (collarbone)

Spinous process

one on each vertebrae

Aortic Arch

located on the left side

Bronchi

branches off trachea

Lateral Decubitis

Patient is lying on side. Looking for air filled/ fluid filled lungs. Use horizontal beams.

Pleural effusion

Fluid in lungs. Costophrenic angles appear blunt, not sharp

Trachea

air filled b/c of inspiration

Technique for PA chest

kV: 110-125. mA:200. Time (sec): 0.02-0.04 mAs: 4-8

Technique for LATERAL chest

kV: 110-125. mA:200. Time (sec): 0.08-0.12. mAs: 16-24

Technique AP chest

kV: 75-85. mA:200. Time(sec): 0.02-0.03. mAs: 4-6

CHEST CONTRAST

Long scale, short wavelength, low contrast. High kVp, low mAs, b/c of soft tissues, air-filled lungs, and bone. Want enough penetration and a long scale of contrast ( shades of gray). Low mAs to reduce pt exposure

Hypersthenic

Very wide/ broad, short torso. Broad and short chest/ lungs. IR crosswise landscape to not cut off anatomy

Sthenic

Average build, IR lengthwise/ portrait

Hyposthenic

Between average and skinny, longer, narrower chest/ lungs, IR lengthwise/portrait

Asthenic

Very slender, long torso. IR lengthwise/portrait

Decubitis

Patient lying down AND horizontal x ray beam. Needed when trying to demonstrate air/fluid. Air rises, fluid sinks. Named for the side that is DOWN

SID and Chest

72 inches. The reason is magnification. Long SID lowers magnification, making the heart look closer to its true size ( more accurate)

MCP (Midcoronal plane) PA CHEST

Runs left to right. Parallel to IR

MCP ( Midcoronal plane) LATERAL CHEST

Runs left to right. Perpendicular to IR because patient turns 90*

MSP ( Midsagittal plane) PA CHEST

Runs front to back. Perpendicular to IR

MSP ( midsagittal plane) LATERAL CHEST

Runs front to back. Parallel to IR because patient is rotated 90*

Primary ( main stem bronchus)

Right and left. The right is shorter and wider; the left is narrower but longer.

Thymus Gland

Located behind the sternum, above and anterior to the heart. Bigger in infants and shrinks over time. Can be seen on PEDIATRICS chest radiograph

Heart

Posterior to the sternum and anterior to T5-T8

“ Great Vessels”- Superior Vena Cava

Located in the mediastinum.

“ Great Vessels”- Inferior Vena Cava

Located in the mediastinum. ( can be seen laterally)

“ Great Vessels”- Aorta

Extends from the heart to L4. The thoracic aorta above the diaphragm. Located in the mediastinum.

“ Great Vessels”- Pulmonary Arteries

Locate in the mediastinum

“ Great Vessels”- Pulmonary Veins

Have a right and a left. Located in the mediastinum

Esophagus

Posterior ( behind) the trachea

The Lungs

Right and left. The right lung has 3 lobes ( superior, middle and inferior); the left lung has 2 ( superior, and inferior)

Pharynx

Posterior area between the nose and mouth ( superiorly) and larynx and esophagus ( inferiorly). Serves as passage for food and air. Divided into 3 parts: Naso, oro and laryngopharynx. ( BEST SEEN LATERAL)

AP LORDOTIC

Erect, one foot from Bucky, leaned back. Shoulders, neck, and back of head against IR. Entire lungs, clavicles above the apices, and distorted ribs displayed. SID 72” Lengthwise, 110-125 kV, 200mA, 0.02-0.04 sec, 4-8 mAs

AP UPPER AIRWAY

Erect, raised chin. Center at T1-2, 1 inch above jugular notch. SID 40” 75-85 kV, 100mA, 0.10-0.12 sec, 10-12 mAs. Slow, deep inspirations

LATERAL UPPER AIRWAY

Erect left/right lateral. Chin elevated, arms behind back. Center C6-7 and MSP. SID 72” 75-85 kV, 100mA, 0.03-0.04 sec, 3-4 mAs. Slow, deep inspirations

PORTABLES CHEST