Positioning Ch 3

Front 1

The bony thorax consists of the single _____, two ______, two _______, twelve pairs of ____, and twelve _______.

Back 1

sternum, clavicles, scapulae, ribs, thoracic vertebrae

Front 2

The two important bony landmarks of the thorax that are used for locating the cetnral ray on a PA and AP chest projections are the ____ and the ____, respectively.

Back 2

vertebral prominens, jugular notch

Front 3

The four divisions of the respiratory system are:

Back 3

pharynx, trachea, bronchi, and lungs

Front 4

Adam's apple

Back 4

thyroid cartalige

Front 5

voicebox

Back 5

larynx

Front 6

breastbone

Back 6

sternum

Front 7

shoulder blade

Back 7

scapula

Front 8

collar bone

Back 8

clavicle

Front 9

The three divisions of the structure located proximally to the larynx that serve as a common passageway for both food and air.

Back 9

nasopharynx, oropharynx, laryngopharynx

Front 10

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?

Back 10

epiglottis

Front 11

The trachea is located _____ to the esophagus.

Back 11

anteriorly

Front 12

The ____ bone is seen in the anterior portion of the neck and is found just below the tongue or floor of the mouth.

Back 12

hyoid

Front 13

If a person accidentally inhales a food particle, which bronchus is it most likely to enter? Why?

Back 13

right. its wider and more horizontal

Front 14

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

Back 14

carina

Front 15

The carina is approximately at the level of ____.

Back 15

T5

Front 16

What is the term for small air sacs located at the distal ends of bronchioles, in which oxygena nd carbon dioxide are exchanged in the blood?

Back 16

alveoli

Front 17

The delicate, double-walled sac or membrane containing the lungs is called the _____.

Back 17

pleura

Front 18

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

Back 18

parietal pleura

Front 19

The inner layer of the pleural membrane that adheres to the surface of the lungs is the _____ or _____.

Back 19

pulmonary or visceral pleura.

Front 20

The potential space between the visceral and parietal pleuras is called the _____.

Back 20

pleural cavity

Front 21

Air or gas that enters the pleural cavity results in the condition is called the _____.

Back 21

pneumothorax

Front 22

lower concave portion of lung

Back 22

base

Front 23

central area in which bronchi and blood vessels enter the lungs

Back 23

hilum

Front 24

upper rounded portion above the clavicles

Back 24

apex

Front 25

extreme, outermost corner of the lungs

Back 25

costophrenic angles

Front 26

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

Back 26

the liver is under the right side

Front 27

What are the four main structures in the mediastinum?

Back 27

thymus gland, heart and great vessels, trachea, esophagus

Front 28

The heart is enclosed in a double-walled membrane called the ____________.

Back 28

pericardial sac

Front 29

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

Back 29

hypersthenic

Front 30

Explain why the right lung is smaller than the left and the right hemidiaphragm is positioned higher than the left hemidiaphragm.

Back 30

the liver is under te right side

Front 31

List the four important structures located in the mediastinum.

Back 31

thymus gland, heart and great vessels, trachea, esophagus

Front 32

The heart is enclosed in a double-walled membrane called the ________.

Back 32

percardial sac

Front 33

The three parts of the aorta are the ______, _______, and ______.

Back 33

ascending, arch, descending

Front 34

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

Back 34

hypersthenic

Front 35

Which body habitus may cause the costophrenic angles to be cut off if careful vertical collimation is not used?

Back 35

hyposthenic and asthenic

Front 36

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

Back 36

10

Front 37

What objects should be removed or moved before chest radiography?

Back 37

necklace, bra, religious medallion around neck, hair fasteners, oxygen lines

Front 38

T/F: Chest radiography is the most commonly repeated radiographic procedure because of poor positioning or exposure factor selection errors.

Back 38

true

Front 39

T/F: Generally, you do not need to use a radiographic grid for adult patients for PA or lateral chest radiographs.

Back 39

False

Front 40

Chest radiography for the adult patient usually employs a kilovoltage peak of ____ to ____ kVp.

Back 40

110-125

Front 41

Optimal technical factor selection ensures proper penetration of the:

Back 41

heart, great vessels, lung regions, hilar region

Front 42

Describe the way optimum density of the lungs and mediastinal structures can be determined on a PA chest radiograph.

Back 42

You should be able to see faint outlines of at least the mid and upper vertebrae and posterior ribs through the heart and other mediastinal structures.

Front 43

T/F: 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.

Back 43

false. situs inversus may be present

Front 44

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

Back 44

Pigg-O-Stat

Front 45

Which exposure factors are recommended for a chest exam of a young pediatric patient?

Back 45

60 to 70 kV, short exposure time

Front 46

T/F: Because they have shallower lung fields, the central ray is often centered higher for geriatric patients.

Back 46

True

Front 47

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

Back 47

second

Front 48

List four pathologic conditions that would suggest the need for both inspiration and expiration PA chest radiographs.

Back 48

atelectasis, foreign body, fixation of diaphragm, small pneumothorax

Front 49

List three reasons that chest radiographs should be taken with the patient in the erect position.

Back 49

diaphragm can move down, air and fluid levels, hyperemia of pulmonary vessels may be prevented

Front 50

Explain the primary purpose and benefit of performing chest radiography using a 72 inch SID.

Back 50

less magnification because beam has less divergence

Front 51

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

Back 51

The liver drops lower, allowing the diaphragm to move farther down. This allows a full inspiration.

Front 52

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

Back 52

air bronchogram

Front 53

Which one of the following anatomic structures is examined to determine rotation on a PA chest radiograph?

Back 53

symmetric appearance of sternoclavicular joints

Front 54

Which positioning tip will help you prevent the patient's chin from being superimposed over the upper airway and apices of the lungs for a PA chest radiograph?

Back 54

extend chin upward

Front 55

What lateral position would you perform on a patient with severe pain in left side of chest?

Back 55

left lateral

Front 56

What lateral position would you perform on a patient with no chest pain but recent history of pneumonia in right lung?

Back 56

right lateral

Front 57

Which lateral position would you perform on a patient with no chest pain or history of heart trouble?

Back 57

left lateral

Front 58

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

Back 58

so the arms aren't in the lung field

Front 59

The traditional central ray centering technique for a PA chest projection requires the technologist to palpate the _________ and measure down from that bony landmark __ inches (___ cm) for a male and __ inches (___ cm) for a female patient.

Back 59

vertebral prominens, 8 inches 20 cm, 7 inches 18 cm

Front 60

Should the 14x17 IR be aligned lengthwise or crosswise for a PA chest projection for a hypersthenic patient?

Back 60

crosswise

Front 61

Should the 14x17 IR be aligned lenthwise or crosswise for a PA chest projection for a hyposthenic patient?

Back 61

lengthwise

Front 62

T/F: With most digital chest units, the question of IR placement into either vertical or longtitudinal positions is eliminated because of the larger IR.

Back 62

false

Front 63

Which one of the following bony landmarks is palpated for centering of the AP chest position?

Back 63

jugular notch

Front 64

T/F: In general, for an average patient more collimation should be visible on the lower margin of the chest image than on the top for a PA or lateral chest projection.

Back 64

false

Front 65

T/F: For most patiets, the central ray level for a PA chest projection is near the inferior angle of the scapula.

Back 65

True

Front 66

T/F: The height of the average-to-large person's chest is greater than the width.

Back 66

False

Front 67

T/F: Single-photon emission computer tomography is frequently used to diagnose myocardial infarction.

Back 67

true

Front 68

T/F: Ultrasound is not an effective modality to detect pleural effusion.

Back 68

False

Front 69

T/F: Echocardiography and electrocardiography are basically the same procedure.

Back 69

False

Front 70

one of the most common inherited diseases

Back 70

cystic fibrosis

Front 71

condition most frequently associated with congestive heart failure

Back 71

pulmonary edema

Front 72

coughing up blood

Back 72

hemoptysis

Front 73

accumulation of air in pleural cavity

Back 73

pneumothorax

Front 74

accumulation of pus in pleural cavity

Back 74

empyema

Front 75

a form of occupational lung disease

Back 75

silicosis

Front 76

a contagious disease cause by airborne bacterium

Back 76

tuberculosis

Front 77

irreversible dilation of bronchioles

Back 77

bronchiectasis

Front 78

most common form is emphysema

Back 78

Chronic obstructive pulmonary disease (COPD)

Front 79

acute or chronic irriation of bronchi

Back 79

bronchitis

Front 80

collapse of all or portion of lung

Back 80

atelectasis

Front 81

inflammation of pleura

Back 81

pleurisy

Front 82

How are manual exposure factors changed for left lung atelectasis?

Back 82

increased

Front 83

How are manual exposure factors changed for lung neoplasm?

Back 83

not changed

Front 84

How are manual exposure factors changed for severe pulmonary edema?

Back 84

increased

Front 85

How are manual exposure factors changed for RDS?

Back 85

increased

Front 86

How are manual exposure factors changed for secondary tuberculosis?

Back 86

increased

Front 87

How are manual exposure factors changed for advanced emphysema?

Back 87

decreased

Front 88

How are manual exposure factors changed for large pneumothorax?

Back 88

unchanged

Front 89

How are manual exposure factors changed for pulmonary emboli?

Back 89

unchanged

Front 90

How are the manual exposure factors changed primary tuberculosis?

Back 90

unchanged

Front 91

How are the manual exposure factors changed for advanced asbestosis?

Back 91

unchanged

Front 92

What are three forms of occupational lung diease?

Back 92

anthracosis, silicosis, asbestosis

Front 93

Wich chest projection is recommended to detect calcifications or cavitations within the upper lung region near the clavicles?

Back 93

AP lordotic

Front 94

Why is a PA chest preferred to an AP projection?

Back 94

places heart closer to IR to reduce magnification of the heart

Front 95

The CR is placed at the level of ___ for a PA chest projection.

Back 95

T7

Front 96

The shoulders need to be rolled forward for teh PA projection to allow the ______ to move laterally and to be clear of the lung fields.

Back 96

scapulae

Front 97

When the AEC is being used for the PA projection, which ionizing chambers should be activated?

Back 97

left and right

Front 98

What is the midline dose range for a PA projection of the chest for an average-sized female?

Back 98

less than 10 mrad

Front 99

T/F: The average breast dose and thyroid dose for a PA chest projection are approximately the same.

Back 99

True

Front 100

The average female breast dose on an AP chest projection is approximately ____ times that for a PA chest dose.

Back 100

4

Front 101

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

Back 101

greater than 1 cm (1/2 inch to 3/4 inch)

Front 102

To prevent the clavicles from obscuring the apices on an AP projection of the chest, the central ray should be angled ____ so that it is perpendicular to the ______.

Back 102

caudad, long axis of the sternum

Front 103

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

Back 103

pleural effusion

Front 104

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

Back 104

left lateral decubitis

Front 105

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

Back 105

pneumothorax

Front 106

which specific position would be sued if the patient were unable to stand but the physician suspected the patient had free air in the left pleural cavity?

Back 106

right lateral decubitis

Front 107

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

Back 107

to r/o calcifications and masses beneath the clavicles

Front 108

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

Back 108

AP semiaxial projection. CR is 15-20 degrees cephallic

Front 109

Which anterior oblique position would best demonstrate the left lung?

Back 109

RAO

Front 110

Which posterior oblique position would be demonstrate the left lung?

Back 110

LPO

Front 111

For certain studies of the heart, the___ anterior oblique requires a rotation of __ degrees.

Back 111

left, 60

Front 112

Which AEC ionization chamber should be activated for an LAO chest projection?

Back 112

right upper chamber

Front 113

Where is the central ray placed for a lateral projection of the upper airway?

Back 113

C6-C7 midway between thyroid cartalige and jugular notch

Front 114

Which tissue gets the greatest dosage during an AP projection of the upper airway?

Back 114

thyroid gland

Front 115

A radiography of a PA view of the chest reveals that the sternoclavicular joints are not the same distance from the spine. The right SC joint is closer the the midline than is the left SC joint. What is the positioning error?

Back 115

Pt. rotated to a slight RAO position

Front 116

A radiograph of a PA projection of the chest shows only seven posterior ribs above the diaphragm. What caused this problem, and how could it be prevented on the repeat exposure?

Back 116

breathing error. need 2 deep breaths

Front 117

A radiograph of a PA and left lateral projection of the chest reveals that the mediastinum of the chest is underpenetrated. The tech used the following factors for the radiograph: 72 in SID, an upright Bucky, a full inspiration exposure, 75 kV and 600 mA and a 1/60 second exposure time. Which factor is most likely the cause of the problem?

Back 117

the kV was too low. 110-125 is ideal range. increase kV and reduce mAs for repeat

Front 118

A radiograph of a PA projection of the chest reveals that the top of the apices are cut off and a wide collimation border can be seem below the diaphragm. In what way can this be corrected during the repeat?

Back 118

center CR higher. level T7

Front 119

A patient with a clinical history of advanced emphysema. AEC not used. How should tech alter the manual exposure settings for this patient?

Back 119

decrease kV moderately

Front 120

A patient with severe pleural effusion. How should the tech alter the manual exposure settings for this patient?

Back 120

increase kV slightly

Front 121

A patient comes for a presurgical chest exam. The clinical history indicates a possible situs inversus of the thorax. which positioning step or action must be taken to perform a successful chest exam?

Back 121

ensure correct anatomical side markers are used

Front 122

A radiograph of a lateral projection of the chest reveals that the posterior ribs and costophrenic angles are separated more than .5 in indicating excessive rotation. Describe a possible method of determining the direction of rotation?

Back 122

determine which hemidiaphragm is more posterior/ anterior

Front 123

A patient enters the ER with a possible hemothorax in the right lung caused by a MVA. The patient is unable to stand or sit erect. Which specific position would best diagnose this condition and why?

Back 123

r lateral decub. side of interest should be done. (fluid)