Chest X-Ray

Front 1

What are the three sections that make up the chest?

Back 1

1. Bony thorax

2. Respiratory system

3. Mediastinum

Front 2

What part of the chest provides a protective framework for the parts involved with breathing and blood circulation?

Back 2

Bony thorax

Front 3

What part of the chest is involved in the exchange of gaseous substances between the air we breath and the bloodstream?

Back 3

Respiratory system

Front 4

What part of the chest is the middle portion of the thoracic cavity between the lungs?

Back 4

Mediastinum

Front 5

What are the 28 structures that make up the bony thorax (from superior to inferior)?

Back 5

1. 2 clavicles

2. 2 scapulae

3. 12 pairs of ribs

4. 12 thoracic vertebrae

Front 6

What are the two topographic positioning landmarks used to center for a chest x-ray?

Back 6

1. Vertebra prominens

2. Jugular notch

Front 7

Which topographic positioning landmark is used to determine the central ray location on a PA chest x-ray?

Back 7

Vertebra prominens

Front 8

Where is the vertebra prominens found?

Back 8

It is the seventh cervical vertebrae that can be found as the first prominent process at the base of the neck

Front 9

Which topographic positioning landmark is used to determine the central ray placement on an AP chest x-ray?

Back 9

Jugular notch

Front 10

Where is the jugular notch found?

Back 10

It is found as a deep depression on the superior portion of the sternum directly below the neck and thyroid cartilage

Front 11

What are the two thoracic vertebrae that "line up" with the jugular notch posteriorly?

Back 11

T2 and T3

Front 12

What are the four divisions of the respiratory system?

Back 12

1. Pharynx

2. Trachea

3. Bronchi

4. Lungs

Front 13

What is an important structure of the respiratory system that is dome-shaped and is considered the primary muscle of inspiration?

Back 13

Diaphragm

Front 14

Which primary bronchi (right or left) is wider, shorter, and more vertical in position?

Back 14

Right

Front 15

Which primary bronchi (right or left) is smaller, longer, and more horizontal in position?

Back 15

Left

Front 16

Which primary bronchi (right or left) is more likely to have food enter it from the trachea and why?

Back 16

Right

The horizontal positioning of the left primary bronchi creates a much smaller diameter to allow food particles and other foreign material in

Front 17

What is the name of the specific prominence or ridge of the lowest tracheal cartilage that divides into the right and left primary bronchi?

Back 17

Carina

Front 18

What is the name of the small air sacs that can be found at the end of the terminal bronchioles?

Back 18

Alveoli

Front 19

How many lobes is the right lung divided into and what are their names?

Back 19

3

1. Superior

2. Middle

3. Inferior

Front 20

How many lobes is the left lung divided into and what are their names?

Back 20

2

1. Superior

2. Inferior

Front 21

What is the name of the light, spongy, highly elastic substance that the lungs are composed of, and is responsible for the expansion and contraction of the lungs (bringing in air and sending out carbon dioxide)?

Back 21

Parenchyma

Front 22

What is the name of the delicate, double-walled sac that each lung contains?

Back 22

Pleura

Front 23

What are the two divisions of pleura and where are they located?

Back 23

1. Parietal located as the outer layer that lines the inner surface of the chest wall and diaphragm

2. Visceral located as the inner layer that convers the surface of the lungs and dips down into the fissures between the lobes

Front 24

What is the name of the potential space between the double-walled pleura that contains a lubricating fluid that allows movement of one or the other during breathing?

Back 24

Pleural cavity

Front 25

What condition occurs when air or gas is present in the pleural cavity and this pressure from the air or gas can cause the lung to collapse?

Back 25

Pneumothorax

Front 26

What condition occurs when there is an accumulation of fluid in the pleural cavity?

Back 26

Hemothorax

Front 27

What are the four structures that are found in the mediastinum?

Back 27

1. Thymus

2. Heart and great vessels

3. Trachea

4. Esophagus

Front 28

What are the seven structures that should be visible on a PA chest x-ray?

Back 28

1. Trachea

2. Apex of each lung

3. Carina

4. Base of each lung

5. Diaphragm

6. Costophrenic angles of the lungs

7. Hilum

Front 29

What is the name of the central area of each lung where the bronchi, blood vessels, lymph vessels, and nerves enter and leave the lungs?

Back 29

Hilum

Front 30

What are the six structures that should be visible on a lateral chest x-ray?

Back 30

1. Apex of the lung

2. Upper lobe of the lung

3. Hilum

4. Lower lobe of the lung

5. Base of the lung

6. Right/left hemidiaphragms

Front 31

What are the four body habitus types?

Back 31

1. Hypersthenic

2. Sthenic

3. Hyposthenic

4. Asthenic

Front 32

Which body habitus is present when a patient has a thorax that is very broad and deep from front to back but shallow in vertical dimension?

Back 32

Hypersthenic

Front 33

When taking a PA chest x-ray of a hypersthenic patient which way should you place the IR in order to ensure the entire anatomy is present on the radiograph (vertical or cross wise)?

Back 33

Cross wise

Front 34

Which body habitus is present when a patient has a thorax that is narrow in width and shallow from front to back but is very long in vertical dimension?

Back 34

Asthenic

Front 35

When taking a PA chest x-ray of an asthenic patient which way would you place the IR in order to ensure the entire anatomy is present on the radiograph (vertical or cross wise)?

Back 35

Vertical

Front 36

Which body habitus is present when the person is considered average?

Back 36

Hyposthenic

Front 37

Which body habitus accounts for 50% of all patients, and consists of more of a stronger and sturdier build?

Back 37

Sthenic

Front 38

What is the best breathing method to use when trying to obtain a good PA chest x-ray?

Back 38

Take one deep breath in and out and then take another deep breath in and hold it until the image is taken

Front 39

Why is it important to take the x-ray on the second inspiration?

Back 39

It allows for a deeper inspiration

Front 40

As a general rule, for the average adult patient, how many ribs should be visible on the PA chest x-ray to be labeled as a good x-ray?

Back 40

10 pairs

Front 41

Give a few examples of objects that should be removed from the patient or pushed off to the side, out of the way of the x-ray beam, in order for them to not show up on the radiograph.

Back 41

1. Clothes with buttons, snaps, or hooks

2. Bras

3. Jewelry

4. Long, braided hair

5. Oxygen lines

6. ECG monitor leads

Front 42

True/False: All chest radiographs should be taken in an upright position if the patient's condition allows.

Back 42

True

Front 43

What are three reasons as to why a chest x-ray should be taken in an upright position?

Back 43

1. Allows the diaphragm to move down further

2. Air and fluid levels become visible in the chest

3. Engorgement and hyperemia can be prevented

Front 44

What term means distended or swollen with fluid?

Back 44

Engorgement

Front 45

What term describes an excess of blood that results from relaxation of the distal small blood vessels or arterioles?

Back 45

Hyperemia

Front 46

What can improve image quality by preventing secondary and scatter radiation from surrounding areas from reaching the IR?

Back 46

Collimation

Front 47

What is the kVp range for a PA chest x-ray?

Back 47

110-125

Front 48

Will the kVp for a PA chest x-ray produce a long or short exposure? What will this result in (more or less grays)?

Back 48

Long

More

Front 49

Will there be a short or long exposure time for a PA chest x-ray?

Back 49

Short

Front 50

True/False: You should ALWAYS try and use a grid when conducting a chest x-ray.

Back 50

True

Front 51

What are some examples of markers that you would use on a chest x-ray?

Back 51

1. Upright

2. AP

3. Left

4. Portable

5. Semi-erect

6. Supine

Front 52

What is the SID for a PA chest x-ray?

Back 52

72"

Front 53

What IR size should be used for a PA chest x-ray?

Back 53

14 x 17

Front 54

What are the four positioning techniques you should instruct your patient to do for a PA chest x-ray?

Back 54

1. Stand erect

2. Chin raised

3. Arms around wall stand

4. Rotate shoulders all the way forward

Front 55

Should you shield your patient when doing a PA chest x-ray?

Back 55

Yes, from the waist down

Front 56

What should your center ray be perpendicular to on the IR on a PA chest x-ray?

Back 56

T7 in the MSP

Front 57

Should there be any rotation on a PA chest x-ray?

Back 57

No

Front 58

Should the scapula be out of the lung fields in a PA chest x-ray?

Back 58

Yes

Front 59

What is the SID for a lateral chest x-ray?

Back 59

72"

Front 60

What IR size should be used for a lateral chest x-ray?

Back 60

14 x 17

Front 61

What are the four positioning techniques you should instruct your patient to do for a lateral chest x-ray?

Back 61

1. Left side against the IR

2. Arms raised above head

3. Chin up

4. Weight evenly distributed on both feet with both feet pointing straight ahead

Front 62

Should you shield your patient when doing a lateral chest x-ray?

Back 62

Yes, from the waist down

Front 63

What should your center ray be perpendicular to on the IR on a lateral chest x-ray?

Back 63

T7 in MSP

Front 64

Should there be any rotation on a lateral chest x-ray?

Back 64

No

Front 65

What is the SID for an AP chest x-ray?

Back 65

72"

Front 66

What IR size should be used for an AP chest x-ray?

Back 66

14 x 17

Front 67

What should your kVp and mAs be at when using a grid for an AP chest x-ray?

Back 67

110 kVp

8 mAs

Front 68

What should your kVp and mAs be at when using a non-grid for an AP chest x-ray?

Back 68

80 kVp

4 mAs

Front 69

Should you shield your patient when doing an AP chest x-ray?

Back 69

Yes

Front 70

How should you position a patient when performing an AP chest x-ray?

Back 70

If a patient is receiving an AP chest x-ray it is because they are in a bed or wheel chair, so they need to be as upright or at least semi-erect as possible

Front 71

Where should the IR be placed in reference to the patient when conducting an AP chest x-ray?

Back 71

Behind the patient with the top of the IR 1.5" above the shoulders

Front 72

What should your center ray be perpendicular to on the IR on an AP chest x-ray?

Back 72

T7

Front 73

How do you get the CR to be perpendicular to the long axis of the sternum when performing an AP chest x-ray?

Back 73

Angle the tube

Front 74

When performing an AP chest x-ray will the heart appear larger or smaller? Why?

Back 74

Larger

Increased magnification from a shorter distance

Front 75

How many ribs should be visible ABOVE the clavicle when conducting an AP chest x-ray?

Back 75

3

Front 76

When conducting a lateral chest x-ray of a patient in a wheelchair or bed, what is the SID, the size of the IR used, and should it be grid or non-grid?

Back 76

72"

14 x 17

Grid

Front 77

When conducting a lateral chest x-ray of a patient in a wheelchair or bed, what is the kVp used, and should you shield your patient?

Back 77

110 kVp

Yes, from the waist down

Front 78

What are the four positioning techniques you should instruct your patient to do for a lateral chest x-ray in a wheelchair or bed?

Back 78

1. Left side against IR
2. Upright with sponge behind patient's back to ensure a straight upright position

3. Arms raised above the head

4. Chin up

Front 79

When conducting a lateral chest x-ray of a patient in a wheelchair, what is important that you remove so that it does not interfere with the x-ray?

Back 79

Arm rests of the wheelchair