Rad 111 Test 2

Front 1

The bony thorax consists of the single (A) __ anteriorly, two (B) __, two (C) __, twelve pairs of (D)__ and twelve (E) __ posteriorly.

Back 1

A) Sternum

B) Clavicles

C) Scapulae

D) Ribs

E) Thoracic Vertebrae

Front 2

The two important bony landmarks of the thorax that are used for locating the CR on a PA or AP projection are the (A) __ and (B) __ respectively.

Back 2

A) Vertebra prominens

B) Jugular notch

Front 3

What are the 4 divisions of the respiratory system?

Back 3

Pharynx, Bronchi, Trachea, Lungs

Front 4

What is the anatomical term for Adam's Apple?

Back 4

Thyroid Cartilage

Front 5

What is the anatomical term for Voice Box?

Back 5

Larynx

Front 6

What is the anatomical term for Breastbone?

Back 6

Sternum

Front 7

What is the anatomical term for Shoulder Blade?

Back 7

Scapulae

Front 8

What is the anatomical term for Collar Bone?

Back 8

Clavicle

Front 9

What are the 3 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 bone

Front 13

If a person accidently inhales a food particle, which bronchus is it most likely to enter, and why?

Back 13

The Right bronchus because it is larger and more verticle

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? Where is it located anatomically?

Back 14

Carina; approximately at the level of T5

Front 15

What is the term for the small air sacs located at the distal end of the bronchioles, in which oxygen and carbon dioxide are exchanged in the blood?

Back 15

Alveoli

Front 16

The delicate, double -walled sac or membrane containing the lungs is called what?

Back 16

Pleurae

Front 17

The outer layer of this membrane adhering to the surface of the chest wall and diaphragm is known as what?

Back 17

partial pleurae

Front 18

The inner layer adhering to the surface of the lungs is __ or __.

Back 18

Pulmonary pleurae or Visceral pleurae

Front 19

The potential space between the partial, visceral, and pulmonary pleurae is

Back 19

Pleural Cavity

Front 20

Air or gas that enters the pleural cavity results in a condition know as

Back 20

pneumothorax

Front 21

What is the lower concave portion of the lung called?

Back 21

Base

Front 22

What is the central are in which bronchi and blood vessels enter the lungs?

Back 22

hilum

Front 23

What is name of the upper rounder portion of the lungs that is above the level of the clavicle?

Back 23

Apex

Front 24

What is the name of the extreme outermost layer of the lungs?

Back 24

Costophrenic Angle

Front 25

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

Back 25

B/c the liver is underneath the right lung

Front 26

What are the 4 important structures located in the mediastinum?

Back 26

Thymus gland, trachea, esophagus, heart, and great vessels

Front 27

Identify the structures

Back 27

A) Thymus Gland

B) Aortic Arch

C) Heart

D) Inf. Vena Cava

E) Sup. Vena Cava

F) Thyroid Gland

G) Trachea

H) Esophagus

Front 28

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

Back 28

Pericardium

Front 29

What are the 3 parts of the Aorta?

Back 29

Ascending, Decending, Arch of the Aorta

Front 30

Identify the structures

Back 30

A) Apex of the left lung

B) Trachea

C) Carina

D) Heart

E) Left costophrenic Angle

F) Right Hemidiaphragm

G) Hilum

H) Apex of the lung

I) Hilum

J) Heart

K) Bil Hemidiaphragm

L) Bil Costophrenic

Front 31

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

Back 31

hyperthenic

Front 32

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

Back 32

Hypostenic and Asthenic

Front 33

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

Back 33

10

Front 34

What objects should be removed or moved before a chest radiograph?

Back 34

Necklace, Bra, Religious medallion around neck, hair fasteners, oxygen lines

Front 35

True or False: Chest radiography is the most commonly repeated radiographic procedure b/c of poor positioning or exposure factor selection errors.

Back 35

True

Front 36

Chest radiography for the adult patient usually employs a kilovoltage peak of ___ to __ kV

Back 36

110 to 125

Front 37

True or False: Generally, you do not need to use radiographic grids for adult patients for PA or lateral chest radiographs.

Back 37

False

Front 38

Optimal technical factor selection ensures proper penetration of

Back 38

Heart, Great Vessels, Lung regions, Hilar region

Front 39

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

Back 39

Outlines of the middle and upper vertebrae and ribs through the heart and other mediastinal structures.

Front 40

True or False: 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 40

False

Front 41

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

Back 41

Pigg-O-Stat

Front 42

Which set of exposure factors is recommended for a chest exam of a young peds patient?

Back 42

70 to 85 kV, short exposure time

Front 43

True or False: Because they have a shallower (superior-inferior dimension) lung fields, the CR is often centered higher for geriatric patients.

Back 43

True

Front 44

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

Back 44

Full

Front 45

List the 4 possible pathologic conditions that suggest the need for both inspiration and expiration in PA chest radiographs.

Back 45

Pneumothorax, foreign body presence, fixation of diaphragm, distinguish opacity

Front 46

Identify the structures

Back 46

A) Left mainstem bronchus

B) Descending Aorta

C) T5

D) Esophagus

E) Region of Carina

F) Right mainstem bronchus

G) Sup. Vena Cava

H) Ascending Aorta

I) Sternum

Front 47

List and explain briefly the 3 reasons chest radiographs should be taken with the patient in the erect position (when the patients condition permits).

Back 47

A) Diaphragm moves down

B) Air and fluid levels in the lungs are better visualized

C) Engorgement and hyperemia of pulmonary vessels can be prevented

Front 48

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

Back 48

Abdominal organs move downward allowing the diaphragm to move farther down and the lungs to fully aerate

Front 49

Explain the primary purpose and benefit of performing chest radiography using a 72-inch (183 cm) SID.

Back 49

Reduce distortion and magnification of the heart and other chest structures

Front 50

What is a common radiographic sign seen on a chest radiograph for a patient with respiratory distress syndrome?

Back 50

Air bronchogram

Front 51

What anatomic structures is examined to determine rotation on a PA chest radiograph?

Back 51

Symmetric appearance of sternoclavicular joints

Front 52

Which positioning tip will help prevent the patients chin and neck from being superimposed over the upper airway and apices of the lung for a PA chest radiograph?

Back 52

Extend the neck and chin upward

Front 53

Which lateral projection would you perform for a patient with severe pains in the left side of chest?

Back 53

Left

Front 54

Which lateral projection would you perform for a patient with no chest pain but recent hx of pneumonia in right lung?

Back 54

Right

Front 55

Which lateral projection would you perform for a patient with no chest pain or hx of heart trouble?

Back 55

Left

Front 56

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

Back 56

Prevents superimposition on the upper chest field

Front 57

The traditional CR centering technique for the chest is to place the top of the IR how many inches above the shoulder?

Back 57

1.5 to 2 inches or 4 to 5cm

Front 58

A recommended CR centering technique for a PA chest projection requires the technologist to palpate (A)___ and measure down from the bony landmark (B) ___ inches for a male and (C) ___ for a female.

Back 58

A) T1

B) 7 inches or 18 cm

C) 8 inches or 20 cm

Front 59

Should the 14 X 17 inch IR be aligned lengthwise or crosswise positions for a PA projection of a hypersthenic patient?

Back 59

Crosswise

Front 60

Should the 14 X 17 inch IR be aligned lengthwise or crosswise positions for a PA projection of a hyposthenic patient?

Back 60

Lengthwise

Front 61

What bony landmark is palpated for centering of the AP chest projection?

Back 61

Jugular Notch

Front 62

True or False: With most digital test units, the question of IR placement into either vertical or crosswise positions is eliminated b/c of the larger IR.

Back 62

True

Front 63

True or False: In general, for an average patient more collimation should be visible on the lower margin of the chest image that on the top for a PA or lateral chest projection.

Back 63

False; it should be equal

Front 64

True or False: For most patients, the CR level for a PA chest projection is near the inferior angle of the scapula.

Back 64

True

Front 65

True or False: The height or vertical dimension of the average-to-large person's chest is greater that the width, or horizontal dimensions.

Back 65

False; greater width

Front 66

True or False: Single-photon emission computed tomography (SPECT) is frequently used to diagnose Myocardial Infarction (MI).

Back 66

True

Front 67

True or False: Ultrasound is not an effective modality to detect pleural effusion.

Back 67

False; it is effective

Front 68

True or False: Echocardiography and electrocardiography are basically the same procedure.

Back 68

True

Front 69

What is Cystic Fibrosis?

Back 69

One of the most common inherited diseases

Front 70

What is Pulmonary Edema?

Back 70

Condition most frequently associated with CHF

Front 71

What is Dyspnea?

Back 71

Shortness of breath

Front 72

What is Pneumothorax?

Back 72

Accumulation of air in the pleural cavity

Front 73

What is Empyema?

Back 73

Accumulation of pus in the pleural cavity

Front 74

What is Silicosis?

Back 74

A form of occupational lung disease

Front 75

What is tuberculosis?

Back 75

A contagious disease caused by an airborne bacterium

Front 76

What is Bronchiectasis?

Back 76

Irreversible dilation of the bronchioles

Front 77

What is COPD?

Back 77

Most common for of Emphysema

Front 78

What is Bronchitis?

Back 78

Acute or Chronic irritation of bronchi

Front 79

What is Atelectasis?

Back 79

Collapse of all or portion of the lung

Front 80

What is Pleurisy?

Back 80

Inflammation of pleura

Front 81

For left lung atelectasis should exposure factors be increased, decreased, or remain the same?

Back 81

Increased

Front 82

For lung neoplasm should exposure factors be increased, decreased, or remain the same?

Back 82

Remain the same

Front 83

For severe pulmonary edema should exposure factors be increased, decreased, or remain the same?

Back 83

Increased

Front 84

For respiratory distress syndrome should exposure factors be increased, decreased, or remain the same?

Back 84

Increased

Front 85

For secondary tuberculosis should exposure factors be increased, decreased, or remain the same?

Back 85

Increased or remain the same

Front 86

For advanced emphysema should exposure factors be increased, decreased, or remain the same?

Back 86

Decreased

Front 87

For large pneumothorax should exposure factors be increased, decreased, or remain the same?

Back 87

remain the same

Front 88

For pulmonary emboli should exposure factors be increased, decreased, or remain the same?

Back 88

Remain the same

Front 89

For primary tuberculosis should exposure factors be increased, decreased, or remain the same?

Back 89

Remain the same

Front 90

For advanced asbestosis should exposure factors be increased, decreased, or remain the same?

Back 90

Remain the same

Front 91

What is a form of occupational lung disease?

Back 91

Anthracosis, Silicosis, Asbestosis

Front 92

What chest projection is recommended to detect calcification or cavitations with in the upper lung region near the clavicles?

Back 92

AP lordotic

Front 93

Why is a PA chest preferred over an AP projection?

Back 93

The heart is closer to the IR to reduce magnification

Front 94

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

Back 94

T7

Front 95

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

Back 95

Scapulae

Front 96

Why should a left lateral be performed unless departmental protocol indicates otherwise?

Back 96

It shows the heart better

Front 97

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

Back 97

> 1cm or .5"-.75"

Front 98

To prevent the clavicles from obscuring the apices on an AP projection of the chest, the CR should be angled (A) ___ so that it is perpendicular to the (B)___.

Back 98

A) + or - 5 degrees

B) Sternum

Front 99

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

Back 99

Pleural Effusion

Front 100

Which specific position would be used if a patient were unable to stand but the physician suspects the patient to have fluid on the left lung?

Back 100

Left Lateral Decubitus

Front 101

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

Back 101

Pneumothorax

Front 102

Which specific position would be used if the patient were unable to stand but the physician suspects the patient to have free air in the left pleural cavity?

Back 102

Right Lateral Decubitus

Front 103

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

Back 103

To r/o calcifications and masses beneath the clavicle

Front 104

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

Back 104

AP semiaxial projection with the patient supine

Front 105

Which anterior oblique projection would best demonstrate the left lung?

Back 105

Right Anterior Oblique (RAO)

Front 106

Which posterior oblique projection would best demonstrate the left lung?

Back 106

Left posterior oblique (LPO)

Front 107

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

Back 107

A) Left

B) 60

Front 108

True or False: A grid is not recommended for a Left Posterior Oblique (LPO).

Back 108

Flase

Front 109

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

Back 109

Level of C6 or C7 midway between the layrngeal prominence of the thyroid cartilage and jugular notch

Front 110

Careful collimation during a chest radiograph will improve image quality by decreasing ___ radiation to the IR.

Back 110

Scatter

Front 111

What are the recommended patient instructions when performing an erect PA chest on a female patient with large breasts?

Back 111

Lift the breasts up and outward and the removed hands as she leans against the bucky

Front 112

True or False: No lead shielding is necessary for male patients or women greater than age 65 during radiographic imaging of the chest.

Back 112

False; shielding is always necessary reguardless of age

Front 113

An erect chest PA radiograph aids the patient to achieve full inspiration and helps prevent ___ and ___ of the pulmonary vessels.

Back 113

Engorgment and Hypermia

Front 114

A radiograph of a PA view of the chest reveals sternoclavicular (SC) joints are not the same distance from the spine. The right SC joint is closer to the midline than is the Left SC joint. What is the positioning error?

Back 114

Rotation. The patient is rotated into a slight Right Anterior Oblique position.

Front 115

A radiograph of a PA projection of the chest shows only 7 posterior ribs above the diaphragm. What caused this problem, and how can it be fixed on the repeat exposure?

Back 115

The lungs are underinflated. Make sure the patient takes a deep breath and take the xray on the 2nd inhalation.

Front 116

A radiograph of a PA and left lateral projection of the chest reveals the mediastinum is underpenetrated. The technologist used the following factors for the image: 72" SID, upright bucky, full inspiration exposure, 75kV, and 600-mA and a 1/60 second exposure time. Which factor is the cause of the problem and how can it be improved?

Back 116

The kV should be between 110-125kV. Increase the kV and decrease the mA.

Front 117

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

Back 117

Center the CR to T7, make sure the IR is centered to the CR and the top collimation boarder is at the vertebral prominence.

Front 118

A patient with a clinical history of advanced emphysema comes to the radiology dept for a chest xray. Automatic Exposure Control (AEC) will not be used. How the should radiographer manually alter the exposure setting for the patient?

Back 118

Decrease the kV moderatly

Front 119

A patient with severe pleural effusion comes to the radiology dept for a chest xray. Automatic Exposure Control (AEC) will not be used. How the should radiographer manually alter the exposure setting for the patient?

Back 119

Increase the kV slightly

Front 120

A patient comes to the radiography dept 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 120

Ensure the correct placement of markers on the IR b/c the heart and other structures maybe transposed from left to right

Front 121

A radiograph of a lateral projection of the chest reveals the posterior ribs and costophrenic angles are sperated more that 1/2 in or 1cm, indicating excessive rotation. Describe a possible method for determining the direction of rotation.

Back 121

Determine which hemidiaphragm is more posterior or anterior the left hemidiaphragm can frequently be identified by visualization of air bubbles or the inferior hear shadow

Front 122

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

Back 122

Right Lateral Decubitus position

Front 123

A young child enters the ER with a possible foreign body in on of the bronchi of the lung. The foreign body, a peanut, cant be seen on the PA and lateral projections. Which additional projections could the technologist perform to locate the foreign body?

Back 123

AP and Lateral upper airway projection

Front 124

A routine chest series indicates a possible mass beneath the a patients right clavicle. The PA and Lateral projections are inconclusive. What additional projections could be take to rule out this condition?

Back 124

AP Lordotic

Front 125

A patient has a possible small pneumothorax. Routine chest projection (PA and LAteral) fail to reveal the pneumothorax conclusively. Which additional projections could be take to rule out this condition?

Back 125

Lateral Decubitus AP with affected side up and/ or inspiration and expiration PA projections

Front 126

A patient with a history of pleurisy comes to the radiology dept. What radiographic series should be performed?

Back 126

Erect PA and Lateral

Front 127

A patient with a possible neoplasm in the right lung apex comes to the radiology dept. for a chest exam. The PA and Lateral projections dont clearly demonstrate the neoplasm b/c of superimposition of the clavicle over the apex. The patient is unable to stand or sit erect. Which additional projections can be taken?

Back 127

AP semiaxial projection; CR is angled 15- 20 degrees cephalad to project the clavicles above the apices and clearly demonstrate the possible tumor.

Front 128

PA and left lateral projections demonstrate a suspicious region in the left lung. The radiologist orders an oblique projection that will best demonstrate or "elongate" the left lung. Which specific oblique projections will best elongate the left lung?

Back 128

Left Posterior Oblique or Right Anterior Oblique

Front 129

Aspiration

Back 129

Occurs when foreign objects are swallowed or aspirated into the air passage of the bronchial tree.

Front 130

Atelectasis

Back 130

A condition in which collapse of all or a portion of a lung occurs as the result of obstruction of the bronchus or puncture or "blowout" of an air passageway.

Front 131

Brochiectasis

Back 131

An irreversible dilation or widening of bronchi or bronchioles that may result from repeated pulmonary infection or obstruction.

Front 132

Bronchitis

Back 132

an acute or chronic condition in which excessive mucus is secreted into the bronchi causing and SOB

Front 133

Chronic Obstructive Pulmonary Disease (COPD)

Back 133

A form of persistent obstruction of the airway that usually causes difficulty in emptying the lungs of air; maybe caused by emphysema or chronic bronchitis

Front 134

Cystic Fibrosis

Back 134

The most common of inherited diseases, is a condition in which secretions of heavy mucus cause progressive clogging of bronchi and bronchioles.

Front 135

Dyspnea

Back 135

Difficulty in breathing

Front 136

Emphysema

Back 136

An irreversible and chronic lung disease in which air spaces in the alveoli become greatly enlarged as a result of alveolar wall destruction and loss of alveolar elasticity.

Front 137

Epiglottitis

Back 137

Swelling of the epiglottis

Front 138

Neoplasm

Back 138

New growth or tumor

Front 139

Benign

Back 139

Non Cancerous

Front 140

Malignant

Back 140

Cancerous

Front 141

Pleural Effusion

Back 141

A condition of abnormal accumulation of fluid in the pleural cavity

Front 142

Empyema

Back 142

Pus in the lungs

Front 143

Hemothorax

Back 143

blood in the lungs

Front 144

Pleurisy

Back 144

inflammation of the pleura surrounding the lungs

Front 145

Pneumonia

Back 145

An inflammation caused by a virus resulting in accumulation of fluid within certain sections of the lungs

Front 146

Aspiration pneumonia

Back 146

Caused by aspiration of a foreign object into the lungs, which irritates the bronchi, resulting in edema

Front 147

Bronchopneumonia

Back 147

Bronchitis of both lungs that caused by strep or staph bacteria.

Front 148

Lobar Pneumonia

Back 148

Pneumonia generally confined to one or two lobes of the lungs

Front 149

Viral (Interstitial) Pneumonia

Back 149

causes inflammation of the alveoli and connecting lung structures.

Front 150

Pneumothorax

Back 150

an accumulation of air in the pleural space that causes partial or complete collapse of the lung and results in immediate and severe SOB and chest pain

Front 151

Pulmonary Edema

Back 151

Excess fluid within the lung that most frequently is caused by a back up in pulmonary circulation commonly associated with CHF

Front 152

Respiratory Distress Syndrome (RDS)

Back 152

An emergent condition in which the alveoli and capillaries of the lungs are injure or infected resulting in leakage of fluid and blood into the spaces between the alveoli

Front 153

Tuberculosis (TB)

Back 153

A contagious disease that is caused by airborne bacteria.

Front 154

Anthracosis

Back 154

Caused by deposits of coal dust

Front 155

Asbestosis

Back 155

caused by inhalation of asbestos dust that results in pulmonary fibrosis

Front 156

Silicosis

Back 156

A permanent condition of the lung that is caused by inhalation of silica dust.

Front 157

Sarcoidosis

Back 157

Fibrous Scaring