Rad 101

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Author:
PeteChin
ID:
101971
Filename:
Rad 101
Updated:
2011-09-16 00:04:54
Tags:
radiography rad 101 chest ray pcc
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Study cards for rad 101. First lecture
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  1. True Anatomical Position
    • Arms Down
    • Palms Forward
    • Toes Pointed down
  2. The plane that transects the body into upper and lower (crainial - caudal) portions
    Axial or Transverse
  3. The place the transects the body into right and left portions
    Sagittal
  4. The plane that transects the body into front and rear (ventral - dorsal) portions
    Coronal
  5. The path of radiation from the tube
    Projection
  6. OID
    Effects on imaging
    • Object to Image receptor Distance
    • Shorter OID decreases magnification of subject
    • Shorter OID decreases penumbra
  7. SID
    Effects on images
    • Source to Image receptor Distance
    • Longer SID decreases magnification
    • Longer SID decreases penumbra
  8. Sections of Thoracic Cavity
    • Respiratory
    • Mediastinal
    • Bony Thorax
  9. Anatomy of the Respirator System
    • Larynx
    • Trachea
    • Bronchi - Mainstem, Secondary
    • Lungs - Lobes: 3 on right, 2 on left
  10. Lung Anatomy
    • Apex
    • Base
    • Costophrenic Angle
    • Cardiophrenic Angle
    • Lingula
    • Diaphragm
    • Pleura - Parietal, Visceral
  11. Mediastinal Anatomy
    • Trachea/Bronchus
    • Esophagus
    • Thymus
    • Heart/Great Vessels
    • Hilus/Hilum
  12. 4 Great Vessels of the Mediastinum
    • Aorta
    • Brachiocephalic - rt carotid, rt subclavian
    • Carotid - left
    • Subclavian - left
    • (ABC'S)
  13. Thymus Gland Function
    • Primary contraller of immune system at birth
    • Produces thymosin
  14. Relative postions of trachea and esophagus
    Esophagus is behind trachea
  15. 2 ducts onf the lymph system in mediastinum
    • Right lymphatic duct - drains rt chest and arm
    • thoracic duct - drains remainder of body
  16. Anatomy of Bony Thorax
    • Sternum
    • Clavicles
    • Scapula
    • 12 Ribs
    • 12 Thoracic vertebrae
  17. Appropriate hanging/displaying of images
    As if facing pt
  18. PA Chest Postitioning guildlines (9)
    • 14 x 17 IR
    • Men vs Women IR orientation
    • Top margin of IR 1.5-2" above shoulders
    • Pt erect, facing IR
    • Center IR to mid-sagittal plane
    • rotate shoulders forward
    • SID = 72"
    • CR = horizontal, centered on T7
    • Collimation = 1" to skin margins (if possible)
  19. PA Chest critique/error
    • Rotation: SC joints equidistant to spine, pedicles equidistant in spine, spinous processes in midline
    • Tilt: Mid-sagittal plane centered to IR
    • Part Angulation: Heads of clavicles 1 1/2 - 2" below top of lung apices
    • Anatomy Included: Lung Apices to costophrenic Angles, 10 posterior ribs
  20. Lateral Chest Positioning Guildlines (9)
    • 14 x 17 IR
    • Men vs Women IR orientation
    • Top margin of IR 1.5 - 2" above shoulders
    • pt erect, in true lateral
    • center mid-coronal plane to IR
    • Arms above head if possible
    • SID = 72"
    • CR = horizontal, center to lvl of T7
    • Collimation = 1" to skin margins (if possible)
  21. Lateral Chest critique/error
    • Rotation: Superimposed posterior rigs - anterior o posterior
    • Tilt: mid-coronal plane centered to IR
    • Part Angulation: Superior & inferior margins of vertebral bodies superimposed - mid T-Spine
    • Anatomy Included: Lung apices to costophrenic & cardiophrenic angles
  22. Chest - Lateral Decubitus (L) Positioning Guildlines (8)
    • IR 1.5 - 2" above shoulders
    • IR extends above pt
    • Elevate pt on pads
    • Center mid-sagittal plane to IR
    • Arms above head
    • SID = 72"
    • CR = horizonal to level of T7
    • Collimation = 1" to skin margins (if possible)
  23. Chest - Lateral Decubitus critique/error
    • Rotation: SC joints equidistant to spine, pedicles equidisant to spinous processes
    • Tilt: mid-sagittal plane centered to IR
    • Part angulation: Top of medial end of clavicles 1.5 - 2" below apices of lungs
    • Anatomy Included: Lung apices to costophrenic angles, 10 posterior ribs
  24. Chest - PA Oblique - RAO or LAO Guildlines (7)
    • IR 1.5-2" above shoulders
    • Rotate pt 45o - study side shoulder against IR, ipselateral side away
    • Elevate ipselateral arm
    • center pt to IR
    • SID = 72"
    • CR = horizontal to level of T7
    • Collimation = 1" to skin margins (if possible)
  25. Chest - PA Oblique - RAO or LAO critique/errors
    • Rotation: Ipsolateral Chest 2x size of side of study(spine to lateral border RAO = L>R, LAO = R>L)
    • Tilt: mid-chest to mid-point of IR
    • Part angulation: medial end of clavicles 1.5 - 2" below lung apices
    • Anatomy Inclued: lung apices to costophrenic angles, 10 posterior ribs - both lungs entirely
  26. Chest AP Apical Lordotic Guildlines (7)
    • IR centered to level of T2 - small IR
    • Pt erect or supine
    • center mid-sagittal plane to IR
    • Rotate shoulders forward
    • SID = 72", 40+" if supine
    • CR 15o - 20o cephalad - entering at mid-sternum
    • Collimation = 1" to skin margins (if possible)
  27. Chest - AP Apical Lordotic critique/errors
    • Rotation: Clavicles equidistant to spine
    • Tilt: mid-sagittal plane aligned with IR
    • Part Angulation: Clavicles horizontal with medial ends overlying 1st or 2nd rib only
    • Anatomy included: Entire apices - whole lung, field if using 14 x 17
  28. Pathology - Atelectasis
    • Collapse of all or part of the lung due to blockage of an air passage (bronchus or bronchiole)
    • May be mucous plug, compression
    • Usually "patch" in appearance when only small area affected
    • Technique Change - possible increase
  29. Pathology - Emphysema
    • Tissue destruction in therminal bronchioles - traps air - not reversible
    • As disease progresses more air trapped in lungs
    • Flattens diaphragms - compresses/elongates heart
    • Technique change - reduce - trapped air = less density
    • Extra view - expiration chest
  30. Pathology - subcuetaneous emphysema
    • Free air under skin
    • Caused by penetrating wound to chest, crushed trachea
    • Patient "crackles" when you touch them - air is forced thru tissue
  31. Pathology - pneumonia
    • Inflammation of the lungs - pt will be symptomatic (cough, fever)
    • "pneumonitis" - localized pneumonia
    • "lobar" - entire lobe involved
    • Technique change - may need to increase
  32. Pathology - Pleural Effusion
    • Potential space between pleural sacs fills with fluid
    • technique change - increase
    • extra view - decubitus - side of interest down
  33. Pathology - Congestive Heart Failure (CHF)
    • Poor cardiac function - blood pools in pulmonary vessels - plasma seeps thru dilated walls = heavy lung markings
    • Technique change - may increase
  34. Pathology - pneumothorax
    • Potential space between lungs fills with air
    • Can be from trauma or spontaneous leak
    • Acute onset of sharp pain, SOB
    • Apex usually shows pneumo best
    • Technique change - may decrease
    • Extra view - expiration PA
  35. Pathology - Hemothorax / hemopneumothorax
    • Potential space between lungs fills with blood
    • hemopneumothorax = collapse with blood
    • Technique change - may increase
    • extra view - expiration PA, decubitus
  36. Pathology - Chronic Obstructive Pulmonary Disease (COPD)
    • Persistent obstruction of bronchial air flow
    • Associated with emphysema/smoking
    • Do not increase pts oxygenTechnique change - decrease
  37. Pathology - pulmonary tuberculosis
    • Contagious bacterial infection caused by Mycobacterium tuberculosis
    • Spread by inhaling droplets sprayed into air from cough or sputum
    • Granulomas develop in infected tissues
    • May spread to other organs
  38. Pathology - Pulmonary emboli
    • Venous thrombo-embolism in the lung. Blockage of a pulmonary artery from a blood clot, fat, air, or clumped tumor cells
    • Most common from DVT - deep vein thrombosis
    • Creates "pie-shaped" atelectatic apperance in lungs

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