Mrt 263

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Mrt 263
2012-02-27 23:19:36
Repiratory system

Mrt 263
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  1. Radiographic Procedures
    • Nasopharynx - General Radiography
    • Trachea General Radiography
    • Modified Barium SwallowLung Biopsy Procedure (Procedure
  2. Anatomy of the Neck who it is connected
    larynx connects pharynx to trachea
  3. Pharynx
    throat, passage for air/food
  4. Nasopharynx
    superiosoft palate (respiratory only)
  5. Oropharynx
    middle portion, soft palate to hyoid bone respiratory and digestive
  6. Laryngopharynx
    • inferior portion, hyoid bone to esophagus/larynx
    • (respiratory and digestive)
  7. Where does the alimentary canal begin for the neck
    • begins at the oral cavity
    • continues as the pharynx,
    • esophagus,
    • stomach, small intestine,
    • large intestine and terminates as the anus
  8. What projection is usaully done for a Soft Palate, Pharynx and Larynx
    Usually only Lateral View is performed
  9. Why is a Soft Palate, Pharynx and Larynx projection/views done
    • Often done for foreign bodies
    • epiglottitis
    • stenosis of the trachea
    • swelling of adenoids
  10. What other name is there for a soft palate,Pharynx and larynx
    Also known as ‘soft tissue neck’
  11. Is there and increase in dose to a patient and what can be done to help
    Yes an increased dose to patient’s thyroid: be sure to collimate well
  12. Soft Palate, Pharynx and Larynx
    Anteroposterior Projection
    Patient postion
    • Patient upright or supine
    • Neck extended slightly
  13. What is the respiration for an anteroposterior projection of the soft palate,pharynx and larynx
    slow inspiration
  14. What is an anteropostier projection of the soft palate,pharynx and larynx used for
    • Useful for barium studies
    • (swallowing),
    • phonation/stress studies
  15. What is the central ray for an anteroposterior projection of the soft palate,pharynx and larynx
    CR: ┴ to laryngeal prominence
  16. Soft Palate, Pharynx and Larynx
    Lateral View
    SID 72”
  17. Soft Palate, Pharynx and Larynx
    Lateral View
    Patient position
    Pull shoulders back and extend neck to prevent superimposition of mandible
  18. Soft Palate, Pharynx and Larynx
    Lateral View
    slow inspiration
  19. Soft Palate, Pharynx and Larynx
    Lateral View
    Central ray for Nasopharynx
    • CR: ┴ to…
    • 1” below EAM
  20. Soft Palate, Pharynx and Larynx
    Lateral View
    Central ray for the Oropharynx
    •Oropharnyx – gonion (C2/3)
  21. Soft Palate, Pharynx and Larynx
    Lateral View
    Central ray for the Larynx,pharnyx and upper esophargus
    Larnyx, pharnyx and upper esophagus laryngeal prominence (C5)
  22. Soft Palate, Pharynx and Larynx
    Variations to study
    Phonation of vowel sounds
    to demonstrate vocal cords and cleft palate
  23. Soft Palate, Pharynx and Larynx
    Variations to study
    Valsalva Maneuver
    • to show complete closure of the glottis. Patient is instructed to take a deep breath and bear down
    • to increase both the intrathoracic and intrabdominal pressure
    • used with esophageal varicies (bleeding)
  24. Soft Palate, Pharynx and Larynx
    Variations to study
    Modified Valsalva
    • to test the elatisity of the laryngral pharnyx. Patient pinches nostrils together with the thumb and forefinger.
    • Patient tries to blow their nose
    • their cheeks will puff out in this procedure
  25. Soft Palate, Pharynx and Larynx
    Variations to study
    Swallowing barium
    may be used to visualize foreign bodies
  26. Phonation in a soft palate,pharynx and larynx demonstrates
    The vocal cords and cleft palate
  27. Valsalva Maneuver
    Soft palate demonstrates
    To distend the subglottic larynx and laryngeal pharynx with air
  28. Soft palate
    Hieght of barium bolus demonstrates
    helps visualise pharyngeal structures
  29. Soft palate
    swallowing a ball of cotton/marshmellow soaked in barium demonstrates
    non opague foreign bodies in the pharynx or upper esophagus
  30. Trachea
    Anteroposterior Projection and Lateral View
    • trachea, thyroid gland, thymus gland and associated pathologies
    • Demonstrate an enlarged thymus or abnormalities in the thymus
  31. Trachea
    Anteroposterior Projection and Lateral View
    localization of foreign body
  32. Trachea
    Anteroposterior Projection
    Patient Position
    • Patient supine or upright
    • Neck extended slightly
  33. Trachea
    Anteroposterior Projection
    • slowly inhale (air filled trachea)
    • Area from midcervical to the midthoracic region
  34. Trachea
    Anteroposterior Projection
    Central Ray
    CR: ┴ to manubrium
  35. Trachea
    Lateral View
    Patient Postion
    • Patient upright
    • Hands clasped behind back
    • Rotate shoulders posteriorly
    • Extend neck
  36. Why do you rotate shoulders posteriorly in a lateral view of the trachea
    to prevent superimposition over superior mediastinum
  37. Trachea
    Lateral View
    slow inspiration
  38. Trachea
    Lateral View
    Central Ray
    CR: ┴ midway between the jugular notch and the midcoronal plane
  39. How is the Trachea visualized in lateral view
    • Air filled trachea
    • To demonstrate the superior mediastinum center 4-5” lower
  40. Modified Barium Swallow
    • A fluoroscopy exam preformed with a speech pathologist to view and assess the swallowing mechanism
    • Recorded on video tape
    • •Patient is sitting and speech pathologist or technologist feeds them different amounts and consistencies of barium and barium coated food.
    • •Starts with small quantities of thin and thick barium and then pudding, applesauce, fruit cup all coated with barium •Different techniques used to demonstrate pathologies and aspiration (from penetration of liquid through vocal cords)
  41. Modified Barium Swallow
    3 phases of swallowing
    Phase 1,Oral phase
    moving the food/liquid to the back of the mouth
  42. Modified Barium Swallow
    3 phases of swallowing
    Phase 2,Pharyngeal phase
    moving the food/liquid over the back of the tongue and down to the pharynx or throat
  43. Modified Barium Swallow
    3 phases of swallowing
    Phase 3,Esophageal phase
    the food/liquid enters the esophagus
  44. When would you do a modified barium swallow
    To identifies problems that occur in the mouth, at the base of the tongue, in the pharynx, or in the esophagus
  45. modified barium swallow is suited for
    • patients with complains of swallowing, choking or regurgitating,
    • patients who have had past episodes of pneumonia which have yet to be diagnosed
  46. What other information does a modified barium swallow provide
    • information about tongue motion and coordination and timing of the swallow
    • How material is managed orally just prior to the swallow and evaluates the mechanical aspects of the swallowing mechanism including airway protection and how well the material moves through the different phases of swallowing
  47. Lung Biopsy
    Thoracic Needle Aspiration
    • usually performed when the abnormal condition is near the surface of the lung, in the lung itself, or on the chest wall
    • Biopsy (tissue sample) is collected for analysis
  48. Lung Biopsy
    When is it performed
    when a suspicion of primary or metastatic malignancy exists, usually based on interpretation of a chest x-ray (previously performed)
  49. Lung Biopsy provides what kind of information on
    the stage and extent of disease
  50. What ways can a lung biopsy be done
    fluoroscopy, CT or angiography
  51. Lung Biopsy
    Three risks for this procedure
    • Collapsed lung
    • (pneumothorax)
    • Bleeding
    • Infection
  52. Lung Biopsy
    • Patient is monitored for 2-4 hrs for signs of pneumothorax
    • PA chest is taken immediately post procedure and then 2-4 hrs afterward
    • Signs of complications – shortness of breath, or chest pain
    • - Chest tube may be required if patient has a large pneumothorax
  53. What is required if Patient has a large pneumothorax
    Chest x ray
  54. Nasopharynx
    Superior portion
    From nose to soft palate
  55. Oropharynx
    middle portion
    From soft palate to hyoid bone
  56. Laryngopharynx
    inferior portion
    From hyoid bone to esophagus
  57. The esophagus is anterior to the trachea
    True or false
  58. What is the Valsalva Maneuver and why do we use it?
    • Forcibly blowing air against a closed airway (a closed glottis)
    • Done to increase venous pressure to demonstrate pathologies such as esophageal varicies
  59. Why are initial images of the pharynx performed during inhalation
    To fill the pharynx with air to provide visualization of its structures
  60. If the results for a lung needle biopsy are positive for a malignant tumor, what are possible steps for procedure and treatment?
    • Surgery to remove tumor
    • Radiation therapy
    • Chemotherapy
  61. What step is done should the tumor be secondary
    If tumor is secondary the primary site needs to be established to determine next step
  62. Deglutition
    the act of swallowing
  63. Dysphagia
    difficultly swallowing
  64. Aspiration
    inhalation into the airways of fluid or foreign body
  65. Valsalva Maneuver
    any forced expiratory effort against a closed airway
  66. What four parts or areas are demonstrated on trachea radiographs
    • Trachea
    • thyroid gland
    • parathyroid glands
    • thymus gland
  67. What is another name for a needle biopsy
    Transthoracic needle aspiration
  68. Name 6 contraindications for this procedure
    • Emphysema bullae
    • cysts
    • blood coagulation disorders
    • pulmonary hypertension
    • severe hypoxia
    • uncooperative patient
  69. What are two major requirements for this examination with regards to patient preparation
    • A through explanation of examination
    • Patient should be on clear liquid diet 6 to 8 hours pior to procedure