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Chest/Thorax is divided into 3 sections. Name the 3 sections.
Bony thorax- framework
Respiratory system- lungs and airways
Mediastinum- space between lungs
The bony thorax consists of:
Sternum- manubrium, body, xiphoid process
12 pairs of ribs
12 thoracic vertebra
The vertebra prominens is located?
C-7 spinous process
The jugular notch is located?
- suprasternal notch
- manubrial notch
- depression on upper sternum T2-T3 interspace
The xiphoid process is located?
Anterior margin of diaphragm T9-T10
what is the purpose of the Respiratory system?
To exchange gaseous substances between air and blood
The Respiratory system has 4 divisions and a diaphragm. name the four divisions.
The pharynx is an upper airway. what are the 3 pharynx?
What is the Larynx?
Organ of voice
suspended from hyoid bone
Level of C3-C6
Thyroid cartilage forms anterior wall of larynx
Laryngeal prominence/ Adam's apple= C5
Cridoid cartilage forms inferior and posterior wall
What is the Trachea?
4.5 inches long
3/4 inch in diameter
16-20 ridges cartilagenous rings
Level of C6-T4
Level of T5 trachea bifurcates into right and left main stem bronchi
Area of bifurcation is carina
Right bronchus is straight and larger
The right lung has ___ lobes. The left lung has ___ lobes.
Right= 3 lobes Left= 2 lobes
The pleura is a doublwall layers covering the lungs. Name the layers
Pulmonary/visceral layer= inner layer
Parietal layer= outer
Pleural cavity= space between the two layers
Regions and specific:chest radiographic anatomy
Right and Left hemidiaphragms
Regions and specific:radiographic anatomy (bones/joints)
Regions and specific:left lateral position
Mediastinum: Medial portion of thoracic cavity between lungs
Be able to locate:
Great vessels: aorta, superior vena cava, inferior vena cava, pulmonary artery and veins
Chest x-ray Pt. prep.
undress from the waist up
remove all opaque objects
always have patient wear shoes
caution: long hair
PA projection of chest x-ray pt. positioning
pt. erect, feet spread slightly.
hands on lower hips, palms out, elbows slightly flexed
shoulders rotated forward against IR to move scapula away from lung field
depress shoulders downward
align MSP to CR and to midline of IR with equal margins between lateral thorax and sides of IR.
Ensure no rotation of thorax
Raise or lower CR and IR to the level of T-7
Top of IR will be 1.5-2 inches above shoulders
Breathing instructions for Chest x-ray
clear, concise directions
expose on 2nd breath
dont assume pt. can hold their breath
Degree of Inspiration
minimum 10-11 ribs
count posterior ribs
3 dimensions: vertical, transverse, AP
14x17 lw/cw depending on pt's body habitus
pt faces IR with shoulders rotated forward
CR directed perpendicular to T7 and midcoronal plane
Top of IR 1 1/2-2 inches above top of shoulders
expose on inspiration
AP chest positioning
position: supine, semi-upright, or upright
CR: angled caudad, perpendicular with long axis of the sternum. (+/- 5 degrees)
CR centering: Level of T7, 3 to 4 inches below the jugular notch
Top of IR 1.5 inches above shoulders
AP chest criteria
Heart will appear larger due to increased OID. (magnification)
Inspiration will not be as full as erect , 8 to 9 posterior wibs visualized above the diaphragm
Scapula might not be all the way out of the lung fields
Correct CR Angle = Three posterior ribs should be seen above the clavicles
Left lateral chest
left side against film
both arms above pt's head
mid-coronal plane perpendicular to IR
Mid-saggital plane parallel to IR
CR perpendicular to T7 and mid-coronal plane
Top of IR at level of top of shoulders
expose on inspiration
Limit repeat exposures
reduce back scatter