Unit 3 (Thoracic Viscera)

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  1. Name how each body habitus is affected in relation to a chest x-ray:
    • Hypersthenic (5%): very broad, cassette CW
    • Sthenic (50%): "normal; what our instructions are based on; cassette LW
    • Hyposthenic (35%): only slightly longer than Sthenic; cassette LW
    • Asthenic (10%): narrow, shallow, and long lung fields; cassette LW (may need an upper an lower)
  2. What area does the the thorax encompass?
    extends from the thoracic aperture to the diaphragm
  3. The space between the lungs that extends from the thoracic aperture to the diaphragm:
  4. What are the three chambers of the thoracic cavity?
    • Pericardial cavity
    • Right pleural cavity
    • Left pleural cavity
  5. What are the four regions of the mediastinum?
    • Superior mediastinum: superior to heart
    • Middle mediastinum: largest, contains heart
    • Anterior mediastinum: shallow area in front of heart
    • Posterior mediastinum: area posterior to heart
  6. What are the four most important structures (radiographically) to be found in the mediastinum?
    • Thymus gland
    • Heart and great vessels
    • Trachea
    • Esophagus
  7. What are the four parts of the respiratory system that are important to us radiographically?
    • Larynx
    • Trachea
    • Bronchi (right and left)
    • Lungs
  8. Why is the pharynx not considered to be part of the respiratory system proper?
    because it is a passageway for both air and food (superior to the larynx)
  9. Name some aspects of the larynx?
    • the "voicebox" where the vocal chords are
    • it's upper margin is at C3, it's lower margin meets the trachea at C6
    • laryngeal prominence (adam's apple) at C5
    • epiglottis (that covers trachea during swallowing) is here too
  10. Where are the trachea and esophagus located in relation to each other?
    trachea is located anteriorly to the esophagus
  11. At what level does the trachea bifurcate, and what is this site called?
    • T4-T5
    • carina (the last cartilaginous ring of the trachea)
  12. Describe the differences of the right and left primary bronchi:
    • the right primary bronchus is wider, shorter, and more vertical than the left bronchus.
    • therefore, foreign objects are more likely to become lodged in the right bronchus - making pneumonia of the right lung more likely to occur
    • though the right bronchus is larger in diameter, the left bronchus is about twice as long.
  13. how many secondary bronchi are there on each side?
    • The right primary bronchus divides into three secondary bronchi
    • The left primary bronchus divides into two secondary bronchi
  14. Name the five levels that the bronchi divide into (largest to smallest):
    • Primary Bronchi (right and left)
    • Secondary Bronchi (three on right, two on left)
    • Tertiary Bronchi
    • Bronchioles
    • Terminal Bronchioles
  15. What do Terminal Bronchioles terminate into?
    small air sacs called alveoli
  16. How many alveoli are there in the two lungs?
    500-700 million
  17. How many lobes and fissures does each lung have?
    • right lung: three lobes (superior, middle, inferior) and two fissures (oblique and horizontal)
    • left lung: two lobes (superior, inferior) and one fissure (oblique)
  18. What is the pleura and what are the names of its layers?
    • the pleura is a delicate double-walled sac that contains the lung
    • the parietal pleura is the outer layer that adheres to the diaphram and chest wall
    • the visceral/pulmonary pleura is the inner layer that covers the surface of the lungs
    • the pleural cavity is the serous-fluid filled space between these two layers
  19. If the lining of the pleura becomes inflammed and the serous fluid dries, this creates friction. This condition is called:
    pleurisy (does not show radiographically)
  20. What connects the pharynx (throat) to the stomach?
    esophagus (from C6-T11)
  21. What are two normal areas of constriction or narrowing of the esophagus?
    • at the aortic arch
    • where the left primary bronchus crosses over
  22. Name four aspects of the thyroid gland:
    • it's part of the lymphatic system
    • it produces the hormone thymosin
    • it's located posteriorly to the upper sternum
    • it's very prominent in infants, but atrophies as a person ages
  23. Describe the position of the heart in the thorax:
    • posterior to the body of the sternum
    • anterior to T5-T8
    • lies in an oblique plane
    • 2/3 of it is lying to the left of the midline
  24. Name three reasons we usually prefer an erect projection of the chest as opposed to a recumbent projection:
    • to allow the diaphragm to move further down
    • to better show possible air/fluid levels in the chest
    • to prevent engorgement and hyperemia (an excess of blood pooling) of the pulmonary vessels
  25. Why do we use a 72" SID for projections of the chest?
    to prevent magnification of the heart shadow as much as possible
  26. Why might special chest projections be taken during inspiration or expiration?
    • to diagnose pneumothorax
    • to diagnose fixation of diaphragm (sniff test)
    • to distinguish between an opacity in the rib or the lung
    • to diagnose atelectasis if it is questionable
  27. What technical factors do you want to use for a chest xray?
    • high kVp for a long scale contrast (low contrast) with more shades of gray
    • short exposure time
    • high mA

    ex. 109-130 kVp, 2.5-3 mAs, with grid
  28. What should you be able to visualize when checking for adequate penetration?
    the t-spine through the heart shadow
  29. How can you tell if a patient was rotated by looking at a PA chest radiograph?
    if there was no rotation, there should be the same amount of space between both SC spaces.

    ex. if the end of the left clavicle is closer to the spine, the pt was rotated into an LAO position (end closer to spine is end closer to IR)
  30. When it comes to oblique projections of the chest, which side is better visualized?
    • posterior obliques better demonstrate the elevated side
    • anterior obliques better visualize the side closest to the IR
  31. When it comes to oblique projections, how do you achieve the best emphasis of the heart?
    by putting the patient into a 60° LAO position
  32. What is the main purpose for a lordotic position and what is an alternative if the patient is unable to hold a lordotic position?
    • purpose: to rule out calcifications and masses beneath the clavicles
    • alternative: axial projection by angling the tube 15-20° cephalic
  33. For a decubitus projection, which side should the anatomical marker represent?
    the side that is up
  34. For a decubitus projection, how should the patient be positioned in relation to pathology?
    • additive: affected side down (like fluid)
    • destructive: affected side up (like air)
  35. Name some basic aspects of a lateral soft tissue neck projection:
    • 72" SID
    • posteriorly rotated shoulders (hands behind back)
    • centered to laryngeal prominence (adam's apple)
    • expose to slow, deep inspiration
    • (according to lecture notes, not check-off notes)
  36. Name some basic aspects of an AP soft tissue neck projection:
    • 40" SID
    • arms hanging by sides
    • centered to manubrium
    • expose to slow, deep inspiration
    • (according to lecture notes, not check-off notes)
  37. What procedure was done after introducing a catheter and positive contrast media into the bronchi, often to rule out obstructions, fistulas, carcinoma, bronchitis, or bronchiectasis? What has replaced this procedure today?
    • Bronchogram
    • Computed Tomography
  38. Name the pathology:
    Image Upload 1
    Atelectasis - collapse of all or part of the lung
  39. Name the pathology:
    Image Upload 2
    Emphysema - destruction of the airway
  40. Name the pathology:
    Image Upload 3
    cystic fibrosis
  41. Name the pathology:
    Image Upload 4
  42. Name the pathology:Image Upload 5
  43. Name the pathology:
    Image Upload 6
    • Pneumothorax
    • caused by air or gas present in the pleural cavity
    • visualized as having no lung markings in that area on the radiograph
  44. Name the pathology:
    Image Upload 7
    Skin Fold (not really a pathology, but an obstruction that could be misdiagnosed as a pathology)
Card Set:
Unit 3 (Thoracic Viscera)
2012-10-11 20:28:33
Radiographic Procedures

do not rely solely upon these cards. last revised fall2011.
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