Pathologies
What is the difference between Apnea and Dyspnea?
Apnea = lack of breathing
Dyspnea = difficulty breathing
Where are the Inferior Scapular Borders located?
T 6/7.
Provide the proper positioning criteria for a PA Chest.
Erect @ 72”
Top of receptor 2” above shoulders
CR @ T6/7
Shoulders rotated forward to move scapulae laterally
Shoulders then depressed to move clavicles below apices
Double inhalation
What is the routine procedure for a Chest Exam?
A PA and Left Lateral Chest.
Provide the proper positioning criteria for an Oblique Chest.
Usually performed to r/o superimposed opacities/pulmonary nodes
Usually 10°-15° RAO & LAO
RAO = left thorax
LAO = right thorax
May employ “nipple markers”
55°-60° LAO for heart studies
What is Atelectasis?
A condition where there's a collapse of all or a portion of a lung.
Where is the Jugular Notch located?
T 2/3.
Provide the proper positioning criteria for a Left Lateral Chest.
Erect @ 72”
Top of receptor 2” above shoulders
Left side to receptor as close as possible
Arms @ chin elevated
CR @ T6/7
Double inhalation
What type of kVp does Chest Radiography require?
High kVp, short scale contrast, (+/- 100), average is 120.
What are the Automatic Exposure Considerations in Chest Radiography?
Requires manual selection of ion chambers
Use left and right “cells” for PA, obliques, and decubitus
Use center “cell” for lateral & apical projections
MAs preset - only select kVp (100+)
What is a Pneumothorax?
An accumulation of air in the pleural space that causes partial or complete atelectasis.
Where are the Sternal Angles located?
T 4/5.
Provide the proper positioning criteria for an AP Axial Chest.
Patient is AP Erect
Requires 15°-20° cephalic angle
CR directed to the MSP and 2” inferior to jugular notch
Use same exposure & SID as for PA chest but with increased collimation
Single inhalation ok
Why should you perform a Chest Exam erect whenever possible?
1. It reduces magnification of cardiac and pulmonary structures
2. Allows for greater lung expansion
What is a Pleural Effusion?
An abnormal collection of fluid in the pleural cavity.
Where is the Xiphoid Process located?
T 9/10.
Provide the proper positioning criteria for an AP Lordotic Chest ("Lindblom" Method).
Patient is AP Erect and instructed to stand 6” away from upright unit
Without assistance, instruct patient to lean back until shoulders touch unit
CR directed perpendicular to MSP and 2” inferior to jugular notch
In what situation would you place the IR crosswise?
Depends on body habits, mostly Hypersthenic patients (males).
What is Pneumonia?
An inflammation of the lungs that results in accumulation of fluid within a certain section of the lungs, creating radio densities in these regions.
Name some of the lung anatomy.
1. Apex = most superior, rounded region above clavicle
2. Base = broader inferior region
3. Costophrenic Angles = lateral aspects of base, above diaphragms
4. Cardiophrenic Angles = medial aspects of base, above diaphragms
5. Hilum = in the medial aspect of each lung, opening for passage of the primary bronchus, pulmonary vessels, nerves, etc.
6. Carina = region of tracheal bifurcation (@T4/5)
7. Pleura = membrane that lines the lungs and thoracic cavity, secretes serous fluid to decrease friction
8. Parenchyma = lung tissue
Provide the proper positioning criteria for a Decubitus Chest.
Left & Right Lateral
Alternate to erect positions for pleural fluid
Patient should be in position 5-10 mins prior to exposure to allow delineation of air/fluid levels
Side “down” is side of interest