Chest

1
Chapter 3

• Chest

2
Bony Thorax

• 1 - _____________- (Breastbone)
• 2 - Clavicles (Collar bones)
• 2 - ____________ (Shoulder Blades)
• 12 - Rib Pairs
• 12 - ________________

3
Lungs

• Two lungs - Right and Left
• Right Lung has ______________
• Superior, middle, and inferior
• Separated by ______________
• Left Lung has ______________
• Superior and inferior
• Separated by ______________

4
Lungs

• ___________
• Rounded upper area
• _______________
• Lower concave area.
• Rests on the ________________
• __________________
• _____________corners where the diaphragm meets
  rib

5
Lung Tissue

• ________________
• Spongy, elastic material
• Allows lungs to _______________

6
Pleura

• _____________
• Sac the lungs are held in
• Two parts
• ___________- Outer layer
• _____________Pleura - Inner layer
• _________________
• Potential space between parietal and pulmonary
  pleura

7
Pleura Problems

• ________________
• Air in the Pleural cavity
• ___________________
• Accumulation of fluid in the pleural cavity
• Hemothorax _________
• Empyema - ________
• ______________
• Inflammation of the pleura membrane

8
Diaphragm

• Large muscle on ___________of the lungs
• Two Hemidiaphragms
• Moves ____________
• Causing air to be Sucked in and expanding
  thoracic cavity
• And _______
• Forces air to be pushed out

9
Pharynx(Upper Airway)

• Three Parts
• ____________ - Posterior to nasal cavity
• __________ - Posterior to oral cavity (mouth)
• _____________- At the junction between larynx and
  esophagus
• Accessory Parts
• Hard Soft Palate, Uvula,

10
Larynx(Voice Box)

• Cartilaginous structure
• From ______________
• Suspended by _______________
• Contains 3 cartilage structures
• ________________
• ________________
• Cricoid Cartilage

11
Trachea(Windpipe)

• Inferior to ____________
• Fibrous Muscular structure
• 3/4 inch diameter
• 4 1/2 inches long
• Surrounded by _______________
• From ____________
• Branches into right and left at the distal
  trachea at the ______________

12
Bronchi

• Right Bronchi
• ________________than left
• Branches into the ________________
• Left Bronchi
• _________________than right
• Branches into the two lobes of the left

13
Mediastinum

• Part of the ____________between the lungs.
• Extending from __________________ and contains
  all thoracic organs excepts the lungs.

14
Mediastinum Organs

• Thymus Gland
• _________________
• Trachea
• ________________

15
Hilum

• A __________________at that part of an organ
  where vessels and nerves enter.
• In the lungs
• ___________
• ___________
• Lymph Vessels
• Nerves

16
Taking a Chest X-ray

• Consider body habitus
• __________________
• short and wide - 14 X 17 crosswise
• _______________
• Average - 14 X 17 cross or lengthwise
• _____________
• longer and more narrow - 14 X 17 lengthwise
• ______________
• long and narrow - 14 X 17 lengthwise

17
Important Landmarks

• __________________
• C-7
• __________
• ______________
• T-2
• ____________
• _______________
• T-9,10
• Anterior Diaphragm

18
Technical FactorsAdult CXR

• ___________
• High ______________
• Long scale
• Low Contrast
• __________determined by pt
• 72 SID

19
Pediatric CXR

• Use ________________ for erect image.
• Decrease kV to _____________
• CR to ________________
• Crying is ______________

20
Patient Prep

• Remove __________around neck area
• Remove shirts with buttons, snaps, etc..
• Remove ______________
• Look for ______________________
• Oxygen tubes, hair braids, etc..
• ______________

21
Patient Instructions

• Typically done ______________
• To get the best inspiration
• Breath in and blow it out take another breath in
  and hold your breath
• Can do on ______________
• Pneumothorax, foreign body, lack of diaphragm
  movement, comparisons.
• Take in a breath blow it all the way out and
  hold it out.

22
Patient PositioningPA

• Erect
• _________________
• No rotation
• Chest against bucky
• Hands on hips
• Shoulder ________________
• ______________

23
Left Lateral

• Left side against IR
• Erect
• ______________
• ______________
• Arms up

24
CR Positioning

• _____________
• ____________to Vertebra Prominens (C7)
• Hand spread method (pg 83)
• Once CR is positioned, _______________

25
Guidelines for a perfect CXRPA and Lt Lat

• No rotation
• PA - ______________
• Equidistance from _________
• Lateral - look at _____________________
• No more than _______________-

26
CXR Guidelines

• Adequate Inspiration
• Minimum of ________________
• Adequate technique PA
• ________________seen with high contrast

27
Other Chest Projections

• AP - Supine or Semi erect
• _____________________
• CR to be _______________________
• Center to mid sternum _________________

28
Decubitus

• Lt/Rt Lateral Decubitus
• Pt recumbent on lt/rt side
• CR shot AP/PA ___________
• For ________________

29
Others continued

• AP Lordotic
• To visualize _______________
• Pt stands _______________an leans back
• Hand positioned as ________________
• CR straight at mid sternum
• Can do supine
• ____________________angle at mid sternum

30
LAO and RAO

• LAO
• ________anterior oblique
• Left side closest to bucky
• Rt arm up
• Lt arm on hip
• ____________
• CR
• Level of T7
• Mid body

• RAO
• ________anterior oblique
• Right side closest to bucky
• Lt arm up
• Rt arm on hip
• ________________
• CR
• Level of T7
• Mid body

31
LPO and RPO

• LPO
• _________posterior oblique
• Lt side closest to bucky
• Lt arm up
• Rt arm on hip and rolled back
• ____________
• CR
• T7
• Mid body

• RPO
• _________posterior oblique
• Rt side closest to bucky
• Rt arm up
• Lt arm on hip and rolled back
• __________________
• CR
• T7
• Mid body

32
S.T. Neck Factors

• ______________for Lateral
• ______________for AP
• 75 - 80 kVp
• Slow ________________
• Fill trachea with air

33
S.T NeckUpper Airway

• AP
• Recumbent or erect
• Pt to look straight ahead
• CR
• Between thyroid and jugular notch
• ________________

• Lateral
• Rt or Lt
• Recumbent or erect
• Chin slightly _____________
• Shoulders rolled back
• CR
• Between ________________