Rt 124 spring week 1 part 1 chest abd a self study review
This presentation is the property of its rightful owner.
Sponsored Links
1 / 48

RT 124 SPRING WEEK 1 – Part 1 CHEST & ABD A “Self Study” Review PowerPoint PPT Presentation


  • 76 Views
  • Uploaded on
  • Presentation posted in: General

RT 124 SPRING WEEK 1 – Part 1 CHEST & ABD A “Self Study” Review. Rev Spring 2010. RT 124 - WEEK 1 (Part 2) is the Lecture Presentation for:. Chest II AP : SUPINE, SEMI-UPRIGHT – UPRIGHT R & L DECUBITUS LATERAL – PT ON GURNEY OR IN W/C ABDOMEN AP SUPINE, UPRIGHT, LLD.

Download Presentation

RT 124 SPRING WEEK 1 – Part 1 CHEST & ABD A “Self Study” Review

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Rt 124 spring week 1 part 1 chest abd a self study review

RT 124 SPRINGWEEK 1 – Part 1CHEST & ABDA “Self Study” Review

Rev Spring 2010


Rt 124 week 1 part 2 is the lecture presentation for

RT 124 - WEEK 1 (Part 2)is the Lecture Presentation for:

Chest II

AP: SUPINE, SEMI-UPRIGHT – UPRIGHT

R & L DECUBITUS

LATERAL – PT ON GURNEY OR IN W/C

ABDOMEN

AP SUPINE, UPRIGHT, LLD

RT 124 – Wk 1 – Part 1 Lecture on web can be reviewed for basic CHEST & ABD anatomy.


A quick review of chest dedicated chest unit

A quick review of CHESTDedicated Chest Unit

  • X-ray machine designed to perform routine chest imaging

    • tube has fixed alignment with imaging plate (IP)

    • when tube moves, IP moves

    • Non-CR has film unit

      • includes stationary grid

      • magazine to hold unexposed film

      • direct hook-up to processor

        [or magazine for exposed film]

      • ID flasher on unit

Digital Chest Unit


Body habitus

Body Habitus


Cassettes w grid caps

CASSETTES W/ GRID CAPS


Grids

Grids

  • Allow primary radiation to reach the image receptor (IR)

  • Absorb most scattered radiation

  • Primary disadvantage of grid use

    • Grid lines on film


Cr grids

CR GRIDS


Chest

CHEST

ANATOMY REVIEW


Chest anatomy

Chest Anatomy

  • Thoracic cavity (chest)

    • Surrounded by boney thorax

    • Separated from abdomen by diaphragm

      • Muscular partition

      • Dome shaped

      • Lungs drape over diaphragm


Bony thorax

Anterior

Posterior

Bony Thorax

  • ENCLOSE THE ORGANS

    • STERNUM (breast bone)

    • 12 PAIR OF RIBS

    • 12 THORACIC VERTEBRA

  • ATTACH UPPER EXTREMITY

    • 2 CLAVICLES

    • 2 SCAPULA


Thoracic cavity

Thoracic Cavity

  • Sections of the thoracic cavity

    • Pleural portion (lungs)

    • Mediastinum (between lungs)

    • Pericardial portion (heart)


Respiratory system

A

A

H

H

 B 

 B 

C 

C

Respiratory System

1. Lungs

  • Lobes

    • Right 3 lobes

    • Left 2 lobes

  • Terminology

    • Apex

    • Hilum

    • Base

    • Costophrenic angles


Bronchial tree

Bronchial Tree

2. Bronchi

  • Air tubes leading into the lung

  • Right more vertical than left

  • Branching structure

    • Primary è 2ndary è teritiary...

  • Only primary visible on PA projection

P


Trachea

Trachea

3.Trachea

  • In mediastinum

  • Passageway for air to/from lungs

  • Approx. 4½" Long

  • Air visible on images

T


Circulatory system

Circulatory System

1. Heart

  • 4 Chambered pump

    2. Great blood vessels

  • Aorta

  • Vena cava

  • Pulmonary Artery

    • Not seen on image

A

PA

VC

VC


Miscellaneous

Miscellaneous

  • Mediastinum contents

    • Trachea

    • Major vessels

    • Esophagus

    • Lymphatics

    • Heart

    • Thymus


Chest examinations

Chest Examinations

  • Most common projections

    • PA in an erect position

    • Right to left lateral in an erect position

  • Less common projections

    • AP -- erect or recumbent position

    • Lateral decubitus


Routine pa l lateral

Routine PA & L Lateral

1. Erect position

  • Diaphragm moves more inferior

  • Demonstrates air-fluid levels

  • Prevents blood pooling in gr. vessels

    2. 72" Sid

  • ê magnification of heart


Routine pa l lateral cont

inspiration

expiration

Routine PA & L Lateral (cont.)

3.Breath held on inspiration

  • Expands lung fields

  • depresses diaphragm

  • Provides contrast (air vs. tissue)

  • 4. Film (adult)

    • 14X17 lengthwise

      • (may be crosswise on broad chested male)


Routine pa l lateral cont1

Routine PA & L Lateral (cont.)

5. Technical factors

  • High kVp (>100)

    • long scale contrast

  • High mA & short time

    • reduces motion

  • AEC

  • Grid

    • decrease scatter on image


Pa projection erect anterior position

PA Projection (erect anterior position)

  • Patient

    • Standing -- weight on both feet

    • Anterior chest against IP

    • MS plane perpendicular to IP & floor

    • Chin raised

    • Posterior of hands on hips or machine “hug”

    • Shoulders depressed & rotated forward


Pa projection cont

PA Projection (cont.)

  • X-ray beam

    • CR

      •  to film

      • in MS plane at T 7

  • Collimation (very little)

    • Full length of film

    • To lateral edges of patient


Pa projection cont1

PA Projection (cont.)

  • Film evaluation

    • Complete anatomy shown

      • apices

        (chin elevated)

      • base

        (both costophrenic angles)

      • scapulae out of lungs

        (shoulder rotation)

      • respiration

        (10 posterior ribs)


Pa projection cont2

PA Projection (cont.)

  • Minimal rotation

    • Symmetry of SC joints

    • MS plane to lateral ribs = distance


Pa projection cont3

PA Projection (cont.)

  • Technique

    • Vertebra seen through heart (kVp)

    • "Good" density

  • Other

    • no film artifacts

    • no motion (blur)


Pa chest anatomy

PA Chest Anatomy


Radiographic anatomy pa

Radiographic Anatomy -- PA


Erect left lateral chest

Erect Left Lateral Chest

  • Patient

    • Standing with weight on both feet

    • L side against film holder

    • Chin raised

    • Arms elevated & immobilized

    • Align MS plane

      • parallel to the film

      •  to the floor


Left lateral chest cont

Left Lateral Chest (cont.)

  • X-ray beam

    • CR

      •  to film

      • in midaxillary plane at level of T7

        (slightly lower than T7 ok)

    • Collimation

      • full length of film

      • to anterior & posterior surfaces of patient


Abdomen anatomy

Abdomen Anatomy

  • Abdominopelvic cavity

    • Abdomen

      • diaphragm to pelvic inlet

    • Pelvic cavity

      • pelvic inlet to floor muscles of the cavity


Abdomen anatomy cont

Abdomen Anatomy (cont.)

  • Abdomen

    • Divisions

      • 4 Quadrants (clinical)

      • 9 Regions (anatomic)


Abdomen anatomy cont1

Abdomen Anatomy (cont.)

  • Boney anatomy

    • lower ribs & T11-T12

    • lumbar spine (5)

    • sacrum & coccyx

    • innominate (2)

      • iliac portion

      • ischial portion

      • pubic portion

    • femur

      • head & neck

      • trochanters


Abdomen anatomy cont2

Abdomen Anatomy (cont.)

  • Topographic (positioning) landmarks

    • Iliac crest (level of L4-5)

    • Anterior superior iliac spine (ASIS)

    • Greater trochanter of femur

    • Pubic symphysis

Iliac

Crest

Lumbar

Vertebra

ASIS

Greater

Trochanter

Symphysis Pubis


Abdomen anatomy cont3

Abdomen Anatomy (cont.)

  • Major muscles (radiographically)

    • Diaphragm

    • R and L psoas muscles


Major abdominal organs

liver (triangular)

stomach

large bowel

gall bladder

pancreas

spleen

  • small bowel

  • duodenum

  • jejunum

  • ileum

Major Abdominal Organs


Urinary organs major vessels

adrenal gland

vena cava

aorta

kidney

ureter

urinary bladder

urethra

Urinary Organs & Major Vessels


Abdominal radiography

Abdominal Radiography

  • Patient preparation

    • KUB & acute abdomen

      • Remove radiopaque clothing & gown

      • Otherwise "as is“

  • Breathing instructions

    • Expose after patient exhales

    • "Take deep breath, blow it all out, stop breathing"

    • Watch patient while giving instructions

    • Contrast media exams

      • Dietary & bowel preps usually required


Abdominal radiography cont

Abdominal Radiography (cont.)

  • Exposure factors (non contrast media)

    • Medium kVp -- 70-80

      • adequate penetration

      • moderate contrast

    • Short exposure time

      • decrease involuntary motion on image

    • Enough mAs for sufficient density

  • Film markers

  • Radiation protection

    • Check for pregnancy on all women

    • Gonadal shielding (???)

  • Collimation

    • to film edge top & bottom

    • to patient width on sides


Abdomen

Abdomen

  • AP projection, supine position

    • KUB, flat plate, plain film, scout film

  • Patient position -- Supine on table with

    • pillow for head

    • support sponge for knees

    • arms at but away from sides

    • legs extended, internally rotatedMidsagittal plane

      • perpendicular to table

      • parallel to table length

    • R & L ASIS level

    • Shoulders level


Abdominal radiography cont1

Abdominal Radiography (cont.)

  • Film & centering

    • 14X17 cassette lengthwise in table bucky

    • Center of film at level of iliac crests

    • CR to center of film passing through the MS plane at level of iliac crests

      • adjust to include pubic symphysis at lower edge of film


Abdominal radiography cont2

Abdominal Radiography (cont.)

  • Film evaluation

    • No rotation

      • symmetry of pelvis & spine

    • Complete anatomy with no motion

      • vertebral column in center of image

      • symphysis pubis at bottom of image

      • kidneys, liver, spleen at top of image


Abdominal radiography cont3

Abdominal Radiography (cont.)

  • density & contrast adequate to see

    • Psoas muscles

    • lumbar transverse processes

    • ribs

    • kidney & liver margins


Other abdominal projections positions

Other Abdominal Projections/Positions

  • AP projection in an erect position

    • CR 2" above iliac crests in MS plane

  • AP or PA projection in a lateral decubitus position

    • CR 2" above iliac crests in MS plane


Abdominal radiography cont4

Abdominal Radiography (cont.)

  • Lateral in a recumbent or erect position

    • Seldom done due to level of radiation

    • lack of significant diagnostic information


  • Login