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Basic Radiographic Procedures CHEST - LAB

Basic Radiographic Procedures CHEST - LAB. RT 123 – WK 4 & 5 SHOW VIDEO. Lab this week. Terminology quiz Begin CHEST positioning Exposures for upright Chest on Simulated Skeleton (?). radiographic procedures.

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Basic Radiographic Procedures CHEST - LAB

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  1. Basic Radiographic ProceduresCHEST - LAB RT 123 – WK 4 & 5 SHOW VIDEO

  2. Lab this week • Terminology quiz • Begin CHEST positioning • Exposures for upright Chest • on Simulated Skeleton (?)

  3. radiographic procedures • Positioning (topographic landmarks, body positions, path of central ray, etc.) • Anatomy (including physiology, basic pathology, and related medical terminology) • Technical factors (including adjustments for circumstances such as body habitus, trauma, pathology, breathing techniques, etc.)

  4. Review SERIES NOTESCHEST PA & LAT PROJECTIONS

  5. ↑ PA CHEST(DO SERIES NOTES) • MSP PERPENDICULAR ┴ TO IR • MCP PARALLEL ║ TO IR • ARMS DOWN BY SIDES • BACK OF HANDS AGAINST HIPS • ROTATE ARMS FORWARD – FREES SCAPULA FROM THE LUNG FIELDS • C/R @ MSP + T-7

  6. POSITIONING PA CHEST

  7. LUNGS WIDEST AT BASE

  8. Topographical Landmarks

  9. Positioning – KEY POINTS • Chest - PA Upright • Patient erect & facing IR • chin raised, • shoulders rotated forward and downward; • CR to midsagittal plane at the level of T-7 (7" - 8" below the vertebra prominens); • respiration suspended on full inspiration.

  10. ANATOMY (Best Seen) • Entire lungs must be included on image • superior apices • to the inferior costophrenic angles, • air-filled trachea, • heart • aortic knob.

  11. Top of collimation skims C-7 Vertebral Prominens

  12. Too Open ! Better Do not get distracted by size of shoulders –look at bases! In some systems you can open the collimation this much – it doesn’t mean you should!

  13. NO ROTATION VS ROTATION

  14. BREATHING INSTRUCTIONS • TAKE IN A DEEP BREATH – • BLOW IT OUT • TAKE IN ANOTHER DEEP BREATH • HOLD IT • “RESPIRE PROFUNDO DE TANGELO”

  15. CASSETTE – IR POSTIONING

  16. Center/Position cassette for Differing Body Habitus

  17. POSITIONING LEFT LATERAL CHEST

  18. ↑ LATERAL CHEST(DO SERIES NOTES) • MSP PARALLEL ║ TO IR • MCP PERPENDICULAR ┴ TO IR • ARMS EXTENDED OVER HEAD • C/R @ MCP + T-7

  19. Chest - Lateral Upright • Patient erect, • left side against IR, • arms extended upwards, • chin raised; • C/R @ midcoronal plane & the level of T-7 • respiration suspended on full inspiration (2x)

  20. Anatomy on Lateral • Entire lungs must be included on image, • superior apices • to the inferior costophrenic angles, • heart • aorta.

  21. TECHNIQUE • PA • LAT ( 4x ↑ from PA) (see last week lecture) • SHORT SCALE CONTRAST • LONG SCALE CONTRAST • DENISTY CHANGES • What are the average KVP ranges for CHEST?

  22. RT 123 2007WK 3 Introduction to Positioning &Terminology Merrill's Ch 1, (2) & 3

  23. CHEST RADIOGRAPHY • UPRIGHT - WITH GRID • KVP RANGE (90 – 120 ) • MAS ( 1 – 3 PA) ( 5 – 20 LAT)

  24. FOR CHEST – TO GO FROM PA TO LAT: • ↑ Technique by 4 x = Double the MAS and go up 10 kvp • INCREASE DENSITY BY 4 X you could: • Example: PA CHEST: 2 mas - 110 kvp FOR LATERAL: • Go up 4 X in mas 8 mas - 110 kvp Go up 2 X MAS & ↑ 15% Kvp 4 mas - 125 kvp

  25. THE “RULES” • WHILE “OBSERVING” – • DO NOT PERFORM EXAMS ON PATIENTS (POSITIONING OR EXPOSE) • DO NOT MAKE EXPOSURES AT THE CLINICS ON ANY PATIENTS • YOU CANNOT BE SUPERVISED BY OTHER STUDENTS • YOU CANNOT PERFORM ANY EXAMSON ANYONE UNDER 18 YEARS OLD

  26. “THE RULES” FOR CHEST IMAGING & COMPETENCIES YOU CANNOT ATTEMPT TO PERFORM A CHEST EXAM ON A PATIENT UNTIL • AFTER PERMANENT ASSIGNMENT • MUST HAVE A ROOM CHECK OFF FIRST (CI) • ONLY DIRECT SUPERVISION THIS SEMESTER – • NEED 25 exams FOR A CHECK OFF • CAN NOT GET A CHECK OFF UNTIL SPRING SEMESTER • If EXAM (written or lab) not passed – must be repeated successfully – original points for grade

  27. CHEST IMAGINGsimulated competency • 1ST LAB PRACTICE ON THURSDAY 9/24/09 • WRITTEN & LAB TEST FOR CHEST • THURS 10/8/09 – Written Test includes CH. 1, 3 & 10 + Rad Protection • AND SIMULATED Lab Eval 10/08/09

  28. LAB PRACTICE

  29. Observe Lab Rules • Work with your Partner & others • Share Time • Communicate • Collimate • Shiled • Practice PREP for Exam when not using the BUCKY

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