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Chapter 2 Chest.

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Presentation on theme: "Chapter 2 Chest."— Presentation transcript:

1 Chapter 2 Chest

2 Bony Thorax 1 - __________ (Breastbone) 2 - Clavicles (Collar bones)
2 - ________ (Shoulder Blades) 12 - Rib Pairs 12 - ________Vertebrae

3 2 Lungs Right has _______ lobes Left has ________ lobes
Superior, middle, ___________ Separated by two deep fissures Left has ________ lobes _________ and inferior Separated by one deep fissure

4 Lungs _________ ___________ ____________ angle Rounded superior area
Inferior concave area. Rests on the diaphragm ____________ angle Inferiolateral corners where the diaphragm meets rib

5 Lung Tissue ___________ Functional tissue Spongy and elastic
Allows lungs to ______________(Breathing)

6 Pleura _____________ Sac the lungs are held in Two parts
__________Pleura - Outer layer __________ (Visceral) Pleura - Inner layer Pleural cavity ________space between parietal and pulmonary pleura

7 Pleura Problems _______________ Pleural ____________
Air in the Pleural cavity Pleural ____________ Accumulation of fluid in the pleural cavity Hemothorax – Blood Empyema - Pus

8 Diaphragm Primary muscle of breathing 3 openings Two ________________
Aorta ___________ Inferior Vena Cava

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 _____________ Thyroid Cartilage Cricoid Cartilage

11 Trachea (Windpipe) Inferior to __________ Fibrous Muscular structure
3/4 inch diameter 4 1/2 inches long Surrounded by 20 cartilaginous rings From ______________ Branches into right and left at the distal trachea at the ____________

12 Bronchi Right Bronchi Left Bronchi Wider and __________ than left
Branches into the three right lobes Left Bronchi Smaller and ___________ than right Branches into the two lobes of the left

13 Mediastinum Part of the _______________cavity between the lungs.
Extending from the _____________ column and contains all thoracic organs excepts the lungs.

14 Mediastinum Organs Thymus Gland __________and great vessels
___________ Esophagus

15 Hilum A ____________________at that part of an organ where vessels and nerves enter. In the lungs: __________ Blood Vessels Lymph Vessels ___________

16 Taking a Chest X-ray Consider body habitus _____________ Sthenic
short and wide - 14 X 17 crosswise Sthenic Agerage X 17 cross or lengthwise longer and more narrow - 14 X 17 lengthwise Asthenic long and narrow - 14 X 17 lengthwise

17 Topographical Landmarks
Vertebra Prominens ________ Apex of lungs Jugular Notch __________ Top of Sternum Xiphoid Tip ____________ Anterior Diaphragm

18 Technical Factors Adult CXR
Erect High kV ____________ Long scale Low _________ mAs determined by pt ____________

19 Pediatric CXR Use immobilizer for erect image.
Decrease kV to __________ CR to mid thorax (___________) Crying is ____________!

20 Patient Prep Remove all _________ around neck area
Remove shirts with ______, snaps, etc.. Remove _________ with clips Look for anything around lung field Oxygen tubes, hair braids, etc.. Nipple markers*

21 Patient Instructions Typically done on ___________
To get the best inspiration “Breath in and blow it out take another breath in and ________________” Can do on expiration Pneumothorax, foreign body, lack of diaphragm movement, comparisons. “Take in a breath blow it all the way out and ______________.”

22 Patient Positioning PA
Erect ____________ No rotation Chest against bucky Hands on hips Shoulder “__________” forward Chin up

23 Left Lateral Left side against IR Erect 72” SID No rotation

24 CR Positioning Mid ___________ (T7)
7-8” __________ to Vertebra Prominens (C7) Hand spread method (pg 83) Once CR is positioned, center _________

25 Guidelines for a perfect CXR PA and Lt Lat
No rotation PA - look at ____________ Equidistance from spine Lateral - look at ___________ posterior ribs No more than 1/4” to ______ separation

26 CXR Guidelines Adequate Inspiration Adequate technique PA
Minimum of ____________on PA Adequate technique PA T-Spine vertebrae seen with ____________

27 Other Chest Projections
AP - Supine or Semi erect Slight ____________(5 degrees) CR to be perpendicular to the ____________ Center to mid sternum (_____ inferior to jugular notch)

28 Decubitus Lt/Rt Lateral Decubitus Pt recumbent on lt/rt side
CR shot AP/PA to mid sternum For _______________or fluid levels

29 Others continued AP Lordotic Can do supine
To visualize apices _____________ Pt stands ______ away from bucky an leans back Hand positioned as per _________ chest CR straight at mid sternum Can do supine ____________degree cephalad angle at mid sternum

30 LAO and RAO LAO CR RAO CR 45 degree anterior oblique
Left side closest to bucky Rt arm up Lt arm on hip ________seen best CR Level of T7 Mid body RAO 45 degree anterior oblique Right side closest to bucky Lt arm up Rt arm on hip ________seen best CR Level of T7 Mid body

31 LPO and RPO LPO CR RPO CR 45 degree posterior oblique
Lt side closest to bucky Lt arm up Rt arm on hip and rolled back _______seen best CR T7 Mid body RPO 45 degree posterior oblique Rt side closest to bucky Rt arm up Lt arm on hip and rolled back _________seen best CR T7 Mid body

32 S.T. Neck Factors _________SID for Lateral _________SID for AP
kVp Slow deep inspiration Fill __________ with air

33 S.T Neck Upper Airway AP Lateral CR CR Recumbent or erect Rt or Lt
Pt to look straight ahead CR Between thyroid and jugular notch _____above jugular notch Lateral Rt or Lt Recumbent or erect Chin slightly elevated Shoulders rolled back CR Between thyroid cartilage and ________

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