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

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Presentation on theme: "Chapter 2 Chest. Bony Thorax 1 - __________ (Breastbone) 2 - Clavicles (Collar bones) 2 - ________ (Shoulder Blades) 12 - Rib Pairs 12 - ________Vertebrae."— 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 –Superior, middle, ___________ –Separated by two deep fissures Left has ________ lobes –_________ and inferior –Separated by one deep fissure

4 Lungs _________ –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 _______________ –Air in the Pleural cavity Pleural ____________ –Accumulation of fluid in the pleural cavity Hemothorax – Blood Empyema - Pus

8 Diaphragm Primary muscle of breathing –Two ________________ 3 openings –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 –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 –_____________ short and wide - 14 X 17 crosswise –Sthenic Agerage - 14 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 –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 –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 –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 –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 Lateral –Rt or Lt –Recumbent or erect –Chin slightly elevated –Shoulders rolled back CR –Between thyroid cartilage and ________ AP –Recumbent or erect –Pt to look straight ahead CR –Between thyroid and jugular notch –_____above jugular notch


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