Download Chest - El Camino College

Basic Radiographic Procedures
CHEST - LAB
RT 123 – WK 4 & 5
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Lab this week
• Terminology quiz
• Begin CHEST positioning
• Exposures for upright Chest
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on Simulated Skeleton (?)
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.)
Review SERIES NOTES
CHEST
PA & LAT
PROJECTIONS
↑ PA CHEST
(DO SERIES NOTES)
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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
POSITIONING
PA CHEST
LUNGS WIDEST AT BASE
Topographical Landmarks
Positioning – KEY POINTS
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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.
ANATOMY (Best Seen)
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Entire lungs must be included on image
superior apices
to the inferior costophrenic angles,
air-filled trachea,
heart
aortic knob.
Top of collimation skims C-7 Vertebral Prominens
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!
NO ROTATION VS ROTATION
BREATHING INSTRUCTIONS
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TAKE IN A DEEP BREATH –
BLOW IT OUT
TAKE IN ANOTHER DEEP BREATH
HOLD IT
• “RESPIRE PROFUNDO DE TANGELO”
CASSETTE – IR POSTIONING
Center/Position cassette for
Differing Body Habitus
POSITIONING
LEFT LATERAL
CHEST
↑ LATERAL CHEST
(DO SERIES NOTES)
• MSP PARALLEL ║ TO IR
• MCP PERPENDICULAR ┴ TO IR
• ARMS EXTENDED OVER HEAD
• C/R @ MCP + T-7
Chest - Lateral Upright
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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)
Anatomy on Lateral
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Entire lungs must be included on image,
superior apices
to the inferior costophrenic angles,
heart
aorta.
TECHNIQUE
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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?
RT
123
2007
WK 3
Introduction to Positioning &
Terminology
Merrill's Ch 1, (2) & 3
CHEST RADIOGRAPHY
• UPRIGHT - WITH GRID
• KVP RANGE (90 – 120 )
• MAS ( 1 – 3 PA) ( 5 – 20 LAT)
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
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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
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 EXAMS
ON ANYONE UNDER 18 YEARS OLD
“THE RULES” FOR CHEST
IMAGING & COMPETENCIES
YOU CANNOT ATTEMPT TO PERFORM
A CHEST EXAM ON A PATIENT UNTIL
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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
CHEST IMAGING
simulated 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
LAB PRACTICE
• Observe Lab Rules
• Work with your
Partner & others
• Share Time
• Communicate
• Collimate
• Shiled
• Practice PREP for
Exam when not using
the BUCKY