basic radiographic procedures chest - lab rt 123 – wk 4 & 5 show video
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Basic Radiographic ProceduresCHEST - LAB
RT 123 – WK 4 & 5
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Lab this week
• Terminology quiz
• Begin CHEST positioning
• Exposures for upright Chest
• 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 NOTESCHEST
PA & LAT
PROJECTIONS
↑ 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
POSITIONING
PA CHEST
LUNGS WIDEST AT BASE
Topographical Landmarks
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.
ANATOMY (Best Seen)
• 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
• 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
• 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
• Entire lungs must be included on image,
• superior apices
• to the inferior costophrenic angles,
• heart
• aorta.
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?
RT 123
2007WK 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 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
• 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 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
LAB PRACTICE
• Observe Lab Rules• Work with your
Partner & others• Share Time• Communicate• Collimate• Shiled
• Practice PREP for Exam when not using the BUCKY