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Chapter 6: Radiographic Assessment

Terms in this set (38)

What type of X-ray view is obtained when the radiographic plate is placed behind the patient's back with the x, and the side up may better define
Anteroposterior view
Posteroanterior (PA):
back to front
Lateral
side, pt standing (airway obstruction)
Lateral decubitus
patient lying on side (free air or fluid)
Obliques
rotated 45 degrees from frontal position (rib fractures)
Forced expiratory images
aspirations in older kids. Gently add pressure to the abdomen, the affected lung will not decrease in size but will remain hyperexpanded.
The lateral decubitus view is a frontal radiographic projection whereby the side down can be evaluated for presence of
A pleural effusion; a pneumothorax
The respiratory therapist is evaluating a child with suspected foreign body aspiration. The radiographer gently adds pressure to the abdomen during expiration to take the chest radiograph. If an obstruction is confirmed, what changes should the RT expect to see?
The size of the affected lung will remain the same or the lung will be hyper-expanded.
How will well-expanded, air-filled lungs appear on a chest radiograph?
Black
the Gold standard in assessing endotracheal (ET) tube placement
X-ray
A respiratory therapist is evaluating a chest radiograph of a patient taken 2 days after being admitted for significant respiratory distress right middle lobe pneumonia. Although the therapist notices a dramatic clinical improvement of the patient, the chest X-ray appears to be more radiopaque than the one on admission. What could explain this situation?
Incorrect exposure of the image receptor may have happened.
A therapist is viewing a chest X-ray of a pediatric patient who recently emerged from general anesthesia after upper abdominal surgery. The right hemidiaphragm is elevated, and atelectasis is seen as a long, thick horizontal line within the right lower lobe. Which of the following terms describes this type of atelectasis?
Plate
proper placement of Chest tube
upper chest - air
lower - fluid
proper placement of Central venous pressure (CVP) line
distal superior vena cava
proper placement of Pulmonary artery catheterization (PAC) catheter
pulmonary artery
A pediatric patient with pneumonia has an infiltrate in the lower half of the right lung. The right heart border is obliterated. In which lobe(s) of the right lung is the infiltrate located?
Right middle lobe
airway obstructions visible on x-ray
- Croup (laryngotracheobronchitis)
- Epiglottitis
- Retropharyngeal cellulitis
Which of the following structures on a chest radiograph projects to the left, causes a prominent bulge of the superior mediastinum, and creates a mild indentation on the trachea?
Aortic arch
characteristics of Croup (laryngotracheobronchitis) on x-ray
Church steeple appearance: subglottic narrowing below the vocal chords and overdistended hypopharynx.
characteristics of Epiglottitis on x-ray
Thumb sign, epiglottis is enlarged
Aryepiglottal folds are thickened.
characteristics of Retropharyngeal cellulitis on x-ray
CT: distinguishes cellulitis from abscess
Enlargement of lymph nodes
Upper respiratory infection spreads along lymph channels and enlargement of soft tissues along neck.
types of respiratory distress in newborns
- Transient tachypnea
- Respiratory distress syndrome (RDS)
- Meconium aspiration syndrome (MAS)
- Congenital diaphragmatic hernia
- Cystic adenomatoid malformation
Transient tachypnea
Mild vascular congestion, pulmonary edema, small pleural effusions
Respiratory distress syndrome (RDS)
- Ground-glass or granular pattern
- Air bronchograms
- Air leaks
Meconium aspiration syndrome (MAS)
Coarse, patchy opacities from bronchial obstruction and areas of hyperinflation
A therapist is examining an AP chest radiograph of a neonate and notices a structure projecting away from the mediastinum toward the right upper lung. This structure looks like a sail with a sharp inferior margin and lateral margins with wavy contours. Which of the following structures is the therapist observing?
Thymus
While viewing the chest X-ray of an 18-month-old boy, a therapist notices that the trachea is truncated and that the right lung is collapsed. Which of the following situations or conditions may have caused this situation?
A mucous plug in the right mainstem bronchus
A therapist is viewing a frontal chest radiograph of a neonate who has just been endotracheally intubated. The tip of the endotracheal tube is located between the inferior clavicular border and the carina. What should the therapist do at this time?
Perform routine respiratory assessment in the morning and care for an intubated patient at this time.
While viewing an anteroposterior view of a chest radiograph of a 24-month-old intubated child, a therapist notices that the endotracheal tube has now migrated right above the inferior clavicular border. What could explain this new location of the endotracheal tube?
Flexion of the head
Which of the following radiographic views provides the best perspective for ascertaining the position of an endotracheal tube in the patient's esophagus?
Lateral view
A therapist is viewing frontal and lateral neck X-rays of a 12-month-old child and notices what is described as the "steeple" or "church steeple" sign: subglottic narrowing below the vocal cords, and an overdistended hypopharynx. Which of the following conditions does this child likely have?
Laryngotracheobronchitis
While viewing a lateral view of a neck radiograph of an 18-month-old child, a therapist notices that the epiglottis is enlarged, the aryepiglottic folds are thickened, and the hypopharynx is overdistended. Which of the following conditions does this child likely have?
Epiglottitis
A mother has just given birth to a 42-week infant who is small for his gestational age. A chest radiograph of this neonate reveals coarse, patchy opacities secondary to atelectasis from bronchial obstruction alternating with areas of hyperinflation. Which of the following clinical disorders does this infant likely have?
Meconium aspiration syndrome
A therapist is viewing frontal chest X-ray of a 12-year-old child and notices mediastinal shift towards the right hemithorax along with elevated hemidiaphragm and vascular crowding. Which of the following conditions does this child likely have?
Atelectasis
Which of the following are criteria to order a chest radiograph in a pediatric patient who does not have chest symptoms?
1. Fever
2. Oxygen saturation < 95%
3. White blood cell count >20,000/mm3
Meconium aspiration syndrome (MAS)
Coarse, patchy opacities from bronchial obstruction and areas of hyperinflation
Congenital diaphragmatic hernia
intestines pushing into the lung area
Cystic adenomatoid malformation
- Pulmonary hypoplasia
- Mediastinal shift
- Spontaneous pneumothorax
- Pleural effusions secondary to hydrops fetalis
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