Chest radiography ppt

This ppt includes indications & all the views taken during a Chest X-ray

1. CHEST RADIOGRAPHY Indications Pneumothorax Hemothorax Hemopneumothorax Lung collapse Tuberculosis Pneumonia Pleural effusion Fractured ribs

2. Views PA (Erect) – Basic view AP (Supine) – Alternate view Lateral View – Additional (Foreign Body) Lordotic View – Right lung’s mid l obe Apicogram – Special View for Apex of lung *To check Air-Fluid Level *PA(Erect) *Semi recumbent *Lateral Decubitus *Dorsal Decubitus

3. PA(Erect) #1. IR Size and position 14” ×17’’ IR placed longitudinally in Vertical Bucky #2. Patient and Part positioning Patient is erect facing the upright image receptor, i.e. Face towards cassette. The superior aspect of the receptor is 2 inches above the shoulder joints.

4. The chin is raised as to be out of the image field. Dorsal aspect of both hands placed on the Iliac Crest Both elbows partially flexed rolling anterior; to keep scapula away from lung field. S houlders are depressed to move the clavicles below the lung apices Feet slightly apart to maintain standing balance

5. Ensure that mid-sagittal plane should coincide with midline of IR & perpendicular to IR Instruct patient that X-Ray will be done in arrested inspiration #3. Collimation and Central Ray Central Ray (CR) should be horizontal and pointed on T-7 (at the level of inferior angle of scapula) Collimated from C-7 to L-1   to allow proper visualisation of the upper airways

6. AP (Supine) Alternate view for the patient who is unable to stand or sit, i.e. trauma patient. #1. IR Size and position 14” ×17’’ IR placed transversally in Table Bucky below the patient so IR’s centre coincide with midline of table. The superior aspect of the receptor is 2 inches above the shoulder joints.

7. #2. Patient and Part positioning Patient in supine position with mid-sagittal plane become perpendicular to midline of table. The chin is raised (if possible) as to be out of the image field. If possible, the hands are placed by the patient's side. Any leads or lines that can be moved should be transferred out of the image area to improve image quality. Instruct patient that X-Ray will be taken in arrested inspiration

8. #3. Collimation and Central Ray Central Ray (CR) should be Vertical and pointed on sternal notch Collimated from C-7 to L-1  to allow proper visualization of the upper airways Chest:- Lateral view Generally, this is performed to localize the foreign body & to see the depth of foreign body entered.

9. #1.IR Size and position 14” ×17’’ IR placed longitudinally in Vertical Bucky #2. Patient and Part positioning standing upright Right side in touch with IR ( if Right lateral), Left side in touch with IR ( if Left lateral) Arms should placed on head or holding onto handles

10. Chin raised out of the image field. Mid- sagittal plane must be parallel to IR. Instruct patient that X-Ray will be taken in arrested inspiration. Legs should be apart to maintain the position.

11. #3. CR and Collimation Central ray should be horizontal and pointed on inferior angle of scapula. Collimated from C-7 to L-1 Lordotic view This view is done to see the middle lobe of Right lung #1. IR Size and Position 14’’ ×17’’ IR placed longitdinally in vertical bucky .

12. #2. Patient and part position The patient is standing with feet approximately 10-12 inches away from the IR, with back arched until upper back, shoulders and head are against the IR The shoulders and elbows are rolled anteriorly The angle formed between the midcoronal body plane and image receptor should be approximately 45 degrees

13. #3. Collimation and Central Ray Central Ray (CR) should be horizontal and pointed on the  Xiphoid process. Collimated from C-7 to L-1  to allow proper visualisation of the upper airways Lateral to the level of the  acromio-clavicular joints

14. Apicogram : Special view This view is performed to see the apex of lungs clearly. #1. IR size and position 14’’ ×17’’ IR placed longitudinally in vertical bucky #2. Patient and part position Patient in same positin as in lordotic view. Both clavicles goes up to make apices of lung visible

15. #3. CR and Collimation CR angled 15-20 degrees cranially at pointed at Xiphoid process. Collimated from C7-L1

16. Lateral Decubitus View Patient and Part position The patient is laying either left lateral or right lateral. The IR is placed horizontally posterior to the patient .  Patient's hands should be raised to avoid superimposing on the region of interest, legs may be flexed for balance

17. Rotation of shoulders or pelvis should be minimised X-ray is taken in full inspiration CR and collimation Horizontal CR at xiphoid process on mid- sagittal plane Collimate superior to the apex and inferior to the T-12

18. Dorsal Decubitus View Patient and Part position the patient is supine the detector is placed landscape of at the patient's left or right hand side running parallel to the long axis of the chest patient's hands should be raised to avoid superimposing on the region of interest; legs may be flexed for balance

19. x-ray is taken in full inspiration CR and Collimation Horizontal CR on mid coronal plane at level of T-7 Collimate superior to the apex and inferior to the T-12

20. THANK YOU