Chest Radiography. CRC 330 Cardiorespiratory Care University of South Alabama
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1 Chest Radiography CRC 330 Cardiorespiratory Care University of South Alabama
2 Objectives Cite the indications for a chest radiograph Describe the radiographic views Describe the systematic review of a chest radiograph Define, list clinical signs, and radiographic evidence of common respiratory problems Identify objects implanted in the chest by radiography
3 Indications for a Chest Radiograph Detect lung pathology Atelectasis, pneumothorax, confirm physical examination Determine appropriate therapy Hyperinflation, chest tube, PEEP Evaluate effectiveness of therapy Determine position of invasive tubes Vascular catheters, chest and N-G tube, ETT Trends disease progression
4 Radiographic Views Posterior-anterior Chest against the film Standard Correct heart size
5 Radiographic Views Anterior-posterior Back against film Portable Enlarges heart
6 Radiographic Views Lateral Decubitus Patient positioned on the side Identifies fluid levels
7 Radiographic Views Lateral Upright Left side against film Sharp view of LLL Identifies presence of fluid in the posterior sulcus Identifies hyperinflation/ increased A-P diameter Retrosternal air
8 Radiographic Views Lateral neck Evaluates periglottic edema Croup Epiglottitis
9 Chest Radiograph Evaluation Systematic Four densities Rotation Exposure Diaphragms Heart shadow Costophrenic angles Ribs Clavicles Lung and vascular markings Trachea and carina Stomach bubble Scapulas
10 Densities
11 Rotation Film should be symmetrical Note position of clavicles Trachea should be midline
12 Exposure Determine the visibility of the intervertebral discs through the heart shadow Lucency of pulmonary blood vessels Overexposed= overdarkened Underexposed= lack of visualization of vertebral bodies through the heart Lungs whiter than normal
13 Normal Chest Radiograph Right diaphragm higher than left Heart shadow < ½ thoracic width Air-filled costophrenic angles
14 Normal Chest Radiograph Posterior ribs are most lucent and horizontal Clavicles are symmetric Lung and vascular markings
15 Normal Chest Radiograph Trachea and carina visible Stomach bubble under left diaphragm Scapulas produce a vertical line through lung fields
16 Atelectasis Definition Loss of air due to compression or absorption Clinical signs Tachypnea, decreased BS Radiology Fissure and mediastinal shift, vascular crowding, increased density of lung fields
17 Hyperinflation Definition Increased air in the chest Clinical signs Barrel chest, increased vocal fremitus, hyperresonance Radiology Increased lucency, depressed diaphragms, narrow heart. Increased retrosternal air
18 Interstitial Lung Disease Definition Diffuse, scarring, alveolar injury Clinical signs Dyspnea, dry cough, increased fremitus, fine crackles Radiography Alveolar filling, granular
19 Pulmonary Edema Definition Fluid in interstitial or alveolar space, diffuse, increased interstitial pressure or permeability Clinical signs Frothy sputum, dyspnea, crackles Radiology Fluffy, enlarged heart in CHF, increased hilar markings
20 Pleural Effusion Definition Fluid in the pleural space Clinical signs Tachypnea, decreased fremitus, decreased BS Radiology Blunted costophrenic angles, air-fluid line
21 Consolidation Definition Fluid or pus filled airspaces without alveolar collapse Clinical signs Tachypnea, fever, decreased fremitus, crackles Radiology Lobar, homogenous, air bronchograms
22 Silhouette Sign In consolidation, there is a loss of border between two objects of similar density Helps determine where the abnormality is Dotted lines indicate loss of border
23 Pneumothorax Definition Air in the pleural space Clinical signs Acute respiratory distress, asymmetrical chest movement, decreased fremitus, hyperresonance, decreased BS Radiology Vertical line, no lung markings outside the line
24 Endotracheal Tube Placement Tip should be 3-5 cm above the carina Here, tip is in Right mainstem Assure equal BS Care in advancing the tube
25 Pulmonary Artery Catheter Catheter proceeds through the VC, RA, RV, and into the PA Catheter should reside in zone 3
26 Chest (Pleural) Tube Inserted by the physician Evacuation of air and/or fluid 32 F Radiopaque stripe Note the ETT
27 Laryngotracheobronchitis (Croup) Definition Viral infection of the larynx and trachea Clinical signs 6mo-3yoa, brassy hoarse cough, stridor, low fever Radiology Narrowing and edema of subglottic trachea, ballooning of hypopharynx
28 Computerized Tomography (CT) Radiographs that focus on slices of the organ being scanned Computer enhanced to improve resolution Able to define small abnormalities and lesions (cancer)
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A. All cells need oxygen and release carbon dioxide why?
I. Introduction: Describe how the cardiovascular and respiratory systems interact to supply O 2 and eliminate CO 2. A. All cells need oxygen and release carbon dioxide why? B. Two systems that help to