Chest
Chest—Positioning Considerations and Radiation Protection*
Correct CR Location
The CR for the AP chest is 3-4 inches (8-11cm) below the jugular notch and angled 3°–5° caudad.
Digital Imaging Considerations*
The following technical factors will reduce dose to the patient and improve image quality:
PA Chest*
Position
• Erect, chin raised, hands on hips with palms out, roll shoulders forward
• Center CR to T7 region. Top of IR will be approximately 2″ (5 cm) above shoulders on average patient.
• Center thorax bilaterally to IR borders with equal margins on both sides; ensure there is no rotation of thorax.
Lateral Chest*
Position
• Erect, left side against IR (unless right lateral is indicated)
• Arms raised, crossed above head, chin up
• True lateral, no rotation or tilt. Midsagittal plane parallel to IR (Don’t push hips in against the IR holder.)
• Thorax centered to CR, and to IR anteriorly and posteriorly
Lateral, Wheelchair or Stretcher*
Position
• Erect, on stretcher or in wheelchair
• Arms raised, crossed above head, or hold on to support bar
• Center thorax to CR, and to IR anteriorly and posteriorly
• No rotation or tilt, midsagittal plane parallel to IR, keep chin up
Lateral Decubitus*
AP Lordotic*
AP Lordotic Chest
Anterior Oblique Chest (RAO and LAO)*
Position
• Erect, rotated 45°, right shoulder against IR holder (RAO) (Certain heart studies require LAO, 60° rotation from PA.)
• Arm away from IR up resting on head or on IR holder
• Arm nearest IR down on hip, keep chin up
• Center thorax laterally to IR margins; vertically to CR at T7
Anterior Oblique Chest—RAO and LAO
AP and Lateral Upper Airway (Trachea and Larynx)*
AP Pediatric Chest*
• 18 × 24 cm or 24 × 30 cm C.W. (8 × 10″ or 10 × 12″)
• TT (tabletop; nongrid). Grid with systems when it can’t be removed.
Erect PA Pediatric Chest (with Pigg-O-Stat)*
• 18 × 24 cm or 24 × 30 cm C.W. (8 × 10″ or 10 × 12″)
• IR (nongrid) or grid with systems when it can’t be removed
Position
• Patient on seat, legs through openings
• Adjust height of seat to place shoulders ≈1″ (2.5 cm) below upper margin of IR.
• Raise arms, and gently but firmly place side body clamps to hold raised arms and head in place.
• Set upper border of lead shield with R and L markers 1-2″ (2.5-5 cm) above level of iliac crest.
Lateral Pediatric Chest*
• 18 × 24 cm or 24 × 30 cm L.W. (8 × 10″ or 10 × 12″)
• TT (tabletop, nongrid) or grid with systems when it can’t be removed
Erect Lateral Pediatric Chest (with Pigg-O-Stat)*
• 18 × 24 cm or 24 × 30 cm L.W. (8 × 10″ or 10 × 12″)
• IR (nongrid) or grid with systems when it can’t be removed
PA (AP) Pediatric Chest
*Bontrager Textbook, 8th ed, pp. 83 and 84.
*Bontrager Textbook, 8th ed, pp. 79 and 85.
*Bontrager Textbook, 8th ed, p. 90.
*Bontrager Textbook, 8th ed, p. 92.
*Bontrager Textbook, 8th ed, p. 93.
*Bontrager Textbook, 8th ed, p. 95.
*Bontrager Textbook, 8th ed, p. 96.
*Bontrager Textbook, 8th ed, p. 97.
*Bontrager Textbook, 8th ed, pp. 100 and 101.
*Bontrager Textbook, 8th ed, p. 631.
*Bontrager Textbook, 8th ed, p. 632.