The four parts of respiratory system proper important in chest radiography are: i. Larynx ii.

Trachea

iii. Right and left bronchi iv. Lungs

Patient
a) b) c) d) Check for pregnancy possibility according to 10-day rule. Remove all radiopaque objects (e.g, necklace, bra, shirt). Ask the patient to change to hospital gown. Ask the patient to tie up hair above shoulders (if patient has long or braided hair).

Room a) Tidy up the room before calling the patient. b) Ensure the availability of protective shielding, immobilization aids. c) Ensure the urinal bowl and vomit bowl also available (in case patient from emergency).

Pneumonia Pleural effusion Pneumothorax Pulmonary edema Tuberculosis Atelectasis Bronchiectasis Bronchitis Chronic obstructive pulmonary disease (COPD) Cystic fibrosis Dyspnea Lung neoplasm Aspiration

Pleural effusion

Tuberculosis

Seat patient at end of table, with elbow flexed about 90 and hand and wrist resting on cassette, palm down.

Align and center hand and wrist to portion of IR that is being exposed. From pronated position, rotate wrist and hand laterally 45 . For stability, place 45 support under thumb side of hand to support hand and wrist in a 45 oblique position, or partially flex fingers to arch hand so that fingertips rest lightly on cassette.

CR perpendicular to IR, directed to midcarpal area. Minimum SID of 40 inches (100cm).

Colimate to wrist on four sides ; include distal radius and ulna and the midmetacarpal area, at least.

IR size- 1824cm ( 810 inches). Division in half, crosswise. Detail screen, tabletop. Digital IR-use lead masking. 60 6kv range. Exposure factors : ~> 64 kvp ~> 4 mAs

Marker
~> Put on left/right upper border, in PA. ~> Do not obscure region of interest (ROI).

Shielding
~> Place lead shield over patient s lap to shield gonads.

Structures shown ~> Distal radius, ulna, carpals, and at least to midmetacarpal area are visible. ~> The trapezium and scaphoid should be well visualized, with only slight superimposition of other carpals on their medical aspects.

Position ~> Long axis of the hand, wrist, and forearm should be aligned with IR. ~> True 45 oblique of the wrist is evidenced by the following : ulnar head partially superimposed by distal radius ; proximal third through fifth metacarpals (metacarpals bases) should appear mostly superimposed.

Collimation and CR ~> Collimation should be visible on four sides to area of affected wrist. ~> CR and center of collimation field should be to midcarpal area.

Exposure criteria ~> Optimal density and contrast with no motion demonstrate the carpals and their overlapping borders, soft tissues margins, and clear, sharp bony trabecular markings.