A PA chest projection with poor positioning demonstrates the scapulae in the lung field and elevated lateral clavicular ends. How should the patient be repositioned for an optimal projection to be obtained?
1)Tilt the upper midcoronal plane away from the IR.
2)Depress the shoulders.
3)Coax the patient into a deeper inspiration.
4)Anteriorly rotate the shoulders and elbows.
A) 1 and 4 only
B) 2 only
C) 2, 3, and 4 only
D) 2 and 4 only

Question

Quizplus · Accepted Answer

Option 2 is correct as the scapulae in the lung field can be caused by elevated shoulders. Depress the shoulders to prevent the overlapping of the lung field by the scapulae.
Option 4 is correct as it helps to prevent the rotation of the clavicles upward, which can impede the visualization of the apices. Anteriorly rotate the shoulders and elbows to avoid the clavicles to overlap the lung field.
Options 1 and 3 are incorrect as tilting the upper midcoronal plane away from the IR may lead to elongation of the heart, and asking the patient to take a deeper inspiration may also not address the issue of the scapulae and the clavicles in the lung field.

A PA Chest Projection with Poor Positioning Demonstrates the Scapulae