Chest PA
Position the Patient
- Upright
- Chin up
- Hands on hips
- Shoulders rolled forward
- Exposure on full inspiration
Words That Work
“Stand facing the board with your chin up. Roll your shoulders forward and down, like you're slouching on purpose, and rest the backs of your hands on your hips. I know it feels strange — it moves your shoulder blades out of the picture. When I say so, take the biggest breath you can, all the way in — and hold it. Don't let any out until I tell you. Ready… all the way in… and hold.”
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PA chest positioning
Set Up the Shot
- Center here
- Central ray
- T7 (inferior angle of scapula)
- Include this in the field
- Collimation
- Lung apices to costophrenic angles · Lateral skin margins
- Set the distance
- SID
- 72"
- Check the technique
- Technique
- 110-125 kVp
- Follow facility protocols
Common Pitfalls
- •Shoulders not rolled forward, causing scapulae to overlap lung fields
- •Exposure not on full inspiration (fewer than 10 posterior ribs visible)
- •Rotation (spinous processes not centered between clavicles)
Evaluate the Image
What should be visible?
- Lungs
- Heart
- Mediastinum
- Pleura
Does the image pass?
- ✓Scapulae out of lung fields
- ✓Roughly 10 posterior ribs visible
- ✓Sharp lung markings
- ✓No rotation