RDGR 281 LO1

Question 1

What are three ways a foreign body can enter the body?

Answer 1

Aspirated, swallowed, penetrating

Question 2

What does imaging a foriegn body verify?

Answer 2

size, position, extent of damage

Question 3

What are the five ways to get high quality images?

Answer 3

small focus spot
remove artifiact 
short exposure time
cassettes clean
post aquisition manipulation

Question 4

What is the positioning for penetration foreign bodies?

Answer 4

• mark entrance and exit wounds
• AP or PA and lateral
• 2 projections 90 degrees

Question 5

Why should compression not be used when taking images of foreign bodies?

Answer 5

• reduces thickness so unknown depth

- May cause further damage

Question 6

What are oblique projections for?

Answer 6

to separate overlying structures (superimposition of the fb and bone)

Question 7

What are the tangential projections for?

Answer 7

useful for depth of fb

Question 8

What is the profunda method?

Answer 8

removal of fb from fluoroscopic guidance, high radiation dose

Question 9

What are 4 ways to increase radiographic detail?

Answer 9

• minimal OID
• Consistent SID
• Close collimation
• Minimize possibility of artifacts

Question 10

What ages of children in airway foreign bodies most common?

Answer 10

ages 6 months to 3 years

Question 11

What is a symptom for a child if they have a foreign body aspirated.

Answer 11

persistent cough, stridor, wheezing cough, recurrent pneumonia or hempotysis. No fever

Question 12

Which projections do you take if you dont know if a child has aspirated or swallowed an object?

Answer 12

• AP chest to include full airway
• AP abdomen to include lung bases and pubic symphysis
• Lateral soft tissue neck (nasion to thoracic inlet including c-spine)

Question 13

If the coin is in the coronal plane, what is it lodged in?

Answer 13

the esophagus (coin facing me)

Question 14

if the coin is in the sagittal plane where is it lodged?

Answer 14

the trachea. (coin facing the side)

Question 15

what is the ball valve effect?

Answer 15

when a fb is aspirated and you can inspire but cant exhale.

Question 16

what are the routine projections for a aspirated fb?

Answer 16

PA inspiration and expiration, Lateral

Question 17

What projections do you take for a child that cant cooperate with breathing instructions?

Answer 17

right and left decubitus

Question 18

What is the routine for soft tissue neck in AP projection?

Answer 18

• CR perpendicular to the laryngeal prominence (upper airway)
• CR perpendicular to the manubrium (larynx and superior mediastinum).
• Collimation: 1” beyond skin line
• respiration: expose on slow inspiration to ensure trachea is filled with air

Question 19

What is the routine for soft tissue lateral?

Answer 19

• center airway to the midline of the IR
• direct CR to the level of the laryngeal prominence (for upper airway) or manubrium (for larynx and superior mediastinum)
  respiration: expose on slow inspiration to ensure trachea is filled with air

Question 20

what are four reasons water-soluble iodinated medium is used for radiolucent fb?

Answer 20

• localize non-opaque fb with opaque coating
• identifies site of obstruction
• permits better evaluation of soft tissue trauma
• does not adhere to fb therefore endoscopic removal is possible

barium suspension adheres to fb, therefore make it slippery and difficult for physician to grasp

Question 21

What is PICA?

Answer 21

compulsive ingestion of nonfood articles

Question 22

what are routine projections for airway foreign bodies?

Answer 22

• AP chest
• abdomen
• lateral STN (nasion to thoracic inlet including c-spine)

Question 23

What symptoms show when the fb is ingested?

Answer 23

drooling and inability to swallow

Question 24

what does the upper airway of the soft tissue neck AP all show from?

Answer 24

superior oropharynx to the proximal trachea.

Question 25

What does the soft tissue neck lateral all show from?

Answer 25

trachea and superior mediastinum

Question 26

Where are opaque foreign bodies lodged in?

Answer 26

pharynx or upper part of the esophagus