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Basic Principles Flashcards

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1
Q

what are all the different imaging modalities?

A 
x ray 
Computer Tomography (CT) 
Magnetic Resonance (MR) 
Ultrasound (U/S) 
Nuclear Medicine
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2
Q

(T/F) x ray uses a single pulse of ionizing radiation

A

True

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3
Q

X ray is good for:?

A

bones and airspaces

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4
Q

x ray is bad for:?

A

soft tissue and overlapping structures

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5
Q

What color is x ray film to start with?

A

white. turns dark when hit with ionizing radiation

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6
Q

the “color” in x rays that is different shades of gray is called what?

A

water density

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7
Q

what are the radiographic densities from DARKEST to LIGHTEST?

A 
Air (darkest) 
Fat (less dark) 
Fluid/Blood/Soft tissue (Gray) 
Bone (white) 
Metal/contrast (most white)
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8
Q

what are the different x ray views

A

AP
Lateral
Oblique
PA

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9
Q

When would you use AP views on x ray?

A

if patient is unable to stand or sit.

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10
Q

Laterals are usually taken in conjunction with what view?

A

PA

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11
Q

What x ray angle is used mostly on limbs?

A

Oblique

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12
Q

Which x ray view gives the heart a minimally magnified image, with sharp borders?

A

PA

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13
Q

Which modality emits radiation, shows color in black, white, and gray and uses multiple pulses of ionizing radiation?

A

Computed Tomography

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14
Q

CT is good for:?

A

Bones, airspace, some soft tissue and overlapping structures.

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15
Q

which modality is especially good for abdomen and in trauma?

A

CT

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16
Q

which modality is bad for soft tissues such as nerves, muscles, connective tissue and patients with retained metallic objects?

A

CT

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17
Q

what are the three CT views?

A

Sagittal (median)
Coronal (front to back)
Axial or Transverse or Cross-Sectional (looking down)

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18
Q

which modality uses electromagnetism and radio frequency properties?

A

Magnetic Resonance (MR)

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19
Q

Which modality gives no exposure to ionizing radiation but is time consuming?

A

MR

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20
Q

MR is good for what?

A

soft tissue (nerves, muscles, connective tissue, brain, joints)

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21
Q

MR is bad for?

A

people who cannot hold still or have ferrous metal in the body

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22
Q

Which modality gives views identical to CT?

A

MR

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23
Q

Which modality uses sound waves, no radiation, but doesn’t go very deep?

A

Ultrasound

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24
Q

which modality is operator dependent, is a focused segment of the object, and is rapid and portable?

A

Ultrasound

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25
which modality is good for determining fluids vs solids, abdominopelvic imaging (gallbladder, kidneys, uterus, testis) and assessing blood flow?
Ultrasound
26
what are the two ultrasound views?
longitudinal (same as sagittal) | Transverse (same as axial)
27
which modality is typical use is to detect stress fractures before being visible on x ray?
Nuclear Medicine
28
Which modality is good for detecting normal or abnormal physiologic processes?
Nuclear Medicine
29
which modality is bad for determining anatomy?
Nuclear Medicine
30
what all do you confirm on a pre read?
``` correct patient correct date correct body part correct type the number of views expected check for comparison films exist ```
31
What is the RIP technique?
Rotation Inspiration Penetration
32
What is the rotation in RIP?
looking at clavicles relative to the vertebral column
33
What is the inspiration in RIP?
counting the ribs. should be 9-10 ribs.
34
what is the penetration of the RIP technique?
should see structures. e.g. ribs through the heart, spine through the heart, pulmonary vessels near the edges of the lungs.
35
what type of film penetration has the lung fields appearing almost completely black or suggests pneumothorax?
Over Penetrated
36
what type of film penetration will have the soft tissue structures obscured and images appear bright suggesting consolidation or pneumonia?
under penetrated film
37
what is the sequence of events for reading a chest x ray
1) pre read 2) technical adequacy (RIP) 3) systematic method (ABCDE)
38
What are the ABCDE of reading chest x rays?
``` A Airway/Airspace B Bones C Cardia Borders D Diaphragm E Everything Else ```
39
What are you looking at with "airways"
trachea midline and patent | and airspaces
40
What do you look at for "bones"
look at clavicles, ribs, pectoral girdle, and spine for alignment, lack of symmetry and fracture lines.
41
What do you look for with "Cardiac Silhouette"
the transverse diameter of the silhouette should NOT exceed 50% of the transverse diameter of the thoracic caged, called the cardiothoracic ratio.
42
What are you looking for with "D-Diaphragm"?
dome shaped, right hemidiaphragm is always higher than or same level as left the costophrenic angles
43
What is "Everything else"?
gastric bubbles | check for EKG leads, lines, tubing, and other missed items (four corners of the film)
44
what should be your findings when reading a lateral chest film?
spine should be brighter as it proceeds inferiorly area behind sternum should be clear behind the heart should be clear middle lobe over the cardiac silhouette cardiac and diaphragmatic borders should be sharp
45
for common primary complaints, when should you order imaging?
to confirm a suspicion should impact treatment imaging should include a relevant and brief patient history with the purpose of evaluation.
46
what are common issues in primary care?
acute foot, ankle, knee pain. back pain and headache.
47
What is defined as acute?
w in 24 hrs.
48
Ottawa ankle rules:
"malleolar" zone pain and bone tenderness at the posterior edge (6cm) of the lateral and medial malleolus. OR inability to bear weight after injury and four steps in the evaluation room.
49
Ottawa foot pain rules:
pain in the "midfoot" region AND tenderness at the base of the 5th metatarsal or navicular OR inability to bear weight both immediately after the injury and for four steps in the evaluation room
50
When can you repeat x rays after normal initial?
10-14 days
51
what is preferred image modality if stress fractures are normal on x ray?
MRI
52
Ottawa knee rules:
age > 55 yo ISOLATED tenderness of the patella tenderness at the head of the fibula inability to flex knee 90 degrees (
53
When would you refer for imaging shoulder pain since there is no specific guidelines?
traumatic cause severe pain Decreased range of motion
54
what are plain films able to identify?
fractures dislocations arthritis AC joint or SC joint injuries
55
what is preferred for labral, ligamentous, or rotator cuff injuries?
MRI
56
what is the view for a suspected fracture of the phalanx?
AP and true lateral
57
what view of the hand is good if a fracture involves or is close to the joint?
an oblique view
58
all metacarpal fractures require which views?
AP, lateral, and oblique views
59
what are the anatomical sites for phalanges and metacarpals?
head, neck, shaft, and base.
60
tuft fractures refer to what?
fractures involving the head of the distal phalanx.
61
what are the three articulations of the elbow?
radiohumeral ulnohumeral radioulnar
62
how is the elbow typically radiographed?
AP and lateral projections
63
how are dislocations of the elbow named?
the direction the radius and ulna dislocate relative to the humerus.
64
imaging for back pain is not indicated in which initial weeks?
4-6 weeks
65
indication for back pain imaging?
``` neurological findings constitutional findings trauma malignancy elderly (>50 yo) infections risk Chronic steroid use radicular pain osteoporosis ```
66
when would you consider images for headaches?
``` trauma new, worse onset headache focal neurological signs thunderclap headache radiating to neck positional headache temporal headache >55 yo infection ```
67
what are the most common issues in primary care?
acute foot, ankle, and knee pain. low back pain and headache.

Radiology (2 decks)

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