RAD POS REVIEW FOR MOCK Flashcards
(211 cards)
1
Q
where are these locations?
Atlas:
Axis:
vertebral promenins:
Larynx:
Jugular notch:
Sternal angle:
xiphoid process:
lower coastal margin:
Iliac crest:
Trachea:
Carina:
A
C1?
C2?
C7
C3-C6
T2-T3
T4-T5
T9-T10
L2-L3
L4-L5
C6-T4/T5
T5
2
Q
where is the esophagus in relation to the trachea?
A
posterior to trachea
trachea is anterior
3
Q
the right lung has how many lobes? left?
the left bronchus has how many branches? right?
which lung sits higher? why?
A
right lung has 3 lobes, left lung has 2 lobes
left bronchus has 2 branches, right has 3
right lung sits higher due to the presence of the liver*
4
Q
what are these pathologies?
Pneumothorax:
hemothorax:
pleura effusion:
atelectasis:
pneumonia:
A
air in pleura space of lung
blood in pleura space of lung
fluids in the pleura space of lung
collapse of all or portions of lung
accumulation of mucus in bronchus*
4
Q
what is the outer layer of the pleura called? Inner?
A
parietal
visceral
5
Q
what are these body habitus’s?
hypersthenic:
hyposthenic:
asthenic:
sthenic:
A
wide physique (5% pop)
skinny physique (35% pop)
old/ill physique (10% pop)
average physique (50% pop)
5
Q
what is the CR for a PA chest x-ray?
AP chest x-ray?
A
7-8 inches inferior to vertebral promenins
3-4 inches inferior to jugular notch
6
Q
what is the kVp range for a chest x-ray?
abdomen x-ray?
A
110-125 kVp
70-80 kVp
7
Q
how many ribs need to be shown on an x-ray to be considered diagnostic?
how should clavicles appear?
A
10 ribs
symmetric SC joints
8
Q
where does the diaphragm move during inspiration?
expiration?
A
downward
upward
9
Q
what are the two radiographically significant muscles in the abdomen?
A
diaphragm (separates the abdominal cavity & thorax)
psoas (located lateral to spinal process)
9
Q
what are the 3 accessory organs of digestion?
A
liver
gallbladder
pancreas
10
Q
what are the parts of the small bowel?
which is the widest?
which makes up 2/5’s & 3/5’s?
what is the most proximal portion of the small bowel?
A
duodenum, jejunum, & ileum
duodenum (c-loop appearance)
jejunum
ilieum
duodenum bulb/cap
11
Q
what is the connection between the small bowel & large bowel?
what is the name of the outer peritoneum cavity called? Inner?
A
ileocecal valve
parietal
visceral
12
Q
what is located in the RUQ?
LUQ?
A
12
Q
what is the Bontrager’s abdomen series?
what is the CR for an upper/erect abdomen x-ray?
supine?
A
AP supine abdomen
AP erect abdomen
PA erect chest
2 inches superior to iliac crest
iliac crest for supine
13
Q
what is located in the RLQ?
LLQ?
A
14
Q
what are the four proximal carpal bones? distal? (from lateral to medial)
what kind of joints are the interphalangeal joints? Carpometacarpal? Metacarpalphalangeal joints?
A
scaphoid, lunate, triquetrum, & pisiform
trapezium, trapezoid, capitate, & hamate
hinge or ginglymus
1st: saddle or sellar; 2-5 hinge or ginglymus
ellipsoid or condyloid*
14
Q
what are these pathologies?
ileus:
Ascites:
pneumoperitoneum:
volvulus:
intussusception:
Crohn’s disease:
A
paralysis of bowel; inability for intestine to contract normally
accumulation of fluid in the abdomen
accumulation of air in the peritoneum space/cavity of abdomen
twisting of an intestinal loop; creating bowel obstruction
inflammation of small bowel; causing fistulas between loops
15
Q
the capitulum is apart of what bone?
A
distal lateral humerus
16
Q
what kind of joint is the distal/proximal radioulnar?
A
pivot or trochoidal
16
Q
Joints must be _____ to IR at?
CR must be:
A
parallel; at all times
perpendicular to IR
17
Q
what position shows the fat pads on an x-ray?
A
arm flexed 90 degrees (lateral)
18
Q
lateral fx is best displayed in?
AP fx is best displayed in?
A
AP view
Lat view
19
what hand view shows arthritis?
carpal tunnel?
what is the CR for these views?
ball catcher *
Gaynor Hart method (25-30 degrees to the long axis of the hand; 1 inch distal to third MCP joint)
19
what fx causes the distal radius to protrude anteriorly with radius & ulna anterior?
smith fx (supine)
20
what fx causes the distal radius to go posterior & radius/ulna to protrude anteriorly?
colles fx
21
what are these fx's?
Barton fx:
Bennett's fx:
boxer's fx:
fx to distal lip of radius (styloid process)
fx to the base of first metacarpal
fx to the 5th metacarpal
22
what is osteoporosis? osteopetrosis? Osteogenesis imperfecta?
decreased bone density; more radiolucent decease technique
hereditary condition with abnormally dense bone; increase technique
condition that causes bones to easily break (affect children mostly)
23
how many phalanx's are there on each digit? IP joints?
2 on first digit, 1 IP joint
3 phalanx on digits 2-5, 2 IP joints
24
what are the projections for a forearm x-ray? CR for these projections?
AP & Lat
Mid-forearm
25
what are the views for a hand x-ray? CR for these views?
what are the views for digits? CR?
PA, OBL, LAT (fan lateral)
3rd MCP for PA + OBL
2nd MCP for fan lateral
PA, OBL, LAT; IP joint
26
what are the views for wrist? what is the CR for these views?
PA, OBL, LAT, & scaphoid
Mid carpal (PA, OBL, & Lat)
15 degrees toward wrist + ulnar deviation (scaphoid)
27
what view shows the process located on the anterior proximal ulna?
internal elbow
coronoid process
28
what view shows the process located on the posterior proximal ulna? what is the name of this process?
lateral view
olecranon process
29
what is name of the fossa located on the anterior distal humerus?
posterior distal humerus?
coronoid fossa
olecranon fossa
30
how are the epicondyles for these elbow projections in relation to the IR?
AP:
LAT
INT/EXT:
parallel to IR
perpendicular to IR
obliqued to IR
31
what is a way to remember the elbow views?
ICER
internal rotation = coronoid process
external rotation= radial head +capitulumn
31
what trauma precaution/view can we do to replace an AP elbow?
what view replaced the oblique elbow views?
2 views; forearm parallel to IR, humerus parallel to IR
coyle views
32
what coyle view is for the coronoid process?
what view is for the radial head?
arm flexed 80 degrees, 45 degrees away from the head (hand pronated)
arm flexed 90 degrees, 45 degree toward the head (hand pronated)
(shoot toward the head for the head)
32
what is the name of the AP view for the first digit? what is the CR? what does this rule out?
Robert's view
15 degrees toward the wrist; centered at first CMC joint
Bennett's fx
32
what view shows the fat pads of the elbow free of superimposition? what are the name of the fat pads?
lateral elbow
supinator fat stripe, anterior, & posterior fat pads
33
what are the IR dimensions & kVp settings for these projections?
hand:
wrist:
forearm:
elbow:
shoulder:
*
34
The upper extremity is apart of what skeletal system?
appendicular skeleton
35
how many fossa's are located on the scapula? where are they located?
4;
subscapular fossa (ventral, anterior)
supraspinous fossa (superior, posterior)
infraspinous fossa (inferior, posterior)
glenoid fossa (lateral)
36
what does the AC joint articulate with?
what does the SC joint articulate with?
what is considered the medial extremity? lateral extremity?
acromion & clavicle
sternum (manubrium) & clavicle
SC joint
AC joint
37
what is the deep groove between the two tubercles?
intertubercular groove or bicipital groove
38
what are the three borders of the scapula? what are the angles of the scapula?
superior border, axillary (lateral) border, & vertebral border (medial)
inferior & superior angles
39
when taking a picture of the Y view (NEER) of the shoulder, what anatomy is shown?
coracoid on the right side
acromion left side
inferior angle
spine of scapula
body of scapula
40
what rotation best shows the greater tubercle free of superimposition? Lesser tubercle?
greater = external
lesser = internal
(GELI)
41
what kind of joints are the AC & SC joints? Scapulohumeral joint?
what kind of mobility type?
plane or gliding
ball or socket (spheroidal)
diarthrodial or freely moveable
42
what is the CR for a Y view shoulder?Neer method?
Axillary shoulder?
45-60 degrees LAO/RAO, affected side; NEER: 10-15 caudad
scapulohumeral joint
42
what is the CR for internal shoulder?
Grashey shoulder?
1 inch inferior to coracoid; internal rotation
35-45 RPO/LPO; 2 inches inferior & medial to supralateral border
42
When you are positioning for a trauma lateral ankle what is necessary?
A. Ensure the plantar surface is in complete contact of the IR
B. Rotate the leg laterally, so the leg is against the table
C. Ensure the plantar surface is perpendicular to the IR
D. Plantarflex the foot
C.
Ensure the plantar surface is perpendicular to the IR
42
what is the hand placement & elbow condyles for internal & external views?
internal= hand pronated & epicondyles perpendicular to IR
external= hand supinated & epicondyles parallel to IR
42
If we want to see the humerus in a AP view what rotation would we perform? Lateral humerus?
external rotation
internal rotation
43
what is the CR for transthoracic? what does it best show? is there breathing instructions?
surgical neck
lateral view of affected humerus
inspiration ALWAYS
43
the west-point projection free's what of superimposition?
what scapular notch is located on what part of the scapula?
the scapula is required to be in what position for the Y view?
coracoid process
superior border
lateral/perpendicular to IR
43
what are the views for clavicle exams? what is the CR?
AP & AP axial clavicle
Mid clavicle; 15-30 cephalic for axial
(25-30 for asthenic)
(15-20 for hypersthenic)
44
what are the views for AC joints? what is the SID? what is the CR?
2 views; 1 WOW, 1 WW
72 in SID
1 inch superior to jugular notch
44
what are these pathologies?
Hill-Sachs defect:
rotator cuff injury:
shoulder dislocation:
compression fx of humeral head
trauma injury to rotator cuff muscles: Tere's minor, supraspinatus, infraspinatus, & subcapularis
removal of humeral head from glenoid cavity; 95% anterior
44
what imaging modality is useful for diagnosing shoulder joints and rotator cuff tears?
US (ultrasound)
45
what is the only articulation between the upper extremities & the upper torso?
the SC joint
45
what type of joint is the ankle? Distal tibiofibular joint? proximal tibiofibular joint?
saddle or sellar
*
46
what is the rotation for a mortise ankle? Oblique ankle?
15-20 medially rotated
45 degrees medially
46
what are the views for the calcaneus? what is the name of these projections? what is the CR?
plantodorsal axial calcaneus & Lat
40 degrees cephalic to the long axis of the foot
47
which projection/rotation has the intermalleolar line parallel to the IR?
which Malleoli is superior?
AP mortise ankle (15-20 internal)
medial malleoli
47
The placement of the top border of the IR should extend at least ___ inches from the knee joint to avoid being projected off due to beam divergence:
A. 4 - 4 1/2 inches
B. 3 - 3 1/2 inches
C. 2 - 2 1/2 inches
D. 1 - 1 1/2 inches
D. 1 - 1 1/2 inches
47
When the patient is standing with the metatarsals of the foot in 90 degrees to the leg with a horizontal beam entering the lateral malleolus, which of the following of the weight-bearing projections?
Standing Lateromedial projection
(key: CR is entering in the lateral malleolus)
48
what do the heads of the metatarsals articulate with? base of the metatarsals?
proximal phalanx's
tarsals
48
If we were to be imaging the second foot phalanx in a lateral position which side would generate the least amount of OID?
medial
49
If we are going to shoot an AP foot with a foreign body, can we angle?
no, bc this will cause shape distortion (elongation) of the object
49
what does the medial foot oblique show free of superimposition? Lateral oblique?
sinus tarsi & cuboid
base of the first metatarsal
49
what are these pathologies?
Pes planus:
Jones/nightstand fx:
Gout:
Don Juan fx:
Osgood Slatter:
flat foot
fx to the base of fifth metatarsal
accumulation of blood in the first MTP, form of arthritus
trauma fx to the calcaneus
inflammation of the tibial tuberosity; most common in boys 10-15
49
In the AP projection of the ankle the:
1. Plantar surface is perpendicular to the IR
2. The Fibula projects more distally than the tibia
3. The calcaneus is well-visualized
1 & 2
49
how many degrees do the epicondyles of the knee differ? how do we correct this for a mediolateral & lateromedial projection?
5-7 degrees
5-7 cephalic
5-7 caudad
50
Which of the following joints is a fibrous syndesmosis Amphiarthodial (slightly moveable) joint?
A. Proximal interphalangeal
B. Talonavicular
C. Proximal tibiofibular
D. Distal Tibiofibular
D. Distal Tibiofibular
50
what kind of joints is the metatarsophalangeal joint?
ellipsoid or condyloid
51
AP ankle the plantar surface is ____ to the IR?
Lateral foot the plantar surface is ____ to the IR?
How about standing?
Perpendicular
Perpendicular supine
Parallel for standing
52
what is eversion? Inversion?
outward turning; aka valgus
inward turning; aka varus
53
what is dorsiflexion? plantarflexion?
what is the name for the posterior foot? anterior?
flexed upwards; dorsal/anterior surface
flexed downwards; plantar/posterior surface
plantar surface
dorsum pedis
54
what are the alternate views for the patella? what is the positioning/CR?
Merchant (supine; 45-degree flexion, 30 caudad into patellofemoral)
Hughston (prone; 55-degree flexion, 45 cephalic)
Settegast (prone; 90-degree flexion)
**
54
During an AP axial projection (frogs) what must be parallel to the image receptor? how many degrees?
femoral neck
30-40 degrees; vertically
55
what is the name of the ruler we use for arthrogram procedures? to best visualize in humerus injections how do we want the arm?
Bell-Thompson
externally rotated
55
what are the views for the intercondylar fossa? what is the positioning/CR?
Rosenberg (Mayo) 45 degree flexion, standing, + 10 caudad)
BeClere (supine, 45 flex CR 1/2in to apex)
Camp Coventry (prone, flex 40-50; angle matches flexion)
Holmblad
55
Which of the following procedures may be performed during a post operative T tube cholangiogram?
A. remove gallbladder
B. remove a liver cyst
C. remove a biliary stone
D. remove the kidney
C. Biliary stone (Gall stone)
56
what view would show the proximal tibiofibular joint open? distal tibiofibular?
45 degree internal/medial oblique
15-20 degree internal/ medial oblique, (mortise)
56
In a lateral projection of a normal knee:
1. The fibular head should be somewhat superimposed on the tibia
2. The patellofemoral joint should be visualized
3. The femoral condyles should be superimposed
1, 2 & 3
56
Is an arthrogram a sterile procedure? Is bile considered sterile?
yes, we need to prep the skin
no
56
what are the most frequent joints for an arthrogram? what joint can't be examined for an arthrogram?
shoulder (mostly) but also knee
pubis symphysis
56
what are the angles for the patient that measures 18-24 from ASIS to tabletop for knee projections? less than 18? greater than 18?
**
56
what is the CR for AP knees?
1/2 inch distal to the apex of patella
57
what can be a contraindication for an ERCP?
where is the most common injection site for a myelogram?
Pseudocyst of pancreas
L3-L4 (subarachnoid space)
57
what are some common reasons we would perform a myleogram?
examine spinal cord/nerves to find pathologies
57
what is the name of the scope for the ERCP? how long does it take for contrast to no longer be radiographically detectable in a myleogram?
duodenoscope
24 hours
57
what are the three things myelograms can be used for?
abnormalities in the spinal cord
spinal stenosis
map out the spinal cord for intrathecal injections (chemo)
58
what does the femur articulate with distally? what does the head of the femur articulate with proximally?
patella + tibia
acetabulum
58
what is a necessity for cervical myleograms?
patient prone/fowler + chin hyperextended
58
what does ERCP stand for? what is it's main purpose?
endoscopic retrograde cholangiography pancreatography
59
what is an hysterosalpingography study?
diagnostic study (fluro) of the uterus/fallopian tubes
59
which parts of the spine demonstrate convexity? what are they referred to as? concavity?
thoracic & sacrum; first & second primary curve
cervical & lumbar; first & second compensatory curve
60
how much oblique for the Judet views? how do we oblique for upside Judet and what is seen?
45 degrees LPO/RPO
Upside: 2 inches inferior to upside ASIS; shows posterior rim of acetabulum & anterior iliopubic column
downside: 2 inches inferior + 2 inches medial downside ASIS; shows anterior rim of acetabulum & posterior ilioschial column
60
where is the injection site for a cisternal myelogram?
C1-C2
61
what makes up the pelvis? what are the divisions of the pelvis? what is the main difference between male & female pevlis's?
2 hips (ossa coxae), sacrum, & coccyx
pubis is anterior, ischium is posterior, & ilium is superior
male <90 shaped like heart
female >90 shaped more obtuse
61
what view would best demonstrate the lesser trochanters within profile? greater trochanters?
external oblique
internal oblique
61
what is the CR for inlet? Outlet? (Taylor method)
40 Caudad; level of ASIS
20-35 for men, 30-45 for women; 1-2 inches inferior to pubis symphysis
61
what can be added to improve the quality of an inferosuperior axial lateral hip?
filter & grid
62
what is a lordosis? where is present? Kyphosis? scoliosis?
increased concavity; thoracic
increased convexity; thoracic
exaggerated lateral curvature of spine
62
what are these pathologies?
Jefferson fx:
clay shoveler's fx:
compression wedge fx:
fx of anterior/posterior arches of C1; from landing on head abruptly
avulsion fx of C6-T1; from hyperextension of neck
collapse of T/L vertebral bodies; shaped more like a wedge instead of block
62
what makes up the zygapophyseal joint? intervertebral foramen?
superior & inferior articular processes
superior & inferior vertebral notch
62
when do we see the cervical foramen & zygapophyseal joints?
45-degree oblique (mark side up)
C1& C2 Z joints in AP open mouth; 2-7 true lateral (90 degree to midsagittal plane)
62
what is the positioning for an AP open mouth? what is the CR for AP C-spine?
upper incisors & base of skull lined up
15 cephalic; C4, MML perpendicular
62
what part of the spine connects the transverse process to the spinous process? vertebral body to transverse?
lamina
pedicle
62
what joint connects the base of the skull and atlas?
atlantooccipital joint
62
where are these located?
EAM:
mastoid tip:
1 inch superior to C1 (mastoid tip)
1 inch inferior to EAM (C1)
63
how does positioning look for flexion C-spine? extension?
true lateral; flex chin to chest
true lateral; raise chin & tilt head as far as possible
63
which foramen is seen in a PA cervical oblique? what is the CR? AP?SID?
downside foramen (closest to IR); 45-degree RAO/LAO 15 caudad to C4
upside foramen (furthest); 45-degree LPO/RPO 15 cephalic to C4
72 inches?*
63
which cervical foramen is shown in these projections?
LPO:
RAO:
RPO:
LAO:
right foramen (upside)
right foramen (downside)
left foramen (upside)
left foramen (downside)
63
what must be perpendicular to the IR for a Judd & Fuchs view? how do these x-rays visually appeal?
MML (mentomeatal line)
Dens seen within foramen magnum
63
when are the zygapophyseal joints shown in the thoracic spine? foramen?
70-75 degree oblique
true lateral
64
when do we best see the intervertebral disc space?
AP
65
what are the parts that make up a vertebrae?
2 pedicles
2 lamina
2 transverse process (laterally)
1 spinous process (posteriorly)
1 vertebral body (anteriorly)
4 articular processes (2 superior, 2 inferior)
65
what is the nucleus pulposus? annulus fibrosis?
inner layer of the disc
outer layer of the disc
66
what are each parts of the scotty dog?
ear:
eye:
nose:
legs:
neck:
body:
tail:
superior articular process
pedicle
transverse process
inferior articular process
pars interarticularis
laminae
spinous process
67
In an RPO position for a lumbar x-ray, which zygapophyseal joints are best displayed? LPO? RAO? LAO? what are these projections?
left z joints (downside); AP projection
right z joints (downside); AP projection
left z joints (upside); PA projection
right z joints (upside); PA projection
68
what are the views for sacrum & coccyx? what is the CR?
AP & Lat
AP: sacrum 15 cephalic (to the nose); 2in inferior to ASIS *
AP: coccyx 10 caudad (to the toes); level of ASIS
Lat: 3-4 inches posterior & 2 inches distal to ASIS (no more than 4)
69
when we are performing obliques for the lumbar, what is the rule for over/under rotation?
pedicle appears too anterior to vertebral body means under rotation (too AP)
pedicle appears too posterior to vertebral body is over rotated (too Lat)
(too anterior = too AP= under rotated)
(too posterior = too Lat = over rotated)
70
when doing a lateral lumbar spine exam, what plane is considered to be parallel to the IR? perpendicular?
mid-sagittal
mid-coronal
71
when do we see the zygapophyseal joints in a lumbar spine? intervertebral foramen?
45 degree LPO/RPO oblique
90 degree lateral
71
what could help reduce the OID/fix the curvature of the spine in an AP lumbar projection?
flexing the knees or place a sponge
71
what are these pathologies?
spondylosis:
spondylolisthesis:
fx to the pars interarticularis (dog wearing collar)
forward slippage of vertebral body; best displayed in Lateral (common in L5-S1)
72
what projections are taken for an SI joint exam? what is the CR? what side is marked?
AP axial & oblique SI joints
AP: 30 cephalic (men) 35 cephalic (women); 2in inferior to ASIS
Obl: 25-30 degree PO + 1in medial from upside ASIS; mark upside
72
what are views taken in a lumbar exam? what is the CR?
AP, Lat, Flex, Ext, Obl, & sometimes a spot
AP, Lat, flex/ext: iliac crest (L4-L5)
obl: 2in medial & 1-2in superior to crest + 45-degree LPO/RPO
spot: 1.5in inferior to crest & 2in posterior to ASIS +5-8 caudad
73
what does flexion/extension of the lumbar spine best demonstrate? sideway bending?
posterior/anterior displacement + instability
lateral displacement
74
what is the posterior end of the rib referred to as? anterior portion?
vertebral end
sternal end
74
If the coccyx appears to have a greater curvature, we should increase the angle to ___ ____
15 caudad
74
which set of ribs connect to the ribs directly? which ribs are termed false ribs? true? which ribs are the floating ribs?
1-7 (true ribs)
8-12 (false ribs)
11-12
75
what are the parts of the vertebral end of the rib? what do these connections create? what types of connections are these?
head, neck, tubercle, & angle
head of rib connects to vertebral body to make the costovertebral joint (head to body)
tubercle of the rib connects to the transverse process of thoracic spine to create the costotransverse joint
plane or gliding
76
what is the breathing technique for upper rib projections? lower?
inspiration (diaphragm goes down); best in erect position
expiration (diaphragm goes up); best in recumbent position
76
what is a crucial step for rib exams? for rib exams if the patient experiences posterior pain what projection will this be? anterior pain?
what would show the left axillary of the ribs? right axillary?
interviewing patient/ locating the pain
AP (downside); LPO/RPO
PA (upside); LAO/RAO
LPO (left posterior pain) & RAO (left anterior pain)
RPO (left posterior pain) & LAO (right anterior pain)
76
how many costotransverse joints are there? costovertebral?
10 (last two ribs don't have tubercles)
12
77
what kind of pathologies can be shown in an expiration x-ray? how?
COPD, pneumothorax, & hemothorax
shows the air leaving (escaping) the pleura cavity
78
what are these pathologies?
Flail chest:
pectus:
tripod fx?
*
*
fx in 3 places of zygoma; from blow to the cheek
78
what are the views for the sternum? what is the CR? what is the SID?
RAO (AP) + Lat
AP: 15-20 RAO & mid-sternum; 48" SID
Lat: mid sternum; 72" SID, arms drawn back
78
If a patient exhibits hemothorax on the right side and cannot stand what view could that best be shown in?
right lateral decubitus (on expiration)
78
what are the projections for an SC joint exam? what is the CR? what side do you mark? LAO best shows which SC joint? RAO?
PA + RAO or LAO (affected side); PA projections
PA: T2-T3
obl: 10-15 AO; T2-T3,1-2in lat from mid sagittal
downside
left
right
79
what is considered to be the thickest/densest part of the cranium? what is the thinnest & most vulnerable portion?
petrous ridges of temporal bone; pyramid shaped
squamous portion of temporal bone (temple)
79
what are the views for the skull?
Lat, Caldwell (reg or exaggerated), Haas (PA axial) or Townes (AP axial)
80
what is the positioning and CR for the Caldwell projection? what should this best show? what is the alternative view?
OML is perpendicular to IR + 15 Caudad angle; CR exits nasion
petrous ridges in the lower 1/3 of the orbit
15 to 30 caudad to place petrous completely out of the orbit
80
how many bones does the occipital bone articulate with? which? Parietal? what bone articulates with all the other cranial bones?
6 CB: 2 parietals, 2 temporals, 1 sphenoid, 1 Atlas (C1)
5CB: 1 frontal, 1 occipital, 1 temporal, 1 sphenoid, opposite parietal
sphenoid (the anchor)
80
what are the different size shapes for the skull & their names?
mesocephalic (average shaped); 47 degrees (from parietal tubercles)
brachycephalic (wide skull); greater than >47 degrees appox. 54 degrees
dolichocephalic (skinny head) <47 degrees
81
what bone houses the hearing organs?
temporal bone (mastoid portion)
81
what do each of these stand for in the cranium?
GML:
OML:
IOML:
AML:
LML:
MML:
GAL:
IPL:
how much difference is seen between OML & IOML?
gabellomeatal line (GML)
Orbitomeatal line (OML)
infraorbitomeatal line (IOML)
Acanthiomeatal line (AML)
lips-meatal line (LML)
mentomeatal line (MML)
Gabellaaveolar line
Interpupilary line
7 degree difference
81
how many bones does the temporal bone articulate with? which? ethmoid? frontal bone?
3 CB: 1 parietal, 1 occipital bone, 1 sphenoid bone
2 CB & 11 FB: 1 frontal, 1 sphenoid
4 CB: 2 parietals, 1 sphenoid, 1 ethmoid
81
what is the positioning & CR for Water's projection? what is another name for this projection?
MML perpendicular to IR; CR exits at acanthion
parietoacanthial
82
what is the positioning & CR for the Haas projection? what is another name for this? what is best demonstrated in this projection?how does it differ from the Townes projection?
OML perpendicular to IR & 25 degrees cephalic; CR exits 1 1/2in superior to nasion
PA axial
dorsum sellae within foramen magnum
occipital bone is more magnified (bc of OID)
82
what bone contains the sellae turcica? what organ lies in this space?
sphenoid bone
pituitary gland
82
what is the positioning & CR for the Townes position? what is best demonstrated? what is another name for this? how does this differ on an x-ray versus the Haas projection?
OML or IOML perpendicular & 30 caudad (OML) 37 caudad (IOML); 2 1/2in superior to gabella
dorsum sellae within foramen magnum
AP axial
orbits are more magnified on the x-ray (from OID)
83
what views are used to evaluate the cranium? sinuses/facial bones?
PA skull, Lat, Caldwell, Townes or Haas
Lat facial bones, Waters, & Caldwell (no anglulation for air fluid levels)
83
If we are shooting an AP axial (Townes) and in the picture the dorsum sellae is below the foramen magnum but the anterior arch of C1 is visible in the foramen. What error has taken place?
too much caudad angle
(almost becoming a tangential)
(dorsum sellae is supposed to be inside the foramen magnum, angling less will place it inside)
84
in the skull how many junctions are there?
6; bregma (anterior), 2 pterion (lateral anterior), 2 asterion (lateral, posterior), lambda (posterior)
85
how many sutures are located within the skull?
2 squamous (lateral), coronal, sagittal (midline), lambdoidal (posterior)
85
how does the stomach lie in a hypersthenic patient? asthenic?
transversely
vertical/ J shaped
85
what is an alternative view to the Water's projection? what is the purpose of this? what is different in the positioning?
transoral (open mouth)
to show the sphenoid sinus (all 4 sinuses shown)
LML is perpendicular (instead of MML); creates 55 degree angle instead of 37
86
what do these mean?
Cysto:
angio:
choles:
Choledocho:
Cholangio:
Cholecyst:
bag or sac
duct
relationship with bile
Common bile duct
bile ducts
gallbladder
86
what is the order for the ducts within the liver & gallbladder?
what is an important ligament in the small bowel? why?
L & R hepatic (extends from liver)
common hepatic duct
cystic duct (gallbladder duct)
common bile duct
pancreatic duct (duct of Wirsung)
sphincter of Oddi (duodenum)
ligament of Trietz; suspensory muscle for duodenum
86
what are the different projections for an esophagogram? what is the CR? what is the positioning?
AP/PA, RAO, LAO, & left lateral
T5-T6 (1in inferior to sternal angle)
LAO/RAO: 35-40 AO; T5-T6
AP/PA: T5-T6
Lat: T5-T6
87
what is the positioning & CR for an upper GI?
RAO & LPO + R lat
RAO: 40-70 oblique; CR at duodenal bulb (L1, 2in superior for hyper & 2in inferior for hypo)
LPO: 30-60 oblique (L1, 2in superior for hyper & 2in inferior for hypo)
R lat: best shows retrogastric space
88
what is the orientation of the stomach?
fundus:
body:
pylorus:
most posterior, proximal
anterior, inferior to fundus
posterior, distal to stomach body
88
what do these positions best demonstrate for an esophagogram?
LAO:
RAO:
PA/AP:
Lat:
esophagus between hilar & thoracic
esophagus between heart & thoracic spine
esophagus with superimposition over spine
esophagus between heart & thoracic spine
89
what is the Kvp range for double contrast exams? single contrast? iodine studies?
90-100 kVp
110-125 kVp
80-90 kVp
90
where is the barium in an LPO upper GI study? air? barium in RAO? air?
barium in fundus, air in pylorus
barium in pylorus, air in fundus
90
what is the prep involved with upper GI exams?
NPO after 8 hours
90
what is chymes?
what is peristalsis?
semifluid mass; result from mixing (churning) stomach contents/fluids
involuntary muscle contractions; aids in swallowing
91
what is swallowing referred to as?
chewing?
what is the rugae?
deglutition
mastication
internal lining of stomach (mucosal folds)
92
Barium is considered to be a?
colloidal suspension
92
what is the unique term for having gallstones?
what are the three cardinal rules of radiation protection?
choleliths
time, shielding, distance (most important)
93
what are these pathologies?
GERD:
trichobezoar:
gastroesophageal reflux disease
mass of ingested hair
94
what small bowel AP oblique best demonstrates the hepatic flexure + ascending colon? PA? what is the CR for small bowel?
LPO
RAO
iliac crest
95
what AP small bowel oblique best displays the splenic flexure & descending colon within profile? PA? what is the CR for small bowel?
RPO
LAO
iliac crest
95
what decubitus position best shows air in the splenic flexure & descending colon? hepatic & ascending colon?
right lateral decub; fluid goes to right side, air rises on left side
left lateral decub; fluid is held down to the left side & air rises on right
96
which oblique places air in the posterior rectum in a small bowel series? anterior rectum?
ventral decubitus
dorsal decubitus
96
where is air & barium while patient is prone (PA projection)? supine (AP projection)?
air: ascending & descending colon; barium: transverse & sigmoid
air: transverse & sigmoid; barium: ascending & descending colon (retroperitoneal)
97
which side of the body are these located on?
hepatic flexure:
liver:
splenic flexure:
spleen:
ascending colon:
descending colon:
heart:
right
right
left
left
right
left
left
98
what part of the large intestine sits the highest in the body? why?
left colic (splenic) flexure
there is no liver blocking it
99
what are some of the contraindications of a barium enema?
perforated bowel & bowel obstructions
100
what is the position the patient must be in for a barium enema insertion? what is the breathing instructions? where should you aim? what is the rule about the barium enema bag? how often should pictures be taken during the series?
sims
expiration
toward the umbilicus (not exceed 3-4 inches)
should not be higher than 24 inches
every 20-30 mins
101
what does a left lateral rectum best demonstrate? what is the CR for this projection?
polyps, strictures & fistulas between rectum/bladder
ASIS
102
what is the positioning & CR for these small bowel projections?
AP axial:
LPO:
PA axial:
RAO:
30-40 cephalic; 2in inferior to ASIS
30-40 LPO & 30-40 cephalic; 2in inferior & 2in medial to right ASIS
30-40 caudad; ASIS
35-45 RAO & 30-40 caudad; ASIS & 2in left of L spine spinous process
102
what is the normal range for creatinine levels? BUN levels?
0.6 to 1.5 mg/dL
8-25mg per 100 ml
102
what do these mean?
micturition:
incontinence:
retention:
anuria:
oliguria:
act of urination (voiding)
involuntary leakage of urine
inability to urinate (void)
kidney's producing no urine; due to blockage
low urine output; related to fluid intake
103
what drugs would we use to reduce a reaction?
prednisone & Benadryl
104
what is a retrograde study?
what is an excretory study?
contrast through catheter (retro=backwards)
contrast through the vein (intravenous) (forward)
104
What position do we need to place the patient in to get the kidneys parallel to the IR?
30 degree LPO/RPO
(30 LPO places right kidney parallel)
(30 RPO places left kidney parallel)
104
What is the name of the functional study of the bladder and urethra? Why do we empty the bladder before doing a IVU study?
voiding cystourethrography (VCU)
a bladder to full could rupture & urine already in the bladder dilutes the contrast medium
104
where should the tourniquet be placed in relation to the injection site? What is the name of the leakage of contrast outside of the vessel and into surrounding tissue?
3-4 inches above injection site
extravasation
105
What calyx’s form the renal pelvis? what is an essential component of the kidneys?
major & minor
nephrons
106
what is metformin related to? what must we do before resuming metrformin?
diabetes
verify proper kidney functions
106
what do these terms mean?
subluxation:
contusion:
fracture:
sprain:
partial dislocation; nurse made jerked elbow
bruise injury; possible avulsion fx
break or altering of bone
forced wrenching/twisting of joint; damage without dislocation
106
what does apposition mean? what are the different types?
how fragmented end of the bone make contact with each other
anatomic: normal, end to end contact
lack of: aligned but no contact
bayonet: shafts make contact but not ends
107
what type of fx are these?
greenstick:
closed:
complete:
transverse:
oblique:
spiral:
communited:
compound:
Pott's:
impacted fx:
hangman's:
fx on is one side only
fx not piercing the skin; aka simple fx
broken into two pieces
near right angle to long axis
fx passes through bone at oblique angle
spirals up the bone
bone crushed, in two or more fragments
portion of fx bone is piercing through skin; aka open fx
complete fx of distal tib/fib
fragment is firmly driven into other
fx occurs in pedicle of C2
107
when we are operating in fluoroscopy what is the most important factor? why? how does this affect the image?
intermittent fluro (pulse mode)
less patient dose
less crisp image
107
what does ORIF stand for? what is it?
open reduction with internal fixation
states fx site is exposed to screws, plates, & rods to maintain alignment
108
what are these pathologies?
NEC (necrotizing enterocolitis):
atresia:
pyloric stenosis:
osteogensis imperfecta:
talipes equinovarus:
croup:
Hirschsprung's disease:
condition where intestinal tissue dies
medical condition of body part that results in tubular shape w/o normal opening
condition that affects muscular opening between stomach & small intestine (babies, rare)
bones break easily; decrease technique
birth defect that causes one or both feet to turn inward & downward
narrowing of the upper airway; best displayed in AP & Lat soft neck
rare birth defect that causes nerves in lower intestine to no develop properly
108
what are the two common types of fx's seen in suspected cases of child abuse? what is the old term for child abuse? new? what is the technical term for a newborn?
bucket & corner fx
battered child syndrome (BCS)
suspected non-accidental trauma (SNAT)
neonate
109
what is the CR for pediatrics abdomen exam? chest?
1" superior to umbilicus
mammillary line
109
what weighted device is used to assist in positioning? flat-radiolucent device with straps that assists for supine imaging? for chest pediatrics? how can we eliminate motion for pediatric patients?
sandbag
tam-em board
pigg-o-stat
shortened exposure time
110
what is a disorder of abnormal development resulting in dysplasia, subluxation, and possible subluxation of hip secondary to capsular laxity and mechanical instability?
DDH (developmental dysplasia of the hip)
110
what exam is performed to determine a child has stopped growing? what modality would assist to diagnose congenital hip dislocations in newborns? what about for ADHD & suspected tumors?
bone age survey ( single x-ray of left hand)
sonography (US)
MRI
111
what is the rule when it comes to pediatrics and tape? at what age can a child be spoken to and follow instructions?
adhesive side of tape should not make contact (undiagnosed allergies)
2-3 years old
111
what is the kVp range for peds AP & Lat x-rays? what is the name of the space between the primary & secondary growth center?
70-80 kVp
epiphyseal plate
