Radiology

Question 1

Excess formation of fluid

Answer 1

CHF, hyponatremia, parapneumonic effusions

Question 2

Decreased resorption of fluid

Answer 2

lymphatic blockage from tumor, elevated central venous pressure, decreased intrapleural pressure

Question 3

transport from peritoneal cavity

Answer 3

ascites

Question 4

interstitial filtrate

Answer 4

diffuse
follow distribution of pulmonary vessels
honeycombing
lung base more radiodense than apex

Question 5

alveolar (airspace) inflitrate

Answer 5

fluffy, cloudlike, hazy opacities
confluent opacities
fuzzy, indistinct margins
silhouette sign
air bonchograms

Question 6

examples of alveolar disease

Answer 6

pneumonia
pulmonary alveolar edema
aspiration

Question 7

recognizing pneumonia

Answer 7

organisms- strep pneumoniae (most common), Hib

*other organisms demonstrate interstitial disease too

Question 8

patterns of penumonia

Answer 8

lobar- homogenous w/ air bronchogram
segmenta- patchy, no air bronchogram, atelectasisl
(bronchopneumonia- staph aureus)
interstitial- retciular,diffuse, progresses to airspace
(viral, mycoplasma pneumoniae,
pneumocystis)
round- spherical, lower lobes, kids
(Hi, strep, pneumococcus)
cavitary- TB, staph penumonia- produce thin-walled pneumatocoeles, strep pneumonia, klebsiella pneumonia, and coccidiomycosis

Question 9

recognizing a pneumothorax

types?

Answer 9

Must be able to identify visceral pleural line

Simple (no mediastinal shift) and Tension (shift present)

Question 10

classic COPD findings on CXR

Answer 10

hyperlucency
hyperinflation
flat diaphragm
bullae
vertical heart

Question 11

3 reasons for enlarged cardiac silhouette

Answer 11

1. cardiomegaly- dilation, hypertrophic, combo
2. pericardial effusion- >200 cc fluid, “water bottle”
3. extracardiac- AP view, suboptimal inspiration, obesity, pregnancy, ascites, pectus excavatum deformity, rotation

Question 12

CHF causes and radiographic presentation

Answer 12

CAD and HTN
-pulmonary interstitial edema
1. Kerley B
2. peribronchial cuffing
3. fluid in fissures
4. pleural effusions
-pulmonary alveolar edema (from elevated pulmonary venous pressure)
1. centrally located
2. fluffy, indistinct, patchy, airspace with
butterfly configuration
3. outer third of lung frequently spared
4. lower lung zones more affected than upper

Question 13

RIP ABCDEFGHI

Answer 13

Rotation
Inspiration (9 ribs)
Penetration (IV discs)
Air 
Bone
Cardiac Silhouette
Diaphragm
Edge of heart
Field of Lung
Gastric bubble
Hilum of lung
Instrumentation

Question 14

patella xray view

Answer 14

PA, lateral, oblique, sunrise

Question 15

femur xray view

Answer 15

AP, lateral

Question 16

pelvis xray view

acetabulum

Answer 16

AP

upside, downside

Question 17

thoracic spine

lumbar spine

Answer 17

AP, lateral

AP, lateral

Question 18

Sternoclavicular

Ribs

Answer 18

PA, oblique

PA chest, oblique

Question 19

dislocations

subluxation

Answer 19

completely is apposition at joints
partial dislocation (at joints)

Question 20

Fx types: complete, incomplete

Answer 20

complete- broken completely through cortex

incomplete- only part of cortex is fx

Question 21

humerus and elbow fat pad sign

Answer 21

sail sign… small anterior fat pad is normal but posterior suggests and occult fracture

Question 22

four parameters for describing fxs

Answer 22

1. number of fxs (simple or comminuted)
2. direction of fx line (transverse, oblique, spiral)
3. relationship of fragments (displacement, angulation, shortening and rotation)
4. communication of the fx w/ outside atmosphere
   (closed or open/compound)

Question 23

Number of fragments

Answer 23

simple (2 fragments)
comminuted (more than 2 fragments…segmental (portion of shaft exists as isolated fragment) AND
butterfly(central fragment has a triangular shape))

Question 24

Direction of the fracture line

Answer 24

transverse (at point of impact)
diagonal (along shaft)
spiral (twisting or torquing injury)

Question 25

relationship of distal fx fragment relative to proximal fragment

Answer 25

``` displacement angulation shortening distraction- away and out (patella) rotation- long bones ```

Question 26

communication with outside atmosphere

Answer 26

closed (didn't break skin) | open or compound (did break skin)

Question 27

greenstick fx

Answer 27

involves only one part of cortex

Question 28

torus fx

Answer 28

longitudinal compression of the soft bone in either radius or ulna or both characterized by localized bulging just have a buckle

Question 29

avulsion fx

Answer 29

pulled from its parent bone by contraction of tendon or ligament occur at predictable locations b/c of known insertions of tendons on bones

Question 30

salter-harris (children)

Answer 30

``` I S- straight across II A- above III L- lower or below IV T- two or through V ER- crush ```

Question 31

colle's fx

Answer 31

fx of distal radius- dorsal angulation caused by FOOSH associated fx of the ulnar styloid

Question 32

smith's fx

Answer 32

fx of distal radius- palmar angulation | opposite of colle's

Question 33

boxer's fx

Answer 33

fx of head of 5th metacarpal- palmar angulation

Question 34

scaphoid fx

Answer 34

suspected w/ tenderness in anatomic snuff box FOOSH hairline-thin radiolucencies

Question 35

galeazzi fx

Answer 35

FOOSH with elbow flexed fx of radius with shortening and dislocation of distal ulna dorsal angulation

Question 36

monteggia fx

Answer 36

direct blow to forearm anterior dislocation of radial head with a fx of the ulnar, usually angulated dorsally (may have associated wrist injury)

Question 37

supracondylar fx

Answer 37

distal humerus *most common fx of elbow in kids posterior displacement of distal humerus anterior humeral line passes anterior to its normal location

Question 38

jones fx

Answer 38

5th metatarsal near base | plantar flexion of foot and inversion of ankle

Question 39

march fx

Answer 39

stress fx | most often shafts of 2nd and 3rd metatarsals

Question 40

hip fx

Answer 40

related to osteoporosis | angulation of the cortex or zones of increased density indicates impaction

Question 41

lisfranc fx

Answer 41

tarsometatarsal jt midfoot excessively loaded twisting injury or jamming foot on brake peddle football injury