RDGR 283 LO2 part 2

Question 1

what are the 2 most common indications for pediatric skull series?

Answer 1

• rule out craniosynostosis (premature closure of one or more of the cranial sutures)
• Rule out fracture (accidental, non-accidental, forcep extraction at birth)

Question 2

What is replacing skull x-ray images?

Answer 2

CT

Question 3

What method is used for newborn to 3 years for skull images?

Answer 3

the bunny method

Question 4

What position are infants in for skull images?

Answer 4

supine

Question 5

What plane is the skull in AP in and where is the CR centered for the skull images?

Answer 5

OML perpendcular. CR centered to nasion

Question 6

What plane is the skull in AP Axial Townes in and where is the CR centered for the skull images?

Answer 6

OML perpendicular to IR. CR enters 1-2” superior to glabella with 30” caudal angle. (2.5 inches superior to glabella passing through the level of EAM)

Question 7

how is the patient positioned for a lateral vertical beam for the skull and where is the CR

Answer 7

position one sponge just posterior to the vertex of the skull, the other hand will hold the mental protuberance of the mandible. CR enters 1cm superior to EAM (2 inches superior to EAM)

Question 8

How is the patient positioned for a lateral horizontal beam for the skull and where is the CR

Answer 8

used to demonstrate air/fluid levels. infant elevated on a radiolucent pad to avoid clipping of the posterior skull. CR enters 1cm superior to EAM

Question 9

What are paranasal sinus images taken for

Answer 9

rule out sinustitis

Question 10

which sinuses are present at birth?

Answer 10

maxillary, ethmoid, sphenoid sinuses.

Question 11

When do frontal sinuses appear?

Answer 11

2nd year

Question 12

What are the two routine sinus projections?

Answer 12

Caldwell, Waters

Question 13

What is the positioning for sinuses in caldwell?

Answer 13

8 years and younger, put forehead and nose against bucky, no angle. older adults position same way. CR exits the nasion

Question 14

What is the positioning for sinuses in waters for sinuses?

Answer 14

Nose and chin on the bucky. CR exits the acanthion

Question 15

What should be included in left lateral sinus images?

Answer 15

include frontal sinus, c-spine and airway to the thoracic inlet (STN)

Question 16

What is a horizontal beam for left lateral sinus show?

Answer 16

demonstrate fluid air levels within the sphenoid sinus

Question 17

Where is CR directed for chest radiography for in peds?

Answer 17

T6-7 nipple

Question 18

where is the collimation for peds chest radiography?

Answer 18

mastoid tips to just above the iliac crests (mastoid tips shows the upper airway, above the iliac crest will ensure the inferior costal margins are included.

Question 19

How old should the patient be to be in a pigg-o-stat?

Answer 19

0-3 years

Question 20

What age should the child be sitting down for a chest image?

Answer 20

3 to 10 years

Question 21

How many posterior ribs should be visible for peds chest?

Answer 21

8-9

Question 22

what are the routine projections for pelvis and hip radiography?

Answer 22

AP and frog leg lateral

Question 23

Where should the shield be placed for males for pelvis images?

Answer 23

place the top of the shield at (or slightly below) the level of the greater trochanter

Question 24

Where should the shield be placed for a female pelvis image?

Answer 24

place the top, widest part of the shield in the midline, level with the ASIS. ensure shield covers the sacrum and SI joints.

Question 25

How is the patient positioned for congenital dislocation of the hip?

Answer 25

bilateral hip projection with both legs forcibly abducted to at least 45 degrees with appreciable inward rotation of the femora

Question 26

What needs to be included in a pelvis x-ray for peds?

Answer 26

include top of the iliac crests to proximal 1/4 of the femora

Question 27

T/F contralateral imaging is done for comparison for pelvis images.

Answer 27

False. for limb radiography

Question 28

what ways of immobilization is for newborn to 2 years old for limb radiography?

Answer 28

- swaddling (bunny) - plexiglass - Sponges - Sandbags - Velcro straps

Question 29

What is the best way to take limb images on preschool age?

Answer 29

nest imaged with the child sitting on the parents lap

Question 30

What is the best way to take limb images on school age patients

Answer 30

same as adult

Question 31

What are the three most sensitive areas of the body to shield?

Answer 31

Thymus, sternum, breast tissue, gonads?

Question 32

What two routine images are done for abdominal xrays

Answer 32

supine abdomen and image to show air-fluid levels

Question 33

Where is the CR for supine abdomen?

Answer 33

perpendicular to L2. Infants and small children CR 1" superior to umbillicus. Larger children, CR level of iliac crest

Question 34

What position for abdomen should be done for children less than 3 years old?

Answer 34

upright preferred over lateral decubitus due to immobilization.

Question 35

where is the CR for abdomen projectitons of lateral decubitus?

Answer 35

1-2" aboce iliac crest

Question 36

What positions are done for neonatal projections of the abdomen?

Answer 36

- supine and left lateral decubitus (air fluid levels). | - supine and lateral verify catheter position.

Question 37

where is the shield for fluoroscopy?

Answer 37

under the patient.

Question 38

What are three specific exams to peds?

Answer 38

- scoliosis - bone age studies - Foreign body surveys

Question 39

what are the three different types of scoliosis?

Answer 39

idiopathic, neuromuscular, congenital

Question 40

What should be included in scoliosis imaging?

Answer 40

EAM to the SI joints

Question 41

How is the degree of bone age determined?

Answer 41

- appearance - size - differentiation of ossification centers

Question 42

bone age protocols for children 1-2 years of age often include...

Answer 42

AP of left knee

Question 43

In developmental dysplasia of the hip, which way does it dislocate?

Answer 43

superiorly and anteriorly

Question 44

What are the different types of osteogenesis imperfecta?

Answer 44

Type 1 = most common and mildest. reduced collagen Type 2 = most severe Type 3 = bone deformities Type 4 = moderately severe