X-Ray Flashcards by Leonela Martinez

used for large objects
 have a short exposure time
increase penumbra (blurrred margins)

Large filaments

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used for small objects
have a longer exposure time
produce a sharper image
decrease penumbra

Small filaments

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is negatively charged and contains a focusing cup

cathode

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is positively charged, made of tungsten, and is the target plate

anode

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makes 85-90% of the x-ray beam and creates the image

Bremsstrahlung radiation (braking radiation or soft x-rays)

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makes 10-15% of the x-ray beam and does not contribute to the formation of the image

Characteristic radiation (hard x-rays)

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complete absorption of x-ray which does not affect the image

photoelectric effect

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two types of radiographic noise

artifact and mottle

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three types of mottle

quantum, structure, and film graininess

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variation of density of a uniformly exposed film that results from random spatial distribution of x-ray quanta absorbed in the screen

quantum mottle

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factors that affect scatter radiation

beam size, field size, and patient size

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4 ways to reduce scatter radiation

reduce beam size
increase beam energy or increase Kvp
decrease field size w/ grid or collimator
air gap technique

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purpose of the grid

to prevent scatter radiation and allow useful x-rays through

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refers to the distance between the object and the film

air gap technique

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what happens when you reduce the OFD

reduce scatter

image magnification

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produces 99% heat and 1% x-rays

anode

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reduces amount of radiation exposure to the patient

port filters and collimator

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increasing the mAs incorporates the use of which filament

large filament

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what is the best grid ratio that also has the greatest effect in reducing scatter radiation

16:1

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what type of crystals does the film consist of

silver halide crystals

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directly proportional to the Kvp and Ma and contributes to the overall darkness of the fil

density

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refers to the differences in the shades of gray of an image and is indirectly related to the Kvp

contrast

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contrast recommended for soft tissue

low contrast (high Kvp)

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contrast recommended for bone

high contrast (low Kvp)

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increasing the OFD results in

image magnification

exposes patient to less radiation, reduces penumbra, decreases magnification, and increases detail

FFD 72 inches (FFD of 40 inches does opposite)

blurred margins

penumbra

sharp margins

umbra

50% decrease in mAs is equivalent to a 15% increase in Kvp

50/15 rule

when decreasing the kvp by 16%, you have to double the mAs or it will halve the film distance OR when increasing the kvp by 20% you have to decrease the mAs by half or you will double the film density

16:20% rule

the anode heel effect is stronger on the cathode or anode

cathode

the cathode should be placed closer to the fatter part of the object in the anode heel effect

FAT CAT

increases film exposure, scatter radiation, and fog and decreases contrast

increasing the kvp

increases film exposure and darkens the film

increasing mAs

radio sensitivity of tissue is directly proportional to the rate at which the tissue multiplies (the more rapid a tissue grows, the more susceptible it is to damage)

bergonie-tribondeau law

radio resistant tissues

brain, spinal cord, thyroid, and muscle

radiosensitive tissues

gonads, bone marrow, lymphoid tissue, colon, and lungs

when taking x-rays in a female, within how many days should the procedure be performed

within 10 days of her LMP

in regards to density, which factors have a direct relationship

Kvp, mAs, collimator

in regard to density, which factors have an inverse relationship

FFD, OFD, grid

in regards to contrast, which factors have a direct relationship

OFD and grid

in regards to contrast, which factors have an inverse relationship

Kvp, mA, collimator

in regards to size distortion, which factor has a direct relationship

OFD

in regards to size distortion, which has an inverse relationship

FFD

in regards to detail, which has a direct relationship

FFD

in regards to detail, which has an inverse relationship

OFD

in regards to exposure time, which factors have a direct relationship

kvp, mAs, OFD

in regards to exposure time, which factors have a inverse relationship

FFD and collimator

all radiographic views have a FFD of 40 inches except the following which are at 72 inches

chest films lateral sternum films full spine films Non-AP cervical films (lateral, oblique, flexion, extension)

all views are AP projections except the following which are PA projections

``` skull mandible chest wrist tunnel patella ```

all oblique films are midway between a PA and a lateral position (usually at 45 degrees) except

thoracic spine | SI joint

all views are taken on suspended on expiration except the following which are performed on full inspiration

PA and lateral chest AP full spine AP and lateral thoracic

gonadal shielding should be used on children and adults within what range

2 inches

grids should be used on

all body parts measuring >12cm to reduce scatter radiation and use 70kvp to penetrate the grid

all tube tilts are cephalic except the following which are caudal

cervical anterior oblique lateral lumbar AP coccyx Y-scapula

CT is measured in what units

Hounsfield

Caldwell view shows what

Frontal sinus

Towne view shows

Foramen magnum

Water view shows

Maxillary sinus

Lateral skull shows

Sella turcica

APOM shows

C1 fractures

AP cervical shows

Luschka joints

Cervical oblique shows

Intervertebral foramina

Apical lordotic shows

Pancoast tumor

Swimmers shows what

C7 spinous process

Frog leg shows

Femoral head in abduction and external rotation

Tunnel shows

Intercondylar fossa in knee

Sunrise shows

Apical view of patella and the intercondylar groove

Lumbar oblique shows

Pars interarticularis

Lumbar lateral shows

IVF

MRI contraindications

pacemaker cochlear implant intracranial aneurysm implanted neurostimulators

MRI is useful in demonstrating what

``` spinal cord and brain pathology disc lesions solid organ pathology metasteses in bone demyelinating CNS disorders musculotendinous disorders ```

Which type pf imaging has contrast resolution that is 10x better for soft tissue pathology

MRI 10x better than CT

CT and bone scan contraindications

pregnancy

CT is useful in demonstrating

``` intraspinal and intracranial masses intracranial bleeding spinal canal stenosis abdominal masses bony structures LUNG pathology (best in CT than in MRI) disc (spiral CT) ```

which form of advanced imaging produces reconstructed axial images in any plane of the body

has a contrast resolution that is 95 times better than conventional radiography

uses a gamma camera to create images

radionuclide bone imaging (bone scan or bone scintigraphy)

what are some common radioactive pharmaceuticals used in a bone scan

technetium 99 and indium 111

what are normal areas of increased uptake on bone scans

``` SI joint SC joint AC joint kidney tips of scapula costochondral joints frontal parasagittal regions of the skull ```

bone scans are useful in determining what

``` primary bone tumors except multiple myeloma blastic metastases osteomyelitis occult or stress Fx avascular necrosis of bone pulmonary embolism ```

what form of imaging is helpful in the investigation of suspected vascular diseases

diagnostic ultrasound

what form of imaging is excellent in determining the size of tumors or abdominal aneurysms

diagnostic ultrasound

what imaging form uses high frequency sound waves

diagnostic ultrasound

diagnostic ultrasound uses

``` abdominal aortic aneursym carotid artery disease vertebral artery disease pregnancy ovarian disease cholelithiasis ```

What form of imaging is used to measure brain activity and changes in blood oxygenation

fMRI

Which form of imaging measures regional cerebral blood flow using radioactive labeled tracer glucose molecules

PET scan

tumors preferentially use the glycolytic pathway for energy therefore, there is a greater concentration of of radioactive glucose in malignant tissues

Warburg Effect (PET SCAN)

what form of imaging uses an injection of radionuclide into the bloodstream

SPECT

mammograms use a ___ Kvp and a ___ mA

lower; higher

is used for blood flow in arteries or veins with ultrasound

doppler

is used to visualize the esophagus

barium swallow

is used to visualize filling defects in the stomach or hiatal hernias

barium meal

is used to visualize filling defects in the small intestines

barium follow through

is used to visualize filling defects in the large intestine

barium enema

is used to visualize narrowing or clots in arterial blood vessels by injecting a radio contrast agent into an artery

angiogram

uses a magnetic field and pulses of radio wave energy to visualize arteries int he body

MRA

What does ALARA stand for

As low as reasonably achievable

what is the screen made from

phosphorus crystals

X-RAY guidelines

``` pain or limitation of motion spinal trauma malignancy congenital anomalies previously detected spinal abnormality scoliosis and kyphosis shoulder or arm pain from suspected cervical radiculopathy occipital headache pain radiating around the chest wall pain radiating into hip, buttock, hip or groin compression Fx ```

radiographs needed if any of the following are present after trauma high risk factors such as older than 65, work with dangerous mechanisms paresthesia in the extremities presence of midline cervical spine tenderness or delayed onset neck pain unable to actively rotate the neck beyond 45 degrees

Canadian C spine rules

``` no radiographs are needed if all of the following are present in a patient with a history of injury to the neck no posterior cervical spine tenderness no evidence of intoxication normal level of alertness no focal neurological damage no painful distracting injury ```

NEXUS (national emergency x-ray utilization study)

ottawa knee rules

X-rays recommended if there is a history of trauma to the knee and if any of the following are present age 55 or over isolated tenderness of the patella (no bone tenderness of the knee other than the patella) tenderness at the head of the fibula inability to flex to 90 degrees inability to take more than 4 consecutive weight bearing steps both immediately and in the office

ottawa ankle rules

X-rays are recommended if there is a history of trauma to the ankle and any of the following: age over 55 unable to take more than 4 successive weight bearing steps shortly after the injury and in the office localized tenderness along posterior aspect or crest of either malleolus localized tenderness over any of the following: talus navicular cuboid 5th metatarsal

champagne glass pelvis, splayed cupped metaphysics, small skull base

achondroplasia

large sella turcica, arrowhead phalanges, heel pad >23mm

acromegaly

soap bubble appearance, metaphysical lytic lesion, filled with blood, balloting of the cortex

Aneurysmal bone cyst

shiny corners, romans lesions, dagger sign, bamboo spine

wedged shape dense *medial upper end of tibia, overweight and black kids

blount

AVN of the *head of the femur, patchy sclerosis and lucency, crescent sign

Chandler

totally disorganized joint with destruction, debris, and distension

Charcot's joint

stones in the upper right quadrant and +Murphys sign

cholelithiasis

dense sclerotic well circumscribed lesion rarely >2 cm in the skull or spine

osteoma

lucent lesion <2cm surrounded by a rim of dense bone, long bone or spine

osteoid osteoma

metaphysical Fxs at different healing stages and pencil thin cortices

osteogenesis imperfecta

broad based bone outgrowth cauliflower or coat hanger look

osteochondroma

AVN, *medial femoral epicondyle, ankle, hip, and elbow, arc like cleft, fragment

ostechondritis dessicans

eccentric, lytic lesion located in the diaphysis or metaphysis or neural arch

osteoblastoma

subluxation of the proximal radio-ulnar joint

nursemaids elbow

triangular sclerosis of the lower ilium near the SI joint, bilateral, and symmetrical

osteitis condensans ilii

solitary oval radiolucent defect, thin cortex, bunch of grapes appearance

non-ossifying fibroma

dystrophic calcification in muscle (brachial, quadriceps, thigh adductors)

myositis ossificans

ivory vertebra, punched out lytic lesions, bilateral hilar lymphadenopathy

lymphoma in bone

small femoral head, mushroom deformity, epiphyseal sclerosis, fragmentation *head of femur in a child

legg calves perthes disease

thick tranverse radio dense metaphysis bands

lead posioning

AVN, partial fragmentation, sclerosis, and collapse of the *navicular bone

Kohler

blocked vertebrae, occipitilization of C1, platybasia, wasp-waist sign

Klippel feil syndrome

AVN, dense sclerotic *lunate bone with partial fragmentation and collapse

Keinbock

salt and pepper skull, acro-osteolysis, bone cysts, rugger jersey spine

hyperparathyroidism

articular irregularity, wide intercondylar femoral groove, soft tissue swelling

hemophilia

beak like spurs on radial sides of metacarpal heads, joint space narrowing

hemochomatosis

osteolytic lesion, corduroy cloth, striated vertebrae, picture frame like

hemangioma

periarticular calcification around the shoulder joint, may affect hip and spine

HADD

soft tissue swelling, periarticular bone erosion, overhanging margin sign

Gout

eccentric metaphysical lesion crosses epiphyseal line, soap bubble appearance

giant cell tumor

AVN, sclerosis, fragmentation and deformation of the *2nd metatarsal head

Freiberg

lytic metaphysical lesion extending into diaphysis, soft tissue involved

fibrosarcoma

circumscribed lytic lesion, ground glass appearance, soap bubble, shepherds crook

fibrous dysplasia

diaphysial permeative, onion skin appearance with cortical saucerization

Ewings sarcoma

geographic lesion medullary region, destructive moth eaten pattern

eosinophilic granuloma

numerous intramedullary lesions in long bones, phlebolith calcifications

enchondromatosis

geographic central expansile lesion with stippled calcification, hand or feet

enchondroma

ADI >5mm in a child, hypo plastic atlas, genesis of the dens

down's syndrome

generalized osteoporosis, compression fractures, cod fish vertebrae

Cushing's syndrome

small femoral epiphysis, lateral femoral displacement, shallow acetabulum

congenital hip dysplasia

absent clavicles, numerous wormian bones, pear shape skull

cleidocranial dystosis

intramedullary lytic soap bubble lesion, speckled calcification in the tibia

chondrosarcoma

round or elongated lesion eccentrically located, thins the cortex

chondromyxoid fibroma

oval epiphyseal lytic lesion in lower or upper tibia, fluffy cotton wool

chondroblastoma

eccentric lucent lesion in metaphysis with cortical depression

chondroma

linear intra articular calcification in the knee, elbow, shoulder, or wrist

CPPD (pseudo gout)

slipping sideways injury through growth plate

Grade 1 (Slipping)

Fx of the edge of the metaphysis and growth plate

Grade 2 (Metaphysis)

fracture through the growth plate and articular surface

Grade 3 (articular)

fracture through the metaphysis and epiphysis into the articular surface

Grade 4 (complete)

compression of growth plate

Grade 5 (Krush)

pseudo fractures in long bones, decreased bone density, coarsened trabeculae

osteomalacia

soft tissue swelling, periosteal elevation, brodies abscess, involocrum

osteomyelitis

plastic metaphysical permeative lesion, conman triangle, sunburst appearance

osteosarcoma

cotton wool skull, mixed plastic/lytic lesion pelvic brim and candle flame sign

Pagets

ossification of medial knee collateral ligament, traumatic

pelligrini stieda disease

AVN, sclerosis and fragmentation of the proximal pole of the *scaphoid

Preiser

cup and pencil deformity of DIP joints, mouse ears, sausage digits

psoriatic arthritis

soft tissue swelling, intra-articular erosions, ulnar deviation of MCP joint

widened growth plate, metaphysical cupping, paint brush appearance in a child

Rickets

anterior wedging, schmorls nodes, decreased disc height in 3+ vertebrae

Scheurmanns disease

ice cream sliding off the cone sign, disrupted kleins line and shentons lines

SCFE

soft tissue retraction, calcinosis cutis and aero-osteolysis

scleroderma

Frankl's line, Pelkens spur, and wimbergers ring

scurvy

AVN, fragmented irregular sclerosis of the *calcaneal apophysis

Sever

hair on end skull, undertubulation of long bones, cod fish vertebrae

sickle cell disease

slippage of one vertebra on the other, most common at L5/S1, pars Fx

spondylolisthesis

expansile geographic defect in proximal humerus or femur, fallen fragment sign

simple bone cyst

small elevated scapula, omovertebral bone (30%), and lipped feel syndrome

sprengels deformity

soft tissue swelling, periarticular osteoporosis, reducible ulnar deviation

SLE

apical cavitation; unilateral or bilateral hilar lymphadenopathy, tracheal shift

causes of AVN (STARS)

``` Sickle cell disease Trauma Alcoholism Radiation Steroids ```

X-Ray Flashcards

(177 cards)