Basic Principles Flashcards

1
Q

What is (CT)?

A

Computed Tomography

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2
Q

What is (MRI)?

A

Magnetic Resonance Imaging

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3
Q

What is (NM)?

A

Nuclear Medicine

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4
Q

What are the 5 different imaging modalities?

A

(1) X-ray
(2) Computed Tomography (CT)
(3) Magnetic Resonance (MR)
(4) Ultrasound (U/S)
(5) Nuclear Medicine

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5
Q

Which image has the lowest dose of radiation?

A

X-ray

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6
Q

X-ray is good for?

A

Bones &
Airspace

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7
Q

What is X-ray bad for?

A

Soft tissue &
overlapping structures

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8
Q

What color is x-ray film to start?

A

white

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9
Q

Bone is what color?

A

White

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10
Q

Air is what color?

A

Black

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11
Q

What are the 5 basic radiographic densities?

A
  1. Air (darkest)
  2. Fat (less dark)
  3. Fluid/Blood/Soft tissue (gray)
  4. Bone (white)
  5. Metal/Contrast (most white)
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12
Q

What are the 4 X-ray views?

A
  1. Anteroposterior (AP)
  2. Posteroanterior (PA)
  3. Lateral (LAT)
  4. Oblique (OBL)
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13
Q

What image uses a single pulse of ionizing radiation?

A

X-ray

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14
Q

What direction of view is AP?

A

front to back

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15
Q

If pt is unable to sit or stand what view do you use?

A

PA

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16
Q

In which view is the heart magnified and borders are fuzzier?

A

AP

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17
Q

Which view shows structures behind the heart and provides a 3-D image?

A

Lateral

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18
Q

What angle is used mostly on limbs?

A

Oblique

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19
Q

What direction of view is PA?

A

back to front

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20
Q

In which view is the heart minimally magnified and borders are sharp?

A

PA

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21
Q

What image uses multiple pulses of ionizing radiation?

A

CT

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22
Q

With CT is radiation dose high or low?

A

high

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23
Q

What is good for bone, airspaces, some soft tissue and overlapping structures, such as abdomen and trauma?

A

CT

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24
Q

What is bad for: Some soft tissues (nerves, muscles, connective tissue), patients with retained metallic objects (causes artifacts)?

A

CT

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25
Q

In which image does the x-ray tube and detector spin rapidly around the pt?

A

CT

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26
Q

Which image produces a “slice” of the patient?

A

CT

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27
Q

What are the 3 CT views?

A
  1. Sagittal/Median
  2. Coronal
  3. Axial/Transverse/Cross-sectional
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28
Q

Which CT view is left to right?

A

Sagittal/Median

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29
Q

Which CT view is front to back?

A

Coronal

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30
Q

Which CT view is top to bottom?

A

Axil/Transverse/Cross-sectional

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31
Q

Which image uses electromagnetism and radio frequency properties?

A

MRI

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32
Q

What image has no exposure to ionizing radiation, but time consuming?

A

MRI

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33
Q

What is good for: Soft tissue (nerves, muscles, connective tissue, brain, joints)?

A

MRI

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34
Q

What is bad for: People who cannot hold still

or have metal in the body?

A

MRI

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35
Q

Which image uses sound waves?

A

Ultrasound

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36
Q

Which image is good for: Determining fluid vs solids, abdominopelvic imaging (gallbladder, kidneys, uterus, testis), assessing blood flow (Doppler)?

A

US

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37
Q

Which image is bad for: Things under bones (chest) and air filled chambers, deep things?

A

US

38
Q

What are the 2 US views?

A
  1. Longitudinal (left to right)
  2. Transverse (top to bottom/up and down)
39
Q

Which image is a radioactive agent given intravenously and is used to create an image showing the distribution of the agent within the body?

A

Nuclear Medicine

40
Q

What is good for: Detecting normal or abnormal physiologic processes?

A

Nuclear Medicine

41
Q

What is bad for: Showing less anatomic detail?

A

Nuclear Medicine

42
Q

What do you confirm during the pre-read?

A
  1. patient
  2. date
  3. body part
  4. image type
  5. # of views
  6. any comparison films
43
Q

What is the RIP technique?

A

R-otation

I-nspiration

P-enetration

44
Q

For Rotation what are you looking for?

A

clavicles are equally spaced relative to the vertebral column

45
Q

For Inspiration you should be able to count how many ribs?

A

9-10

46
Q

For Penetration what should you be able to see?

A
  1. ribs through the heart
  2. barely see the spine through the heart
  3. pulmonary vessel near the edges of the lungs
47
Q

over-penetrated films will be what color?

A

black

48
Q

under penetrated films will be what color?

A

white

49
Q

over penetrated lungs suggests what?

A

pneumothorax

50
Q

under penetrated film suggests what?

A

pneumonia

51
Q

What are the 3 steps to reading a CXR?

A
  1. pre-read
  2. Assess RIP
  3. Conduct ABCDE
52
Q

What does ABCDE stand for?

A

A- airways

B- bones

C- cardiac shadow

D- diaphragm

E -everything else

53
Q

What are you checking the trachea for?

A

midline and patent

54
Q

ABCDE What bones are you looking at?

A

clavicles, ribs, pectoral girdle, and spine

fractures, alignment, symmetry

55
Q

The transverse diameter of the silhouette should NOT exceed ____ of the transverse diameter of the thoracic cage, called cardiothoracic ratio (only applies to PA film).

A

50%

56
Q

Right hemidiaphragm is always ________compared to the left.

A

higher than or same level

57
Q

imaging should be ordered for what reasons?

A

confirm a suspicion

impact your treatment

58
Q

Your imaging request should include what?

A

relevant and brief patient history

purpose of the evaluation

59
Q

Ottawa Rules:

Ankle series

A
  1. Pain in “malleolar” zone AND
  2. Bone tenderness at the posterior edge (6cm) of the lateral or medial malleolus OR
  3. Inability to bear weight both immediately after the injury and for four steps in the evaluation room.
    1) If the patient can transfer weight twice to each foot, the patient can bear weight.
    2) If the patient limps, the patient can bear weight.
60
Q

Ottawa Rules:
Acute Foot series

A
  1. Pain in “midfoot” region AND
  2. Bone tenderness of the 5th metatarsal or the navicular OR
  3. Inability to bear weight both immediately after the injury and for four steps in the evaluation room.
    a) If the patient can transfer weight twice to each foot, the patient can bear weigh.
    b) If the patient limps, the patient can bear weight..
61
Q

Ottawa Rules:

Knee series

A
  1. Age <55 year old
  2. Isolated tenderness of the patella (with no other bony tenderness to the knee).
  3. Tenderness at the head of the fibula.
  4. Inability to flex the knee to 90 degrees.
  5. Inability to bear weight both immediately after the injury and for four steps in the evaluation room (limping is allowed).
62
Q

If you suspect ligamentous injury, what is the preferred imaging?

A

MRI

63
Q

Plain films will be able to identify:

A
  1. Fractures
  2. Dislocations
  3. Arthritis
  4. Acromioclavicular (AC) joint or Sternoclavicular (SC) joint injuries
64
Q

What is the preferred modality for labral, ligamentous or rotator cuff injuries?

A

MRI

65
Q

If a fracture of the phalanx is suspected what views do you take?

A

AP & Lateral views of the digit

66
Q

Dislocation of the elbow is named for the direction

A

the radius and ulna dislocate relative to the humerus

67
Q

Imaging of back pain is not indicated in the first 4-6 weeks unless:

A
  1. neurological findings/cauda equina
  2. elderly <50y/o
68
Q

What is the preferred modality for serious trauma?

A

CT

69
Q

What is the preferred choice for back pain with prior surgery?

A

MRI

70
Q

What is the preferred imaging for suspected infection?

A

MRI

71
Q

What is the preferred imaging for spinal cord injury?

A

MRI

72
Q

What is the preferred modality for tumor?

A

MRI

73
Q

What is the preferred modality for cord compression?

A

MRI

74
Q

Consider imaging for headaches if:

A
  • thunderclap headache
  • temporal headache & <55y/o
75
Q

What modality should be used to rule out hemorrhage, bone abnormalities, or lumbar punctures?

A

CT

76
Q

What is preferred for soft tissue causes such as tumors or vascular?

A

MRI

77
Q

What are the 8 common fractures seen in orthopedic x-rays?

A
  1. Oblique- has angulated fracture line
  2. Transverse- runs perpendicular to the shaft of the bone
  3. Spiral- multiplanar and complex fracture line
  4. Overriding- one bone is displaced over the other
  5. Distraction- fragments are separated by a gap
  6. Torus- looks like a bump, incomplete fx
  7. Greenstick- fx by bending, incomplete fx
  8. Comminuted- more than 2 fx fragments
78
Q

What is darkest on an x-ray?

A

Air

79
Q

What is Less Dark on a x-ray?

A

Fat

80
Q

What is gray on a x-ray?

A

Fluid/Blood/Soft Tissue

81
Q

What is white on a x-ray?

A

Bone

82
Q

What is Most white on a x-ray?

A

Metal/Contrast

83
Q

What is used for technical adequacy?

A

RIP

84
Q

Angulated fracture line

A

Oblique

85
Q

Perpendicular to the shaft of the bone

A

Transverse

86
Q

Multiplanar and complex fracture line

A

Spiral

87
Q

One bone is displaced over the other

A

Overriding

88
Q

fragments are separated by a gap

A

Distraction

89
Q

bump classified as incomplete fracture seen in children

A

Torus

90
Q

fractures by bending, incomplete fracture seen in children

A

Greenstick

91
Q

More than 2 fracture fragments

A

Comminuted