Ch. 15 Trauma, Mobile, and Surgical Radiography Flashcards by Holly c

the displacement of a bone that is no longer in contact with its normal articulation

dislocation

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the most common dislocations encountered in trauma involve this region

shoulder, fingers/thumb, patella, and hip

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a traumatic partial dislocation of the radial head of a child, caused by hard pull on the hand and wrist of a child

nursemaid elbow; jerked elbow

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a forced wrenching or twisting of a joint resulting in a partial rupture or tearing of supporting ligaments, without dislocation

sprain

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bruise type of injury with a possible avulsion fracture

contusion

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a football injury involving contusion of bone at the iliac crest of the pelvis

hip pointer

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a disruption of bone caused by mechanical forces applied either directly to the bone or transmitted along the shaft of the bone

fracture

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this refers to the associative relationship between long axes of the fracture fragments

alignment

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a fracture is aligned if…

long axes of the bone remain parallel to each other

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this describes how the fragmented ends of the bone make contact with each other

apposition

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anatomic alignment of ends of fractured bone fragments, wherein the ends of the fragments make end-to-end contact

anatomic apposition

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the ends of fragments are aligned but pulled apart and are not making contact with each other

lack of apposition (distraction)

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the fracture fragments overlap and the shafts make contact, but not at the fracture ends

Bayonet apposition

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this describes loss of alignment of the fracture

angulation

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this describes the direction or angle of the apex of the fracture, such as a medial or lateral apex, wherein the point or apex of the fracture points medially or laterally

apex angulation

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the distal fragment ends are angled toward the midline of the body and the apex is pointed away from the midline

varus deformity

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the distal fragments ends are angled away from the midline and the apex is pointed toward

valgus deformity

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a fracture in which the bone does not break through the skin

simple (closed) fracture

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fracture in which a portion of the bone (usually the fragmented end) protrudes through the skin

compound (open) fracture

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this type of fracture does not traverse through the entire bone

incomplete (partial) fracture

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what are the two major types of incomplete fractures

torus and greenstick

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this is a buckle of the cortex, characterized by localized expansion of the cortex, possibly with little or no displacement, and no complete break in the cortex

torus fracture (buckle fracture)

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this is a fracture on one side only, the cortex on one side of the bone is broken and the other side is bent

greenstick fracture (hickory or willow stick fracture)

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in this fracture, the break is complete and includes the cross-section of bone, the bone is broken into 2 pieces

complete fracture

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what are the 3 major types of complete fractures

transverse, oblique, spiral fracture

fracture is at a near right angle to the long axis of the bone

transverse fracture

fracture passes trough bone at an oblique angle

oblique fracture

the bone has been twisted apart and the fracture goes around the long axis of the bone

spiral fracture

in this fracture, the bone is splintered or crushed at the site of impact, resulting in two or more fragments

comminuted fracture

what are the 3 types of comminuted fractures

segmental, butterfly, and splintered fracture

a type of double fracture in which two fracture lines isolate a distinct segment of bone; the bone is broken into 3 pieces, with the middle fragment fracture at both ends

segmental fracture

a comminuted fracture with two fragments on each side of a main, wedge-shaped separate fragment

butterfly fracture

a comminuted fracture in which the bone is splintered into thin sharp fragments

splintered fracture

in this fracture, one fragment is firmly driven into the other, such as the shaft of the bone being driven into the head or end segment. most commonly occurs at distal or proximal ends of femur humerus or radius

impacted fracture

intra-articular fracture of the distal radius often associated with dislocation or subluxation of the radiocarpal joint

Barton fracture

fracture of the distal phalanx caused by a ball striking the end of an extended finger. the DIP joint is partially flexed, and an avulsion fracture is frequently present at the posterior base of the distal phalanx

baseball (mallet) fracture

this longitudinal fracture, which occurs at the base of the 1st metacarpal with the fracture line entering the carpometacarpal joint, generally includes a posterior dislocation or subluxation

Bennett fracture

this fracture usually involves the distal 5th metacarpal, with an apex posterior angulation best demonstrated on the lateral view

boxer fracture

this fracture of the wrist, in which the distal radius is fracture with the distal fragment displaced posteriorly, may result from a forward fall on an outstretched arm

colles fracture

this is a fracture of the wrist with the distal fragment of the radius displaced anteriorly, commonly results from a backward fall on an outstretched arm

smith (reverse colles) fracture

this fracture occurs through the pedicles of the axis (C2), with or without displacement of C2 or C3

hangman's fracture

this is an intra-articular fracture of the radial styloid process

Hutchinson (chauffeur) fracture

this fracture of the proximal half of the ulna, along with dislocation of the radial head, may result from defending against blows with the raised forearm

monteggia fracture

a complete fracture of the distal fibula with major injury to the ankle joint, including ligament damage and frequent fracture of the distal tibia or medial malleolus

pott's fracture

this fracture results from severe stress to a tendon or ligament in a joint region. a fragment of bone is separated or pulled away by the attached tendon or ligament

avulsion fracture

these fractures, which result from a direct blow to the orbit and/or maxilla and zygoma, create fractures to the orbital floor and lateral orbital margins

blowout and/or tripod fracture

this fracture involves an isolated bone fragment

chip fracture

vertebral fracture caused by compression-type injury, vertebral body collapses

compression fracture

in this fracture of the skull, a fragment is depressed

depressed fracture (ping-pong fracture)

a fracture through the epiphyseal plate, one of the most easily fractured sites in long bones of children

epiphyseal fracture

these fractures are due to disease process within the bone, such as osteoporosis, neoplasia, or other bone disease

pathologic fracture

the lines radiate from a central point of injury with a starlike pattern, most common example of this type of fracture occurs at the patella

stellate fracture

this type of fracture is nontraumatic in origin, results from repeated stress on a bone such as from marching or running

stress or fatigue fracture (march fracture)

this fracture of the ankle joint involves the medial and lateral malleoli as well as the posterior lip of the distal tibia

trimalleolar fracture

comminuted fracture of the distal phalanx may be caused by a crushing blow to the distal finger or thumb

tuft or burse fracture

fracture fragments are realigned by manipulation and are immobilized by a cast or splint; nonsurgical procedure

closed reduction

for severe fractures with significant displacement or fragmentation, a surgical procedure is required, the fracture site is exposed and screws, plates, or rods are installed as needed to maintain alignment of the bony fragments until new bone growth can take place

open reduction

battery driven and battery operated mobile x-ray units are powered by these

10-16 rechargeable, sealed, lead acid-type 12 volt batteries

what is top speed of battery driven mobile units

2.5-3 mph with max 7 degree incline

driving range of mobile unit

10 miles on level surface with full charge

what are the battery driven and operated mobile x-ray units driven and maneuvered by

dual-drive motors

what can the battery driven and operated mobile x-ray units be recharged at

110-220 volts

what do the standard power source, capacitor-discharge, non-motor driven units operate on

110 v, 15 amp power source or 220v, 10 amp power source

for upper and lower limb follow up examinations what must be included

minimum of one joint - nearest the site of injury

this imaging modality is useful for evaluating emergency conditions such as pulmonary embolus, testicular torsion, and GI bleeding

nuclear medicine

how far should top of IR be above the shoulders for an AP chest

about 2" (4-5cm) above shoulders

what is CR on an AP chest

3-4" below jugular notch and angles 3-5 degrees caudad

to determine air fluid levels when the patient cannot be elevated sufficiently for an erect chest, what is performed

left lateral decubitus position

when an upright abdomen is not possible, what projection is taken to see air-fluid levels and possible free air in the abdomen

left lateral decubitus position

where is CR on an AP supine abdomen

iliac crest

where is CR on a left lateral decubitus abdomen

2" above iliac crest

for a lateral decubitus abdomen how long must the patient be laying on their side before making an exposure

minimum of 5 minutes

what is a dorsal decubitus abdomen used for

possible abdominal aortic aneurysms or in place of lateral decubitus if patient can't be moved

CR for scapular Y

scapulohumeral joint - 2-2.5" below top of shoulder

CR for inferosuperior axial of shoulder

CR angled 15-30 degrees (less angle for less abduction of arm)

CR for trauma oblique foot

angled lateromedially 30-40 degrees

CR for trauma mortise

angled lateromedially 15-20 degrees

CR for AP pelvis

midway between ASIS and pubic symphysis - 2" inferior to ASIS (top of IR 1" above iliac crest)

CR for trauma AP hip

1-2" distal to midfemoral neck

IR placement for lateral horizontal beam of c-spine

top of IR 1-2" above EAM

CR for cervicothoracic swimmers

C7-T1 - 1" above jugular notch (5 degree caudal angle may be necessary if pt can't depress shoulder)

where is CR for lateral lumbar spine

L4 - iliac crest

physician licensed and trained in general surgery or a specialty such as cardiovascular or orthopedic procedures

surgeon

this person specializes in administering anesthetic drugs to induce and maintain anesthesia in the patient during surgery

anesthesiologist (physician anesthesiologist or certified nurse anesthetist)

this person's range of responsibilities may include suctioning, tying and clamping blood vessels and assisting in cutting and suturing tissue

surgical assistant (physician, physician assistant, CST, or RN)

health professional who prepares the OR by supplying it with the appropriate supplies and instruments

certified surgical technologist

nonsterile CST or RN who assists in the OR by responding to the needs of scrubbed members in the sterile filed before, during, and after the surgical procedure

circulator

someone who prepares the sterile field scrubs, gowns the members of the surgical team, and prepares and sterilizes the instruments before the surgical procedure is begun

scrub (CST or RN)

equipment permanently stored in the surgical area must be cleaned how often

weekly or as needed

why are intramedullary rods better than compression plates and screws for reducing mid shaft fractures

minimizes amount of tissue exposed during surgery, decrease surgical and healing time, reduces opportunity for postsurgical infection

this is taken when the urologist withdraws the catheter and injects contrast into one or both ureters

ureterogram

this is taken when the urologist injects 3-5mL of contrast directly through the catheter into the renal pelvis of one or both kidneys

pyelogram

this is performed during surgery to demonstrate anatomy of the biliary ductal system

operative (immediate) cholangiography

this provides a less invasive approach for the removal of a diseased gallbladder

laparoscopic cholecystectomy

this position is helpful in projecting the biliary ducts away from the spine

RPO position

this is a nonfunctional exam of the urinary system during with contrast is introduced against the flow

retrograde urography