Ch. 15 Trauma, Mobile, and Surgical Radiography Flashcards
the displacement of a bone that is no longer in contact with its normal articulation
dislocation
the most common dislocations encountered in trauma involve this region
shoulder, fingers/thumb, patella, and hip
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
a forced wrenching or twisting of a joint resulting in a partial rupture or tearing of supporting ligaments, without dislocation
sprain
bruise type of injury with a possible avulsion fracture
contusion
a football injury involving contusion of bone at the iliac crest of the pelvis
hip pointer
a disruption of bone caused by mechanical forces applied either directly to the bone or transmitted along the shaft of the bone
fracture
this refers to the associative relationship between long axes of the fracture fragments
alignment
a fracture is aligned if…
long axes of the bone remain parallel to each other
this describes how the fragmented ends of the bone make contact with each other
apposition
anatomic alignment of ends of fractured bone fragments, wherein the ends of the fragments make end-to-end contact
anatomic apposition
the ends of fragments are aligned but pulled apart and are not making contact with each other
lack of apposition (distraction)
the fracture fragments overlap and the shafts make contact, but not at the fracture ends
Bayonet apposition
this describes loss of alignment of the fracture
angulation
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
the distal fragment ends are angled toward the midline of the body and the apex is pointed away from the midline
varus deformity
the distal fragments ends are angled away from the midline and the apex is pointed toward
valgus deformity
a fracture in which the bone does not break through the skin
simple (closed) fracture
fracture in which a portion of the bone (usually the fragmented end) protrudes through the skin
compound (open) fracture
this type of fracture does not traverse through the entire bone
incomplete (partial) fracture
what are the two major types of incomplete fractures
torus and greenstick
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)
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)
in this fracture, the break is complete and includes the cross-section of bone, the bone is broken into 2 pieces
complete fracture
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
