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Radiology > Chap 1 Basic Principles > Flashcards

Chap 1 Basic Principles Flashcards

1
Q

Five 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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2
Q

X-rays are good for:

A

Bones and airspaces

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3
Q

X-rays are bad for:

A

Soft tissue and overlapping structures

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4
Q

X-ray film starts off:

A

White

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5
Q

X-ray film turns ____ when hit with ionizing radiation

A

Dark

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6
Q

What material makes film brighter?

A

Dense

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7
Q

Different shades of gray in an x-ray

A

Water density

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8
Q

Radiographic density: Darkest

A

Air

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9
Q

Radiographic density: Less dark

A

Fat

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10
Q

Radiographic density: Gray

A

Fluid

Blood

Soft tissue

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11
Q

Radiographic density: White

A

Bone

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12
Q

Radiographic density: Most white

A

Metal/Contrast

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13
Q

Two-dimensional representation of a three-dimensional object

A

X-ray

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14
Q

Used if patient is unable to stand or sit for a PA view

Lower quality than PA view

Back is placed next to film

Heart is magnified and borders are fuzzier

A

Anteroposterior

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15
Q

Usually taken in conjunction with a PA view

Allows viewing of structures behind the heart (mediastinum) and provides three-dimensional image

A

Lateral (LAT “side view”)

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16
Q

X-ray:

At an angle used mostly on limbs

A

Oblique (OBL)

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17
Q

Object that is closer to the film has sharper borders

Chest is placed next to the film thereby placing most of the important structures, such as heart and great vessels, closer to the film

Heart size is minimally magnified and borders are sharp

A

Posteroanterior (PA “back to front”)

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18
Q

Similar to x-ray: Shows black, white, gray depending on density

Multiple pulses (shots)
 -Radiation dose is high
A

CT

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19
Q

CT is good for:

A

Bone

Airspaces

Some soft tissue and overlapping structures (especially abdomen in trauma)

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20
Q

CT is bad for:

A

Some soft tissues (nerves, muscles, connective tissue)

Patients with retained metallic objects (causes artifacts)

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21
Q

CT X-ray tube is in the:

A

Housing

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22
Q

CT views:

A

Sagittal / Median

Coronal

Axial / Transverse / Cross-sectional

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23
Q

Uses electromagnetism and radio frequency properties

No exposure to ionizing radiation

A

Magnetic resonance (MR)

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24
Q

MR is good for:

A

Soft tissue (nerves, muscles, connective tissue, brain, joints)

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25
Q

MR is bad for:

A

People who cannot hold still or have ferrous metal in the body

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26
Q

Difference in CT and MR views

A

They’re identical

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27
Q

Uses sound waves (like SONAR)

No radiation, but can’t go very deep

Operator dependent

Image produced is a focused segment of the object

A

Ultrasound

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28
Q

U/S is good for:

A

Determining fluid vs solids

Abdominopelvic imaging (gallbladder, kidneys, uterus, testis)

Assessing blood flow (doppler)

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29
Q

U/S is bad for:

A

Things under bones (chest)

Air filled chambers

Deep things

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30
Q

Radioactive agent is given intravenously

Agent participates in physiologic processes while emitting radiation

Radiation is detected and is used to create an image showing the distribution of the agent within the body

Typical use is to detect stress fractures before being visible on x-ray

A

Nuclear medicine

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31
Q

Nuclear medicine is good for:

A

Detecting normal or abnormal physiologic processes

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32
Q

Nuclear medicine is bad for:

A

Showing less anatomic detail

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33
Q

U/S views

A

Longitudinal (sagittal)

Transverse (axial)

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34
Q

Pre-read:

A

Correct Patient

Correct date

Correct body part

Correct type

Image has the number of views expected

Check to see if any comparison films exist

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35
Q

What is used to assess technical adequacy?

A

RIP

  • Rotation
  • Inspiration
  • Penetration
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36
Q

Look at the clavicles relative to the vertebral column

They should be equally spaced

If not properly aligned, structures will change in appearance which may mean abnormal

A

Rotation

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37
Q

Look at the ribs:

  • Should be able to count 9-10 ribs
  • Posterior ribs are easier to see (more horizontal and project from the spine)
A

Inspiration

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38
Q

Should see the ribs through the heart

Should barely see the spine through the heart

Should see pulmonary vessel near the edges of the lungs (lungs should not be completely black)

A

Penetration

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39
Q

Lung fields completely black

Suggests pneumothorax

A

Over-penetrated film

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40
Q

Soft tissue structures are obscured

Image appears bright suggesting consolidation (pneumonia)

A

Under-penetrated film

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41
Q

Chest X-ray:

ABCDE

A

Airway/Airspaces

Bones/Soft tissue

Cardiac Shadow

Diaphragm

Everything else

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42
Q

Order of reading a Chest X-ray

A

Pre-read

Technical adequacy of the film (RIP)

Systematic method (ABCDE)

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43
Q

Cardiothoracic ratio only applies to what?

A

PA film

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44
Q

Transverse diameter of the cardiac silhouette should not exceed __% of the transverse diameter of the thoracic cage

A

50%

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45
Q

Film that magnifies the heart

A

AP

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46
Q

Makes the heart horizontal and larger

A

Shallow inspiration

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47
Q

Upper right heart border

A

Superior vena cava

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48
Q

Lower right heart border

A

Right atrium

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49
Q

Left heart border (from the top)

A

Aortic arch

Pulmonary arteries

Left atrial appendage

Left ventricle

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50
Q

Dome shaped

Right side is always higher than left

A

Diaphragm

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51
Q

Diaphragm:

Dark and have sharp points like upside down cat ears

A

Costophrenic angles (sulcus)

52
Q

Falls under “Everything Else”

A

Look for gastric bubble (left side)

Check for EKG leads, lines, tubings, and other missed items (four corners of the film)

53
Q

Lateral chest film:

The spine should appear:

A

Brighter as it proceeds inferiorly

54
Q

Retrosternal space should be:

A

Clear; Contains upper lungs

55
Q

Retrocardiac space should be:

A

Clear; contains lower lungs

56
Q

LAT:

Middle lobe projects over:

A

The cardiac silhouette

57
Q

LAT:

Cardiac and diaphragmatic borders should be:

A

Sharp

58
Q

Imaging should _______ a suspicion

A

Confirm (NO FISHING)

59
Q

Imaging should _______ your treatment

A

Impact

60
Q

Imaging “_________” should be avoided

A

“Just in case”

61
Q

Your imaging request should include:

A

Relevant and brief patient history

Purpose for evaluation

62
Q

18-year-old non-smoker with fever, cough, dullness to percussion at left lower lobe, course crackles. Please evaluate for pneumonia.

Is an example of what?

A

Good imaging request

63
Q

Common issues in primary care:

A

Acute foot pain

Acute ankle pain

Acute knee pain

Lower back pain

Headache

64
Q

Ankle series is indicated if:

A

Has pain in the malleolar zone

AND

Has bone tenderness at the posterior edge (6cm) of the lateral or medial malleolus
OR
Inability to bear weight both immediately after the injury and for four steps

65
Q

Foot series is indicated if:

A

Has pain in the midfoot region

AND

Has bone tenderness at the base of the 5th metatarsal or the navicular
OR
Inability to bear weight both immediately after the injury and for four steps in the evaluation room

66
Q

Initial imaging for stress fractures:

A

X-ray

67
Q

Can show abnormalities before X-ray findings

A

Bone scan

68
Q

What should you “Consider” for suspicion of stress fractures?

A

CT or MRI

69
Q

Knee series is indicated if age is:

A

> 55

70
Q

Knee series indicated if:

A

Isolated tenderness of the patella

Tenderness at the fibula head

Inability to flex the knee 90 degrees

Inability to bear weight

71
Q

Preferred imaging for knee ligamentous injury

A

MRI

72
Q

Knee:

What should you do while awaiting further evaluation?

A

Immobilize

73
Q

Knee:

If plain radiographs are negative and you still suspect bony fracture, consider:

A

CT

74
Q

Image the shoulder if:

A

Traumatic cause

Presence of pain

Loss of range of motion

75
Q

Shoulder:

Plain films will be able to identify:

A

Fractures

Dislocations

Arthritis

AC joint or SC joint injuries

76
Q

Preferred imaging for labral, ligamentous or rotator cuff injuries

A

MRI

77
Q

Hand:

Type of radiograph is based on:

A

Physical examination & Mechanism of injury

78
Q

Images for a fracture of the phalanx:

A

AP and true lateral views

79
Q

Hand:

When the fracture involves or is close to the joint, what view is helpful?

A

Oblique

80
Q

Hand:

If the fracture cannot be delineated because of superimposed digits, such as the base of the proximal phalanx, a radiograph of what must be obtained?

A

Entire hand

81
Q

All metacarpal fractures require:

A

AP

LAT

Oblique

82
Q

Hand fractures are described radiologically primarily by:

A

Location

Geometry

Comminution is present

83
Q

The most precise method of describing hand fracture is to name:

A

Broken bone and finger involved

84
Q

Anatomical sites for phalanges and metacarpals include:

A

Head

Neck

Shaft

Base

85
Q

Fractures specifically involving the head of the distal phalanx

A

Tuft

86
Q

Anatomical sites of scaphoid fracture are:

A

Tubercle

Waist

Proximal pole

Distal pole

87
Q

Fractures involving the joint

A

Intra-articular

88
Q

Views of the initial evaluation of patients with chronic wrist pain

A

PA

LAT

Oblique

89
Q

Wrist:

PA view, wrist is held at what degree of rotation:

A

0 degrees (neutral)

90
Q

Wrist:

Lateral view must be obtained with the wrist at what degree?

A

0 degrees

91
Q

True lateral views show the ______ projected over the scaphoid tubercle

A

Pisiform

92
Q

Wrist (LAT):

Scapholunate angle greater than ___ degrees suggests possible scapholunate instability

A

60

93
Q

Wrist (LAT):

An angle of less than __ degrees suggests ulnar-sided wrist instability

A

30

94
Q

Scaphoid view

A

Wrist in ulnar deviation

95
Q

Clenched fist view to check:

A

Scapholunate joint space widening seen with ligament disruptions

96
Q

Hamate fractures

A

Hook view

97
Q

Radiocarpal joint is characterized by narrowing of the joint space and sclerosis of the articular surfaces

A

Osteoarthritis

98
Q

Three articulations of the elbow:

A

Radiohumeral

Ulnahumeral

Radioulnar

99
Q

Capitellum of the humerus with the radial head

A

Radiohumeral

100
Q

Trochlea of the humerus with the trochlear notch of the ulna

A

Ulnohumeral

101
Q

Radial head with the radial notch of the ulna

A

Radioulnar

102
Q

Elbow:

Fractures most common in falls

A

Distal humerus

Radial head

103
Q

Elbow:

View frequently used to better visualize the radial head

A

Oblique

104
Q

Elbow:

Fracture is not seen but there is suspicion, what view can be performed?

A

Coyle’s

105
Q

Elbow:

Even when a fracture cannot be identified, the presence of joint effusion in adults should be treated as:

A

Non-displaced radial head fracture

106
Q

Elevated anterior fat pad

A

Sail sign

107
Q

Elbow effusions are best seen on:

A

Lateral projection

108
Q

Elbow:

Posteriorly, the pericapsular fat is usually hidden in the:

A

Olecranon groove and fossa

109
Q

Dislocations of the elbow are named for:

A

The direction of the radius and ulna dislocate relative to the humerus

110
Q

Ulnar collateral ligament is commonly found in:

A

Baseball pitchers

111
Q

Lateral epicondylitis

A

Tennis elbow

112
Q

Back pain:

Imaging is not indicated in the first __ weeks

A

4-6 weeks

113
Q

Back pain:

Some reasons to get imaging before the 4-6 week mark:

A

Neurological findings (Cauda equina)

Constitutional findings

Trauma

Malignancy

Elderly

IV drug use, immunosuppression

Chronic steroid use

Nerve root irritation

Osteoporosis

114
Q

Back pain, imaging:

Helpful for fractures or joint degeneration:

A

X-ray

115
Q

Back pain, imaging:

Preferred in serious trauma:

A

CT

116
Q

Back pain, imaging:

Imaging of choice with prior surgery, suspected infection, spinal cord injury, tumor, or cord compression

A

MRI

117
Q

Headache, consider imaging if:

A

Head/neck trauma

Worse or new features (Abrupt onset of headache)

Thunderclap headache

Neurologic signs or symptoms

Headache radiating to the neck

Persistent positional headache

Temporal headache in older than 55 y/o

Suspect infection (cough, exertion, sexual activity)

118
Q

Headache, imaging:

Preferred for trauma, to rule out hemorrhage, bone abnormalities, or prior lumbar fractures

A

CT

119
Q

Headache, imaging:

Preferred for soft tissue causes such as tumors or vascular

A

MRI

120
Q

Angulated fracture line

A

Obique

121
Q

Runs perpendicular to the shaft of the bone

A

Transverse

122
Q

Has a multiplanar and complex fracture line

A

Spiral

123
Q

One bone is displaced over the other

A

Overriding

124
Q

Fragments are separated by a gap

A

Distraction

125
Q

Looks like a bump classified as incomplete fracture seen in children

A

Torus

126
Q

Fractures by bending like a green twig classified as incomplete fracture seen in children

A

Greenstick

127
Q

Have more than two fracture fragments

A

Comminuted

Radiology (1 decks)

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