Chapter 19 (Special Radiographic Procedures) Flashcards
Which of the following is generally true for knee arthrography?
a. A common nontrauma clinical indication is a Baker’s cyst.
b. A minimum of 20 mL of positive contrast media is introduced into joint.
c. During fluoroscopy, views are taken of each meniscus with the knee rotated 30
degrees between exposures.
d. The amount of aspirated joint (synovial) fluid should equal the amount of injected
contrast media.
A common nontrauma clinical indication is a Baker’s cyst
What imaging modality is most frequently used to study the soft tissue structures of the temporomandibular joint?
a. Computed tomography (CT)
b. Magnetic resonance imaging (MRI)
c. Conventional radiography
d. Ultrasound
Magnetic resonance imaging (MRI)
Which of the following instruments is not required during a knee arthrogram?
a. Sterile gauze
b. 10-mL syringe
c. 20-gauge needle
d. Arthroscope
Arthroscope
During an arthrogram, why is the knee flexed following injection of contrast media before imaging?
a. To reduce the viscosity of the contrast media
b. To force the contrast media outside of the joint if there is a tear
c. To coat the soft tissue structures with contrast media
d. None of the options; the knee should not be flexed during an arthrogram after injection of contrast media.
To coat the soft tissue structures with contrast media
A common fluoroscopy routine for knee arthrography is:
a. nine views of each meniscus rotated 20 degrees between exposures.
b. nine views total of each knee rotated 20 degress between exposures.
c. six views each of lateral and medial menisci rotated 20 degrees between
exposures.
d. horizontal beam projections, six exposures per knee.
Nine views of each meniscus rotated 20 degrees between exposures
Which of the following is not an indication for knee arthrography?
a. Injury or tears to rotator cuff
b. Evaluate for Baker’s cyst
c. Injury or tears to collateral or cruciate ligaments
d. Injury or tears to menisci
Injury or tears to rotator cuff
What size needle is used to introduce the contrast media during a shoulder arthrogram?
a. 2 inches, 16 gauge
b. 1 1/2 inches, 18 gauge
c. 2 inches, 25 gauge
d. 2 3/4- to 3 1/2-inch spinal needle
2 3/4- to 3 1/2- inch spinal needle
Which of the following projections would NOT be commonly performed during a shoulder arthrogram?
a. Anteroposterior external/internal rotation projections
b. Scapular Y projection
c. Glenoid fossa projection
d. Transaxillary projection
Scapular Y projection
What is the most common clinical indication for a postoperative (T-tube) cholangiogram?
a. Jaundice
b. Pancreatitis
c. Chronic cholecystitis
d. Residual calculi
Residual calculi
The patient must be NPO ____ hours (minimum) before a postoperative (T-tube) cholangiogram.
a. 4
b. 6
c. 8
d. 12
8
The majority of ERCP procedures are performed by a:
a. radiologist.
b. radiologic technologist.
c. gastroenterologist.
d. surgeon.
Gastroenterologist
Which of the following conditions is often a contraindication for an ERCP?
a. Pseudocyst
b. Biliary stenosis
c. Hepatitis
d. Cirrhosis
Pseudocyst
Which of the four divisions of the uterus is the largest?
a. Fundus
b. Corpus (body)
c. Isthmus
d. Cervix
Corpus (body)
The uterine (fallopian) tubes are approximately ____ cm in length.
a. 3 to 4
b. 6 to 8
c. 10 to 12
d. 15 to 18
10 to 12
Which of the four segments of the uterine tube communicates with the uterine cavity?
a. Interstitial
b. Isthmus
c. Ampulla
d. Infundibulum
Interstitial
The fingerlike extensions termed fimbriae connect to which part of the uterine tube?
a. Interstitial
b. Isthmus
c. Ampulla
d. Infundibulum
Infundibulum
Which part of the uterine tube opens into the peritoneal cavity?
a. Isthmus
b. Interstitial
c. Infundibulum
d. None of the options
Infundibulum
The purpose of the hysterosalpingography is to demonstrate the:
a. interior of the cervix, uterus, uterine tubes, and ovaries.
b. interior of the uterus for neoplasms or other abnormalities.
c. uterine cavity and the patency of the uterine tubes.
d. degree of openness of the cornu between the uterus and uterine tubes.
Uterine cavity and the patency of the uterine tubes
Which of the following is a contraindication to hysterosalpingography?
a. Pregnancy
b. Active uterine bleeding
c. Pelvic inflammatory disease
d. All of the options
All of the options
The preferred contrast medium for hysterosalpingography is:
a. positive, ionic, and oil based.
b. positive, nonionic, and water soluble.
c. negative carbon dioxide gas.
d. thin barium sulfate.
Positive, nonionic, and water soluble
Imaging for a hysterosalpingography includes centering of the CR and image receptor (IR) to:
a. 4-inch (10-cm) superior to the symphysis pubis.
b. the symphysis pubis.
c. the level of the ASIS.
d. 2-inch (5-cm) superior to the symphysis pubis.
2-inch (5-cm) superior to the symphysis pubis
Which of the following is NOT a valid radiographic criterion for hysterosalpingography?
a. Cannula or balloon catheter should be seen within the cervix.
b. Ovaries should be opacified and well demonstrated.
c. Contrast medium should be seen within the peritoneum.
d. The pelvic ring should be centered within the collimation field.
Ovaries should be opacified and well demonstrated
Where is the contrast media instilled during a myelogram?
a. Subarachnoid space
b. Epidural space
c. Subdural space
d. Spinal cord
Subarachnoid space
What is the most common clinical indication for a myelogram?
a. Benign tumors
b. Malignant tumors
c. Herniated nucleus pulposus
d. Increased intracranial pressure
Herniated nucles pulposus
Myelography is often contraindicated if a lumbar puncture has been performed within the previous:
a. 2 weeks.
b. 3 weeks.
c. 30 days.
d. 6 months.
2 weeks
Which of the following is a contraindication for myelography?
a. Arachnoiditis
b. Blood in the CSF
c. Increased intracranial pressure
d. All of the options
All of the options
What is the most common injection site for a myelogram?
a. C1-2
b. T12
c. L4-5
d. L3-4
L3-4
During a myelogram performed with the patient prone, why is a positioning block (bolster) placed under the abdomen for the lumbar puncture?
a. To force the contrast media toward the head
b. For patient comfort
c. To widen the interspinous spaces
d. To prevent lux of contrast media back into the syringe
To widen the interspinous spaces
Other than prone, what additional position is recommended for a cisternal puncture?
a. Erect-seated
b. Left lateral decubitus
c. Right lateral decubitus
d. Trendelenburg
Erect-seated
How is the water-soluble contrast media eliminated following a myelogram?
a. Withdrawn through a needle/syringe.
b. Remains in the spinal canal.
c. Excreted by the kidneys.
d. Excreted by the lungs.
Excreted by the kidneys
What is an average dosage of contrast media given during a myelogram?
a. 1 to 2 mL
b. 3 to 4 mL
c. 9 to 15 mL
d. 20 to 24 mL
9 to 15 mL
What is the most common type of contrast media given during a myelogram?
a. Iodinated, oil based
b. Room air
c. Carbon dioxide
d. Nonionic, water soluble
Nonionic, water soluble
The suggested positioning routine for lumbar myelography is:
a. patient prone: semierect horizontal beam lateral, left and right lateral decubitus
(AP and PA), and PA projection.
b. patient on side: right lateral decubitus (AP) and left lateral decubitus (PA).
c. patient prone: semierect horizontal beam lateral.
d. patient supine: semierect AP and horizontal beam lateral.
Patient prone: semierect horizontal beam lateral
Why is the supine AP projection rarely taken during a thoracic spine myelogram?
a. Patient discomfort at puncture site
b. Contrast media may leak from puncture site
c. Contrast media tend to pool near the midthoracic region
d. Excessive radiation exposure to anterior chest structures
Contrast media tend to pool near the midthoracic region
Which of the following is a suggested conventional positioning routine for cervical myelography following fluoroscopy and spot imaging?
a. Patient prone: PA lateral, swimmer’s lateral, and one lateral decubitus-horizontal beam
b. Patient on side: right lateral decubitus (AP) and left lateral decubitus (PA)
c. Patient prone: PA horizontal beam and swimmer’s lateral of C6 or C7
d. Patient prone: horizontal beam lateral (centered to C4-5) and swimmer’s
horizontal beam lateral (centered to C7)
Patient prone: horizontal beam lateral (centered to C4-5) and swimmer’s horizontal beam lateral (centered to C7)
If the uterine tubes are patent, the injected contrast media will ____________.
a. flow back into the uterus
b. flow into the peritoneal cavity
c. flow into the urinary bladder
d. remain in the uterine tubes
Flow into the peritoneal cavity
Which of the following positions is rarely performed during an HSG?
a. AP
b. LPO
c. Lateral
d. RPO
Lateral
The goal of the skeletal survey is to:
a. identify the focal and diffuse abnormalities of the skeleton.
b. identify the degree of curvature of the spine.
c. verify proper placement of an internal fixation device.
d. identify the potential height of a child.
Identify the focal and diffuse abnormalities of the skeleton
What is the recommended SID for a hip-to-ankle long bone measurement study?
a. 60 inches (150 cm)
b. 100 inches (255 cm)
c. 120 inches (300 cm)
d. 72 inches (180 cm)
120 inches (300 cm)
Which of the following devices is required when performing the hip-to-ankle long bone measurement study?
a. Magnification marker
b. Metal ruler
c. Short SID
d. Must be performed erect
Magnifaction marker
Which one of the following is not a factor that directly controls or influences the amount of tomographic blurring?
a. Size of anatomy
b. Tomographic angle
c. Object-IR distance
d. Exposure angle
Size of anatomy
Which one of the following is not a factor that directly controls or influences the amount of tomographic blurring?
a. Size of anatomy
b. Tomographic angle
c. Object-IR distance
d. Exposure angle
Size of anatomy
The pivot point between the x-ray tube and IR in a tomographic system is termed:
a. amplitude.
b. fulcrum.
c. tube trajectory.
d. objective plane.
Fulcrum
The total distance the x-ray tube travels is termed:
a. tomographic angle.
b. fulcrum.
c. objective plane.
d. fulcrum level.
Tomographic angle
Objects within the body that are farther from the objective plane have:
a. greater movement.
b. increased blurring.
c. less blurring.
d. both greater movement and increased blurring.
Both greater movement and increased blurring
Objects within the objective plane will appear:
a. blurred.
b. sharper and in relative focus.
c. as radiolucent densities.
d. as streaks.
Sharper and in relative focus
Which of the following exposure angles will produce the thinnest sectional thickness?
a. 10 degrees
b. 20 degrees
c. 30 degrees
d. 40 degrees
40 degrees
Objects within the body above and below the focal plane appear blurred because:
a. they are not placed parallel to the direction of tube travel.
b. their images move from one part of the IR to another as the tube and IR move
through their travel during the exposure.
c. they are situated too close to the focal plane.
d. the body part is too large for sufficient penetration of x-rays.
Their images move from one part of the IR to another as the tube and IR move through their travel during the exposure
Which of the following statements is not true in regard to digital tomosynthesis (DTS)?
a. It produces multiple projections of the anatomy during one sweep or exposure.
b. It produces less dose as compared to CT.
c. It requires a continuous exposure of the tube during the linear sweep.
d. It can produce up to 60 images per linear sweep.
It requires a continuous exposure of the tube during the linear sweep
The fundamental principle behind DTS takes advantage of:
a. parallax.
b. blurring.
c. exposure arc.
d. pulsed generator.
Parallax
(T/F) Intercondylar fossa projections are often required during a conventional knee arthrogram
False
(T/F) CT and MRI arthrography has significantly reduced the number of radiographic arthrograms performed.
True
(T/F) The technologist must follow standard precautions when handling bile.
True
(T/F) An endoscopic retrograde cholangiopancreatography (ERCP) can either be a diagnostic or a therapeutic procedure.
True
(T/F) The patient must remain NPO (nothing by mouth) a minimum of 8 hours following an ERCP.
False
(T/F) Arachnoiditis is a clinical indication for a myelogram procedure.
False
(T/F) Most disk pathology of the spine occurs in the cervical and lumbar regions.
True
(T/F) A skeletal survey is intended to identify injury or disease only, not healing.
False
(T/F) Gonadal shielding cannot be used for hip-to-ankle measurement studies for males or females.
False
(T/F) The lateral malleoli should be placed 20 cm apart for a bilateral hip-to-ankle measurement study
True
(T/F) A radiographic skeletal survey is often performed for metastatic disease.
True
(T/F) The ovaries are demonstrated during a HSG.
False
(T/F) Only the thoracic and lumbar spine are examined for a radiographic skeletal survey.
False
(T/F) The HSG procedure is typically performed 7 to 10 days after the onset of menstruation.
True
(T/F) Digital tomosynthesis produces a similar amount of patient dose as compared to CT.
False
