Final Exam - Past Questions Flashcards
how many bones in adult vertebral column?
26
most post. part of typical vertebra?
spinous processes
joints btw articular processes of vertebra
zygapophyseal joints
Does C1 have a vertebral body?
no
what must tech make sure to do on spine XRs to improve the vis. of spine?
coll. lat borders
AP C-Spine CR?
CR 15-20º cephalic to C4
why is AP C-spine angled 15º cephalic?
to open joint spaces
During AP “open mouth”, an imaginary line btw what 2 landmarks is made perp to IR?
lower margin of incisors/mastoid tip (skull base)
AP “Open Mouth” dens shows what?
C1 & C2
Is the Judd method intended to show the zygapophyseal joints btw C1 & C2?
no
what pos’s project dens thru shadow of foramen magnum when upper portion of dens is obscured by teeth, when skull base and upper incisors are superimposed?
Fuchs/Judd method
C-vert. contain what in their transverse processes?
foramen
detail is improved on a lat c-spine by using what?
sm focal spot
What XR shows articular pillars & zygapophyseal joints on C-spine?
lat C-spine
what is done on an ant. obl c-spine to prevent the superimposition of the mandible?
extend chin
an ant obl c-spine shows the IV foramina/pedicles ______ to IR
closest
an LAO c-spine show’s what?
L IV foramina/pedicles
which obl’s are preferred for C-spine? why?
ant. obl.; less thyroid dose
CR for post obl c-spine?
15º cephalic to C4
An RPO of c-spine shows what?
L IV foramina/pedicles
In a post obl c-spine, the IV foramina/pedicles _______ to IR are shown
furthest
CR AP T-spine?
perp T7 (3-4” inf. jugular notch)
what manual technique is done in the lat T-spine to enhance the visualization of the vertebral bodies?
low mA & 3-4s exposure T (w orthostatic breathing)
the Lat T-spine shows what?
open IV foramina
on the lat T-spine, the vertebral column must be _______ to tabletop to open up IV joint spaces
II
what can be done on a lat T-spine to improve vis. of post. spine by preventing excessive density along post. aspect of spine?
pb apron behind pt
which XR best demonstrates a compression fracture of T-spine?
lat T-spine
which XR best demonstrates C7-T1?
Swimmer’s lat/Twining method
what is performed when the upper aspect of T-spine is obscured by shoulders, when the upper T-spine is the area of interest?
Swimmer’s lat/Twining method
if pt enters ER bc of MVA & is on backboard w C-collar, and initial XR only shows C1-C6, & no CT is available, what XR should be performed?
horizontal beam Swimmer’s lat
what kind of contrast/latitude is preferred for L-spine?
short-scale, narrow latitude
iliac crest is located at the level of?
L4-5
what 2 L-spine XRs would show a possible compression fracture of L3, by best demonstrating body of L3 & IV joint spaces above and below it?
collimated AP & lat L-spine
if you must perform an L-spine on a pregnant female, what 3 things should a tech do?
- use higher kVp & lower mAs,
- increase SID,
- coll. as much as possible
neck of Scottie dog?
pars interarticularis
what is the sm bone found btw the sup. & inf. articular processes?
pars interarticularis
ear of scottie dog?
sup. articular process
eye of scottie dog?
pedicle
foot of scottie dog?
inf. articular process
nose of scottie dog?
transverse process
scottie dogs are only seen on what projections?
obl L-spine XRs
what XRs best show the degree of movement at the fusion site (after a spinal fusion was performed at L3-4)?
lat hyperextension & hyperflexion
why should a pt flex knees during an AP L-spine?
to reduce lordotic curve/straighten spine
CR for AP L-spine?
perp to iliac crest
what should tech do to prevent scatter from reaching IR on a lat L-spine?
pb mat behind pt
what is shown on a lat L-spine?
IV foramina, IV joint/disk spaces of L-spine
how much is a pt rotated for an obl L-spine?
45º
what pos should you place a pt to see the L apophyseal joints of L-spine?
LPO
how much rotation should you rotate pt to see the zygapophyseal joints at L1-2?
50º obl
how much rotation should you rotate pt to see the zygapophyseal joints at L5-S1?
30º obl
what pos demonstrates the R apophyseal joints of L-spine?
RPO
how much body rotation is needed to best demonstrate the L3-4 zygapophyseal joints?
45º
which ant obl L-spine XR will show the R apophyseal joints?
LAO
CR for lat L5-S1 spot when pt has insufficient waist support?
5-8º caudad to 1.5” inf. iliac crest & 2” post. ASIS
for a cone down view of L5-S1 in an AP projection, must angle CR?
30-35º cephalic
S1-2 is located at the level of?
ASIS
another term for sacral horn
cornu of sacrum
term for sup. aspect of coccyx?
base
an avg of ___ segments make up the adult coccyx
4
CR for AP Axial Sacrum?
15º cephalic to midway btw pubic symphysis & ASIS
CR for AP Axial Coccyx?
10º caudad to 2” sup. to pubic symphysis
CR for lat Sacrum/Coccyx?
perp to 3-4” post. ASIS
how many degrees do you int. rotate feet for AP pelvis?
15-20º (IF NO FRACTURE SUSPECTED)
how much do you abduct femora from vertical on a bilat frog/modified cleaves for pelvis?
40-45º
for the Lauenstein-Hickey method (for unilat hip) the pt is what?
rotated onto affected side until femur touches table and is II to IR
Lauenstein-Hickey method for hip shows what?
foreshortened femoral neck, but shows head & acetabulum
humeral epicondyles are _________ to IR for AP Int Shoulder
perp
humeral epicondyles are __________ to IR for AP Ext Shoulder
II
AP Int Shoulder shows what?
lesser tubercle in full profile (med)
AP Ext Shoulder shows what?
greater tubercle in profile (lat)
CR for AP Int/Ext Shoulder
perp 1” inf. coracoid process (which is 3/4” inf. to lat. portion of clavicle)
Post Obl shoulder aka?
Grashey method
Grashey method shows
glenoid cavity in profile; open scapulohumeral joint space
on Grashey for shoulder, a person w a round/curved back needs ______ rotation to place body of scapula II to IR
more
how much body rotation is needed for Grashey method?
35-45º towards affected side
breathing technique for clavicle?
full inspiration (to raise clavicles out of lung field)
CR for AP Axial clavicle?
15-30º cephalic to midclavicle
thin pt’s need ___________ angle than thick pt’s for AP Axial clavicle
10-15º more
what must pt do for positioning of AP scapula?
abduct arm 90º and supinate hand (salute)
which landmarks are used for positioning go scapula “Y” lat?
sup. angle of scapula & AC joint (rotate until imaginary line btw is perp to IR)
min weights used for AP AC joints w weights?
5-8 lbs
what is done to project the AC joint sup. to acromion for optimal vis.?
Alexander method, CR 15º cephalic to midpoint btw AC joints
What SID for AC joints?
72”
breathing technique for AP scapula?
orthostatic breathing
3 potential errors in skull positioning
- excessive neck flexion/extension
- head rotation/tilt
- incorrect CR angle
how do you find the sella turcica?
3/4” ant. & 3/4” sup. to EAM
sella turcica houses the?
pituitary gland
neuro XRs use _____ focal spot
sm
which XR puts the petrous ridges below the maxillary sinuses?
Parietoacanthial (Waters) method
what must be done before performing SMV XRs?
rule out fractures/subluxation of C-spine
pt enters ER w possible fracture of R zygomatic arch, what is the best XR routine?
SMV, bilat obl tangential, & AP Axial
what line is II to IR for SMV of zygomatic arches?
IOML
if pt cannot hyperextend neck enough for SMV, what should tech do?
make CR perp to IOML
what is the pt pos for obl inferosuperior tangential zygomatic arch (Mays view)
(from SMV pos) pt must rotate & tilt 15º toward affected side
CR for AP axial Towne zygomatic arch when IOML perp to IR
37º caudad to 1” sup. glabella (exiting level of gonion)
what XR will show blowout & tripod fractures?
PA Waters
pt enters ER and the doc is concerned about a blowout fracture of the L orbit. what 3 routine XRs will best demonstrate this injury?
modified parietoacanthial, 30º PA facial, & lat facial
optic foramina are located w/in
sphenoid bone
what XR best demonstrates orbital floors?
PA 30º Orbits or Modified Waters
just PA Caldwell is NOT a good answer
what XR puts petrous ridges in lower 1/2 of maxillary sinuses?
parietoacanthial (modified/shallow) waters
what XR uses the 3pt landing?
parietoorbital obl optic foramina/Rhese method (chin, cheek, nose)
the Rhese method projects the optic foramina in?
the lower outer quadrant
TMJ XR’s are routinely done w?
mouth open & closed
CR for axiolat TMJ (modified schuller)
25-30º caudad to 1/2” ant. & 2” sup. EAM
CR for axiolat obl TMJ (modified law)
15º caudad to 1.5” sup. to EAM
panorex of mandible requires pt’s chin adjusted so the _____ is II to the floor
IOML
the _____________ of the mandible extends upward from the post. part of the ramus up to the adjacent joint
condyloid process
the _____ is perp to IR during PA Axial Mandible
OML
CR for PA Axial mandible
20-25º cephalic, exit acanthion
CR for AP Axial (Towne) mandible when OML perp to IR
35º caudad to glabella
the AP Axial (Towne) Mandible best demonstrates what portion of the mandible?
condyloid processes (bilat)
CR for Axiolat Obl Mandible
25º cephalic from IPL to exit downside mandibular region
30º rotation towards IR on axiolat obl mandible demonstrates?
body of mandible
45º rotation towards IR on axiolat obl mandible demonstrates?
mentum
10-15º rotation towards IR on axiolat obl mandible demonstrates?
general survey of mandible
0º rotation towards IR on axiolat obl mandible demonstrates?
ramus
the chin is extended in the axiolat obl mandible to?
free C-spine of superimposition of ramus
which bones are assoc. w the inner canthus of the eye?
lacrimal
what XR of sinuses does a trauma pt in a C-collar need to demonstrate blood/fluid levels?
horizontal beam lat
what is the sm flap of cartilage that covers the ear opening?
tragus
CR for lat facial?
perp to zygoma (midway btw outer canthus & EAM)
OML is at how many degrees from IR on a parietoacanthial (waters) for facial?
37º
what touches the upright bucky for a waters facial?
chin
____ neck extension is required for a modified/shallow waters
less
OML is at how many degrees from IR on a modified waters for facial?
55º
which XR gives vest view of orbital floors?
Modified water facial
CR for modified waters?
perp, exit acanthion
CR for PA Axial (Caldwell) facial
15º caudad, exit nasion
what must be done to the PA Caldwell facial to put petrous ridges below the IOM & demonstrate the orbital floors?
increase CR angle to 30º caudad, exit nasion
which waters method demonstrates zygomatic arches?
parietoacanthial (waters) method
tube that passes from the kidney to the urinary bladder
ureter
which of the following is not found in the urinary system?
glomerulus, calyx, adrenal, nephron
adrenal
which kidney is usually always more inf.?
R kidney
avg adult bladder can hold how much fluid?
350-500 mL
when pt signs consent form, legally this means that once the consent has been signed, the pt
may still claim that they were not properly informed of the procedure risks
when do you pull on the catheter to create pressure?
never
when pt is vomiting, the pt’s head is lifted/turned to the side to prevent?
aspiration
AP trendelenburg pos (for IVP/VCUG) enhances
pelvicalyceal filling
routine IVPs are done w what breathing technique?
expiration
what is a good example of a routine IVP?
scout KUB, nephrogram, AP KUB, RPO KUB, LPO KUB, & post void
which procedure requires an injection of contrast media into a vein to vis. kidneys?
intravenous pyelography
what must be included on the AP scout for an IVP/IVU?
pubic symphysis
if a nephrogram taken during an IVU shows that the renal parenchyma is poorly visualized, but the calyces are contrast enhanced, what did the tech do?
exposure was not taken soon enough following contrast injection
CR centering for nephrotomogram?
midway btw xiphoid process & iliac crest
in tomography, the area of interest is at the same height as the?
fulcrum
RPO for IVP puts which kidney in profile?
L
an LPO taken during an IVU shows that the R kidney is foreshortened & superimposed on the spine, what should tech do?
decrease rotation
during a retrograde cystogram, the contrast media is normally introduced by
gravity flow thru a catheter
term for voiding under voluntary control
urination
in an AP cysto, contrast fills
slowly by gravity - never by force
(Cysto) what is needed to see the posterolateral aspect of the bladder, especially UV junction?
steeper obl (60º rotation)
what pos do you place a male pt for a VCUG?
rotate into 30º RPO (superimpose urethra over R thigh)
during a VCUG, pt is asked to void during XR to vis. the?
urethra
gallbladder is located where?
RUQ
what is peristalsis?
normal contractive waves of digestive system
what term describes the formation of sacs/pouches in colon?
diverticulosis
veriform appendix is attached to the
cecum
the opening btw the esophagus & stomach
cardiac orifice
what type of pt has a transverse stomach
hypersthenic
CR for RAO UGI?
perp to L2/duodenal bulb (1-2” sup. to lower lat rib margin) midway btw spine & L/upside lat border of abdomen
pt enters ER w possible perforated ulcer, what should be performed?
UGI w gastroview
what is demonstrated on RAO for UGI?
BaSO4 filled duodenal bulb & c-loop in profile
what pos is preferred for SBS?
prone KUB
the supine KUB for SBS is centered where?
@ iliac crest
KUB stands for
kidneys, ureters, & bladder
how much BaSO4 is given to the pt for a SBS?
16 oz (2 cups)
CR for AP scout for SBS
perp iliac crest
PA SBS, after an hour, should be centered at
iliac crest
the SBS is completed after?
contrast passes ileocecal valve
enema tip for BE should be inserted into rectum on
suspended expiration
if tech experiences resistance while inserting enema tip, the tech should
have radiologist insert tip using fluoro guidance
what sign is frequently seen w carcinoma of the colon?
napkin ring/apple core sign
LPO for BE shows which colic flexure?
R colic/hepatic flexure
the lat rectum (BE) demonstrates what filled w contrast?
recto-sigmoid region
if the pt is undergoing a double-contrast study, or just cannot be put in a recumbent lat pos, what should tech do instead?
ventral decubitis
how much do you rotate a pt for an AP Axial Obl butterfly for BE?
30-40º LPO
CR for AP Axial Obl Butterfly for BE?
30-40º cephalic to 2” inf. & 2” med. to R/upside ASIS
why perform an AP Axial Obl Butterfly?
to demonstrate elongated rectosigmoid segments, w less superimposition
what is the most diagnostic study for detecting possible diverticulosis?
double-contrast BE
when performing a double-contrast BE, what must be done to the kVp?
reduce to 90-100 kVp
if pt is having a mild adverse reaction to contrast, suffering from nausea, flushing, hyperventilation, & urticaria should be treated w
benadryl
2 types of contrast media
ionic & non-ionic
which contrast media is more expensive?
non-ionic
which contrast has low osmolality, less chance of reaction, & the inability to dissociate into 2 separate ions?
non-ionic contrast
which contrast agents may increase the severity of side effects?
ionic
what is the correct course of action when a pt experiences a side effect of mild hot flashes, & some metallic taste during an injection?
reassure pt, contin. injection/XR, while carefully observing pt for possibly more severe reactions
term for leakage of contrast media from a vein into surrounding tissue
extravasation
recommended treatment for extravasation?
warm towel over injection site
the rapid introduction of contrast agents into the vascular system
bolus injection
moderate itching/sneezing, mild urticaria (hives) are
mild systemic reactions to contrast
some metallic taste in mouth & temp. hot flashes occur
in many pt’s & is an expected outcome/side effect from the introduction of contrast media
how long is it recommended to withhold metformin (glucophage, diabetes medication) following a contrast media procedure?
48 hrs
primary purpose of the premedication procedure before an iodinated contrast study is?
to reduce the risk of a contrast media reaction
what is often given before an IVU to reduce risk of a contrast media reaction?
prednisone (and benadryl)
if a pt comes in for an IVU and the lab report indicates that a w/in normal range of creatinine and BUN levels, the tech should
proceed w study
what should the tech do if the pt experiences a hot flash after the injection of an iodinated contrast?
comfort pt; this is a common side effect
routine NT shoulder?
AP Int/Ext
which shoulder needs pt rotated 45-60º?
Scapula Y view
which XR puts greater tubercle in profile medially?
none
acromion located on?
scapula
clavicle articulates w?
sternum & scapula
humeral head articulates w
glenoid cavity of scapula
ant/post shoulder dislocations more common?
ant.
which shoulder rotation puts humeral epicondyles perp to IR?
AP Int
shoulder XR’s are centered to which landmark?
1” inf coracoid process
which shoulder rotation provides a lat prox humerus?
AP Int
what is in profile on AP Int shoulder?
lesser tubercle (medially)
what is in profile on AP Ext shoulder?
greater tubercle (laterally)
what shoulder pos is done when pt has suspected shoulder fracture?
AP neutral
how much do you rotate pt for Grashey?
35-45º toward affected side
CR for post obl shoulder/Grashey?
perp scapulohumeral joint (2” inf & med from superolat border of shoulder)
which XR puts glenoid cavity in profile?
Grashey
which XR shows open scapulohumeral joint space?
Grashey/post obl shoulder
how much do you rotate a pt to get glenoid fossa in profile?
45º to affected side
2 pos/XRs for routine clavicle?
AP & AP 15º cephalic
arm pit aka
axilla
0º AP & AP Axial w 15-30º cephalic angle are ___________ clavicle XRs
routine/common
med. end of clavicle
sternal extrem.
pt enters ER w possible fracture of mid wing area of scapula. pt can stand. in addition to routine AP scapula w arm abducted, what should be done to show this area?
have pt drop affected arm behind them for lat scapula
pt enters ER w multiple injuries. dr. concerned about dislocation of prox humerus. pt cannot stand. what is best routine?
AP shoulder (neutral) & Neer method
pt enters ER w dislocated shoulder. tech attempts to pos. pt in transthoracic lat but unable to raise unaffected arm completely over head; tech should?
angle CR 10-15º cephalic
XR of ant obl scapular Y shows scapula slightly rotated; vertebral & axillary borders are not superimposed, axillary border is more lat than vertebral border; tech should?
increase rotation
pt comes in for treatment of arthritic R shoulder; pt can’t abduct arm enough for axiolat of scapulohumeral joint. what other XR will best show scapulohumeral joint?
Scapula Y
pt enters ER w possible R AC joint separation; R clavicle and AC joint exams are ordered. clavicle shows sm linear fracture; tech should?
consult w dr. before continuing w AC joint study
what other XR can be performed if separation of AC joint is suspected?
AP 15º cephalic (Alexander method)
CR AP Axial clavicle?
15-30º cephalic to midclavicle
if AP Axial clavicle shows clavicle w/in mid aspect of lung apices, tech should
increase cephalic CR
what angle joins the med & lat borders of scapula?
inf angle
scapula articulates w?
clavicle & humerus
coracoid process is the most ____ part of scapula
ant
how should pt pos arm for AP scapula?
abduct 90º & supinate hand
what type of obl is a lat scapula Y?
ant obl (pt PA)
which landmarks are palpated for lat scapula Y?
sup scapula angle & AC joint
how many degrees do you rotate pt for lat scapula Y?
45-60º
CR for lat scapula Y?
perp to midvertebral border (or med border) of scapula
the scapular spine is _____ to IR in a lat scapula Y
perp
which XR provides a true lat of scapula & scapulohumeral joint?
lat scapula Y
SID for AC joints?
72”
CR for AC joints?
perp to 1” sup to jugular notch
