Final Exam S1 Flashcards
review for semester one final
What can the technologist do to reduce the magnification of the heart?
increase SID reduces OID
If there is a perforated colon what would the doctor order?
What series of x-ray:
acute abdomen series
(entire abdomen series)
(this is for perforation/obstruction because we want to see the air-fluid levels)
What is accumulation of fluid in abdomen called?
ascites
why is your central ray higher for an erect abdomen vs supine abdomen?
because we need to see diaphragm
Breathing instructions for abdomen x-rays:
Expose on expiration
moves the diaphragm up
what can you do to find pubic symphysis without palpating?
feel for the greater trochanter
if we are looking for intraperitoneal air what x-ray views would we do for that?
AP Upright abdomen or decubitis
parietal peritoneum
&
visceral peritoneum:
Parietal peritoneum- outer layer of the abdomen
Visceral peritoneum- inner layer of abdomen
Hypersthenic:
Wider/shorter physique
5% of population
(Broad and very deep front to back but shallow in vertical dimensions)
Asthenic:
(most likely going to be on exam)
(will use this on exam vs hyposthenic)
Narrow in width long vertical dimensions
10% of population
Sthenic:
Average build
50% of population
Hyposthenic:
Very thin physique
If we are looking for fluid in the left lung on a decubitus chest, what side do we position the patient?
Left side affected side
(Fluid will go to left side, air to the right due to buoyancy and gravity)
If the patient is in a left lateral decubitus where does the marker go?
Which side is the fluid and which side is the air?
- Marker goes side up (right side)
Fluid is going to be in the left lung
air will be in the right lung (gravity)
If we are looking for fluid in the right lung on a decubitus chest, what side do we position the patient?
Right decubitus
(Fluid in the right lung, air in the left)
Where is the jugular notch?
T2-T3
Between the two clavicles
where is the sternal angle?
In between the manubrium and body of the sternum
Where is the xiphoid process/tip located?
T9/T10
Where is the carina?
T5
Where is the hilum?
Near the heart and great vessels
“party at the hilum”
(T6-T7)
In an acute abdomen series, we do these positions:
(Bontrager’s, will be on exam and this is the answer)
Upright abdomen (2 inches above iliac)
supine KUB (at crest)
PA chest
What is pneumoperitoneum?
How would you visualize this on an x-ray (patient position)?
Free Air in the peritoneum (abdomen) cavity
Best visualized on a decubitus, erect abdomen or chest radiograph.
Appears as a air bubble in the abdomen cavity
(Joiel question)
Which of the following is evaluated to check for rotation on an AP projection on a supine abdomen?
A. Ascending colon is centered in the collimated field
B. Right and left ASIS is symmetrical and equal distance to the mid-sagittal plane.
C. The abdominal aorta & inferior vena cava are visible in the middle of the image.
D. ischial tuberosity and pubic symphysis are in the mid-sagittal plane
B
What is the rule for markers on abdomen decubitus?
Marker on the side up
(ex: left lateral decubitus, marker on the right side)
What is a pigg-o-stat and when do we use it?
Immobilization device for pediatric patients
On CXR (infants)
What would we do if the x-ray order was printed out incorrectly?
Verify name, DOB, assess patient, get with doctor or lead technologist. Don’t change the order yourself
what is a pulmonary embolism?
Sudden blockage of artery in lung
What is pleurisy?
Inflammation of pleura
“Rubbing when inspiration”
What is hemothorax?
Accumulation of blood in the pleura space
What is pneumothorax?
Accumulation of air in the pleura space
RAO is equal to:
LPO?
If we are doing a lateral chest x-ray and there is an increase in OID and the costophrenic angles are cut-off from the image receptor. How would we correct this?
A. Rotate the patient 5 degrees
B. Place both shoulders and hips along the image receptor
C. Raise the CR
D. Lower the CR
Lower the Central ray
LAO:
LPO:
RAO:
RPO:
Left anterior oblique
Left posterior oblique
Right anterior oblique
Right posterior oblique
RPO is equal to:
LAO?
For pneumothorax would we increase or decrease technique?
Decrease technique
(less tissue)
For hemothorax would we increase or decrease technique?
Increase technique
(more tissue)
What are the breathing instructions for a chest x-ray?
Breathe in
Exhale
Deep breath in
Hold!
(expose on inspiration)
What would we do to get the shoulders out of the lung field for a PA chest:
Rotate the shoulders forward
(this removes the scapula)
Lateral chest is the mid-coronal perpendicular or parallel to the IR?
Perpendicular
Lateral chest is the mid-sagittal perpendicular or parallel to the IR?
Parallel
PA chest is the mid-sagittal perpendicular or parallel to the IR?
Perpendicular
PA chest is the mid-coronal perpendicular or parallel to the IR?
Parallel
Joiel question
If the dome of the diaphragm moves down does it:
A. Increase the volume of thoracic cavity?
B. Decrease the volume of thoracic cavity
C. Does not change the volume of thoracic cavity
D. Not enough information to give an answer
A.
Increase the volume of thoracic cavity?
What is long scale vs short scale?
Long scale = low contrast (more greys)
abdomen & chest
Short scale = high contrast (black & white) upper extremity’s
What is the kvp range for chest?
110-125 kvp
What is the Kvp range for a mobile chest x-ray?
80-90 kvp
Central ray should always be:
in the center of the image receptor
(especially for chest and abdomen)
What is the CR for chest in AP?
3-5 inches below jugular notch
What is the central ray for PA chest?
7-8 inches below vertebral prominence (c7)
7 for females
8 inches for men
What is a lordotic chest?
What does it show?
A view that places the clavicles above the apices
Shows under the clavicles
Chief muscle for respiration:
Diaphragm
What is the vertebral prominence?
Topographic landmark for PA chest
The last cervical vertebral
C7
Where does the trachea bifurcates?
(22:04)
breaks of into the left and right bronchi at T4/T5 (carina)
If the sternal end of right clavicle is closer to the mid-line than the left clavicle, this means that:
Patient is rotated on chest x-ray
How long is the trachea?
From _____ to _____:
C6 to T4/T5
3/4 inches wide, 4 1/2 inches long
3 parts of the chest:
Bony thorax
respiratory system
mediastinum
MR.B
For females and males how does the CR for chest differ?
7 inches below vertebral prominence for female
8 inches for men
In a lordotic position how are the clavicles?
above the apices
How many ribs need to be seen on a chest x-ray?
10 ribs
For lordotic we are looking under the clavicles how do the ribs appear in this position?
ribs appear distorted
Ventral decubitus:
Laying on stomach
Horizontal CR beam
Right Decubitus:
Laying on right side
Horizontal beam
Marker on left side
Dorsal decubitus:
Laying on back
Horizontal beam
How many interphalangeal joints are in the digits:
2
distal interphalangeal (DIP)
proximal interphalangeal (PIP)
1st digit= 1 IP joint
Left Decubitus:
Laying on left side
Horizontal beam
Marker goes on right side
What side are we placing the fifth digit on for a lateral?
Why?
Medial side
to decrease the amount of OID
What side are we placing the second digit on for a lateral?
Why?
lateral side
for least amount of OID
Where is the Central ray for digits?
PIP joint
Proximal interphalangeal joint
to evaluate interphalangeal joints in the oblique and lateral positions the digit must:
A. Be radiographed in its natural flexion
B. radiographed in palmar flexion
C. must be supported parallel to the IR
D. Rest on the IR for immobilization
C.
must be supported parallel to the IR
(Joint must always be parallel to the IR)
CR for PA & oblique hand:
third MCP joint
CR for fan lateral:
second MCP joint
Where is the coronoid process?
Anterior surface of the proximal ulna?
What bone is on the coronoid process?
Ulna?
Where is the olecranon process?
Posterior side of ulna
What bone is the olecranon process located?
posterior Ulna?
What type of joint is the elbow?
Hinge?
What kind of joint are the DIP and PIP?
Hinge joints
What kind of joints are the MCP joints?
Ellipsoidal or condyloid
How are the epicondyles in AP elbow?
Parallel to IR
What kind of joints are the carpometacarpal joints?
1st sellar or saddle
2-5 plane or gliding
What kind of joints are the distal radioulnar and proximal radioulnar joints?
Pivot or trochoidal joints
How are epicondyles in internal elbow oblique?
Shoulder internal?
Elbow: 45 degrees oblique to IR
Shoulder: perpendicular to IR
How are the epicondyles in Lateral elbow?
Perpendicular to IR
2nd Coyle view
(will be tons on test)
Elbow flexed 80 degrees flexed
45 degree angle away from the head
For coronoid process
What does ICER stand for?
Internal elbow= coronoid
External elbow = Coronoid
how are the epicondyles in an external elbow?
45 degrees Obliqued to IR
How many views for a forearm?
2 views:
AP
Lateral
How do we demonstrate the coronoid process:
Internal rotation of elbow
1st Coyle view
(will be tons of questions on test)
90 degree arm flex
45 degrees toward the head
For the radial head
(Toward the head for the head)
If the patient can not perform the Internal and external rotation for elbow projections what would we substitute for?
Coyle view
2 views
(angle towards the head for the radial head)
(away from the head for coronoid process)
When is the olecranon process best shown free of superimposition?
Lateral elbow
AP forearm hand is:
supinated
Where is the radial tuberosity?
Where is radial notch?
tuberosity: On the proximal side radius
notch: On the proximal side of ulna
What are the proximal carpal bones?
Scaphoid
Lunate
Triquestrum
Pisiform
What are the distal carpal bones?
Trapezium
Trapezoid
Capitate
hamate
What is a mediolateral projection?
Xray beam shooting from medial side to lateral
What would show anterior posterior fx best?
a lateral view
What would we best see a lateral fx best in?
AP view
What does the proximal carpals articulate with proximally?
scaphoid and lunate articulate with radius
What do the carpals articulate with distally?
metacarpals
What are proximal phalanges?
phalanges closest to the hand that articulates with metacarpals
Where are the distal phalanges?
outer most portion of the fingers
Fingertips
The hand is made of what 3 parts?
(distal to medial)
- phalanges
- metacarpals
- carpals
What is the CR for hand?
third MCP joint
What hand view places the thumb in an oblique position?
AP hand naturally obliques thumb
What is the capitulum?
anatomy above the radial head
Located on distal humerus
“cap sits on the head”
What is the capitate?
One of the distal carpal bones
external rotation arm and hand placement:
arm abducted and hand supinated
neutral rotation arm and hand placement:
hand pronated and arm slightly abducted
internal rotation arm and hand placement:
hand placed on hip palm facing outward (pronate hand)
arm slightly abducted
long scale:
low contrast
(chest, abdomen etc more anatomy)
Needs more greys
Short scale:
high contrast
(digits/hands etc)
Increase in OID:
increases magnification and distortion
Joiel question
When you are describing a patients position which is true?
1. The description of the position will include which side of the patient is closest to the x-ray tube
2. The description will include a portion of the patient, which is struck first by the CR
3. The side of the patient that is closest to the IR
- This question is referring to the projection vs projection
Trendelenburg:
recumbent
feet above the head
Fowlers
recumbent
head above the feet
Sims
patient lying on left anterior side with right knee flexed
“simp position”
Volvulus:
twisting loop of intestine
creates obstruction
Ascites:
Abnormal accumulation of fluid in the peritoneal cavity
Ileus:
paralysis of ileus
cause obstruction
Crohn’s Disease:
inflammation of the intestinal wall
bowel obstruction seen in half of patient
Joiel Question
Trama involved projection which statement is true?
A. Low mAs long exposure
B. Short exposure time is recommended
C. high mAs increase penetration (kVp) creates more scatter
D. Higher kVp and listed on technique and does not require a grid
b.
Short exposure time
(trauma patient tend to move due to pain)
Osteoporosis:
reduction in the quantity of bone
Osteopetrosis:
hereditary disease that results in abnormally dense bone
increase technique
Boxers fx
fx of the fifth metacarpal
commonly seen in bar fights
Smiths
distal part goes anterior
radius and ulna go posterior
Colles:
distal part goes posterior
radius and ulna go anterior
Carpal tunnel:
compression of the median nerve of wrist
painful disorder
Inferosuperior axillary best shows what in profile?
Coracoid process
Distal clavicle articulates with _____ distally
AC joints
What is the only articulation between the lower trunk and the upper trunk of the body?
SC (sternoclavicular joint)
- Know the synovial joints (7):
- plane or gliding (sliding)
- Ginglymus or hinge (flexion/extension)
- Pivot or trochoid (rotational movement)
- ellipsoid or condyloid (flex/ext or abduct or adduct)
- saddle or sellar (flex/ext abduct or adduct)
- ball and socket or spheroidal (flex/ext lateral and medial rotation flex/ext)
- Bicondylar (single direction movement)
CR for the neer view:
mid-scapula
10-15 degrees caudad
What is arthrology?
Study of joints
What kind of bone is the patella?
chap 1
sesamoid bone
Caudad:
away from the head
Cephalic:
towards the head
tangential:
Projection beam skims the body part
CR for internal shoulder:
1 inch inferior to coracoid process
What anatomy is taken on a 14 x 17 IR?
forearm
humerus
What anatomy is taken on a 10 x 12 IR?
elbow
clavicle
shoulder
*** What is anatomic position?
(textbook definition)
upright position
arms abducted slightly down
hands by side palms forward
head and feet together directed forward
3 cardinal rules for radiation safety:
time
distance
shielding
** difference between the plantar surface and the dorsal surface of the foot:
plantar= sole of foot
dorsal- anterior/top side of foot
Mid-sagittal vs sagittal:
longitudinal plane
Mid= separates body into right and left parts
Coronal vs mid- coronal:
separates the body into anterior and posterior parts
Transverse plane:
divides body into superior and inferior parts
What is the correct term for laying down?
recumbent
Range for axial clavicle:
15-30 degrees cephalic
25-30 degrees for asthenic
15-20 for hyperstenic
Range for axillary shoulder (degrees):
10-15 degrees
(joiel uses 13)
Proximal:
Towards the center line of the body
Distal:
Away from the body
Angle for the carpal tunnel view:
Aka?
Gaynor hart method
25-30 degrees 1 inch distal to third MCP (towards center of the palm)
What is seen on a carpal tunnel view?
(what carpals)
Hook of the hamate (hamulus)
pisiform
What level is the iliac crest at?
L4-L5
(Joiel question)
lateral projection with the patient placed in a dorsal decubitus position left lateral projection and the left lateral decubitus of the abdomen all require:
1. CR to enter the left side of the patient
2. the patient should be suspend respiration after expiration
3. the patient should suspend inspiration after expiration
4. the CR should enter the anterior side of the patient
18:09
**we expose after expiration
option 3?
Know what paristaltic actions?
20:24
involuntary movement that cannot be controlled
What system does the spleen belong to?
lymphatic system
What quadrant is the spleen in?
Left upper quadrant
LUQ
What is in the RLQ?
ascending colon
appendix
cecum
2/3 of ileum
ileocecal valve
What is in the RUQ?
liver
gallbladder
right colic flexure
duodenum (c-loop)
head of pancreas
right kidney
right suprarenal gland
What is in the LLQ?
descending colon
sigmoid colon
2/3 of jejunum
What is in the LUQ?
spleen
stomach
left colic flexure
tail of pancreas
left kidney
left suprarenal gland
When we are palpating for positioning an abdomen what could we palpate on the superior anterior portion of the abdomen?
xiphoid process
(t/f) we can use the belly button for a topographic landmark for abdomen positioning.
False
(belly buttons move around)
When is the appendix located?
What quadrant?
RLQ
What is the CR for decubitus abdomen and upright abdomen?
2 inches above iliac crest
(we want to include diaphragm)
CR for a KUB abdomen is:
iliac crest
What are the technical factors to stop motion?
shorten exposure time
Where its centered means the same as
where is the central ray
What is the duodenum shaped as?
Shaped as a C
What is nestled in the duodenum?
What is this also called?
head of the pancreas
romance of the stomach
If the patient moves or something happens after the exposure (falls) the blame is on the:
Technologist/ radiographer
(eyes should always be on the patient)
Accumulation of pus in the pleura cavity is called:
Empyema
If we see small amounts of air in the peritoneum cavity what images would best show that?
Lateral Decubitus affected side up
Lateral position of the chest what would be seen anteriorly?
heart
hilum
sternum
What is ulna deviation?
wrist rotated outwards toward the Ulna
Ulna deviation will display which side of the carpals?
lateral side of the carpals
(scaphoid)
(Joiel question) (possibly ignore)
What is true regarding the y view?
1. The mid-sagittal plane should be 60 degrees from the IR
2. The scapula border should be superimposed on the humeral shaft
3. oblique projection of the shoulder is obtained
2,3
(gonna change this question)
(joiel question)
What is true about AC joints?
1. It is performed when the patient is erect
2. weights are added to show joint separation
3. the procedure should be avoided if there is a suspected if there is a dislocation/separation is suspected
1,2
Still perform if there’s a joint separation suspected
(joiel question)
If were talking about the Norrgard/ball-catchers what is true?
1. Bilateral oblique hands are obtained
2. This is for early detection of rheumatoid arthritis
3. Hands are obliqued 45 degrees palm up
all 3 are correct
How do get an AP elbow if there’s trauma and the patient is unable to fully extend:
2 views
forearm parallel to IR
Humerus parallel to IR
If you are doing an AP projection of the clavicle what needs to be seen?
1. the clavicular body
2. the acromion clavicular joint (AC joint)
3. the sternocostal joint
1,2
What is aspiration?
foreign objects entering the air passageway
most common right bronchus
(Joiel question)
If you want to see the size of the liver and the kidney what view would you pick?
KUB
What view shows arthritus?
Ball catcher
What view best shows carpal tunnel syndrome?
Gaynor hart method
Olecranon process is located:
posterior/superior of proximal ulna
only seen in lateral elbow
coronoid process is located:
anterior (slightly inferior) of the proximal ulna
best seen in internal elbow
Where is the olecranon fossa located?
distal posterior humerus
Where is the coronoid fossa located?
distal anterior humerus
Need to focus on studying:
-Peritoneum vs pleura
-the different diseases
-intra, infra,inter peritoneal organs
- the locations of topographic landmarks (vertebral prominence, xiphoid, trachea, iliac carina)
-abdomen x-ray series
-different quadrants
fluff
ALOT of chest and abdomen questions (10:20)
Tons of coyle view questions (31:44)
ALOT OF ICER/ GELI questions
KNOW WHAT IS ON SHOULDER (a lot of questions)
(ALOT OF CARPAL BONE, ELBOW AND SHOULDER QUESTIONS)
(mostly multiple choice)
(couple matching)
(few quadrant question)
study quadrant
fluff
Where is the larynx?
Between C3-C6
Where is the trachea?
Anterior to esophagus
C6-T4/T5
2 cm (3/4 inch) in diameter
11 cm (4 1/2 inches) in Length
Where is the thyroid gland?
Below the larynx
3 parts of the chest
Mediastinum
Bony thorax
Respiratory system
(MR.B)
Where is mid-thorax?
T7
What is intussusception?
“Telescoping” of the bowel
Creates an obstruction
Ascites:
Abnormal amount of accumulation of fluid in the peritoneal cavity
Crohn’s:
Inflammation of intestinal wall that results in bowel obstruction
Volvulus:
The twisting of a loop of intestine
Creates obstruction
Decrease technique
Ileus-non mechanical bowel obstruction
Paralysis of ileus
Lack of intestinal mobility
What is aspiration?
Foreign objects in the air passages of bronchial tree
What is atelectasis?
Collapse of a portion of lung
What is bronchitis?
Chronic condition of excessive mucus in the bronchi
What is pulmonary edema?
Accumulation of fluid in the lung
What is Emphysema?
Irreversible chronic lung condition that prevents oxygen from leaving the body
Lungs appear radiolucent
Decrease technique
What is Dyspnea?
Condition of shortness of breath
What is Pleura effusion?
Abnormal Accumulation of fluid in the pleural cavity
What kind of joints are the carpal joints?
Plane or gliding
What kind of joint is the radoiocarpal joint (wrist)?
Ellipsoidal
What kind of joint is the radioulnar?
Pivot (trochoidal) joints
What kind of joints are the carpometalcarpal joints (CMC) 2-5?
Plane or gliding
What is the first carpometacarpal joint?
Saddle or sellar joint
1st Coyle view:
90 degrees flexed
45 degrees toward the head
For radial head
“Towards the head for the head”
What are the nine abdominal regions?
right side (1,4,7): right hypochondriac, right lateral, right inguinal (iliac)
Middle (2,5,8): epigastric, umbilical, pubic (hypogastric)
left side (3,6,9): left hypochondriac, left lateral (lumbar), left inguinal (iliac)
What is an acute abdomen series?
AP upright abdomen
AP supine abdomen
PA chest
2 main muscles in the abdomen?
Psoas
Diaphragm
What is the kVp for abdomen?
70-80 kvp
Diaphragm shaped:
Umbrella shaped
Separates thoracic and abdominal cavity
What ducts drain into the duodenum?
Liver
Pancreas
Gallbladder
LPG (Daytona) ladies professional golf
Topographic landmark for abdomen?
Iliac crest
Proximal portion of duodenum:
Duodenal bulb or cap
Ileum is:
3rd segment of the small intestine
(3/5 of small bowel)
Peritoneal cavity is:
The space in between visceral and parietal peritoneum
Which of the following is not an accessory organ for digestion?
Spleen
Urinary system consists of:
1 bladder
1 urethra
2 kidneys
2 ureters
2 suprarenal glands
Routine abdomen is:
AP supine (KUB)
3 positions for abdomen:
KUB
acute abdomen series (most popular)
Decubitus positions
Pneumonia:
inflammation of the lungs
causes accumulation of fluid in certain sections of the lungs
What replaces the obliques of the elbow in a trauma setting?
Coyle
1st Coyle for radial head
2nd Coyle for coronoid process
What replaces the AP elbow in the trauma setting?
2 views
forearm parallel to IR
Humerus parallel to IR
