Final Review Flashcards
Pathologies of hand
For pediatrics, what device should be used for chest projections?
What should we do to help with pt dose for peds?
Who can hold the anatomy of a child during x-rays?
Pigg-o-stat
short exposure time (decrease it)
parent/guardian
Which decubitus projection is normally used?
lateral
What position is used if a patient is unable to stand but there is suspected to be fluid in the left lung?
left lateral decubitus
An elbow projection is taken with the posterior surface placed against the IR. The elbow is rotated 20° externally. Which specific projection has been performed?
AP oblique w lateral rotation
A specific projection of the foot in which the CR enters the anterior surface and exits the posterior surface is termed:
dorsoplantar
3 functional classifications of joints and what they mean:
synarthrosis: immovable
amphiarthrosis: limited movement
diarthrosis: freely movable
3 structural classifications of joints and what they are:
synovial: freely movable joints that have a fibrous capsule containing synovial fluid
cartilaginous: articulating bones held together by cartilage
fibrous: lack joint cavity
The best position to evaluate the posterior fat pads of the elbow joint is:
lateral
flexed 90°
A pediatric patient with a possible radial head fracture is brought into the ER. It’s too painful to extend the elbow beyond 90° or to rotate the hand. What type of special projection could be performed on this patient to confirm the diagnosis without causing further discomfort?
Coyle method
What is a Barton fracture and what projection is needed?
fracture/dislocation of the posterior lip of the distal radius
lateromedial wrist
What is a Colles fracture and what projection is needed?
transverse fracture of distal radius that is displaced posteriorly
lateromedial wrist
What is a Smith fracture and what projection is needed?
opposite of Colles - transverse fracture of distal radius displaced anteriorly
lateromedial wrist/forearm
What is the projection that is used to best view fractures of the scaphoid?
AP/PA axial wrist with ulnar deviation
What should be seen on a KUB?
kidneys, ureters, and bladder
along with pancreas, margin of liver processes, and lumbar transverse process
How would you correct positioning for PA scaphoid projection when some bones are superimposed?
make sure there is no rotation of the wrist and ulnar deviation is used
What does medial rotation of the elbow demonstrate? If anatomy isn’t shown, what way should it rotate?
coronoid process of ulna and trochlea
internally
What does lateral rotation of the elbow demonstrate? If anatomy isn’t shown, what way should it rotate?
head and neck of radius and capitulum of humerus
externally
For a KUB projection, what is the positioning of IR and CR?
center of IR to level of iliac crests w bottom margin at symp. pubis
CR perpendicular and centered to iliac crest (IR)
For an AP erect abdomen projection, what is the positioning of IR and CR?
IR centered 2 inches above iliac crest with top of IR at axillary level
CR to center of IR perpendicularly
What does a grid do? When should it be used?
catches scatter radiation
when body part is thicker than 10 cm
AP acute flexion - elbow
to see distal humerus and proximal forearm
CR to see the distal humerus in the AP acute flexion elbow projection:
perp. to humerus, directed midway between epicondyles
CR to see the proximal forearm in the AP acute flexion elbow projection:
CR perp to forearm, directed 2 inches proximal/superior to olecranon process
CR, anatomy demonstrated in AP projection of thumb (1st digit)
CR: first MCP joint
anatomy demonstrated: distal and proximal phalanges, 1st metacarpal, trapezium, and associated joints, IP and MCP joints should appear open
CR, anatomy demonstrated in PA oblique projection of thumb (1st digit)
CR: first MCP joint
anatomy demonstrated: distal and proximal phalanges, 1st metacarpal, trapezium, and associated joints in a 45° position
Why is the AP projection of the thumb more ideal than the PA?
loss in definition due to increased OID
How should the epicondyles be on an AP projection?
parallel
How should the epicondyles be on a lateral projection?
90° or perpendicular
How should the epicondyles be in a neutral position?
45°
what is ileus and what projection(s) best demonstrates it?
nonmechanical bowel obstruction (without power or force)
acute abdomen series (KUB, erect abdomen, PA chest)
What is intussusception and what projection(s) best demonstrates it?
telescoping of a section of bowel in another loop
acute abdomen series
What is ascites and what projection(s) best demonstrates it?
accumulation of fluid in peritoneal cavity of abdomen
acute abdomen series
dynamic (mechanical) vs adynamic (nonmechanical)
dynamic = with power or force
nonmechanical = without power or force
anatomy involved in RUQ:
liver, gallbladder, right colic flexure, right kidney
anatomy involved in LUQ:
spleen, stomach, left colic flexure, left kidney
anatomy involved in RLQ:
ascending colon, appendix, cecum, ileocecal valve
anatomy involved in LLQ:
descending colon and sigmoid colon
male shielding:
shields should be placed distally to symphysis pubis covering testes and scrotum
shields tapered slightly at top and wider at bottom
female shielding:
shields should be placed to cover ovaries, fallopian tubes, and uterus but may be difficult to achieve
shield 4.5-5 inches prox. (superior) to symphysis pubis
breathing instruction for PA chest:
one breath in, exhale, another breath in, expose
define pneumothorax and when to expose:
air in the pleural cavity
expose on expiration
What are the patient instructions when performing PA chest on a female with larger breasts?
lift breasts up and out and move hands
CR for Judet method of pelvis (posterior oblique) to visualize acetabulum and anatomy demonstrated:
affected side down: direct 2 inches distal and medial to downside ASIS; visualizes anterior rim of acetabulum and posterior column plus iliac wing
affected side up: directed 2 inches distal to upside ASIS; visualizes posterior rim of acetabulum and anterior column plus obturator foramen
CR for Judet method of pelvis (posterior oblique) to visualize pelvic ring and anatomy demonstrated:
CR 2 inches inferior from ASIS level and 2 inches medial to upside ASIS
visualizes ilioischial and iliopoubic columns
AP axial inlet projection CR and anatomy demonstrated:
CR 40° caudad
demonstrates pelvic ring/inlet
AP axial outlet (Taylor method) projection CR and anatomy demonstrated:
CR - males: 20-35° cephalad
females: 30-45° cephalad
demonstrates rami of pubis and ramus of ischium
If ribs on the radiograph appear greater than 2 cm, what should you do?
repeat it
PACS and what it is
picture archiving communication system
array of hardware and software that can connect all modalities with digital output (digital archive)
RIS
radiology information system
HIS
hospital information system
When should a grid be used?
anatomy is greater than 10 cm or kVp is greater than or equal to 100
What does using a grid increase?
contrast
patient dose by 5x
longitudinal plane that divides the body into right and left parts
sagittal plane
longitudinal plane that divides the body into anterior and posterior parts
coronal plane
What are the 2 ways to do the lordotic projection?
pt can lean back or you can angle the tube
What type of projection is used to view the sesamoid bones of the foot?
tangential
when should a minimum of three projections be used?
when joints are in area of interest
a fractures require a minimum of ____ projections
two
What projections do we do to view pneumothorax?
erect PA and lateral chest/decub w affected side up
What projections do we do to view hemothorax?
erect PA and lateral chest/decub w affected side down
what would you do to reduce magnification of the heart in chest radiography?
minimize OID by increasing SID
image criteria for chest
kVp 110-125
exposure on second inspiration
top of IR 1.5-2 in above shoulders
include both costophrenic angles and apex of lungs
atelectasis
collapse of all or portion of lung
PA chest CR:
at level of T7
general kVps:
chest
abdomen
upper limb (hand/fingers/wrist, forearm/elbow)
humerus and shoulder
lower limb (toes, foot, calcaneus/ankle, tib fib/knee)
femur and pelvic girdle
110-125
70-85
60-80 (55-65, 65-80)
70-85
50-85 (50-60, 60-70, 60-75, 65-80)
75-95
Projections:
PA
AP
lateral
axial
tangential
transthoracic
plantodorsal
*enters from posterior to anterior
*enters from anterior to posterior
*enters medial or lateral side
*angle of 10° or more
*skims a body part
*lateral projection through thorax
*enters plantar surface and exits dorsal surface
fowler vs trendelenburg
fowler: head higher than feet
Trendelenburg: head lower than feet
Sims position
recumbent oblique position with knees and hip flexed and thighs abducted and rotated externally
radiographic film:
produced with the use of traditional film-screen (analog) technology
radiographic image:
produced with the use of digital technology displayed on monitors
radiographic examination involves 5 general functions:
- positioning of body part and CR/IR alignment
- application of radiation protection
- exposure factors
- instructions to patient related to breathing
- processing of systems
Lawrence method/inferosuperior axial of shoulder:
CR 25-30° medially to axilla and humeral head
coracoid process of scapula and lesser tubercle of humerus seen in profile
Grashey method/AP oblique glenoid cavity of shoulder:
body 35-45° to affected side
CR to scapulohumeral joint 2 inches inferior and medial
glenoid cavity seen in profile
Garth method/AP apical oblique axial of shoulder:
CR 45° caudad and inferior to coracoid process
humeral head, glenoid cavity, and scapula neck/head visualized
PA axial transaxillary of shoulder (modified bernageau):
CR 30° caudally to pass through scapulohumeral joint
lateral view of prox humerus in relation to scapulohumeral articulation visualized
dislocations of shoulders use:
internal and external rotation AP projections
Criteria for AP ankle:
CR midway between malleoli with foot dorsiflexed
medial mortise joint is open and lateral mortise is closed
some superimposition of distal fibula by the distal tibia and talus
When the anterior and posterior rims of the Grashey shoulder method are not superimposed:
it’s a rotation issue
setup for weightbearing knees:
CR 5-10° caudad directed to midpoint between knee joints at level .5 inch below apex of patella
pt positioned with feet straight ahead with weights evenly distributed
number of bones in foot:
phalanges
metatarsals
tarsals
26 total:
14 phalanges
5 metatarsals
7 tarsals
clavicle angulation for asthenic vs hypersthenic patients:
25-30° asthenic
15-20° hypersthenic
Scap Y-view:
CR 2 inches below AC joint
pt rotated 45-60°
knee flexed only _____ for lateral patella and _____ for lateral knee
5-10°; 20-30°
Mortise joints rotation:
15-50° internally
Danelius-Miller/axiolateral inferosuperior hip:
flex and elevate unaffected leg
internally rotate affected leg 15-20° unless otherwise told
CR perp to femoral neck and to IR
modified cleaves/AP bilateral frog leg of pelvis:
CR 3 in below ASIS lvl (1 in above symp. pubis)
knees flexed 90° and femora abducted 40-45°
Teufal method/PA axial oblique: acetabulum
patient in anterior obliqued 35-40°
CR 12° cephalad directed to 1 inch superior to level of greater trochanter
AP axial Beclere method for intercondylar fossa:
tube angulation perpendicular to:
knee flexed:
patient position:
tibia/fibula
40-60°
lying supine
mediolateral vs lateromedial foot
mediolateral: knee flexed 45° (medial side of foot up) directed to medial cuneiform at base of 3rd metatarsal
lateromedial: directed to medial cuneiform at base of 3rd metatarsal (lateral side of foot up)
lateral hip angles:
45°
