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PTRS 746 Exam 1 Combined and Randomized > Medical Imaging > Flashcards

Medical Imaging Flashcards

1
Q

Diagram: Identify the image below

A

CT image of left actabular fracture

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2
Q

Q: Sensitivity - A negative test means…

A

You definitely don’t have the condition

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2
Q

Term: Ability of the x-ray beam to pass through substance to reach the film plate

A

Permeability

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2
Q

Diagram: Radiograph coloring review

A
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3
Q

Q: What are the ABCs of Radiology?

A

Alignment, Bone Density, Cartilage, Soft tissue

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3
Q

Term: Atomic nuclei allign in an electromagnetic field

A

Resonance

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4
Q

Q: How are lateral view named?

A

For the side closer to the film plate

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4
Q

Content: 3 parts of soft tissue

A
  1. Gross size of musculature
  2. Outline of joint capsules
  3. Periosteum
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5
Q

T/F: A radiograph is simply a representation of the radiographic densities of anatomical structures

A

True

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5
Q

Diagram: Identify the problem

A

Metastic bone lesion (from primary lung cancer)

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6
Q

Q: What is the error rate in radiological interpretation (by radiologists and radiology residents)?

A

May be as high as 20-40%

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6
Q

Q: High object radiodensity results in _____________ radiography density on the film, thus the object appears ________.

A

Decreases, whiter

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6
Q

Term: Maximized by positioning patient so structure of interest is closest to film plate

A

Detail

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6
Q

Q: How does an MRI generate an electromagnetic field?

A

Uses pulses of radiofrequnecy and a strong external magnet

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7
Q

Term: How long resonating protons remain in phase following a RF pulse

A

Transverse magnetization (T2)

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8
Q

Defn: Errors of interpretation

A

The injury is there but the radiologist misses it. Ex. Fracture is there but is not seen

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9
Q

Diagram: Identify the problem

A

Osteoarthritis of the left hip, with joint collapse

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10
Q

Q: What gives an x-ray image with the most detail and least distortion?

A

Have the part of interest as close to the film or plate as possible

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11
Q

Q: What produces a radio frequency signal that can be captured and processed into an MRI image?

A

The release of resonant energy

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12
Q

Term: Clarity of the image

A

Geometric qualities

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13
Q

Defn: Contrast enhancement

A

Injection or ingestion of radiocontrast medium prior to radiographic study

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15
Q

T/F: diagnostic imaging and PT guides and informs the PT’s treatment plan.

A

True

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15
Q

Content: 3 disadvatnages of MRI

A
  1. Relatively low specificity
  2. Expensive
  3. Contraindicated if pt. has ferrous metal implant or exposure
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16
Q

Q: What are the 4 advantages of conventional radiographs (x-rays)?

A
  1. Time and cost efficient
  2. Non-invasive
  3. Low risk
  4. Good for screening
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17
Q

Term: Objects or structures further from the film appear larger than closer points

A

Magnification

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18
Q

Q: What is the first order diagnostic modality?

A

Conventional radiographs or x-rays

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18
Q

Q: What color is the exposed film in radiographic images?

A

Dark

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19
Q

T/F: With interpretation, insignificant findings may prove significant, while significant findings may prove insignificant.

A

True

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20
Q

Content: The 4 parts of alignment

A
  1. Gross bone size
  2. Number of bones
  3. Shape and contour of cortical outline
  4. Joint position and alignment
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21
Q

T/F: In x-rays, one view is no view.

A

True, in terms of interpretation. X-rays are 2D images, need more than one image to reconstruct into 3D

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22
Q

T/F: Diagnostics are the tools and are the answer.

A

False: they are a tool, NOT the answer.

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23
Q

Q: What can a PT offer when interpretation is difficult for even the specialist? (3)

A
  1. Managing care 2. Directing imaging 3. Relating imaging studies to clinical evaluation
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24
Q

T/F: Diagnostic findings, including imaging, must be used in the context of clinical presentation.

A

True

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24
Q

Defn: True positive

A

Test detects something that is really there

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26
Q

Defn: False positive

A

Test detects something that is not really there

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26
Q

Defn: Specificity

A

A test’s ability to identify a true negative

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27
Q

Q: What is the least radiodense stubstance in the body?

A

Air

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28
Q

Diagram: Identify the problem

A

Biconcave “fish” vertebrae, indicative of osteopenia

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28
Q

Diagram: CT Basics

A
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29
Q

Diagram: Identify the problem

A

Osteonecrosis of femoral head, femoral head begins to flatten

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31
Q

Defn: Errors of observation

A

The image doesn’t look like what you think it is Ex. Fracture doesn’t show up

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33
Q

Term: Reduced strength or density of the x-ray beam as it passes through a medium

A

Attenuation

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34
Q

Diagram: Identify the problem

A

Fat pad or “sail” sign: note faint density change at arrows as edema pushes fat pad out of fossa

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36
Q

Defn: False negative

A

Test detects nothing, but there is something there

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36
Q

Q: Given that HIV blood tests are very sensitive, what can you assume about the presence of the virus from a negative test?

A

That the test will rarely come up negative is the virus is present - SNOUT

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37
Q

T/F: Ortopedic hardware is ferromagnetic, however surgical clips and pacemakers are safe during an MRI.

A

False, flip it

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38
Q

Term: How long it takes protons to relax back to resting state following a RF pulse

A

Longitudinal magnetization (T1)

39
Q

T/F: The radiodensity of an object is directly related to the radiodensity (amount of blackening) on the radiograph.

A

False: inversely

41
Q

T/F: Diagnostic imaging and PT improves the PT/physician communication.

A

True

42
Q

Diagram: In the image below label each line

A

Red = anterior vertebral line

Blue = posterior vertebral line

Green = spino-laminar line

Orange = posterior spinous line

44
Q

Term: Refers to a test’s ability to identify a true negative

A

Specificity

44
Q

Q: With ________ MRI, tissue enhancement is ______________ to blood flow to the tissue.

A

Contrast, proportional

45
Q

Q: What acronym is helpful for specificity?

A

SPIN Specificity, Positive, Ruled In

45
Q

Diagram: Identify the problem

A

Left intertrochanteric and subtrochanteric hip fractures

46
Q

Term: visibility of the image

A

Photographic qualities

47
Q

Term: also known as sharpness or resolution

A

Detail

48
Q

Q: What are the 2 advantages of CT?

A
  1. Sensitive and specific for fracture
  2. Useful for rapid assessment of brain or neurologic injury
49
Q

Q: By what percent was diagnostic imaging reduced when military PT’s were given the ability to order images.

A

50%

51
Q

Q: List the substance that represents the color on radiograph (shown below) from darkest to lightest.

A
  1. Air
  2. Fat
  3. Water
  4. Bone
  5. Contrast Media
  6. Heavy Metals
52
Q

Table: Fill in the table below

A
53
Q

Term: amount of blackening on the radiograph dependent on distance, time, and current

A

Density

55
Q

Term: Image appears shorter and wider than the actual object or structure

A

Foreshortening

57
Q

Q: What is the main disadvantage of conventional radiographs?

A

They may be normal when a pathology actually exists

58
Q

Q: Given that home pregnancy tests are very specific, what can you assume about the presence of a pregnancy from a positive test?

A

That a positive test is almost always due to pregnancy - SPIN

59
Q

Q: What are the 3 disadvantages of CT?

A
  1. Radiation exposure
  2. Discriminates density, but limited in precise histologic differences
  3. Small volume of tissue image as a uniform shade of gray
60
Q

T/F: Diagnostic imaging and PT adds nothing to the comprehensive PT eval.

A

False: enhances

62
Q

T/F: PT’s should be independently interpreting imaging results.

A

False

63
Q

Term: Refers to a test’s ability to identify a true positive.

A

Sensitivity

64
Q

Q: During an MRI, nuclei realign to their _________ state when the field is _________, release _________ energy.

A

Resting, removed, resonant

65
Q

Table: Fill in the table below

A
66
Q

Term: Usually occurs due to distance between beam source, patient, and image receptor, and from alignment and positioning issues

A

Distortion

66
Q

Content: 4 parts of cartilage

A
  1. Joint space width
  2. Subchondral bone
  3. Joint margins (smoothness)
  4. Epiphyses and growth plates
69
Q

Diagram: Identify the problem

A

“Teardrop” fracture of 2nd cervical vertebrae

71
Q

Term: differences between adjacent tissue densities

A

Contrast

72
Q

Term: easily penetrated by x-rays - i.e. low attenuation

A

Radiolucent substance

73
Q

Diagram: Identify the type of MRI image.

A

T2 image of a herniated lumbar disk

75
Q

Defn: True negative

A

Test detects nothing and nothing is there

76
Q

T/F: MRI images are based on two different processes of proton realignment.

A

True

77
Q

Term: X-ray absorption capacity, based on substances composition, density, and thickness

A

Radiodenisty

78
Q

Q: Specificity - A positive test means…

A

You definitely have a condition

79
Q

Q: What are the 3 common radiograph names?

A

anterioposterior (AP), posterioanterior (PA), Lateral/oblique

80
Q

Diagram: Identify the contrast enhancement

A

Barium swallow

81
Q

Diagram: X-ray Basics

A
82
Q

Diagram: Identify the problem

A

Compression fracture of 4th lumbar vertebrae

83
Q

Q: What is one thing to be careful of when viewing radiographs?

A

The identification letters may appear backward or upside down

84
Q

Content: 4 advantages of MRI

A
  1. Good sensitivity
  2. Images soft tissue well
  3. No radiation
  4. Little distortion as images are obtained in one plane
86
Q

Term: Not easily penetrated by x-rays - i.e. high attenuation

A

Radioopaque substance

87
Q

Q: How are radiographs named?

A

For the beam directions relative to the patient/patient position

88
Q

Content: Computed tomography basics (4)

A
  1. Uses x-ray attenuation to produce cross-sectional images
  2. X-ray tube and film move about a fulcrum
  3. Provides detailed anatomical imaging of bone
  4. Travserve images are read from the bottom looking up
89
Q

Q: In what ways can MRI contrast be delivered into the pt.’s system?

A

IV or intra-joint injection

91
Q

Q: What contrast media is typically used?

A

Barium sulfate (in swallow studies)

92
Q

Diagram: Identify the image below

A

3D image of tibial plateau and proximal fibular fractures

93
Q

Defn: Sensitivity

A

A test’s ability to identify a true positive

94
Q

Content: 4 parts of bone density

A
  1. Cortical margins dense, lower density in cavity
  2. Weight bearing should be higher density
  3. Osteoporosis is suggested by low contrast - “washed out”
  4. Sclerosis or arthritis will appear as a brighter white
95
Q

Q: What acronym is helpful for sensitivity?

A

SNOUT Sensitivity, Negative, Ruled Out

97
Q

Diagram: Identify the type of MRI image

A

T1 image of right hip chondrosarcoma

98
Q

Diagram: Idenifty the type of MRI image

A

T2 image of tibial plateau and femoral condyle contusion

99
Q

Content: Functional MRI (2)

A
  1. Based on increased BF that accompanies cerebral activity
  2. Uses magnetic properties of deoxyhemoglobin as an endogenous contrast agent
100
Q

Content: DEXA (4)

A
  1. Gold standard for body composition
  2. Measure bone density
  3. Determines density based on difference between absorption of beams
  4. Radiation exposure approx. = to a flight from NYC to LA and back
101
Q

Content: Nuclear Medicine (3)

A
  1. Uses radiopharmaceuticals for diagnosis, therapy, and reserach
  2. Radiopharmaceuticals are radioactive tracers that are absorbed according to the metabolic properties of the tissue
  3. Detection of the location and concentration of radioactive elements is used to produce an image
102
Q

Content: Types of Nuclear Medicine (4)

A
  1. SPECT
  2. PET
  3. SPECT or PET in combo with CT
  4. Radionuclide scintigraphy or bone scan
103
Q

Content: Radionulcide scintigraphy (3)

A
  1. Labeled methylene is injected, scanning occurs 2-3 hours following injection
  2. High uptake = increased bone activity or mineral turnover
  3. Modality of choice for detecting stress fractures and metastatic bone disease
104
Q

Content: 3 advatanges of radionuclide scintigraphy

A
  1. Highly sensitive for early bone and joint disease
  2. Fast
  3. Reasonable cost
105
Q

Content: 2 disadvantages of radionuclide scintigraphy

A
  1. Poor specificity
  2. Easily influenced by osteoblastic activity or BF of any etiology
106
Q

Diagram: Idenifty the type of image

A

Radionuclide scintigraphy - metastatic prostate cancer

107
Q

Content: Ultrasonography (4)

A
  1. Images produced by sound waves
  2. Tissues have unique acoustic qualities
  3. Useful for OBGYN and musculoskeletal tissue
  4. Can be used with activity
108
Q

T/F: Ultrasound is operator independent, and does not require practice to have good technique.

A

False

109
Q

T/F: Ultrasound is included in the PT practice act, but should only be used to confirm diagnosis.

A

True

110
Q

Q: ____________ ____________ are generally the first order modality.

A

Conventional , radiographs

111
Q

Q: ______ is used to visualize complex anatomy

A

CT

112
Q

Q: ________ is used to assess soft tissue.

A

MRI

113
Q

Content: 3 parts of a trauma survey

A
  1. Diagnose and evaluate fracture or disloaction
  2. Match MOI to clinical presentation
  3. Assess treatment and monitory healing
114
Q

Q: What types of images are typically taken for a trauma evaluation? (3)

A
  1. Lateral chest
  2. AP chest
  3. AP pelvis
115
Q

Diagram: Identify the following clinical decision rule;

Sensitivity ______, Specificity ______

A

Pittsburg Decision Rule for Knee Trauma

99%, 60%

116
Q

Diagram: Identify the following clinical decision rule;

Sensitivity ______, Specificity ______

A

Ottowa Knee Rule

97%, 27%

117
Q

Diagram: Identify the following clinical decision rule;

Sensitivity ______, Specificity ______

A

Ottowa Ankle and Foot Rules

100%, 40%

118
Q

Diagram: Identify the following clinical decision rule;

A

Imaging Guidelines for Actue LBP

PTRS 746 Exam 1 Combined and Randomized (7 decks)

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