Merryl Fulmer Procedures Flashcards
The difference in degrees between the OML and IOML is:
7 degrees
The difference in degrees between the GML and OML is:
8 degrees
What is this image:
AP Townes View of the Skull
Demonstrates the dorsum selli and posterior clinoid processes portrayed in the shadow of the foramen magnum
Occipital Bone
Symmetrical Petrous Ridges
Which sinuses are demonstrated on an AP Townes:
NONE
What image is this?
PA Skull
Petrous Ridges Fill the orbit
CR is perpendicular
The PA skull shows what sinuses?
the frontal sinuses
PA Axial (Caldwell) Skull
Submentovertical
IOML Parallel to the IR
MSP perpendicular
CR perpendicular to the IOML
Sphenoid sinuses, ethmoid sinuses
OML- 30 degrees caudal
IOML- 37 degrees caudal
the spongy cancellous bone separating the inner and outer layers of the cortical bone of the skull
Diploe
Waters Method
Demonstrate maxillary sinuses
Done Erect with horizontal beam
MML perpendicular
OML 37 degrees
Petrous ridges below the floor of the maxillary sinuses
Modified Waters
Petrous ridges in the lower 1/3 of the sinus
OML 55 degrees
chin down
best demonstrates the floor of the orbits
If the patient is having an MRI
Cervical Vertebrae
holes in 6 of the 7 transverse process
holes are called transverse foramen
C1-C6 have a hole
vertebral artery go up to the brain
C7 does not have a hole
Hole in the vertebrae: vertebral foramen
AP Cervical Spine, demonstrates C3, C4
Do not see C1 or C2 on the AP C-Spine because the purpose of C1-C3 is the open mouth
C1- lateral masses of C1
C2- has the dense that fits up into the area of C1
Upper oclusal plane and the mastoid tip perpendicular
Lateral Cervical Spine
We should be seeing T1
“Ask the patient to take in a deep breath and blow the air out” act of expiration drops the shoulders down
Lateral cervical spine shows the: zygopophyseal joints NOT Intervertebral foramina.
Spine has a lordotic curvature
CR perpendicular
LPO- right intervertebral foramina
RPO- left intervertebral foramina
45 degree oblique
angle 15-20 cephalic
RAO-
LAO
15-20 caudad
Flexion (look at feet) of the cervical spine
Is this cervical, thoracic, or lumbar?
Thoracic Vertebrae (facets attach to the ribs)
Which vertebrae?
Thoracic Vertebrae
Lateral Thoracic Spine
Seeing Intervertebral Foramina
Scoliosis Study
Breast Shields, gonad shield
Scoliosis- lateral curvature of the spine
PA because of breast exposure
overexposed lumbar spine
hard to see the transverse processes
SI joints- angle cephalic 30-35 degrees to see them better
If patient is in LPO and centered 1 inch medial to ASIS- demonstrates SI Joint
What vertebrae?
Lumbar
Failure of the lamina to unite posteriorly:
spina bifida
3?
6?
4?
2?
5?
Spinous Process
Body
Superior Articulating Process
Inferior Articulating Process
Transverse Process
What position- structures shown?
Oblique Lumbar Spine
Scotty Dogs
I.
II.
III.
V.
IV.
IV. neck, pars interarticularis
V- eye, pedical
III. Transverse Process, nose
II. body, lamina
I. ear, superior articular process
foot- inferior articulating process
Which is which and which angle?
Sacrum, 15 degree cephalic angle
also do a lateral do both sacrum and coccyx on one exposure
*ask the patient to use the bathroom
Which is which and which angle?
Coccyx
*ask the patient to use bathroom
10 degrees caudad
also do a lateral do both sacrum and coccyx on one exposure
A radiographic examination of the spinal canal
Myelography
The type of injection into the spinal canal is called:
intrathecal
The level the injection for a myelography and location of the needle:
L3-L4
location of needle: subarachnoid space cerebrospinal fluid is produced
Which one is male and which female?
Left male (acute angle less than 90 degrees)
Right female (angle of pubic bone more than 90 degrees obtuse)
Male
Right Hip
See the greater trochanter
Do not see the lesser trochanter, rotate the leg 15 degrees inward
Head of the femur sits into the socket called the acetabulum
Top part of acetabulum: iliem
Hole- obterater foramen, made up of pubic and ichium
What is the largest foramen in the body?
Obturator Foramen
Hysterosalpingograms
girls only
see the entire fallopian tube before it empties out.
If the contrast is spilling out: ducts are patent (good)
done for fertility issues
For right posterior rib pain
AP
RPO
Right anterior rib pain:
PA
LAO
What is the purpose of doing an oblique of the rib?
to see the axillary part of the rib, it brings the rib parallel to the IR.
Diaphragm Up or Down
Inspiration or Expiration
Inspiration
Diaphragm moves down
Diaphragm Up or Down
Inspiration or Expiration
Expiration
Diaphragm moves down
Three reasons why we do inspiration and expiration?
rule out foreign bodies
demonstrate excursion or movement of the diaphragm
Why do we do chest x-rays erect?
to allow the diaphragm to move down further
Presence of the liver
arrow- sternoclavicular joint, test rotation on a PA chest
Left- erect
Right- recumbent
left- PA
right- AP
reduce heart magnification (PA)
10 pairs of good posterior ribs on a chest x-ray.
male
What is wrong with this image?
Done erect
Air fluid levels present
What is wrong with this
Person has the heart on the wrong side
Situs Inversus
Describe the flow of the heart:
deoxygenated blood enters the heart by way of the superior vena cava and inferior vena cava, the right atrium pumps forcing the blood into the tricuspid valve into the right ventricle, the right ventricle pumps and pushes the blood through the pulmonary valve which is headed towards the lungs, at the lungs you breathe in and out to get the deoxygenated blood to the oxygenated blood, the cells in the lungs by the four pulmonary veins, the veins take the blood through the mitral (bicuspid valve)
The pulmonary artery is the only artery that takes deoxygenated blood
Viens take blood toward the heart
Arterys take blood away from the heart
Study, Position, Breathing
Sternum
RAO Sternum
Shallow breathing over a time of three seconds
Long time and low mA
Orthostatic Breathing
Why do you do an RAO sternum? If you cant do one what is the other position?
Superimpose the sternum over the heart shadow
LPO
What type of breathing for soft tissue neck?
slow inhalation
Left- PA abdomen (ala go in)
Right- AP abdomen (ala come out)
What study is this?
Upper GI and small bowel
What study is this?
IVU
IV urogram
What study is this? Position?
Upper GI
Prone (air in fundus)
Study and position?
Prone
Small bowel study
Study and What demonstrating?
Right Lateral Upper GI
Retrogastric Space
Left: polyps (hang down into the lumen of the bowel)
Right: Diverticula (outpouched)
What is the purpose of the galbladder?
store bile
Label
Where is bile produced?
by the liver
What is the purpose of bile?
emulsify or breakdown fat
ERCP
Endoscopic retrograde cholangiopancreatography