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ARRT Kettering > Merryl Fulmer Procedures > Flashcards

Merryl Fulmer Procedures Flashcards

1
Q

The difference in degrees between the OML and IOML is:

A

7 degrees

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2
Q

The difference in degrees between the GML and OML is:

A

8 degrees

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3
Q

What is this image:

A

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

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4
Q

Which sinuses are demonstrated on an AP Townes:

A

NONE

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5
Q

What image is this?

A

PA Skull
Petrous Ridges Fill the orbit
CR is perpendicular

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6
Q

The PA skull shows what sinuses?

A

the frontal sinuses

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7
Q
A

PA Axial (Caldwell) Skull

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8
Q
A

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

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9
Q

the spongy cancellous bone separating the inner and outer layers of the cortical bone of the skull

A

Diploe

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10
Q
A

Waters Method
Demonstrate maxillary sinuses
Done Erect with horizontal beam
MML perpendicular
OML 37 degrees
Petrous ridges below the floor of the maxillary sinuses

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11
Q
A

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

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12
Q
A

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

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13
Q
A

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

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14
Q
A

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

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15
Q
A

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

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16
Q
A

LPO- right intervertebral foramina
RPO- left intervertebral foramina
45 degree oblique
angle 15-20 cephalic
RAO-
LAO
15-20 caudad

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17
Q
A

Flexion (look at feet) of the cervical spine

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18
Q

Is this cervical, thoracic, or lumbar?

A

Thoracic Vertebrae (facets attach to the ribs)

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19
Q

Which vertebrae?

A

Thoracic Vertebrae

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20
Q
A

Lateral Thoracic Spine
Seeing Intervertebral Foramina

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21
Q
A

Scoliosis Study
Breast Shields, gonad shield
Scoliosis- lateral curvature of the spine
PA because of breast exposure

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22
Q
A

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

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23
Q

What vertebrae?

A

Lumbar

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24
Q

Failure of the lamina to unite posteriorly:

A

spina bifida

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25
Q

3?
6?
4?
2?
5?

A

Spinous Process
Body
Superior Articulating Process
Inferior Articulating Process
Transverse Process

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26
Q

What position- structures shown?

A

Oblique Lumbar Spine
Scotty Dogs

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27
Q

I.
II.
III.
V.
IV.

A

IV. neck, pars interarticularis
V- eye, pedical
III. Transverse Process, nose
II. body, lamina
I. ear, superior articular process
foot- inferior articulating process

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28
Q

Which is which and which angle?

A

Sacrum, 15 degree cephalic angle
also do a lateral do both sacrum and coccyx on one exposure
*ask the patient to use the bathroom

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29
Q

Which is which and which angle?

A

Coccyx
*ask the patient to use bathroom
10 degrees caudad
also do a lateral do both sacrum and coccyx on one exposure

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30
Q

A radiographic examination of the spinal canal

A

Myelography

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31
Q

The type of injection into the spinal canal is called:

A

intrathecal

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32
Q

The level the injection for a myelography and location of the needle:

A

L3-L4
location of needle: subarachnoid space cerebrospinal fluid is produced

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33
Q

Which one is male and which female?

A

Left male (acute angle less than 90 degrees)
Right female (angle of pubic bone more than 90 degrees obtuse)

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34
Q
A

Male

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35
Q
A

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

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36
Q

What is the largest foramen in the body?

A

Obturator Foramen

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37
Q
A

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

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38
Q

For right posterior rib pain

A

AP
RPO

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39
Q

Right anterior rib pain:

A

PA
LAO

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40
Q

What is the purpose of doing an oblique of the rib?

A

to see the axillary part of the rib, it brings the rib parallel to the IR.

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41
Q

Diaphragm Up or Down
Inspiration or Expiration

A

Inspiration
Diaphragm moves down

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42
Q

Diaphragm Up or Down
Inspiration or Expiration

A

Expiration
Diaphragm moves down

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43
Q

Three reasons why we do inspiration and expiration?

A

rule out foreign bodies
demonstrate excursion or movement of the diaphragm

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44
Q

Why do we do chest x-rays erect?

A

to allow the diaphragm to move down further

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45
Q
A

Presence of the liver
arrow- sternoclavicular joint, test rotation on a PA chest

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46
Q
A

Left- erect
Right- recumbent

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47
Q
A

left- PA
right- AP
reduce heart magnification (PA)

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48
Q
A

10 pairs of good posterior ribs on a chest x-ray.
male

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49
Q

What is wrong with this image?

A

Done erect
Air fluid levels present

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50
Q

What is wrong with this

A

Person has the heart on the wrong side
Situs Inversus

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51
Q

Describe the flow of the heart:

A

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

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52
Q

Study, Position, Breathing

A

Sternum
RAO Sternum
Shallow breathing over a time of three seconds
Long time and low mA
Orthostatic Breathing

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53
Q

Why do you do an RAO sternum? If you cant do one what is the other position?

A

Superimpose the sternum over the heart shadow
LPO

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54
Q

What type of breathing for soft tissue neck?

A

slow inhalation

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55
Q
A

Left- PA abdomen (ala go in)
Right- AP abdomen (ala come out)

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56
Q

What study is this?

A

Upper GI and small bowel

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57
Q

What study is this?

A

IVU
IV urogram

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58
Q

What study is this? Position?

A

Upper GI
Prone (air in fundus)

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59
Q

Study and position?

A

Prone
Small bowel study

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60
Q

Study and What demonstrating?

A

Right Lateral Upper GI
Retrogastric Space

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61
Q
A

Left: polyps (hang down into the lumen of the bowel)
Right: Diverticula (outpouched)

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62
Q

What is the purpose of the galbladder?

A

store bile

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63
Q

Label

A
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64
Q

Where is bile produced?

A

by the liver

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65
Q

What is the purpose of bile?

A

emulsify or breakdown fat

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66
Q

ERCP

A

Endoscopic retrograde cholangiopancreatography

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67
Q

Antegrade flow of contrast medium through superficial vein in arm and absorbed in the kidney

A

IVU (Functional Study)

68
Q

Retrograde flow into the bladder through urethral catheter driven by gravity

A

Retrograde cystography (structural study)

69
Q

Retrograde flow into bladder through urethral catheter, followed by withdrawl of catheter for imaging during voiding

A

Voiding Cystourethrography

70
Q

Retrograde injection through brodney clamp or special catheter

A

Retrograde Urethrography (male)

71
Q

Where do we find Bowans Capsule?

A

At the Glomerolus

72
Q
A

Intravenous Urogram (Pyelogram)

73
Q
A

Retrograde Urogram (Pyelogram)

74
Q

30 degrees LPO

A

shows the right kidney
left ureter

75
Q

Venipuncture Procedure, Apply the tourniquet:

A

8-10 cm above the site
3-4 inches above the kidney

76
Q
A
  1. PA Abdomen
  2. PA Abdomen Erect
  3. PA Abdomen
77
Q
A
  1. PA Abdomen (Hypo/Asthenic Patient)
  2. Small bowel
  3. IVU IV urogram
    *done on expiration
78
Q

What is the best position for the Esophagus?

A

RAO Esophagus
Esophagus between the vertebrae and the heart

79
Q

Dysphagia

A

Difficulty Swallowing

80
Q

Dysphasia

A

Difficulty Speaking

81
Q
A

Barrette’s Esophagus
Stricture or “streaked” appearance of distal Esophagus

82
Q

Achalasia

A

Stricture or narrowing of esophagus

83
Q

Esophageal Varicies

A

Narrowing or “worm like” appearance of esophagus

84
Q
A

zenker diverticulum
Endless recess or cavity in proximal esophagus

85
Q
A

Meckel Diverticulum

86
Q

Hypertrophic Pyloric Stenosis

A

Distention of stomach owing to obstruction of pylorus
Vomiting
First noticed in babies

87
Q

Hiatial Hernia

A

Gastric bubble or protruding aspect of stomach above diaphragm or Schatzki Ring

88
Q

Projectile Vomitting in babies

A

Hypertrophic Pyloric Stenoisis

89
Q

What study is this?

A

Upper GI
Patient is Prone, Air in fundus
PA stomach

90
Q

What positition?

A

The best position for the esophagus.
Removes the esophagus from superimposition and places it between the heart and thoracic spine

91
Q

What study? What position?

A

RAO Oblique
Upper GI
There is barium in the duodenal bulb and pyloric canal
Air in fundus

92
Q
A

Right Lateral
Stomach
Shows retrogastric space

93
Q
A

Chrohn’s Disease
Segmants of the lumen narrowed and irregular “cobble stone appearance and “string sign” common

94
Q
A

Small Bowel Obstruction
Illeus
Mechanical Tumor

95
Q

Feathery Appearance

96
Q
A

Double Contrast Enema
Barium and Air
Decubitus (Right Lateral Decubitus)

97
Q
A

Decubitus
Left Lateral Decubitus
Double Contrast Enema
Mucosa lined with barium

98
Q
A

Upper GI (seeing the stomach)
PA
Air in the fundus

99
Q
A

Stomach
Hypersthenic Patient
Small Bowel Series

100
Q
A

Double Contrast Enema
Air in the transverse colon (more anterior)
Supine because there is air in the transverse colon

101
Q
A

Ventral Decubitus
Air in the rectum
If it is a double contrast study BE: do a right lateral decubitus, left lateral decubitus, ventral decubitus
Single contrast study: Decubitus is not required

102
Q

How do you localize the hip joint?

A

Feel for the ASIS and Symphysis pubis bisect halfway go down an 1.5 inches at the head of the femur, go down 2 inches your’e at the neck of the femur.
3-5 cm medial
8-10 cm distal
Female patient this is.

103
Q
A

Cross Table Horizontal Lateral Hip
Danielles Miller Method
-Center to the grid
-do not center, get grid cut off
-raise the patient up

104
Q

A.
B.
C.
D.
E.
F.
G.
H.
I.
J.

A

A. Liver (lower portion of right lobe)
B. Galbladder
C. Small Intestine
D. Spleen
E. Left Kidney
F. Left renal cortex
G. Abdominal Aorta*
H. Right psoas muscle
I. Right ureter
J. Right kidney
The way you view is from below at the end of the table looking up.

105
Q
A

Voiding Cystourethrogram
RPO of bladder male
Using a brodney clamp*

106
Q
A

IVU radiograph, demonstrates kidney, ureters, and bladder
contrast absorbed by kidney in collecting system on its way down
Supine

107
Q
A

Benign prostatic hyperplasis (BPH)
Elevated or indented bladder floor
IVU

108
Q

Inflammation of bladder

109
Q
A

Staghorn Calculus

110
Q

The Bowmans capsule would be found:

111
Q

The functioning unit of the kidney:

112
Q

What position?

A

Left lateral rectum
Show rectum on single contrast study

113
Q
A

Show rectum on double contrast study
Ventral Decubitus

114
Q

Why do you do this?

A

obliques on an enema open up flextures
Obiques you do when the patient is supine:
RPO and or an LPOx
RPO- left flexture open up
LPO- right flexture open up

115
Q

For a small bowel series what cells would you use?

116
Q
A

Left Lateral Decubitus
Double contrast study

117
Q
A

Sims position
Position you are in to insert the enema tip

118
Q
A

Image intensifier
Lead drapes- 2.5 equivalent

119
Q
A

Cecal Volvulus
Twisting of the bowel
Only way to correct it is surgery
Beak sign

120
Q
A

Virtual CT colonoscopy
They still have to go to the GI doctor to get this removed

121
Q
A

Neoplasm colon cancer with “apple core”
Classic sign of cancer of large intestine

122
Q
A

Double contrast study pointing to outpouches
Diverticulosis

123
Q
A

ERCP
Endoscopic Retrograde colangiopancreatography

124
Q

What are some reasons a person may need a BE?

A

colitis (inflammation of the large intestine)

125
Q
A

Intravenous Urogram (Pyelogram)

126
Q
A

Seeing the structure of the collecting system
Retrograde Urogram (Pyelogram)

127
Q
A

Retrograde Urography
Performed in surgery
Contrast media delivered retrograde through catheter
Lithotomy Position

128
Q
A

IVU- Posterior Obliques
RPO- left kidney parallel to the IR, right ureter
70-80 kVp for iodine

129
Q

Where do you place the tourniquet for a Venipuncture Procedure?

A

8-10 cm above the site

130
Q

A?
B?
C?
D?
E?
F?
G?

A

Minor calyx
Major calyx
Renal Pelvis
Uretopelvic Junction
Proximal Ureter
Distal Ureter
Urinary Bladder

131
Q

The centering for a hand:

A

3rd metacarpophalangeal joint

132
Q

How many phalanges in the hand?

133
Q
A

3rd metacarpal phalangeal joint
3rd MCP joint
this is a child because we see the epiphysis

134
Q

Secondary center of ossification

135
Q
A

Gaynor Hart Position
Tangential Carpal Canal
*know the anatomy

136
Q

1.
2.
3.
4.
5.
6.

A
  1. 1st Metacarpal
  2. Greater Multangular or Trapezium
  3. Navicular or Scaphoid
  4. Hamulus of Hamate
  5. Pisiform
  6. 5th metacarpal

Gaynor Hart Method
Tangential Carpal Tunnel

137
Q

A.
B.
C.

A

A. AP elbow (do not see coronoid process in profile) (the head of the radius is superimposed) (Epicondyles are parallel)
B. Pronated Hand, Internal Rotation 45 degrees (Epicondyles 45 degrees)
C. Ap External Position 45 degrees (head of the radius not superimposed) (Epicondyles are 45 degrees

138
Q
A

Lateral Elbow (Epicondyles perpendicular to IR)
Fat Pads
Evidence of Fat Pads there is a fracture

139
Q

What do you do if they patient can not fully extend their arm?

A

Do two AP
One with humorous parallel to IR
One with the radius and ulna parallel to the IR
CR is perpendicular*

140
Q

How do you get obliques of an elbow if the patient can not extend their arm?

A

Coyles Method
Pronate the hand

141
Q
A

Coyles method of the elbow
Oblique of the elbow
Pronate the hand*
45 degree angle both away and toward the elbow
1st image- 90 degrees
2nd image- 80 degrees
Radial head- 90 degrees
Coronoid process- 80 degrees

142
Q
A

AP internal shoulder
Greater tuberosity in profile
Epicondyles are parallel to the IR
3. coracoid process

143
Q
A

Inferosuperior axial (Lawrance)
CR directed at the surgical neck

144
Q
A

Transthoracic lateral shoulder
Breathing technique to blur out the ribs

145
Q

Four positions that you can do orthostatic breathing on:

A

RAO sternum
Transthoracic lateral
AP scapula
Lateral T-spine

146
Q

What study?

A

Y-View for scapula
RAO
Effected side against the IR

147
Q
A

AC Joints
Get both on one IR
Done with weights and without weights to see if there is a ligament tear.
*Weights are draped around the wrist

148
Q
A

Avulsion Fracture
Chipped fracture

149
Q

attaches muscle to bone

150
Q

Attaches bone to bone

151
Q
A

AP Tib Fib
4. Tibia
10. Fibula (lateral to the Tibia) Posterior by 15 degrees

152
Q
A

Medial Oblique (open up distal tibia fibular joint space)

153
Q
A

Mortise Ankle
15-20 degrees internally rotated

154
Q

What is this?

A

AP ankle
2. medial mallioulus
5. lateral mallioulus

155
Q

Where do you center?

A

the base of the third metatarsal
we have 5 metatarsals
we have 7 tarsals

156
Q
A

the medial femoral condyle is bigger than the femoral lateral condyle of the knee
Medial femoral condyle is further from the IR than the lateral condyle
angle cephalic on a lateral knee 5-7 degrees

157
Q
A

30-35 degrees
The base of the fifth metatarsal is the most frequently fractured tarsal bone (Jones Fracture)

158
Q
A

A. Tangential

159
Q
A

Camp Coventry (PA- axial intercondyloid fossa)

160
Q
A

Settegast (tangential patella)

161
Q
A

A. pattella (Houston)
B. patella (Settegast)
C. patella (Settegast)

162
Q
A

Intercondyloid fossa
Camp Coventry

163
Q
A

Patella
Houston

164
Q
A

Patella
Settegast

165
Q
A

Bad
Lateral condyle and medial condyle not superimposed
5-7 degrees cephalic angle* NEEDS

166
Q
A

Adductor Tubercle

ARRT Kettering (15 decks)

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