Midterm review- image criteria and non routine stuff

Question 1

What anatomy are we trying to visualize on an AP axial c-spine?

Answer 1

C3 to c7 and surrounding soft tissues.

Question 2

On an odontoid (dens) image what should be equidistant from the dens?

Answer 2

Lateral masses of atlas.

Question 3

what should be equidistant from the lateral masses??

Answer 3

Mandibular rami.

Question 4

which joint should be open in an odontoid image?

Answer 4

Atlantoaxial joint.

Question 5

Where should the dens be?

Answer 5

Middle of the middle.

Question 6

What should appear open on AP Axial Oblique C-spine images?

Answer 6

2nd through 7th intervertebral foramina are open, intervertebral disc spaces are open.

Question 7

Which vertebrae are we trying to visualize in AP axial oblique c-spine?

Answer 7

C1-T1.

Question 8

When the patient is in RPO position, which pedicles are in profile? (C-spine oblique)

Answer 8

Left.

Question 9

what parts of the atlas should be seen on ap oblique axial c-spine?

Answer 9

Posterior arch and vertebral foramen .

Question 10

Which Projection will show c-spine zygapophyseal joints? Why?

Answer 10

Lateral, because zygapophyseal joints in c-spine are perpendicular to the midsagittal plane.

Question 11

what should be seen nicely in profile in lateral c-spine?

Answer 11

Spinous processes.

Question 12

Should the mandible be superimposing c1 and c2? (C-spine lateral)

Answer 12

Nope.

Question 13

Should the posterior arch of c1 and spinous processes of c2 be superimposed by the occipital bone?(c-spine lateral)

Answer 13

Nope.

Question 14

What range of anatomy should we see in a lateral c-spine?

Answer 14

Sella turcica to t1.

Question 15

What should appear open on lateral C-spine images?

Answer 15

Intervertebral joint spaces.

Question 16

What anatomy should be demonstrated in an AP t-spine image?

Answer 16

C7 to L1.

Question 17

Which foramina are demonstrated in a lateral T-spine image?

Answer 17

Intervertebral foramina

Question 18

what are in profile in a lateral t-spine?

Answer 18

Pedicles.

Question 19

What are open in a lateral t-spine?

Answer 19

Intervertebral joint spaces.

Question 20

how much space is allowed (max) between posterior ribs in a lateral T-spine?

Answer 20

1.25 centimeters.

Question 21

What should be included in a lateral t-spine and what should be well demonstrated?

Answer 21

C7 to L1 included, T3 or 4 to L1 well demonstrated.

Question 22

What joints should be superimposed in a Swimmer’s projection?

Answer 22

Zygapophyseal.

Question 23

What is the center of the field in a swimmer’s projection, and what is included in the field?

Answer 23

T1 is in the centre, c5 to t3 is included.

Question 24

What is included in a Lumbar spine AP projection?

Answer 24

T12 to SI joints.

Question 25

Where is the marker in an AP lumbar spine projection?

Answer 25

Lower lateral corner (at A S I S)

Question 26

Which lumbar spine projection demonstrates both the intervertebral joint spaces and intervertebral foramina?

Answer 26

Lateral.

Question 27

What suggests that there is no rotation in a lateral L-spine image?

Answer 27

Superimposition of posterior surfaces of vertebral bodies.

Question 28

What suggests that there is no tilt in a lateral L-spine image?

Answer 28

Superimposition of superior surfaces and inferior surfaces of vertebral bodies.

Question 29

What is included in lateral l-spine images?

Answer 29

T12 to S1 or 2.

Question 30

Which projection demonstrates the L-spine zygapophyseal joints?

Answer 30

45 degree oblique.

Question 31

What do we want in the center of an L5 S1 projection?

Answer 31

Open L5 S1 intervertebral space.

Question 32

What should be superimposed in L5 S1 images?

Answer 32

L5 pedicles, and pelvic alae.

Question 33

What should not be superimposing the sacrum in an AP Axial Sacrum image?

Answer 33

Symph.

Question 34

What should be aligned with symph in an AP axial sacrum image?

Answer 34

Median sacral crest and coccyx.

Question 35

what’s in profile in a lateral sacrum image?

Answer 35

Median sacral crest.

Question 36

are the alae completely superimposed in a lateral sacrum image?

Answer 36

No, nearly.

Question 37

What should be completely superimposed in a lateral sacrum?

Answer 37

Greater sciatic notches.

Question 38

What should appear symmetrical in AP Axial S I Joint images?

Answer 38

Sacral ala.

Question 39

What should be superimposed over 5th sacral segment in AP axial SI joint?

Answer 39

Symph.

Question 40

What should be open in an AP oblique S I Joint projection?

Answer 40

SI joint should be open

Question 41

How much superimposition of the illium and sacrum should there be in an AP oblique S I joint projection?

Answer 41

None.

Question 42

What’s in the middle of an AP oblique S I joint image?

Answer 42

The S I joint.

Question 43

What 4 things should be seen over the heart shadow in a PA oblique R A O sternum?

Answer 43

Manubrium, SC joints, sternum, xiphoid.

Question 44

What is at the centre of the field in a PA oblique R A O sternum?

Answer 44

Mid sternum.

Question 45

should anything be superimposing the sternum in a lateral sternum image? What should be out of the way?

Answer 45

Nope. Anterior ribs and humeral heads out of the way.

Question 46

In an upper rib projection, what should be adjacent to lateral edge of the vertebral column?

Answer 46

Medial end of clavicle.

Question 47

What should be moved out of the way of the lung field?

Answer 47

Scapula.

Question 48

Which ribs should be seen above diaphragm in upper ribs image?

Answer 48

1 to 9.

Question 49

What projection shows off costovertebral joints?

Answer 49

Oblique rib.

Question 50

How are axillary ribs demonstrated in an oblique rib image?

Answer 50

Without foreshortening.

Question 51

what is the most common of all radiographic procedures?

Answer 51

Chest x-ray.

Question 52

What 3 reasons should chest routines be done upright?

Answer 52

Prevent blood from pooling in the pulmonary vessels, Allow gravity to pull the diaphragm inferiorly, And Demonstrate air fluid levels.

Question 53

what part of the lung field should be demonstrated in a P A chest image?

Answer 53

All of it.

Question 54

What 5 anatomy thingies should be demonstrated in a P A chest?

Answer 54

Entire lung field, air filled trachea, hilar region markings, heart and great vessels, bony thorax.

Question 55

what should appear symmetrical on a PA chest image?

Answer 55

SC joints and distance from right and left rib margins to spine.

Question 56

How many ribs above the diaphragm on a PA chest?

Answer 56

10 posterior ribs.

Question 57

What 2 (3, technically) things are off of the lung field?

Answer 57

Chin and scapulae.

Question 58

What can arms superimposing the lateral chest wall mimic?

Answer 58

Pleural thickening.

Question 59

where should the 5th to 7th anterior ribs intersect the diaphragm?

Answer 59

The midclavicular line.

Question 60

What marker requirements do chest radiographs have?

Answer 60

Anatomical marker and arrow or supine or erect marker.

Question 61

What anatomy is demonstrated on a lateral chest x-ray?

Answer 61

Entire lung field from apices to costophrenic angles, and from sternum to posterior ribs.

Question 62

What do we want evenly superimposed on a lateral chest x-ray?

Answer 62

The anterior ribs and the posterior costophrenic recess.

Question 63

How does the heart appear on an AP supine versus P A erect and why?

Answer 63

Larger because of short SID and increased OID

Question 64

How do the lung markings and fields appear on an AP supine versus P A erect?

Answer 64

Markings more pronounced, fields will appear whiter.

Question 65

How many posterior ribs can be visualized on an AP supine?

Answer 65

Only 8 to 9 because can’t breathe as deep.

Question 66

How do the ribs appear on an AP supine versus P A erect?

Answer 66

Less curved.

Question 67

When is full inspiration used in chest x-rays?

Answer 67

Routine Chests

Question 68

When are chest x-rays taken on inspiration and expiration?

Answer 68

Foreign bodies, pneumothorax, movement of diaphragm, lesion localization.

Question 69

When are chest x-rays taken on expiration?

Answer 69

Post lung biopsies.

Question 70

Why do abdomen radiographs need a grid?

Answer 70

Scatter.

Question 71

What are the 4 evaluation criteria of upright abdomens?

Answer 71

Bilateral diaphragms, as much of lower abdomen as possible, no rotation, spine centered to I R.

Question 72

Why would a left lateral decubitus abdomen be taken?

Answer 72

Demonstrates air/fluid levels when an upright abdomen cannot be taken.

Question 73

Where does one center for an L L D abdomen?

Answer 73

Midsagittal, 2 inches above iliac crests.

Question 74

How should L L D abdomen images be displayed?

Answer 74

Anatomically

Question 75

What is a patient cannot roll onto their side, what is the next best thing for air/fluid in abdomen?

Answer 75

Dorsal Decubitus.

Question 76

For supine abdomen image, what must be included inferiorly?

Answer 76

Superior rami of symph

Question 77

What differences are there between Hospital C-Spine and Clinic C-Spine Routines?

Answer 77

Clinic routine includes AP 15° axial obliques

Question 78

Standard Fuch's, What is that??

Answer 78

If you are unable to demonstrate the odontoid this is another option on a NON-TRAUMA patient.

Question 79

Modified Fuch’s : what is that.

Answer 79

As a replacement for odontoid view, can be done supine with the patient in a c-spine collar.

Question 80

What routine is very similar to c-spine for query foreign body, tissue swelling such as epiglottitis?

Answer 80

soft tissue neck, which consists of 15° AP axial and Lateral.

Question 81

How is lateral soft tissue neck different from c-spine?

Answer 81

Demonstrates nasopharynx to lung apices, Collimate to exclude eyes, Decreased technique to better visualize soft tissue, Taken on modified Valsalva manouever to demonstrate air in the pharynx and trachea.

Question 82

How is Soft Tissue Neck AP different from AP c-spine :

Answer 82

Chin is extended higher than for c-spine AP, Collimate from lower level of nasal bones to sternal angle, taken on modified Valsalva maneuver to demonstrate air in the pharynx and trachea.

Question 83

What are the point of Special Request Lateral c-spine images? What should be ruled out before taking? 

Answer 83

Hyperflexion Lateral and Hyperextension Lateral are a Functional study, Rule out fracture first.

Question 84

What are Evaluation Criteria for Lateral Hyperflexion and Hyperextension c-spine images?

Answer 84

C1-C7 visualized, No rotation, Hyperflexion–Spinous processes well separated, Hyperextension–Spinous processes in close proximity, Optimal exposure factors.

Question 85

What are special request lumbar spine positions and what are they for?

Answer 85

Hyperflexion and extension. Used to determine amount of movement after a spinal fusion, or to localize a herniated disc.

Question 86

What are routine protocol projections for SC Joints?

Answer 86

P A and fifteen degrees p A oblique, bilateral.

Question 87

How should the PA SC joint projection be performed? (center, collimation, position).

Answer 87

Upright or prone, center on midsagittal plane 3 inches below vertebra prominens, collimate to include SC joints.

Question 88

How should the PA oblique SC joint projection be performed? (center, position).

Answer 88

Rotate MCP until SC joints move off to side away from I R. Center on the jugular notch 3 inches inferior to vertebra prominens.

Question 89

Which SC joint opens in a P A Oblique projection?

Answer 89

The one closest to the IR.