Mobile/Trauma Radiography Flashcards by Emily Mott

CR centering/angle for supine mobile chest

3-5 degrees caudad at T-7

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CR centering/angle for semi-erect mobile chest

CR perpendicular to plane of IR at T-7

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SID for mobile chest radiographs

40 inches minimum

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CR for AP mobile abdomen

Level of the iliac crest

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CR for left lateral decubitus abdomen

Level 1-2” above the iliac crest (diaphragm included)

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A ____ can be taken to show a possible AAA or as a substitute for a lateral decubitus if the patient can not move

lateral dorsal decubitus

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Often inserted under C-arm guidance or in an interventional suite

Pacemaker

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displacement of a bone that is no longer in contact with its normal articulation

Dislocation

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occurs when a bone is partially pulled or pushed out of place in relation to its normal alignment

Subluxation

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a wrenching or twisting of a joint resulting in a tearing or rupturing of associated soft tissues without dislocation

Sprain

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a bruise type of injury. Can sometimes be associated with a bony injury

Contusion

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a disruption of bone caused by a force applied either directly to the bone, or transmitted along the shaft of the bone.

Fracture

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how the fragmented ends of the bone make contact with each other

Apposition

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the fractured ends of the bone align anatomically making contact with each other

Anatomic apposition

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the ends of the fragmented bone are aligned, but pulled apart with a gap between them

Lack of apposition (distraction)

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the bone fragments are displaced and overlapping each other so that the shafts of the bone are in contact with each other

Bayonet apposition

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describes the loss of alignment of the fracture and the direction caused by this misalignment

angulation

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The ____ of the angulation is opposite in relation to the distal ends of the fractured bone

apex

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describes the angle or direction of the fragment such as a medial or lateral apex in which the point of the angle points medially or laterally

Apex angulation

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Apex is pointing away from the midline of the body and the distal ends of the fractured bone are angled towards the midline of the body

Varus deformity

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apex is pointing to the midline of the body and the distal ends of the fractured bone are angled away from the midline

Valgus deformity

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fracture in which the bone does not break through the skin

Simple fracture (closed)

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a fracture in which a portion of the bone breaks through the skin. This is typically the fragmented end

Compound fracture

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fracture does no completely transverse the bone. More common in pediatric patients who still have more flexible bone tissue

Incomplete fracture (partial)

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a buckle of the outer portion of the bone (the cortex) with localized expansion of the cortex with little to no displacement or complete break in the cortex

Torus/"Buckle" fracture

this fracture is on one side of the bone only with the cortex of the affected side of the bone broken and the cortex on the other side bent

Greenstick fracture

the bone is broken into two separate pieces.

Complete fracture

the fracture is nearly at a right angle to the long axis of the bone

transverse fracture

the fracture crosses the long axis of the bone at an oblique angle

Oblique fracture

the bone has been twisted and the fracture spirals around the long axis of the bone

Spiral fracture

the bone is splintered and/or crushed at the site of the fracture resulting in two or more pieces.

Comminuted fracture

three basic types of comminuted fracture that have direct implications regarding treatment and prognosis primarily due to the impact on blood supply

Segmental, butterfly, splintered

3 basic types of complete fractures

Transverse, oblique, spiral

Two main types of incomplete fractures

Torus/"Buckle", greenstick

Three terms to describe angulation of fracture

apex, varus, valgus

three terms to describe apposition

anatomic, lack of (distraction), bayonet

two fracture lines that create three distinct sections of bone with the middle section being fractured at both ends

segmental fracture

a fracture with two pieces on each side of a main wedge-shaped piece

Butterfly fracture

can be caused by direct trauma in which a fracture is created with thin sharp fragments

Splintered fracture

severe stress to a tendon or ligament which causes it to pull away a section of bone

Avulsion fracture

caused by blunt trauma to the orbit, maxilla, or zygoma which causes fracturing to the orbital floor and lateral orbital margins

Blowout fracture

a compression type injury in which a vertebral body collapses or is compressed. Typically seen radiographically in the anterior aspect of the vertebral bodies forming a wedge-like appearance

Compression fracture

most common in pediatric patients. It’s a fracture at the growth plate of a bone. One of the most common fracture sites in children

Epiphyseal fracture

fracture lines radiate outwards from the focal point of trauma in a “star-like” pattern most commonly seen in the patella.

Stellate fracture

ankle joint fracture involving both the medial and lateral malleoli as well as the posterior lip of the distal tibia

Trimalleolar fracture

a fracture in which one segment is driven into the other such as the shaft of a bone being driven into the distal end of the bone such as a Buckle Fracture

Impacted fracture

fracture of the distal phalanx caused by being struck by a ball. Frequently an avulsion fracture at the base of the distal phalanx is seen with this injury

Baseball (Mallet) fracture

usually seen in the distal part of the fifth metacarpal caused by punching. It is best visualized on the lateral image

Boxer fracture

a wrist fracture in which the distal fragment is displaced posteriorly. May be caused by a forward fall

Colles fracture

a wrist fracture in which the distal fragment is displaced anteriorly. May be caused by a backward fall

Smith's fracture

a bilateral fracture traversing the pars interarticularis of cervical vertebrae 2 (C2) with an associated traumatic subluxation of C2 on cervical vertebrae 3 (C3). It is the second most common fracture of the C2 vertebrae following a fracture of the odontoid process.

Hangman fracture

intra-articular fracture of the radial styloid process

Hutchinson (Chauffer) fracture

a fracture to the proximal half of the ulna with an associated radial head dislocation. This could be a self defense injury to the arm

Monteggia fracture

a complete fracture to the distal fibula with accompanying major damage to the joint and associated soft tissues (ligaments etc.) and often seen with fracturing to the medial malleolus and/or distal tibia

Pott's fracture

the pieces of bone are put back into alignment manually. This is non surgical and is often used in conjunction with x-ray or fluoroscopy

Closed reduction

this is a surgical procedure. The fracture may or may not be aligned prior to incision.

Open reduction

three principles when performing trauma radiography:

1. Two projections must be attained at 90º planes from each other (orthogonal views) 2. Included the entire structure or trauma area on the IR 3. Maintain patient, public, and healthcare worker(s) safety

Injured limbs should be lifted with support at:

Both joints

Two projections must be attained at 90º planes from each other. The two prefered views are:

True AP/PA and lateral

Trauma hip

Danelius-Miller

For a Danelius-Miller, rotate the IR so that it is parallel with the:

Femoral neck

abduct the bottom of the IR ___ away from the body for Danelius-Miller

15-20º

CR centering for Danelius-Miller

Horizontal to femoral neck

CR centering for trauma AP pelvis

Midway between ASIS and pubic symphysis

CR centering for trauma pelvis inlet view

40 degrees caudad at ASIS

CR centering for trauma pelvis inlet view (male)

20 - 35 degrees cephalad 2 inches distal to superior margin of pubic symphysis (or greater trochs)

CR centering for trauma pelvis outlet view (female)

30 - 45 degrees cephalad 2 inches distal to superior margin of pubic symphysis (or greater trochs)

CR centering for trauma trans-thoracic shoulder

through the thorax and exiting at the level of the surgical neck of the affected shoulder

CR centering for trauma trans-thoracic humerus

through the thorax and exiting a level near the mid-shaft of the affected humerus