Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AA Radiology > Other than Chest X-rays > Flashcards

Other than Chest X-rays Flashcards

1
Q

Neck

A

Evaluate stridor with plain x-ray, but may need CT.

Consult endocrinologist before ordering a thyroid study.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stridor

A

Stridor is an abnormal, high-pitched, musical breathing sound caused by a blockage in the throat or voice box (larynx). It is usually heard when taking in a breath.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Spine

A

Lateral spine should line up.
Can order either cervical, thoracic, or lumbar spine.

Vertebrae:
Cervical 1 - 7 (Eat breakfast at 7.)
Thoracic 1 - 12 (Eat lunch at 12.)
Lumbar 1 - 5 (Eat dinner at 5.)
Sacrum and coccyx.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Scoliosis … order …

A

For suspected scoliosis, order one view of the thoracolumbar spine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cervical spine

A

The normal lines should have no sharp angulation.
Look for normal prevertebral soft tissue space widths.
Soft tissue swelling alone may indicate fracture and can threaten the spinal cord, get a CT scan.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

C-Spine

A

Two anterior view are done after the lateral view is found to be free of fracture of subluxation.
One: mouth open, view to the odontoid.
One: mouth closed.

Major trauma? CT or MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Subluxation

A

Partial or complete dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Scaphoid fracture

A

Scaphoid fracture is a common injury encountered in family medicine. To avoid missing this diagnosis, a high index of suspicion and a thorough history and physical examination are necessary, because early imaging often is unrevealing. Anatomic snuffbox tenderness is a highly sensitive test for scaphoid fracture.

The scaphoid bone is the most commonly fractured carpal bone; this injury occurs most often in young men. Scaphoid fractures are rare in young children and the elderly because of the relative weakness of the distal radius compared with the scaphoid in these age groups.

Risk of misdiagnosis: aseptic necrosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Scaphoid bone

A

The scaphoid bone is the most common carpal bone to fracture. Usually d/t a fall onto an outstretched hand.
Presentation:
- wrist pain and swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Scaphoid bone fracture, what to do

A

As x-ray may be negative, it is easy to decide this is a sprained wrist. Tenderness in the anatomic snuffbox is indicative of scaphoid bone fracture. So:
Immobilize wrist adequately with a thumb spica.
Remove the case after 10 days, repeat x-rays.
Vascularization is tenuous.
Because vascularization is tenuous, there is a high risk for non-union and avascular necrosis d/t blood supply interruption.
TREATMENT: Acute - fixation with compression screw.
Non-union: bone graft with compression screw.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Salter Harris classification of epiphyseal fractures in children.

A

Type I: straight across the epiphyseal plate.
Type II: involves a portion of the plate and a corner fracture through the metaphysis.
Type III: Involves only part of the epiphysis
Type IV: involves part of the epiphysis and metaphysis.
Type V: involves direct impaction and has the most serious consequences.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mnemonic for Salter Harris classification:

A

Pearls: Mnemonic for Salter Fracture: SALTER

Slip or Separate (Epiphysis separated from shaft)
Above the physis
Low anatomic (Below the physis)
Together or through (Epiphysis and Metaphysis)
Everything (Compressed)
Round, ruined or Rang
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Epiphysis

A

n the terminal portion of a long bone. The epiphysis is separated from the diaphysis during growth by a cartilaginous zone that serves as a growth center. Once ossification unites the epiphysis with the diaphysis, growth is completed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Elbow

A

The fat pad sign.
Trauma: order AP and oblique; extended and lateral view with elbow flexed.
A posterior fat pad is never normal and indicates fracture of the radial head.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Positive fat pad sign

A

A positive fat pad sign: displacement of the intra articular fat pads within the elbow away from the bone indicates trauma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Knee

A

Order AP and lateral.
Lateral view is taken with knee flexed.
AP views are for assessing joint space narrowing and if there is calcification on the cartilage.
Lateral view to evaluate patella and determine joint effusion.
Clinical exam (history and physical) is better than plain film for soft tissue injuries of knee.
MRI is indicated when exam is inconclusive or equivocal and ligament tear is suspected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ottawa Ankle Rules

A

Ankle film only if pain near malleoli and either:
- inability to bear weight or
- bony tenderness malleolar
Foot film if mid foot pain and either:
- inability to bear weight or
- bony tenderness at navicular or base of 5th metatarsal

18
Q

Ankle sprain

A

Always check for pain at base of 5th metatarsal.
Always check calf tenderness to r/o proximal fibular fracture; if tender, obtain tib-fib film to r/o intra-osseous tear.

Recheck calf in 48 hours:

  • If better, no worries
  • If not, MRI and refer.
19
Q

Abdomen

A

Usually order flat plat and upright

20
Q

Abdomen, x-ray examination

A

Look for:

  • Gas patterns
  • organ shapes and sizes
  • calcifications
  • asymmetric Psoas margins
  • Skeleton
  • Basilar lung abnormalities
21
Q

Large bowel

A

Large bowel gas often mixed with fecal material and has bubbly appearance.
Normal diameter: not more than 6 cm.
Normal diameter of cecum: not more than 9 cm.

22
Q

Appendicitis and X-ray

A

Often, usually, negative

23
Q

Acute abdominal pain, suspected perforation, what to do:

A

In addition to H & P, EKG, labs, order:
PA of the chest and spine
Upright view of the abdomen
If pregnant or suspect gall bladder disease, order US.

24
Q

CT scan, abdomen

A

Order for non-intestinal abdominal pathology

25
Q

US, abdomen

A 
US is used for:
liver
kidneys
gallbladder
common bile duct
appendix, maybe
pancreas, maybe
26
Q

Kidney stone, order?

A

CT scan, no contrast

27
Q

Appendicitis, order?

A

CT scan, with contrast

28
Q

Hematuria, order?

A

CT scan, with and without contrast
Most stones will show without contrast
IVP for the young
CT if older or concern for CA

29
Q

Peptic Ulcer Disease suspected, order?

A

Upper GI or endoscopy (endoscopy is the gold standard)

30
Q

Fracture suspected, order?

A

Plain x-ray
Occult (hidden) hip: MRI
Occult knee: MRI
Stress fracture: nuclear medicine bone scan
Metastasis-fracture: nuclear medicine bone scan
Osteomyelitis: plain s-ray, then nuclear medicine bone scan

31
Q

Back pain with radiculopathy, order?

A

MRI

radicuolopathy is characterized by pain that radiates from the spine

32
Q

Arthritis, order

A

Non-septic: plain x-ray

Septic: plain x-ray plus joint aspiration

33
Q

Tips

A

If fracture is suspected, x-ray joints above and below.

With children, order bilateral films for comparison.

34
Q

CT scan

A

Two dimensional display of two-dimensional info.
Objects appear where they really are in space
Pts receive 10-100 times more radiation with CT than radiograph.
Allows simultaneous visualization of a large number of structures.
Useful for fine bone structure, skull, spine, and pelvis.

35
Q

CT and contrast

A

Healthy patients: normal creatinine is sufficient.
In severe renal impairment, an alternate test may be suggested.
Metformin (Glucophage) - kidney elimination - Withhold for 48 hours post intravascular iodinated contrast material

36
Q

MRI

A

Uses a powerful magnetic field, radio waves, and a computer to produce detailed pictures or organs, soft tissues, bone, and virtually all other internal body structures.
No ionizing radiation.
Useful for soft tissue: muscle, ligament, cartilage, spinal cord, marrow spaces.
Contraindications, d/t magnets: pacemakers, defibrillators, spinal cord stimulators, aneurysm clips

37
Q

US

A

Uses high-frequency sound waves to make images
Echoes are the result of changes in density between tissues
No radiation exposure
Allows real time structure and movement of organ evaluation.

38
Q

Child abuse, x-ray findings

A

Multiple rib fractures
Multiple fractures in different stages of healing
Femur fracture

39
Q

Commonly missed fractures

A

Ribs
Navicular Schaphoid (lawsuit bone)
Tarsal/Metatarsal

40
Q

Follow Up and Referral

A

Repeat X-ray in 6 weeks to 2 months to determine healing.
Refer children with fractures that extend through the growth plate
Open fractures warrant aggressive treatment and referral

41
Q

Patient education, reasons to refer

A

Immediately report:
intense pain
hypoesthesia (partial loss of sensation)
paresthesia (abnormal sensation, burning, tingling)
muscle weakness or paralysis (compartment syndrome)

Refer all of the above

42
Q

Patient education

A

Previously fractured and healed bones are more prone to refracture.
Encourage good physical conditioning and consistent exercise to strengthen muscles.
Work and play safely.

AA Radiology (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions