Past Positioning Questions Flashcards
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how many bones in adult vertebral column?
26
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most post. part of typical vertebra?
spinous processes
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joints btw articular processes of vertebra
zygapophyseal joints
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Does C1 have a vertebral body?
no
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what must tech make sure to do on spine XRs to improve the vis. of spine?
coll. lat borders
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AP C-Spine CR?
CR 15-20º cephalic to C4
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why is AP C-spine angled 15º cephalic?
to open joint spaces
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During AP “open mouth”, an imaginary line btw what 2 landmarks is made perp to IR?
lower margin of incisors/mastoid tip (skull base)
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AP “Open Mouth” dens shows what?
C1 & C2
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Is the Judd method intended to show the zygapophyseal joints btw C1 & C2?
no
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what pos’s project dens thru shadow of foramen magnum when upper portion of dens is obscured by teeth, when skull base and upper incisors are superimposed?
Fuchs/Judd method
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C-vert. contain what in their transverse processes?
foramen
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detail is improved on a lat c-spine by using what?
sm focal spot
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What XR shows articular pillars & zygapophyseal joints on C-spine?
lat C-spine
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what is done on an ant. obl c-spine to prevent the superimposition of the mandible?
extend chin
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an ant obl c-spine shows the IV foramina/pedicles ______ to IR
closest
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an LAO c-spine show’s what?
L IV foramina/pedicles
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which obl’s are preferred for C-spine? why?
ant. obl.; less thyroid dose
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CR for post obl c-spine?
15º cephalic to C4
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An RPO of c-spine shows what?
L IV foramina/pedicles
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In a post obl c-spine, the IV foramina/pedicles _______ to IR are shown
furthest
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CR AP T-spine?
perp T7 (3-4” inf. jugular notch)
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what manual technique is done in the lat T-spine to enhance the visualization of the vertebral bodies?
low mA & 3-4s exposure T (w orthostatic breathing)
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the Lat T-spine shows what?
open IV foramina
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on the lat T-spine, the vertebral column must be _______ to tabletop to open up IV joint spaces
II
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what can be done on a lat T-spine to improve vis. of post. spine by preventing excessive density along post. aspect of spine?
pb apron behind pt
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which XR best demonstrates a compression fracture of T-spine?
lat T-spine
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which XR best demonstrates C7-T1?
Swimmer’s lat/Twining method
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what is performed when the upper aspect of T-spine is obscured by shoulders, when the upper T-spine is the area of interest?
Swimmer’s lat/Twining method
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if pt enters ER bc of MVA & is on backboard w C-collar, and initial XR only shows C1-C6, & no CT is available, what XR should be performed?
horizontal beam Swimmer’s lat
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what kind of contrast/latitude is preferred for L-spine?
short-scale, narrow latitude
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iliac crest is located at the level of?
L4-5
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what 2 L-spine XRs would show a possible compression fracture of L3, by best demonstrating body of L3 & IV joint spaces above and below it?
collimated AP & lat L-spine
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if you must perform an L-spine on a pregnant female, what 3 things should a tech do?
- use higher kVp & lower mAs, 2. increase SID,3. coll. as much as possible
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neck of Scottie dog?
pars interarticularis
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what is the sm bone found btw the sup. & inf. articular processes?
pars interarticularis
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ear of scottie dog?
sup. articular process
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eye of scottie dog?
pedicle
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foot of scottie dog?
inf. articular process
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nose of scottie dog?
transverse process
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scottie dogs are only seen on what projections?
obl L-spine XRs
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what XRs best show the degree of movement at the fusion site (after a spinal fusion was performed at L3-4)?
lat hyperextension & hyperflexion
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why should a pt flex knees during an AP L-spine?
to reduce lordotic curve/straighten spine
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CR for AP L-spine?
perp to iliac crest
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what should tech do to prevent scatter from reaching IR on a lat L-spine?
pb mat behind pt
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what is shown on a lat L-spine?
IV foramina, IV joint/disk spaces of L-spine
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how much is a pt rotated for an obl L-spine?
45º
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what pos should you place a pt to see the L apophyseal joints of L-spine?
LPO
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how much rotation should you rotate pt to see the zygapophyseal joints at L1-2?
50º obl
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how much rotation should you rotate pt to see the zygapophyseal joints at L5-S1?
30º obl
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what pos demonstrates the R apophyseal joints of L-spine?
RPO
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how much body rotation is needed to best demonstrate the L3-4 zygapophyseal joints?
45º
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which ant obl L-spine XR will show the R apophyseal joints?
LAO
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CR for lat L5-S1 spot when pt has insufficient waist support?
5-8º caudad to 1.5” inf. iliac crest & 2” post. ASIS
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for a cone down view of L5-S1 in an AP projection, must angle CR?
30-35º cephalic
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S1-2 is located at the level of?
ASIS
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another term for sacral horn
cornu of sacrum
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term for sup. aspect of coccyx?
base
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an avg of ___ segments make up the adult coccyx
4
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CR for AP Axial Sacrum?
15º cephalic to midway btw pubic symphysis & ASIS
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CR for AP Axial Coccyx?
10º caudad to 2” sup. to pubic symphysis
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CR for lat Sacrum/Coccyx?
perp to 3-4” post. ASIS
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how many degrees do you int. rotate feet for AP pelvis?
15-20º (IF NO FRACTURE SUSPECTED)
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how much do you abduct femora from vertical on a bilat frog/modified cleaves for pelvis?
40-45º
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for the Lauenstein-Hickey method (for unilat hip) the pt is what?
rotated onto affected side until femur touches table and is II to IR
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Lauenstein-Hickey method for hip shows what?
foreshortened femoral neck, but shows head & acetabulum
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humeral epicondyles are _________ to IR for AP Int Shoulder
perp
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humeral epicondyles are __________ to IR for AP Ext Shoulder
II
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AP Int Shoulder shows what?
lesser tubercle in full profile (med)
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AP Ext Shoulder shows what?
greater tubercle in profile (lat)
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CR for AP Int/Ext Shoulder
perp 1” inf. coracoid process (which is 3/4” inf. to lat. portion of clavicle)
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Post Obl shoulder aka?
Grashey method
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Grashey method shows
glenoid cavity in profile; open scapulohumeral joint space
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on Grashey for shoulder, a person w a round/curved back needs ______ rotation to place body of scapula II to IR
more
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how much body rotation is needed for Grashey method?
35-45º towards affected side
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breathing technique for clavicle?
full inspiration (to raise clavicles out of lung field)
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CR for AP Axial clavicle?
15-30º cephalic to midclavicle
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thin pt’s need ___________ angle than thick pt’s for AP Axial clavicle
10-15º more
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what must pt do for positioning of AP scapula?
abduct arm 90º and supinate hand (salute)
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which landmarks are used for positioning go scapula “Y” lat?
sup. angle of scapula & AC joint (rotate until imaginary line btw is perp to IR)
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min weights used for AP AC joints w weights?
5-8 lbs
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what is done to project the AC joint sup. to acromion for optimal vis.?
Alexander method, CR 15º cephalic to midpoint btw AC joints
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What SID for AC joints?
72”
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breathing technique for AP scapula?
orthostatic breathing
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3 potential errors in skull positioning
- excessive neck flexion/extension2. head rotation/tilt3. incorrect CR angle
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how do you find the sella turcica?
3/4” ant. & 3/4” sup. to EAM
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sella turcica houses the?
pituitary gland
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neuro XRs use _____ focal spot
sm
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which XR puts the petrous ridges below the maxillary sinuses?
Parietoacanthial (Waters) method
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what must be done before performing SMV XRs?
rule out fractures/subluxation of C-spine
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pt enters ER w possible fracture of R zygomatic arch, what is the best XR routine?
SMV, bilat obl tangential, & AP Axial
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what line is II to IR for SMV of zygomatic arches?
IOML
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if pt cannot hyperextend neck enough for SMV, what should tech do?
make CR perp to IOML
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what is the pt pos for obl inferosuperior tangential zygomatic arch (Mays view)
(from SMV pos) pt must rotate & tilt 15º toward affected side
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CR for AP axial Towne zygomatic arch when IOML perp to IR
37º caudad to 1” sup. glabella (exiting level of gonion)
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what XR will show blowout & tripod fractures?
PA Waters
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pt enters ER and the doc is concerned about a blowout fracture of the L orbit. what 3 routine XRs will best demonstrate this injury?
modified parietoacanthial, 30º PA facial, & lat facial
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optic foramina are located w/in
sphenoid bone
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what XR best demonstrates orbital floors?
PA 30º Orbits or Modified Waters (just PA Caldwell is NOT a good answer)
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what XR puts petrous ridges in lower 1/2 of maxillary sinuses?
parietoacanthial (modified/shallow) waters
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what XR uses the 3pt landing?
parietoorbital obl optic foramina/Rhese method (chin, cheek, nose)
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the Rhese method projects the optic foramina in?
the lower outer quadrant
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TMJ XR’s are routinely done w?
mouth open & closed
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CR for axiolat TMJ (modified schuller)
25-30º caudad to 1/2” ant. & 2” sup. EAM
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CR for axiolat obl TMJ (modified law)
15º caudad to 1.5” sup. to EAM
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panorex of mandible requires pt’s chin adjusted so the _____ is II to the floor
IOML
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the _____________ of the mandible extends upward from the post. part of the ramus up to the adjacent joint
condyloid process
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the _____ is perp to IR during PA Axial Mandible
OML
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CR for PA Axial mandible
20-25º cephalic, exit acanthion
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CR for AP Axial (Towne) mandible when OML perp to IR
35º caudad to glabella
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the AP Axial (Towne) Mandible best demonstrates what portion of the mandible?
condyloid processes (bilat)
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CR for Axiolat Obl Mandible
25º cephalic from IPL to exit downside mandibular region
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30º rotation towards IR on axiolat obl mandible demonstrates?
body of mandible
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45º rotation towards IR on axiolat obl mandible demonstrates?
mentum
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10-15º rotation towards IR on axiolat obl mandible demonstrates?
general survey of mandible
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0º rotation towards IR on axiolat obl mandible demonstrates?
ramus
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the chin is extended in the axiolat obl mandible to?
free C-spine of superimposition of ramus
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which bones are assoc. w the inner canthus of the eye?
lacrimal
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what XR of sinuses does a trauma pt in a C-collar need to demonstrate blood/fluid levels?
horizontal beam lat
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what is the sm flap of cartilage that covers the ear opening?
tragus
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CR for lat facial?
perp to zygoma (midway btw outer canthus & EAM)
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OML is at how many degrees from IR on a parietoacanthial (waters) for facial?
37º
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what touches the upright bucky for a waters facial?
chin
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____ neck extension is required for a modified/shallow waters
less
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OML is at how many degrees from IR on a modified waters for facial?
55º
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which XR gives vest view of orbital floors?
Modified water facial
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CR for modified waters?
perp, exit acanthion
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CR for PA Axial (Caldwell) facial
15º caudad, exit nasion
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what must be done to the PA Caldwell facial to put petrous ridges below the IOM & demonstrate the orbital floors?
increase CR angle to 30º caudad, exit nasion
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which waters method demonstrates zygomatic arches?
parietoacanthial (waters) method
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tube that passes from the kidney to the urinary bladder
ureter
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which of the following is not found in the urinary system?(glomerulus, calyx, adrenal, nephron)
adrenal
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which kidney is usually always more inf.?
R kidney
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avg adult bladder can hold how much fluid?
350-500 mL
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when pt signs consent form, legally this means that once the consent has been signed, the pt
may still claim that they were not properly informed of the procedure risks
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when do you pull on the catheter to create pressure?
never
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when pt is vomiting, the pt’s head is lifted/turned to the side to prevent?
aspiration
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AP trendelenburg pos (for IVP/VCUG) enhances
pelvicalyceal filling
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routine IVPs are done w what breathing technique?
expiration
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what is a good example of a routine IVP?
scout KUB, nephrogram, AP KUB, RPO KUB, LPO KUB, & post void
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which procedure requires an injection of contrast media into a vein to vis. kidneys?
intravenous pyelography
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what must be included on the AP scout for an IVP/IVU?
pubic symphysis
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if a nephrogram taken during an IVU shows that the renal parenchyma is poorly visualized, but the calyces are contrast enhanced, what did the tech do?
exposure was not taken soon enough following contrast injection
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CR centering for nephrotomogram?
midway btw xiphoid process & iliac crest
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in tomography, the area of interest is at the same height as the?
fulcrum
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RPO for IVP puts which kidney in profile?
L
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an LPO taken during an IVU shows that the R kidney is foreshortened & superimposed on the spine, what should tech do?
decrease rotation
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during a retrograde cystogram, the contrast media is normally introduced by
gravity flow thru a catheter
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term for voiding under voluntary control
urination
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in an AP cysto, contrast fills
slowly by gravity - never by force
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(Cysto) what is needed to see the posterolateral aspect of the bladder, especially UV junction?
steeper obl (60º rotation)
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what pos do you place a male pt for a VCUG?
rotate into 30º RPO (superimpose urethra over R thigh)
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during a VCUG, pt is asked to void during XR to vis. the?
urethra
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gallbladder is located where?
RUQ
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what is peristalsis?
normal contractive waves of digestive system
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what term describes the formation of sacs/pouches in colon?
diverticulosis
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veriform appendix is attached to the
cecum
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the opening btw the esophagus & stomach
cardiac orifice
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what type of pt has a transverse stomach
hypersthenic
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CR for RAO UGI?
perp to L2/duodenal bulb (1-2” sup. to lower lat rib margin) midway btw spine & L/upside lat border of abdomen
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pt enters ER w possible perforated ulcer, what should be performed?
UGI w gastroview
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what is demonstrated on RAO for UGI?
BaSO4 filled duodenal bulb & c-loop in profile
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what pos is preferred for SBS?
prone KUB
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the supine KUB for SBS is centered where?
@ iliac crest
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KUB stands for
kidneys, ureters, & bladder
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how much BaSO4 is given to the pt for a SBS?
16 oz (2 cups)
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CR for AP scout for SBS
perp iliac crest
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PA SBS, after an hour, should be centered at
iliac crest
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the SBS is completed after?
contrast passes ileocecal valve
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enema tip for BE should be inserted into rectum on
suspended expiration
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if tech experiences resistance while inserting enema tip, the tech should
have radiologist insert tip using fluoro guidance
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what sign is frequently seen w carcinoma of the colon?
napkin ring/apple core sign
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LPO for BE shows which colic flexure?
R colic/hepatic flexure
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the lat rectum (BE) demonstrates what filled w contrast?
recto-sigmoid region
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if the pt is undergoing a double-contrast study, or just cannot be put in a recumbent lat pos, what should tech do instead?
ventral decubitis
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how much do you rotate a pt for an AP Axial Obl butterfly for BE?
30-40º LPO
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CR for AP Axial Obl Butterfly for BE?
30-40º cephalic to 2” inf. & 2” med. to R/upside ASIS
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why perform an AP Axial Obl Butterfly?
to demonstrate elongated rectosigmoid segments, w less superimposition
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what is the most diagnostic study for detecting possible diverticulosis?
double-contrast BE
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when performing a double-contrast BE, what must be done to the kVp?
reduce to 90-100 kVp
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if pt is having a mild adverse reaction to contrast, suffering from nausea, flushing, hyperventilation, & urticaria should be treated w
benadryl
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2 types of contrast media
ionic & non-ionic
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which contrast media is more expensive?
non-ionic
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which contrast has low osmolality, less chance of reaction, & the inability to dissociate into 2 separate ions?
non-ionic contrast
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which contrast agents may increase the severity of side effects?
ionic
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what is the correct course of action when a pt experiences a side effect of mild hot flashes, & some metallic taste during an injection?
reassure pt, contin. injection/XR, while carefully observing pt for possibly more severe reactions
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term for leakage of contrast media from a vein into surrounding tissue
extravasation
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recommended treatment for extravasation?
warm towel over injection site
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the rapid introduction of contrast agents into the vascular system
bolus injection
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moderate itching/sneezing, mild urticaria (hives) are
mild systemic reactions to contrast
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some metallic taste in mouth & temp. hot flashes occur
in many pt’s & is an expected outcome/side effect from the introduction of contrast media
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how long is it recommended to withhold metformin (glucophage, diabetes medication) following a contrast media procedure?
48 hrs
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primary purpose of the premedication procedure before an iodinated contrast study is?
to reduce the risk of a contrast media reaction
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what is often given before an IVU to reduce risk of a contrast media reaction?
prednisone (and benadryl)
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if a pt comes in for an IVU and the lab report indicates that a w/in normal range of creatinine and BUN levels, the tech should
proceed w study
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what should the tech do if the pt experiences a hot flash after the injection of an iodinated contrast?
comfort pt; this is a common side effect
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routine NT shoulder?
AP Int/Ext
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which shoulder needs pt rotated 45-60º?
Scapula Y view
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which XR puts greater tubercle in profile medially?
none
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acromion located on?
scapula
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clavicle articulates w?
sternum & scapula
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humeral head articulates w
glenoid cavity of scapula
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ant/post shoulder dislocations more common?
ant.
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which shoulder rotation puts humeral epicondyles perp to IR?
AP Int
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shoulder XR’s are centered to which landmark?
1” inf coracoid process
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which shoulder rotation provides a lat prox humerus?
AP Int
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what is in profile on AP Int shoulder?
lesser tubercle (medially)
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what is in profile on AP Ext shoulder?
greater tubercle (laterally)
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what shoulder pos is done when pt has suspected shoulder fracture?
AP neutral
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how much do you rotate pt for Grashey?
35-45º toward affected side
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CR for post obl shoulder/Grashey?
perp scapulohumeral joint (2” inf & med from superolat border of shoulder)
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which XR puts glenoid cavity in profile?
Grashey
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which XR shows open scapulohumeral joint space?
Grashey/post obl shoulder
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how much do you rotate a pt to get glenoid fossa in profile?
45º to affected side
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2 pos/XRs for routine clavicle?
AP & AP 15º cephalic
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arm pit aka
axilla
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0º AP & AP Axial w 15-30º cephalic angle are ___________ clavicle XRs
routine/common
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med. end of clavicle
sternal extrem.
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pt enters ER w possible fracture of mid wing area of scapula. pt can stand. in addition to routine AP scapula w arm abducted, what should be done to show this area?
have pt drop affected arm behind them for lat scapula
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pt enters ER w multiple injuries. dr. concerned about dislocation of prox humerus. pt cannot stand. what is best routine?
AP shoulder (neutral) & Neer method
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pt enters ER w dislocated shoulder. tech attempts to pos. pt in transthoracic lat but unable to raise unaffected arm completely over head; tech should?
angle CR 10-15º cephalic
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XR of ant obl scapular Y shows scapula slightly rotated; vertebral & axillary borders are not superimposed, axillary border is more lat than vertebral border; tech should?
increase rotation
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pt comes in for treatment of arthritic R shoulder; pt can’t abduct arm enough for axiolat of scapulohumeral joint. what other XR will best show scapulohumeral joint?
Scapula Y
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pt enters ER w possible R AC joint separation; R clavicle and AC joint exams are ordered. clavicle shows sm linear fracture; tech should?
consult w dr. before continuing w AC joint study
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what other XR can be performed if separation of AC joint is suspected?
AP 15º cephalic (Alexander method)
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CR AP Axial clavicle?
15-30º cephalic to midclavicle
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if AP Axial clavicle shows clavicle w/in mid aspect of lung apices, tech should
increase cephalic CR
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what angle joins the med & lat borders of scapula?
inf angle
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scapula articulates w?
clavicle & humerus
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coracoid process is the most ____ part of scapula
ant
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how should pt pos arm for AP scapula?
abduct 90º & supinate hand
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what type of obl is a lat scapula Y?
ant obl (pt PA)
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which landmarks are palpated for lat scapula Y?
sup scapula angle & AC joint
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how many degrees do you rotate pt for lat scapula Y?
45-60º
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CR for lat scapula Y?
perp to midvertebral border (or med border) of scapula
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the scapular spine is _____ to IR in a lat scapula Y
perp
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which XR provides a true lat of scapula & scapulohumeral joint?
lat scapula Y
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SID for AC joints?
72”
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CR for AC joints?
perp to 1” sup to jugular notch
