Procedures Kettering Audio Flashcards
What does the term Decubitus mean?
Lying down with a horizontal beam
The elbow is ________ in relationship to the wrist.
Proximal
The wrist is _________ in relationship to the elbow
Distal
Sthenic Body Habitus
Average Body Habitus
Where can you find the stomach on a hypersthenic patient? How do you place the cassette to capture?
The stomach is higher, more transverse, more lateral
-Landscape Cassette
On a hypo and asthenic body habitus where is the stomach located?
Lower, more midline, more J shape
-Place the Cassette Portrait
Axial Skeleton Definition:
A portion of the skeleton toward the center or midline of the body. (Skull all the way down through Coccyx)
Appendicular Skeleton Definition:
Upper and Lower Extremities, shoulder and pelvic girdles
Anatomical Position Definition:
Standing erect, palms facing forward, looking straight ahead
In the hand the first digit is ________.
Thumb
More lateral
What is the medial bone of the lower leg?
Tibia
What is the Lateral bone of the lower leg?
Fibula
The medial bone of the forearm is:
The Ulna
The lateral bone of the forearm is:
Radius
Radiographic View Definition:
The body part as seen by the image receptor or other recording medium.
Radiographic Position Definition:
A specific body position or part that’s nearest to the IR
singular surface in contact
Radiographic Projection Definition:
Refers to the path of the CR/path of x-ray beam travel
If you are lying down on your back the position would be?
Supine Position
OR
Posterior Position
If you are standing with your back against the IR (chest stand) the position is:
Erect/Upright Position
If you are standing facing the tube the position is:
Erect/Upright Position
OR
Posterior Position
If the patient is supine the projection is:
AP projection
The path of the x-ray beam travel
Radiographic Projection
In a routine PA chest x-ray the PA stands for:
Posterior-Anterior
Posteroanterior
PA projection definition:
Enters the posterior surface and exits the anterior surface
Supine definition:
Lying down flat on back
If you are in the RPO Position you will also be in the:
Ap oblique projection
What is this image best demonstrating?
Flexion View of the L-Spine L4/L5 Spondylotisthesis (patient leaning forward)
ASIS location:
level of S1
Located at the C4-5 interspace
Thyroid Cartilage
Sternal angle located at the:
Level of T4-5
Sternal Notch is located:
level of T2, T3
Inferior angle of the scapula for a PA chest x-ray is located at the level of:
T7 (PA Projection of the chest)
Tip of the xiphoid process located:
At the level of T10 or T9-10 interspace
The umbilicus located at the level of:
L3-4 interspace of the lumbar spine
The iliac crest located:
At the level of L4-L5
The greater trochanter located:
same level of symphysis pubis
What is the same level of the symphysis pubis?
Greater trochanter
For a Lateral C-spine what are you seeing?
zygopophyseal joints superimposed (no intervertebral foramina)
a. Left Posterior Oblique Position
b. Left Anterior Oblique Position
c. Right Anterior Oblique Position
d. Right Posterior Oblique Position
24/7 36/5 immobilization devices that the technologist can use:
Sand bags, compression bands, sponges, draw sheets, adhesive tape, pig-O-stat.
Devices or custom built devices are commonly used for pediatric or limited population departments
“Pig-O-stat”
Glabellomeatal line (GML)
Orbitomeatal line (OML)
Infraorbitomeatal line (IOML)
Acanthiomeatal line (AML)
Lipsmeatal line (LML)
Mentomeatal line (MML)
External Acoustic Meatus (EAM)
The patient had his or her hands taped against their will:
Illegal restraint
The only person that can order a restraint device is the:
Physician
You can lose your license if you do so
As a technologist if you choose to angle the tube 30 degrees caudally for an AP Axial projection of the skull, then we position the:
OML Perpendicular
As a technologist if you choose to angle the tube 37 degrees caudally for the AP Axial Projection of the skull then we position the:
IOML perpendicular
A patient has trauma to the anterior surface of the ribs. What you should do as a technologist?
Put them in a PA Projection and put the surface in contact with the IR
If you want to demonstrate the best detail of the clavicle:
Put them in the PA Projection
Which of the following projections should a longitudinal arch of the foot be preformed routinely?
Lateromedial Projection
If I patient has a sinus headache what should you do as a technologist?
Ask them “patient what side are you hurting on, left side pain left side against”
When you preform an AP Axial Projection of what bone of the skull is in contact with the IR?
Occipital Bone
OR
Occipital Position
If you as a technologist are doing the AP Axial Projection 30 or 37 degrees of the skull what is the point of demonstration/criteria/purpose?
Project Dorsum cella and posterior clinoids directly through the foramen magnum
If the patient is lying down on their left ear the MSP is:
Parallel to the IR
Or
Parallel to the table
If the patient is lying down on their left ear the IP is:
Perpendicular
For a lateral projection of the skull the CR enters:
Perpendicular to the IR
5cm Superior to the EAM
2 inches x 2.5= 5 cm
1inch= 2.5 cm
PA Axial Projection of the skull CR:
(caldwell) 15 degrees caudad to exit the nasion
MSP and OML perpendicular to the IR
Where can you find the Petrous ridges in the PA Axial Projection?
Lower 1/3 of the orbits
Where can you find the Petrous ridges in the PA Projection of the skull?
Completely fill the orbits
On the PA projection what is in contact with the IR?
Nose and Forehead
OML perpendicular
SMV (full basal) line ______ to the IR:
IOML parallel to the IR
CR is perpendicular
A patient is elderly and cannot lean head all the way back, what do you do?
Unspecified Cephalic angle of the tube
Relationship between the IOML and the IR for SMV:
Parallel
Not flexible patient, the relationship between the CR is always __________ to what baseline of the SMV?
Perpendicular to the IOML
The IOML is positioned if flexible:
Parallel to the CR
THE CR IS _______ to what baseline (not flexible)
Perpendicular to the IOML
For the Lateral Skull the MSP is:
Parallel to the IR
For the Lateral skull the IPL is:
Perpendicular to the IR
The CR for a Lateral Skull:
Perpendicular to the IR to a point 5cm superior to the EAM
Facial bone views should be done _____ whenever possible to demonstrate air fluid levels.
Upright
Lateral Facial Bone CR enters:
halfway between the outercanthus and the EAM at the zygoma
Parietocanthial Projection (facial bones) :
MSP and MML perpendicular to IR
(neck is hyperextended so the OML forms a 37 degree with the IR)
How many degrees does the OML baseline form with the plane of the IR in the parietocanthial projection?
37 degrees*
PA Axial Caldwell:
15 degrees caudal to exit the nasion*
Parietocanthial projection CR exits:
Acanthion*
Where can you find the petrous ridges in the Parietocanthial projection?
The floor to the maxillary sinuses
(Completely below)
Inferior to the maxillary sinuses
PA modified Parietocanthial baseline:
OML forms a 55 degree angle with the plane of the IR*
What is the blow out fracture?
Fracture of the inferior orbital rim
Which of the following procedures will best demonstrate the blow out fracture of the orbit? Inferior orbital rim fracture.
Modified Parietocanthial projection*
What structures/anatomy make up a blowout fracture (fracture of inferior orbital rim)?
Zygomatic Arch
Zygoma
Maxilla
Palatine
Axio-lateral oblique (closed mouth)
Identify the image:
Lateral Flexion View of C-Spine
Identify the image:
Lateral Extension View of the C-Spine.
Identify the Image
External Oblique of the Elbow
Identify the Image
Internal Oblique of the Elbow
For the temporomandibular Joints the CR is angled:
25 degrees cephalic total angle
What is the CR for the axiolaterial oblique mandible?
CR directed 25 degrees Cephalic through the mandibular ramus closest to the IR.
As an operator if you place the patients head in a true lateral position tempomandibular joints then the point of demonstration of the mandible is:
Ramus
If you rotate the patient 30 degrees toward the IR the point of demonstration for the mandible is?
The body
If you rotate the face 45 degrees toward the IR (mandible) the point of demonstration is:
Mental Point (symphysis)
TMJ (Temporalmandibular Joints) routine should always be done:
With both open and closed mouth views
The Parietocanthial projection will demonstrate:
the Nasal Septum
The lateral nasal bone is to be done:
Table top
Bilateral for comparison
MSP parallel
IP perpendicular
CR 3/4 inch (2cm) below the nasion
Image on the left:
Image on the right:
Left: AP
Right: PA
(orbit size is larger because of OID)
Lateral Skull
Looking at the sella turcica (saddle)
2 inches above EAM
When would you use cross table lateral? Truama
PA Haas Method
OR
Reverse Townes
Helpful for Kyphotic Patients
The lateral facial bone projection shows:
Nasal Bone
How many septum’s do you have and nasal bones?
Right and left septum and one nasal bone
Paranasal Sinuses are to be done in what position?
Erect or Upright Position
What is the purpose of performing paranasal sinuses in the erect position?
Show air fluid levels
How many vertebrae are in this lateral c-spine?
7 (if you do not see the T1 articulation) what do you do next? lateral cervical projection
The only time you can demonstrate all four sets of sinuses at one time is through the:
Lateral paranasal sinuses projection
PA Axial projection for paranasal sinuses best demonstrates:
Frontal and anterior ethmoid sinuses
The PA Axial Projection, what sinuses are best demonstrated?
Frontal and anterior ethmoids
On the Parietocanthial projection what sinuses are best demonstrated?
The maxillary sinuses demonstrated free of superimposition
When preforming the open mouth perietocanthial what sinus is projected through the open mouth?
Sphenoid is demonstrated directly through the open mouth
The CR for the AP Axial Cervical Spine:
CR is angled 15-20 degrees Cephalic to the level of C4
40 inch SID
What is the purpose of the angular ion of the tube for the AP axial Cervical Spine?
Help open up the intervertebral disk spaces (joint spaces)
15-20 degrees Cephalic angulation on the Axial C-Spine, what is its purpose?
To open up the intervertebral joint spaces
What demonstrates the C1-2 relationship? (Pivot head back and forth)?
AP Open Mouth (Odontoid)
With the mouth wide open the occlusal plane is:
Perpendicular
Define occlusal plane:
Imaginary line drawn from the upper incisors (the biting surface of the teeth) to the tip of the mastoid or base of the skull
The occlusal plane is:
Perpendicular
If the base of the skull are superimposed on the AP open Mouth (odontoid) how do you fix it?
Place the chin closest to the chest (flexion) flex the head and neck
If you look at an examination and you see that the teeth are superimposing the odontoid process? How do you fix it?
Extend the head and neck. Raise the chin up (extension)
What do you do to the head and neck to fix this?
Extend the head and neck
How do you fix this?
Flex the head and neck
If you see the base of the skull is superimposed on top of the odontoid process:
Flex the head and neck
If you see the teeth are superimposed on top of the odontoid process:
Extend the head and neck
Lateral C-Spine SID:
Performed with 180 cm
Counteracts magnification, decrease OID
Can you count on a lateral C-Spine (C8) articulation. If you count and are missing the T-1 articulation (C-8). What do you do next?
Lateral cervical thoracic projection. Look to use hand weights to relax the shoulders and pull down in order to see the area.
If a patient comes in immobilized on a spine board as a technologist what are we going to do?
Horizontal beam lateral
Properly get it cleared by the attending physician
Anterior obliques positions (back to the c-ray tube) of the cervical spine best demonstrates the:
Intervertebral foramina closest to the IR
If the patient is facing the x-ray tube for a Anterior oblique cervical spine angle the tube:
15-20 degrees cuadad directed to the level of C4
-angle down, face down, side down
If the patient is in a Posterior oblique position for the cervical spine, what angle is the tube?
15-20 degrees cephalad to the level of C4
Face up, angle up, side up
Posterior Obliques of the cervical spine best demonstrates:
The foramina farthest from the IR
AP and PA Axial Obliques of the C-Spine best demonstrates:
The intervertebral foramina
If the patient is in a posterior oblique position (AP oblique projection) (when the patient is facing the tube) of the cervical spine. What angle?
15-20 caudad CR directed to the level of C4
BEST DEMONSTRATES UPSIDE
If the patients back is to the x-ray tube for a cervical spine, (anterior oblique position) what angle?
15-20 Cephalic angle
BEST DEMONSTRATES DOWN SIDE
When you do obliques of the spine C,T,L:
C best demonstrates: intervertebral foramina furthest to the IR
T best demonstrates zygo furthest to the IR
L best demonstrates zygo closest to the IR
When the patient is in the RPO Position facing the tube for the cervical spine best demonstrates:
Intervertebral foramina that is furthest from the IR
When the patient is in the RPO Position facing the x ray tube, the T-Spine best demonstrates:
The zygo furthest from the IR
In an RPO of the lumbar spine you best demonstrate:
Zygo closest to the IR
FFC (Fresh fried chicken)
Furthest furthest closest
When the patient had their back to the x-ray tube:
Anterior oblique position
PA oblique projection
On the anterior oblique positions PA oblique projections you best demonstrate:
Closest intervertebral foramina of the cervical spine
Closest zygo in the thoracic spine
Furthest zygo in the lumbar spine
(CRISPY CRUNCHY FRIES) CCF
When the patient is facing the tube what do we use?
Fresh fried chicken
When the patients back is to the tube:
CCF CRISPY CRUNCHY FRIES
Whose arm is up on the swimmers?
The arm closest to the IR
Which arm is down on the swimmers?
The arm closest to the tube
What is best demonstrated on the lateral swimmers?
Shows the cervical thoracic area or region
For the AP thoracic spine the CR:
Directed perpendicular to the IR to the level of T7 (inferior angle of the scapula)
Who’s part of the tube should be placed over the upper portion of the T-Spine?
Anode
What part of the tube should be placed over the lower part of the T-Spine?
Cathode
Lateral breathing and lateral expiration of the T-Spine CR:
Perpendicular to the IR at the level of T7
Which of the following examinations would require the use of a breathing technique?
- Lateral T-Spine
- AP projection of the Scapula
- Transthoracic lateral for the proximal humerus and shoulder (Lawrence method)
- Soft tissue neck
How do you reduce the ESE to the vitally sensitive organs?
Put them in the PA projection, turn the back to the beam
Definition of Scoliosis:
Abnormal lateral or side to side curvature of the spine
When the patient flexed the knees, what is the purpose?
- Reduce the normal lordotic curvature
- open up the joint (intervertebral) spaces
The CR for the lumbar spine?
Transversely at the top of the iliac crest (L4-L5) interspace
(Biggest cassette)
The CR for a lumbar spine if downsize the cassette?
Transversely 2.5 cm above the crest
The lumbar spine best demonstrates:
The heights of the lumbar vertebral bodies and intervertebral disk spaces
Definition of spondylotisthesis:
Forward displacement of one vertebra on top of another vertebra
Which of the following will best demonstrate the presence of spondylotisthesis?
L5-S1 Spot
Lateral
On an average male angle the tube: (L5-S1 spot lateral)
3-5 degrees caudally
On an average female (L5-S1 Spot) angle the tube:
5-8 degrees caudally
When the patient is on the back AP oblique projection lumbar spine (posterior oblique position) best demonstrates?
Zygopophyseal closest to the IR
The only time you can see a Scotty dog is through the?
Oblique of the lumbar spine
Pedicle of the Scotty dog:
Eye
Superior articular process of the Scotty dog?
Ear
The transverse process of the Scotty dog is the:
Nose
The neck of the Scotty dog is called the:
Pars Interacticularis
The front foot of the Scotty dog is:
The inferior articulating process
The back foot of the Scotty dog?
Inferior articular process of the opposite side
label D
Pedical
A?
Superior
Articular
Process
E?
Transverse Process
B?
zygapophyseal Joint
C?
Pars Interarticularis
The body of the Scotty dog?
Lamina and spinous process
The tail of the Scotty dog is the:
Superior articular process of the other side
The patient is lying on their back in an AP Axial Projection of the sacrum what is the angle of the tube?
15 degrees Cephalic alone the MSP to a point midway between the ASIS and symphysis pubis
When the patient is prone for an AP axial projection of the sacrum what is the angle of the tube?
CR is 15 Caudual along the MSP to a point midway between the ASIS and the symphysis pubis
The patient is lying on their back for the AP Axial coccyx what is the CR?
CR is angled 10 degrees caudad along the MSP to a point 5cm (2 inch) superior to the symphysis pubis
If the patient is prone for the AP axial coccyx what is the CR?
CR angled 10 degrees Cephalic along the MSP to a point 2 inches or (5 cm) superior to the symphysis pubis
What is a myeologram?
Sterile procedure done under fluoroscopic conditions
Where do you inject for a myeologram?
Contrast media is administered via spinal puncture into the subarachnoid space (intrathecal injection)
What does intrathecally refer to?
within the spinal canal
For a myelogram the preferred site of spinal puncture is:
L3-4 interspace
Primary pathology for myelogram is HNP stands for
herniated nucleus pulposus
Conus medullaris
lower border of L1 must inject lower than this level
Water soluble contrast is deposited into the:
Subarachnoid space
Primary purpose of performing a myelography is:
HNP (herniated nucleus pulpous)
Slipped disk
Sacroiliac Joints. When the patient is placed in a 25-30 degree posterior oblique position the CR:
1 inch (2.5 cm) medial to the upside ASIS
1 inch medial to ASIS
SI joint
Myelogram. Never inject into the body inject:
Below L1
When the patient is placed in a 25-30 posterior oblique. The CR will enter 1 inch medial to the upside ASIS, best demonstrated is the:
SI joint farthest from the IR
A patient is in an 25-30 degree anterior oblique and the CR is entering 1 inch medial to the ASIS, what is it best demonstrating?
The SI joint closest to the IR
The CR for an AP hip:
Perpendicular to the IR 6 cm distal to the midpoint of the line drawn between the symphysis pubis and the ASIS
For the AP hip the leg is rotated:
Internally 15 degrees
You have done the AP hip no obvious fracture is indentified, move on to the frog leg lateral? How many degrees from vertical is the leg abducted?
40-45 from vertical
You have done the AP hip, there is an obvious fracture and dislocation identified. Which of the following will take the place of the frog leg lateral?
Danelius-Miller Method
Cross table lateral hip
On a cross table lateral (horizontal beam) the CR is:
Perpendicular to the femoral neck and IR
The patient is lying on their back, the unaffected leg is up and out of the way, and you are shooting through the x-ray tube,neck, IR
Parallel
But the CR is perpendicular to the femoral neck
A patient presents with a bilateral hip fracture, what do you do?
Axiolateral Inferosuperior trauma (Clement’s-Nakayama)
Patient lies supine with lower limbs in neutral position
What is the axiolateral inferosuperior (Clements-Nakayama) preformed for?
Bilateral hip fractures
innominate bone consists of:
Ilium iscium pubis
Right innominate bone and Left innominate bone
What part of the innominate bone is formed by all three innominate bones ilium, ischium, and pubis?
Acetabulum