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Registry Prep > Rad POS review > Flashcards

Rad POS review Flashcards

1
Q

Which two types of fractures are most commonly seen in victims of child abuse?

A

Bucket & Corner fx

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2
Q

What is necrotizing enterocolitis (NEC)?

A

condition causes the intestinal tissue to die

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3
Q

What is the life-threatening condition that occurs when the intestines fold into itself?

A

intussusception

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3
Q

What position of the abdomen is recommended for demonstrating the prevertebral region of the abdomen?

A

Dorsal Decubitus

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4
Q

what is atresia?

A

a medical condition where a body part that tubular in shape and either closed or doesn’t have a normal opening

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5
Q

What must you never do when using tape on a pediatric patient?

A

stick the adhesive side to the patient
(could have an undiagnosed allergy to adhesives)

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6
Q

what set of images would best demonstrate Croup?

A

AP + Lateral soft tissue neck

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6
Q

what is a weighted device used to assist in positioning?

A

sandbag

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7
Q

What is the primary technical factor to eliminate motion for pediatric patients?

A

shorten exposure time

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7
Q

What is pyloric stenosis?

A

rare condition affects the pylorus and muscular opening between the stomach and the small intestine in babies

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8
Q

For a patient with osteogenesis imperfecta how would you properly adjust your technique?
What is this?

A

decrease technique
a condition where bones easily break

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9
Q

What genetic disorder that causes bones to break easily?

A

osteogenesis imperfecta

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9
Q

What is the name of the flat radiolucent device with straps that assists with supine imaging?

A

Tam-em board

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10
Q

what is a common birth defect that causes one or both feet to turn inward and downward?

A

talipes equinovarus

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10
Q

What us the CR for a KUB of an infant?

A

1” superior to umbilicus

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11
Q

What is the mummifying technique?

A

technique that helps to immobilize the child’s arms
(by wrapping patient up in a towel)

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12
Q

what is the rare birth defect that occurs when the nerves in the lower part of the intestine don’t develop properly?

A

Hirschsprung’s disease

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13
Q

which modality would help to diagnose congenital hip dislocations in newborns?

A

sonography (US)

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13
Q

what is the technical term for newborn?

A

neonate

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14
Q

what is the device used to image a child in upright/erect position?
What exams are these for?

A

pigg-o-stat
erect abdomen + chest

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15
Q

By the age of ______ a child can be spoken to and they can follow instructions

A

2-3 years old

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16
Q

what position is performed to look at both hip joints in a lateral perspective?

A

bilateral frogs
(included as much as possible in one image)

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17
Q

what exam or position is performed to determine if a child has stopped growing?

A

bone age survey
(one x-ray of the left hand)

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18
Q

what is a disorder of abnormal development resulting in dysplasia, subluxation, and possible subluxation of hip secondary to capsular laxity and mechanical instability?

A

DDH
(developmental dysplasia of the hip)

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19
Q

what is croup?
How is it diagnosed?

A

infection in the upper airway which becomes more narrow and making it hard to breathe
AP + Lat soft neck tissue

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20
Q

What is intussusception?

A

telescoping of the bowel causing life threatening folds in the stomach

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21
Q

What is RDS?
what exam would we perform for this?

A

respiratory distress syndrome
chest x-ray

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22
Q

What is the older term for child abuse?
What is the new & more acceptable term?

A

Battered child syndrome
suspected non- accidental trauma (SNAT)

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23
Q

What is osteogenesis imperfecta?
what happens to technique?

A

bones that easily break
decreases

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24
Q

What is RSV?

A

Respiratory syncytial virus
Common virus that affects most infants by age 2 & mimics symptoms of a cold
(Cough + running nose)

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25
Q

What is cystic fibrosis?

A

inherited disease which causes heavy mucus or clogging in the bronchi
hyperinflation of lungs from blocked airways
(shows up on x-rays as radiopaque & not obvious at birth but are more obvious later on)

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26
Q

What is Croup?
how is diagnosed (what exams)?
how is it treated?

A

caused by viral infection
causes labored breathing & harsh dry cough along with fever
AP & Lat soft neck tissue x-rays
antibiotics

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27
Q

What is the space between the primary and secondary growth center is called?

A

epiphyseal plate

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28
Q

hat are the different abdomen positions?
why are these used?

A

Lat Decub + erect abdomen (to evaluate air-fluid levels)
Dorsal decub (to see pre-vertebral region of the abdomen)
Supine abdomen (regular KUB)

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29
Q

what demonstrates the pre-vertebral region of the abdomen?

A

dorsal decubitus

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30
Q

What are these?
SCA:
SNAT:
PIT:
BCS:

A

suspected child abuse
suspected non-accidental trauma
pediatric intentional trauma
battered child syndrome (old name)

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31
Q

what is the kVp range for PA + lateral chest x-rays?

A

70-80 kVp or 75 to 85 (D)
75-80 or 80-85 kVp (D)

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32
Q

what are the restraining devices used?

A

sandbag
pigg-o-stat

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32
Q

What aids motion in pediatric exams?

A

short exposure time

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33
Q

how are hip dislocations identified in newborns?

A

ultrasound (sonography)

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34
Q

What modality would we use to diagnose for ADHD & evaluate for suspected tumors?

A

MRI

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35
Q

what is the CR for KUB?
Chest?

A

1” above umbilicus
Mammillary line

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36
Q

What is the hip protocol for pediatric patients?

A

if it is paired with other imaging complete in one exposure to reduce radiation exposure (ALARA)

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37
Q

what is a neonate?

A

technical term for newborns

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38
Q

how should tape be applied to pediatric patients?

A

adhesive side not touching patient
(could have an undiagnosed allergy)

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39
Q

What are Pigg-O-stats?

A

immobilization technique for erect abdomen & chest for infant up to age 5

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40
Q

What are the six categories of child abuse?

A

neglect
physical abuse
sexual abuse
psychological maltreatment
medical neglect
other

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41
Q

What is radiation protection for child?
what is optimal regarding exposures and imaging?

A

Gonadal shielding
if there are exams including wrist and forearm complete in one exam
(hip to ankle)

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42
Q

what is the CML fx?
what is another name for this?

A

classic metaphyseal lesion
fx along the metaphysis that results in tearing or avulsion fx
can be also called corner fracture

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42
Q

What positioning aid can we use for erect abdomens?

A

pigg-o-stat

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43
Q

What is subluxation?
what is an example of this?

A

a partial dislocation
nursemaids jerked elbow

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43
Q

What is apposition?
what are the types?

A

how fragmented ends of the bone make contact with each other
anatomic apposition (normal, end-to-end contact)
lack of apposition (distraction, end of fragments are alligned but don’t make contact with each other)
bayonet apposition (fx fragments overlap and shafts make contact but not the fx ends)

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44
Q

What is a contusion?

A

bruise injury
(possible avulsion fx)

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45
Q

What is a fracture?

A

a break or altering of the bone

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46
Q

What is a sprain?

A

forced wrenching/twisting of a joint (damages ligament without dislocation)

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46
Q

What is varus?
What is valgus?

A

valgus is away from the mid-line (lateral)
Varus is toward from mid-line (medial)

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47
Q

What is a greenstick fracture?

A

fx is on one side only

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47
Q

What is a closed fx?
also known as?

A

fx with bone not though the skin
simple fx

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48
Q

What is a complete fx?
what are the 3 types of fx?

A

fx is complete, broken into two pieces
transverse fx (transverse fx near the right angle to long axis)
oblique fx (fx passes through bone at oblique angle)
spiral fx (bone is twisted, fx spirals around long axis)

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49
Q

what is a smiths fx?

A

fx of the wrist with distal radius displaced anteriorly, with radius & ulna posteriorly

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49
Q

What is a comminuted fracture?
what are the types?

A

bone is splintered/crushed causing it to be in two or more fragments
segmental fx: (bone broken into 3 pieces, middle fragment fx at both ends)
butterfly fx: two fragments on each side of the main, wedged shape resemblance to butterfly)
splintered fx: splintered into thin sharp fragments

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50
Q

what is a colles fx?

A

distal radius is displaced posteriorly, with radius & ulna anteriorly

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51
Q

What is compound fracture?
also known as?

A

portion of bone (fx) is piercing through the skin
open fx

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52
Q

What is a stellate fx?
most commonly seen?

A

fx lines radiate from central point of injury that resembles a star-like pattern
(ex: most commonly seen in the patella, after knees hitting the dashboard in an accident)

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53
Q

What is a pott’s fx?

A

complete fx of distal tib/fib
(major injury to ankle + ligament damage)
(commonly seen in medial malleolus/distal tibia)

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54
Q

what is a boxer’s fx?

A

fx of distal 5th metacarpal
(fx comes from punching)

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55
Q

What is an impacted fx?
most common in?

A

one fragment is firmly driven into the other
(most common in femurs, humerus, & radius)

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56
Q

What is a jefferson fx?
aka?
how does this happen?

A

comminuted fx of anterior/posterior arches of C1
seen from landing on the head
(skull slams into the ring)

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57
Q

what is the minimum distance you should be away from exposing on portable x-ray?

A

6 feet

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58
Q

what is a hangman’s fx?

A

fx occurs in pedicles of C2 or with/without displacement of C2/C3

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59
Q

what is a compression fx?

A

vertebral fx from compression injury
(vertebral body collapses or compresses)

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60
Q

why do we prefer AP over PA view of the thumb?

A

for OID

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61
Q

what is the CR for a portable chest?

A

AP: 3-4 inches inferior to jugular notch (T7)
3-5 caudad
CR perpendicular to the long axis of the sternum

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61
Q

If a patient has a dislocated shoulder, unable to sit erect or stand what view should we do to replace a lateral?

A

supine, transthoracic
(usually will have to break it up into a distal and proximal because of tissue)

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62
Q

What is asepsis?

A

practice of removing/minimizing infectious agents in surgical environment (surgical asepsis)

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63
Q

What are the roles of the CST?
What does it stand for?

A

prepares with OR + supplying appropriate supplies and instruments
(prepping patient for surgery, connect surgical equipment, maintain a sterile field)

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64
Q

what is spiral fracture?

A

bone is twisted apart & fx spirals around the long axis

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65
Q

when using fluro & boost fluro it is important to use:
Why?
How does image look?

A

intermittent fluro (pulse fluro)
bc less patient dose
less crisp

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66
Q

What does ORIF stand for?
What is it?

A

open reduction with internal fixation
fx site is exposed to a variety of screws, plates, & rods inserted to maintain alignment

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67
Q

What is the normal range for creatinine levels?

A

0.6 to 1.5 mg/dL

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67
Q

What is the average levels for BUN?

A

8-25mg per 100 ml

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68
Q

What medication do you hold for urinary & intravenous procedures?

A

Metformin 48 hours before or after administration of iodinated contrast
(other combinations): glucovance, metaglip, jentadueto, ActoPlus Met, Prandimet, Avandamet)
(other brands: glucophage, fortamet, glumetza, & Riomet)

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68
Q

What is micturition?

A

the act of voiding or urination

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69
Q

What is incontinence?

A

involuntary passage (leakage) of urine through the urethra
(failure to control vesical and urethral sphincters)

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69
Q

What is retention?

A

inability to void: bladder unable to empty
(obstruction in the urethra or lack of sensation to urinate)

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70
Q

What exams/studies would you need to premedicate for?
What medications?
What are examples of procedures?

A

patients with history of hay fever, asthma, or food allergies
antihistamines (Benadryl) + prednisone 12 or more hours prior to procedure
IVU

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70
Q

What position would you use for voiding cystograms?
What are the procedure steps?
What supplies do you need?

A

supine or erect (makes voiding easier) (women)
30 degree RPO (male, best shown bc of anatomy)

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71
Q

what drugs would you use to reduce a reaction?

A

prednisone & Benadryl

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72
Q

What are mild reaction symptoms?

A

non allergic reactions:
anxiety
lightheadedness
nausea
vomiting
metallic taste (common side effect)
mild erythema
warm flush (common side effect)
itching
mid scattered hives

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73
Q

what is an IVU?

A

excretory urography
IV injection with contrast through superficial vein in arm

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73
Q

What is a retrograde urography study?

A

injection through ureteral catheter by urologist as a surgical procedure

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74
Q

What is a retrograde cystography?

A

contrast flowing to bladder through urethral catheter pushed by gravity

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74
Q

what is a voiding cystourethrography?
what is the positioning?

A

contrast flowing to from urethral catheter to bladder & withdrawal of catheter for voiding imaging
women: supine (lithotomy) or erect AP
men: 30 degree RPO

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74
Q

what is a retrograde urethrography study?
(RUG)

A

for males
retrograde injection through Brodney clamp or special catheter

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75
Q

What are moderate reaction symptoms?

A

true allergic reactions (anaphylactic):
urticaria
possible laryngeal swelling
bronchospasm
angioedema
hypotension
tachycardia >100 beats/min
bradycardia >60 beats/min

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76
Q

what are severe reaction symptoms?

A

vasovagal (life-threatening reaction):
hypotension (systolic <80)
bradycardia (<50 beats/min)
cardiac arrhythmias
laryngeal swelling
possible convulsions
cardiac arrest
respiratory arrest
no detectable pulse

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77
Q

What is an HSG?
What is it looking for?

A

contrast study of the uterus to assess the function

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77
Q

Which kidney sits lower than the other?
Why?

A

right sits more inferior to the left kidney
bc of the presence of the liver

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78
Q

What are the functions of the kidneys?

A

filter blood & remove waste through urine

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79
Q

What are the reasons for using a uterus compression study?
Where do you place the compression device? (what level)

A

enhance filling of pelvicalyceal system/proximal ureters & allows renal collecting system to retain the contrast medium longer
(at ASIS) inflated paddles over outer pelvic brim

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79
Q

How do you position for an IVU?
What is the prep?

A

Scout: supine (AP) CR is iliac crest
5 min: Supine (AP) (KUB) CR is iliac crest
10-15 min: supine (AP +KUB) CR is iliac crest
20 min: 30 degree LPO/RPO (ureters away from spine) CR is iliac crest
postvoid: prone or erect AP (include bladder)
Prep:
light evening meal before procedure
bowel-cleansing laxative
NPO after midnight
enema on morning of exam

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80
Q

What is an essential component of the kidney?

A

nephrons

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80
Q

What is a retrograde study?
What is an excretory study?

A

contrast through catheter (retro=backwards)
contrast through the vein (intravenous) (forward)

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80
Q

What organs make up the urinary system?

A

two kidneys
two ureters
one urinary bladder
one urethra

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81
Q

Where do the suprarenal glands lie in relation to the urinary system?

A

superior and medial to each kidney
(important glands of the endocrine system located in fatty capsule that surrounds each kidney)

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82
Q

What position do we need to place the patient in to get the kidneys parallel to the IR?

A

30 degree LPO/RPO
(30 LPO places right kidney parallel)
(30 RPO places left kidney parallel)

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83
Q

What is the name of the functional study of the bladder and urethra?

A

voiding cystourethrography (VCU)

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84
Q

What study measures the functional aspects of the urinary system?

A

intravenous urography
(excretory urography or IVU (true functional aka intravenous pyelography)

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84
Q

Why do we empty the bladder before doing a IVU study?

A

a bladder to full could rupture & urine already in the bladder dilutes the contrast medium

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85
Q

what angle does the kidney sit to the midsagittal plane?

A

20 degrees from the midsagittal plane due to the psoas major muscles (vertical angle)

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86
Q

where should the tourniquet be placed in relation to the injection site?

A

3-4 inches above injection site

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87
Q

What is acute renal failure?

A

inability of a kidney to excrete metabolites & inability to retain electrolytes (at normal plasma levels
& under normal conditions)

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88
Q

What is oliguria?

A

diminished amount of urine in relation to fluid intake
low urine output
(less than 400mL in 24 hr)

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88
Q

What is retention?

A

inability to void: bladder unable to empty
(due to obstruction in urethra or lack of sensation to urinate)

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88
Q

What is anuria?

A

complete cessation of urinary secretion by the kidneys
(kidneys producing none-little urine due to a blockage)

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89
Q

At what level does the kidney lie in an adult body?
Where in relation to the abdomen?

A

T11-T12 (between xiphoid process (T10) and iliac crest (L3-L4)
(Left kidney T11-T12)
(Bottom right is at L3)
retroperitoneal

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89
Q

What is the bladder capacity?

A

350ml-500ml

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90
Q

What views shows the ureters without obstruction (superimposition)?

A

LPO & RPO

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91
Q

What is the purpose of premedication before a study?

A

To prevent contrast reactions

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92
Q

What is the name of the leakage of contrast outside of the vessel and into surrounding tissue?

A

extravasation

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93
Q

This exam may be performed to demonstrate uterine position, uterine lesions, and uterine tubal obstruction?

A

HSG study
(hysterosalpingography)

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94
Q

What calyx’s form the renal pelvis?

A

major & minor

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95
Q

What drug combination is given to patients before an IVU to reduce the risk of a reaction?

A

prednisone + Benadryl

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96
Q

What type of contrast reaction affects the entire body or a specific organ system?

A

systemic reaction

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97
Q

What is it called when there is a diminished amount of urine being excreted?

A

oliguria

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97
Q

What is the device used and positioned at the level of ASIS?

A

ureteral compression device

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97
Q

The right kidney sits ____ to the left kidney due to the liver

A

inferior

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97
Q

for a male retrograde urethrogram the patient position should be?

A

30 degree RPO

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97
Q

What drug should be withheld for 48 hours following a contrast study?

A

metformin

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97
Q

What is the purpose for voiding a cystourethrogram?

A

to evaluate the patient’s ability to urinate

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98
Q

What is the name of the action urination?

A

micturition

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98
Q

AP oblique that best demonstrates hepatic flexure + ascending colon?
What is the PA oblique?
What is the CR?

A

AP: LPO
PA: RAO
at crest

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99
Q

What is the AP oblique that best shows splenic flexure + descending colon?
PA oblique?

A

AP: RPO
PA: LAO

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99
Q

Which decubitus position best shows the air the splenic flexure + descending colon?
Why?

A

Right lateral decub
bc splenic flexure is on the left side of the body and to see air levels we need it to be side up

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99
Q

What decubitus position best shows the air in the posterior rectum?
What decubitus position best shows the air in the anterior rectum?
Why?

A

Ventral decubitus
Dorsal decubitus
bc air/fluid levels move depending on gravity. In prone position, air goes posterior and barium goes anterior

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99
Q

Where is the barium while the patient is PA?
Where is the air?
Why?

A

B: transverse & sigmoid colon
A: ascending & descending colon

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100
Q

Which decubitus position best shows the air the hepatic flexure + ascending colon?
Why?

A

left lateral decubitus
bc we want to see the air levels on the hepatic (right side) so we must have right side of the body up

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100
Q

Where is the barium when the patient is AP?
where is the air?
Why?

A

B: ascending & descending colon
A: transverse & sigmoid colon
bc of gravity and the ascending & descending colon are retroperitoneal

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101
Q

Splenic flexure is located on ___ side
Ascending colon is location on ___ side
Hepatic flexure is located on ____ side
descending colon is location on ____ side

A

left
right
right
left

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101
Q

Which aspect of the large intestine is the highest?

A

left colic flexure

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101
Q

What part of the large intestine is the widest?
What about the small intestine?

A

L: cecum
S: duodenum

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101
Q

How long should the patient NPO for a barium enema?

A

8 hours

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102
Q

What are the contraindications for a barium enema?

A

perforated hollow viscus & large bowel obstruction
(water-soluble could be used for these precautions)

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103
Q

When inserting the tip for a barium enema it must be on:
What position is best for a tipped insertion for small bowel study?

A

expiration
(relaxes the abdominal muscles)
sims

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103
Q

Where should you aim for when doing a barium enema insertion for small bowel?

A

aim tip toward umbilicus approximately 1-1/2 inches (3-4 cm)

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104
Q

where is the CR for an initial small bowel study?
Where is the CR after 1-2 hours?

A

Initial: 2 inches above crest
1-2hr: at crest (bc barium has made its way from the stomach to bowel)

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104
Q

What does LPO best show in the small bowel?

A

Right hepatic flexure + ascending colon

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104
Q

Why do we prefer to take our images in PA vs AP during a small bowel study?

A

compresses the small bowel to best show the loops

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105
Q

What does ventral decubitus best display in small bowel?

A

Air in the posterior portion of the rectum

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106
Q

What does LAO best show in small bowel?
What is the CR?

A

Splenic flexure + descending colon
2 inches superior to crest + 1 inch to the right of MSP

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107
Q

What does RPO best display in small bowel?

A

Splenic flexure + descending colon

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107
Q

What does right lateral best display in small bowel?

A

Air in the splenic flexure + descending colon
(The side up)

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107
Q

What does left lateral decubitus best display in small bowel?

A

air in the hepatic flexure + ascending colon + cecum
(air in side up)

107
Q

What does RAO best display in the small bowel?
what is the CR?
how much oblique?

A

hepatic flexure + ascending colon
CR at crest
35-45 oblique

108
Q

what does lateral rectum best show in small bowel?
what positions achieve this?
what the is the CR?

A

demonstrates polyps, strictures, & fistulas between rectum & bladder/uterus
left lateral rectum or Ventral decubitus
CR is at ASIS

108
Q

What is the difference between a PA and AP image for small bowel?
right/left lateral?

A

PA: Barium in the transverse & sigmoid with air in the A & D colon
AP: Barium in the Ascending + descending with air in the Sigmoid + transverse
R lateral: Air in the splenic + descending barium in hepatic + ascending
L lateral: Air in the hepatic + ascending barium in the splenic + descending

109
Q

What is the CR for RPO/LAO for small bowel?
why?

A

2 inches superior to crest + 35-45 PO/AO obliques (LAO 1 inch to the right of MSP)
bc the splenic flexure is superior to the hepatic

109
Q

What is the CR for LPO/RAO for small bowel?

A

RAO: crest + 1 inch to the left of MSP
LPO: crest + 1 inch to elevated side from MSP
35-45 AO/PO oblique

109
Q

what is the obliquity for PO/AO obliques for small bowel?

A

35-45 degrees

109
Q

The enema bag should not be higher than _____

A

24 inches above table (2 feet)

110
Q

During small bowel studies how often should images be taken?

A

every 20-30 minutes

111
Q

Which part of the small intestine makes up the 3/5’s?
which part makes up the 2/5’s?

A

ileum
& jejunum

111
Q

how are each of these structures in the abdomen?
Cecum:
Ascending:
Transverse:
Descending:
Sigmoid:
Upper Rectum:
Lower rectum:

A

intraperitoneal
retroperitoneal
intraperitoneal
retroperitoneal
intraperitoneal
retroperitoneal
infraperitoneal
(retro=behind) (intra=within) (infra= below)

112
Q

What are the small intestines functions?
What are the large intestines functions?

A

digestion (chemical & mechanical)
Absorption & reabsorption (duodenum/jejunum)
some reabsorption + elimination (defecation)

112
Q

Contraindications to laxatives?

A

gross bleeding
severe diarrhea
obstruction
appendicitis

113
Q

The insertion tip should not exceed _____

A

3-4 inches (7.5cm-10cm)

114
Q

How does the stomach lie in a hypersthenic patient?
What level is the stomach, pyloric portion, & duodenal bulb?

A

high & transverse
Stomach: T9-T12
Pyloric portion: T11-T12
Duodenal bulb: T11-T12

115
Q

How does the stomach lie in a hyposthenic/asthenic patient?
What level is the stomach, pyloric portion, & duodenal bulb?

A

low & vertical (J shaped)
Pyloric portion: L3-L4
Duodenal bulb: L3-L4

115
Q

What is bile?

A

made by the liver
breaks down fats

115
Q

How does the stomach lie in a sthenic patient?
What level is the stomach, pyloric portion, & duodenal bulb?

A

Normal stomach
Stomach: T10-L2
Pyloric portion: L2
Duodenal bulb: L1-L2

116
Q

What does Cysto mean?
What does angio mean?
What does Choles mean?

A

bag or sac
duct
relationship with bile

116
Q

What is the CR for Upper GI RAO?
For sthenic?
Hyperstenic?
Asthenic?

A

40-70 degree RAO prone rotation
Sthenic: 45-55 oblique CR at L1 (duodenal bulb)
Hypersthenic: 70 degree oblique (2 inches superior to L1)
Asthenic: 40 degree oblique (2 inches inferior to L1)
(suspend respiration, expose on expiration)

117
Q

What is the CR for Upper GI LPO?
Sthenic:
Hypersthenic:
Asthenic:
Expose on?

A

30-60 degree LPO supine rotation
Sthenic: 45 degree oblique at L1
Hypersthenic: 60 degree oblique 2 inches superior to L1
Asthenic: 30 degree oblique 2 inches inferior to L1
(suspend respiration, expose on expiration)

117
Q

What is the CR for upper GI AP?
Sthenic:
Hypersthenic:
Asthenic:

A

Sthenic: at L1 45 LPO
Hypersthenic: 2 inches superior to L1 60 LPO
Asthenic: 2 inches inferior to L1 30 LPO
(suspend respiration, expose on expiration)

117
Q

What is the CR for an AP/PA esophagogram?
expose on?

A

T5-T6
1 inches inferior to sternal angle or
3 inches inferior to jugular notch
(suspend respiration, expose on expiration)

118
Q

What is the CR for LAO/RAO esophagogram?

A

35-40 degree AO prone oblique
CR: (LAO T5-T6) (RAO T6)
(2-3 inches inferior to jugular notch)

118
Q

What does LAO esophagogram show?
What does RAO show?

A

LAO: esophagus is seen between hilar region & thoracic spine
RAO: Esophagus is seen between thoracic spine & heart
(entire esophagus is filled (or lined) with contrast)

119
Q

What is the stomach orientation?

A

Fundus (most posterior)
Body (anterior/inferior to fundus)
Pylorus (posterior/distal to body)

120
Q

What is the CR for right lateral upper GI?
For sthenic?
Hyperstenic?
Asthenic?
what anatomy is shown?

A

Sthenic: L1(duodenal bulb) 1-1/2 inches anterior to midcoronal
Hypersthenic: 2 inches superior to L1
Asthenic: 2 inches inferior to L1
retrogastric space

120
Q

What is the CR for an esophagram?

A

T5-T6

120
Q

What is the order for all the ducts in upper GI? (in order from superior to inferior)

A

Left & right hepatic (from liver)
Common Hepatic duct
cystic duct (duct into gallbladder)
Common bile duct
Pancreatic duct (duct of wirsung)
Duodenum (sphincter of Oddi)

121
Q

How much do you oblique for an esophagogram?

A

35-40 degree anterior oblique (LAO/RAO)

121
Q

What do you see in a lateral esophagogram?
What is the CR?

A

esophagus is seen between the thoracic spine and heart
T6 (2-3 inches inferior to jugular notch)

122
Q

What do you see in a RAO esophagogram?
What is the CR?

A

esophagus is seen between the spine and the heart
35-40 anterior oblique + T6 (2-3 inches inferior to jugular notch)

123
Q

What do you see in LAO esophagogram?
What is the CR?

A

Esophagus is seen between the hilar region & the thoracic region
35-40 degree anterior oblique + T5-T6 (2-3 inches inferior to jugular notch)

124
Q

What do you see in a AP/PA esophagogram?
What is the CR?

A

Esophagus superimposed over the spine
T5-T6 (1 inch inferior to sternal angle)

124
Q

What is the sphincter of Oddi?
Also known as?

A

muscle fibers of the duct walls leading into the duodenum
hepatopancreatic sphincter

125
Q

How do you oblique for an Upper GI study?

A

40-70 degree anterior oblique for RAO
30-60 degree posterior oblique for LPO

126
Q

What is seen in LPO upper GI?
What is the CR?
For different body habitus?

A

entire stomach + duodenum (unobstructed view of the duodenal bulb)
Sthenic: L1 + 45 degree oblique
Hypersthenic: 2 inches superior to L1 + 60 posterior oblique
Asthenic: 2 inches below L1 + 30-degree posterior oblique

126
Q

What is seen in an RAO upper GI?
What is the CR?
For different body habitus?

A

Entire stomach + c-loop of duodenum
40-70 anterior oblique (RAO)
Sthenic: L1 45-55 RAO
Hypersthenic: 2 inches superior to L1 70 degrees RAO
Asthenic: 2 inches inferior to L1 40-degree RAO

126
Q

What is the ligament of Treitz?
Where is located?
Why is this important?

A

fibrous muscular band
superior to the duodenojejunal flexure
suspensory muscle of the duodenum

127
Q

What is the kvp range for a double contrast exam?
single contrast?

A

90-100 kVp
110-125 kVp (to increase visibility of barium-filled structures)

127
Q

What are the ionated contrasts?
What else can you use this for?
How does it taste & what is this an example of?

A

gastrogavin
omnipaque
visipeg
pre-surgical exams
bitter + water-soluble contrast

128
Q

What is anterior & posterior when it comes to the trachea/esophagus?

A

trachea is anterior to the esophagus
esophagus is posterior

129
Q

When you inhale diaphragm moves:
When you exhale diaphragm moves:

A

moves downwards
moves upwards

130
Q

Where is the gallbladder located?
What is its main purpose?
what are the 3 parts of the gallbladder?
how much bile can it hold?

A

inferior to the liver
1. store bile, 2. concentrate bile (Hydrolysis: removal of water) (choleliths: gallstones), 3. contract
1. Fundus, Body, Neck
30-40 mL of bile

130
Q

How do we prep for an upper GI exam?

A

NPO 8 HRS
no gum chewing **
Determine if patient is pregnant (interrogate the patient, collect a history)

131
Q

What is the kVp range for water-soluble contrast studies?

A

80-90 kVp

132
Q

In RAO how is the esophagus anatomy positioned?
What are we looking for?

A

esophagus is between the spine & heart

132
Q

In LAO how is the esophagus anatomy positioned?
What are we looking for?

A

esophagus is un between the spine & hilar region

133
Q

What do these mean?
Chole:
Cysto:
Angio:
Choledocho:
Cholangio:
Cholecyst:

A

Relationship with bile
Bag/sac
duct
Common bile duct
bile ducts
gallbladder

134
Q

What do these terms mean?
Cholecystography:
Cholangiography:
Cholecystangiography:

A

Radiography of gallbladder
radiographic study of biliary ducts
radiography of both gallbladder & biliary ducts

135
Q

In LPO how is the barium in the stomach?

A

Barium in the fundus & Air in the pylorus

135
Q

In RAO how is the barium in the stomach?

A

Barium in the pylorus & Air in the fundus

135
Q

Which oblique places air in the fundus?

A

RAO

136
Q

What view superimposes the esophagus over the spine?

A

AP or (PA)

136
Q

What oblique places barium in the pylorus of the stomach?

A

RAO (has to be prone)

137
Q

Which oblique places air in the in the pylorus of the stomach?

A

LPO (has to be supine)

138
Q

Which oblique places barium in the fundus of the stomach?

A

LPO (has to be supine)

139
Q

What is chymes?

A

semifluid mass as a result of mixing (churning) of stomach contents & stomach fluids

139
Q

Where is the duct or wirsung?
Also known as?

A

Duct leading into the pancreas
Pancreatic duct

139
Q

Which view of the stomach best displays the retrogastric space?

A

R lateral (upper GI) view
(lateral)

139
Q

What is swallowing called?

A

deglutition

140
Q

What is chewing called?

A

Mastication

141
Q

Where does barium go if the patient is lying prone?
Where is the air?
what is a common oblique we would use for this?

A

barium in pylorus & air in the fundus
RAO

141
Q

What is peristalsis?

A

involuntary muscle contractions
(wavelike movements that propel solid/semisolid structures)

142
Q

What is the epiglottis?
What does it do?

A

membrane-covered cartilage that moves down to cover the opening of the larynx during swallowing
(to prevent aspiration)

142
Q

What are the contraindications for water-soluble contrast?

A

if patient is sensitive to iodine (allergic)
experiencing severe dehydration

142
Q

How does the fundus lie in the stomach?

A

fundus is posterior

143
Q

Barium is a:

A

colloidal suspension
(not a solution)

144
Q

Where is the cardiac notch located?
also called:

A

medial to the fundus
(superior to the esophagogastric junction)
incisura cardiaca

144
Q

What is rugae?
where is the location?

A

internal lining of stomach thrown into numerus mucosal folds
(when the stomach is empty)
greater curvature

145
Q

What helps food gets down the esophagus?

A

peristalsis
(gravity + involuntary movement)

146
Q

What is the gastric canal?
Where is it located?
What is its function?

A

canal formed by rugae
along the lesser curvature
funnels fluids directly from the stomach’s body to the pylorus

146
Q

Where is the cardiac antrum at?

A

distal portion of esophagus, that curves sharply into expanded portion of the esophagus
(right before the esophagogastric junction)

147
Q

Where is the esophagogastric junction?

A

aperture or opening between the esophagus and stomach

148
Q

The fundus is ___ filled

A

air filled

149
Q

Where is the angular notch?
also known as:

A

ring like area that separate the body and pylorus region
incisura angularis

149
Q

What is GERD?

A

gastroesophageal reflux disease

150
Q

What is an accessory organ?
What is an example?

A

not a digestive organ but aids in digestion
salivary glands, pancreas, liver, & gallbladder

151
Q

What is used to prevent scatter radiation in fluro?

A

Bucky slot shield
(lead drape shield, exposure patterns, lead aprons)

151
Q

What is the 3 cardinal rules of radiation protection:

A

Time
Shielding
Distance (most crucial)

152
Q

What sits inside the C loop of the duodenum?
What is it referred to as?

A

The head of the pancreas
Called the romance of the abdomen (stomach)

152
Q

What is the special name for having gallstones?

A

choleliths
(biliary calculi)

153
Q

What is a trichobezoar?

A

Mass of ingested hair

153
Q

What are the 3 parts of the pharynx?

A

Nasopharynx (nose area)
Oropharynx (mouth)
Laryngopharynx (throat area)

154
Q

In which body habitus is the stomach most horizontal (transverse)?

A

Hypersthenic

154
Q

What does the parietal bone articulate with?

A

5 cranial bones:
1 frontal
1 occipital
1 temporal
1 sphenoid
1 (opposite parietal)

155
Q

What does the temporal bone articulate with?

A

3 cranial bones:
1 parietal bone
1 occipital bone
1 sphenoid bone

155
Q

What does the sphenoid bone articulate with?

A

all 7 of the cranial bones & 5 facial bones
acts as the anchor for the cranium

156
Q

What does the ethmoid bone articulate with?

A

2 cranial bones & 11 facial bones
1 frontal bone
1 sphenoid bone

157
Q

What does the frontal bone articulate with?

A

4 cranial bones:
2 parietals (L & R)
1 sphenoid
1 ethmoid

157
Q

What is GML?
What is OML?
What is IOML?
What is AML?
What is LML?
What is MML?
What’s the degree difference between OML and IOML?

A

gabellomeatal line (GML)
Orbitomeatal line (OML)
infraorbitomeatal line (IOML)
Acanthiomeatal line (AML)
lips-meatal line (LML)
mentomeatal line (MML)
7 degree difference

158
Q

What is GAL?
What is IPL?

A

Gabellaaveolar line
Interpupilary line *

159
Q

What line is parallel or perpendicular in the SMV projection?

A

IOML is parallel to IR
GAL is perpendicular to IR

159
Q

Where is the pituitary gland?

A

in the sellae turcica of the sphenoid bone

160
Q

Where is the supraorbital groove located? (SOG)

A

slight depression above eyebrow

161
Q

Your patient comes to radiology for a study of the cranium and is unable to flex his head and neck to place the OML perpendicular to the IR for an AP axial projection (Townes). What should the technologist do to compensate for this without causing distortion?

A

increase the angle by 7 degrees caudad to match the IOML
(we don’t switch to Haas because PA projection would enlarge the occipital bone)

161
Q

What bone contains the sellae turcica?
What organ lies in the sellae turcica?

A

Sphenoid bone
Pituitary gland

162
Q

What is the widest portion of the skull?

A

parietal tubercles (eminences)

163
Q

What bones make up the orbit?

A

3 cranial bones & 4 facial bones
C: frontal, sphenoid, & ethmoid
F: Maxilla, zygoma, lacrimal, palatine

164
Q

What is another name for Waters?
What is another name for Haas?
What is another name for Townes?

A

parietoacanthial projection: Waters
PA axial: Haas
AP axial: Townes

165
Q

How does Waters differ physically on an x-ray?
What line is the IR?
What is the CR?
What is best shown?
What is it also called?

A

Waters: MML perpendicular to IR
CR exits acanthion
best shows sinuses, nasal septum
Parietoacanthial

166
Q

How does Haas differ physically on an x-ray?
What line is on the IR?
What is the angle?
What is the CR?
What’s is best shown?
What is magnified vs the Townes?
Also called?

A

Haas: OML perpendicular to IR,
CR exits 1 1/2 superior to nasion
25 cephalic
best shows dorsum sellae in foramen magnum,
Occipital bone is more magnified
PA axial

166
Q

What bone is the cribriform plate & Crista galli located on? *
What lies anterior or posterior to each other?

A

ethmoid bone
Crista galli located anterior to cribriform plate
“Crista galli also known as rooster comb”

167
Q

Where is the zygomatic process located?

A

anteriorly from the squamous portion of the temporal bone *
(goes on to form a part of the palpable zygomatic arch)

167
Q

Where is the supraorbital margin located? (SOM)

A

superior rim of each orbit

168
Q

Where is the supraorbital notch located?
What do they also refer to this as?

A

small hole within the SOM (supraorbital margin)
“foramen”

168
Q

Where is the CR entering or exiting in the Caldwell projection?

A

CR is exiting the nasion
(15 caudad/ 30 caudad exaggerated)

169
Q

Where is the CR entering or exiting in the Townes projection?

A

CR enters 2 1/2 inches above the Gabella
through the foramen magnum
exiting at the base of the occipital bone

169
Q

Where is the CR entering or exiting in the exaggerated Caldwell projection?

A

CR is exiting the nasion
30 caudad

170
Q

Where is the CR entering or exiting in the Haas projection?

A

CR exits 1 1/2 inches superior to nasion
Enters 1 1/2 below inion
25 degrees cephalic

171
Q

Where is the Maxillary sinus located?

A

2 maxillary sinuses in both maxillae
(only sinus that correlates to facial bones)

171
Q

What views are for cranium?

A

PA skull
Lateral skull
Caldwell + exaggerated Caldwell
Townes (AP) or Haas (PA)

171
Q

What views are for facial bones/sinuses?

A

Lateral facial bones
Waters
Caldwell

172
Q

How do sinus and cranium views differ?

A

no angle for sinus views (we want to see air fluid levels)
(sinus doesn’t need full skull, cranium doesn’t need mandible)

173
Q

Where is the ethmoid sinus located?

A

lateral masses of the ethmoid bone
(anterior, middle, and posterior portions)

173
Q

Where is the sphenoid sinus located?

A

body of Sphenoid bone, inferior to sellae turcica

174
Q

Where is the frontal sinus located?

A

Frontal bone
(posterior to Gabella, rarely symmetric & mostly separated by a septum)

174
Q

If we are shooting an AP axial (Townes) and in the picture the dorsum sellae is below the foramen magnum but the anterior arch of C1 is visible in the foramen. What error has taken place?

A

too much caudad angle
(almost becoming a tangential)
(dorsum sellae is supposed to be inside the foramen magnum, angling less will place it inside)

175
Q

Should the orbital grooves be superimposed in the PA projection of the skull?

A

No
Only superimposed in a right lateral cranium

175
Q

How many junctions are there?

A

6 junctions

176
Q

What is the name of the anterior junction?

A

(1) bregma junction

176
Q

What is the name of the lateral junctions?

A

(2) Pterion junctions (L & R)

177
Q

What is the name of the lateral posterior junctions?

A

(2) asterion junctions (L & R)

177
Q

How many total sutures are there?

A

5 sutures

178
Q

What is the name of the posterior junctions?

A

(1) lambda junction

179
Q

What is the name of the lateral sutures?

A

squamous suture

179
Q

What is the name of the anterior suture?

A

coronal suture

180
Q

What is the name of the posterior suture?

A

lambdoidal suture

180
Q

What is the name of the suture that goes down the midline of the cranium?

A

sagittal suture

180
Q

What is best displayed in a Caldwell?
What is the name & difference with the alternative view?
Why would we want to shoot an alternative view?

A

petrous pyramids in lower 1/3 (15), or below the IOML in exaggerated (30)
Exaggerated Caldwell (15 to 30 caudad) places petrous pyramids completely out of orbit
to see the whole orbit

181
Q

What is best show in a Water’s projection?
What is the alternative view and when do we use this?

A

Open mouth (transoral) Water’s to show the sphenoid sinus (which shows the last and all 4 sinuses)

182
Q

What is best shown in a Haas?
What is best shown in a Townes?

A

Haas & Townes: best shows dorsum sellae in the shadow of the foramen magnum, & occipital bone, petrous pyramids
(Haas enlarges the occipital bone, Townes enlarges the orbits)

182
Q

What does the Haas do the x-ray?
What does the Townes do to the x-ray?

A

enlarge the occipital bone
enlarge the orbits

182
Q

Which sinus is not seen due to superimposition?
What projections free this sinus of superimposition?

A

Sphenoid
(superimposed by ethmoid)
lateral ***
Right lateral sinus
Waters open mouth

183
Q

For the parietoacanthial projection, where does the CR exit?

A

Acanthion
(hint the name parietoacanthion)

183
Q

For a modified parietoacanthial projection how many degrees does it place the OML to the IR?

A

55 degrees
(37 for regular waters)

184
Q

What is the tragus?

A

external structure that acts as a shield to ear opening located anterior to EAM

185
Q

What is the name of the two part articulation between the skull and the atlas?

A

atlanto-occipital joint

186
Q

What are the two lateral oval convex processes located on each side of the ______?

A

Foramen magnum
A: Occipital condyles

186
Q

What is a tripod fracture?

A

a blow to the cheek resulting in a fx to the zygoma in 3 places

186
Q

What is sphenoid effusion?

A

basal skull fx, results in blood of CSF leaking from fx into sphenoid sinus

187
Q

What kind of joint is the TMJ?

A

Synovial
Bicondylar (plane or gliding)

188
Q

What are two terms for the small & irregular bones found in the adult skull sutures?

A

sutural or Wormian

189
Q

What sinus do you see in the mouth for the transoral parietoacathial projection?

A

sphenoid sinus (in the mouth)
(All 4 sinuses are shown)

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Registry Prep (7 decks)

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