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Proc > RDGR Trauma > Flashcards

RDGR Trauma Flashcards

1
Q

Define Trauma

A

a severe injury or damage to the body caused by an accident or violence

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2
Q

What ages are leading cause of death for trauma?

A

15-24

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3
Q

What is level 1 trauma?

A
  • provides the most comprehensive emergency care 24 hrs per day
  • Usually a research facility such as universtiy hospitals

(RUH)

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4
Q

what is level 2 trauma?

A

have all the usual specialized care but are usually not a research centre

(st. pauls)

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5
Q

What is level 3 trauma?

A

usually do not have all specialists but can stabilize the patient before transferring them to a level 1 centre

(humboldt)

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6
Q

What is level 4 trauma?

A
  • clinics or outpatient centres
  • Equipped to handle only minor emergency situations

(clinics and small town hospital)

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7
Q

Motor vechile accidents, falls and assaults are examples of what trauma?

A

Blunt

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8
Q

Gunshot wounds, stabbings, impalements, foreign body injections or aspiration are examples of what trauma?

A

Penetrating

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9
Q

Pressure shock waves, high velocity projectiles, burns are example of what trauma?

A

explosive

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10
Q

Fire, steam and hot water, chemicals, electrcity and frostbite are examples of what trauma?

A

Burns

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11
Q

What are 5 examples of radiation protection?

A
  • close collimation
  • Gonadal shielding
  • Lead aprons
  • Exposure factors
  • Announcement
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12
Q

What is the normal respiations for adults?

A

12-20 per minute

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13
Q

What is the normal resting pulse for adults?

A

60-100 beats per minute

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14
Q

What is the normal BP?

A

systolic- 95-120 mm Hg

Dialstolic - 60-80 mm Hg

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15
Q

What is the normal oxygen saturation?

A

95-100%

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16
Q

What are the common symptoms of shock?

A
  • diaphoresis (sweating)
  • Cool, clammy skin
  • Decrease in venous pressure
  • Decrease in urine output
  • Thirst
  • Altered state of consciousness
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17
Q

What is the fracture that has the highest mortality rate?

A

pelvic (as high as 50%)

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18
Q

What does CAB stand for?

A

Compression
Airway
Breathing

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19
Q

What changes in status should be reported immediatelt to the physician or radiologist?

A
  • loss of consciusness
  • Pale or bluish skin
  • Seizures
  • Increasing abdominal distension and firmness to palpation
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20
Q

What is the best practices in trauma radiography?

A

Speed

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21
Q

What are the three trauma series for mobile radiography?

A
  • cross-table lateral cervical spine
  • Chest AP supine
  • Pelvis - r/o # causing hemorrhagic shock
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22
Q

What are three radiography done if patient is stable in trauma situations?

A
  • remainder of cervical spine
  • Lumbar/thoracic spines
  • Upper and lower extremities
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23
Q

What is the order of projections for trauma?

A
  1. AP’s: Superior to inferior

2. x-table laterals: inferior to superior

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24
Q

What position is done before moving the patient to the imaging table?

A

cross table laterals using upright grid

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25
Q

How is the CR projected in trauma projections?

A

perpendicular

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26
Q

What are the three principles for postioning in trauma?

A
  • 2 projections 90 degrees to each other with true CR part iR alignment.
  • Entire structure or trauma area on IR
  • Maintain the safety of the patient, health care workers and the public
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27
Q

Does the radiographer have to makw a note on type of modification and reason for trauma?

A

yes

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28
Q

What is always the forst exposure for C-spine?*

A

lateral projection: dorsal decubitus position

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29
Q

What is the dorsal decubitus psotion for c-spine for?

A

To rule our fractures of c-spine

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30
Q

What is the SID for lateral c-spine?

A

72”

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31
Q

Where is the CR directed for lateral c-spine

A

Horizontal at level of C4

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32
Q

What needs to be included in the lateral c-spine?

A

sella turcica (2” anterior and superior to the EAM) to T1 (2” above jugular notch)

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33
Q

What must be done if C7-T1 is not shown for lateral c-spine?

A

swimmers

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34
Q

Does swimmers need approval of the physician?

A

Yes

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35
Q

Should you document which physicain gave you the approval for swimmers?

A

yes

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36
Q

Where is the CR directed for swimmers?

A

horizontal to C7-T1 (about 2” above jugular notch)

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37
Q

What should be done if the shoulders are aligned in the same horizontal plane for swimmers?

A

angle 3-5 degrees caudad

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38
Q

If you are using the upright bucky for swimmers and the shoulders are in the same horzintal plane, what should be done?

A

angle the foot of teh stretcher toward the wall 3-5 degrees.

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39
Q

What should all be included in the swimmers projection?

A

level of mastoid tip to 1” below the jugular notch as well as entire soft tissue.

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40
Q

What are the prevertebral fat stripe visualization used for?

A

detection and localization of fractures, masses and inflammation

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41
Q

What is the anterior vertebral line for?

A

used to assess the anterior margin of the vertebral bodies

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42
Q

What is the posterior vertebral line for?

A

used to assess the posterior margin of the vertebral bodies

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43
Q

What is the spinolaminar line for?

A

used to assess the posterior margin of the spinal cord

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44
Q

What is the posterior spinous line used for?

A

used to assess the spinous processes

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45
Q

What should the prevertebral fat stripes of the neck look like?

A

smooth and slightly lordotic curve

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46
Q

What is the wackenheims line?

A
  • a line drawn from the dorsum sellae along the clivus to the basionm should align with the dens
  • A line drawn from the posterior margin of the foramen magnum should meet the spinolaminar line
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47
Q

What is the basion?

A

the midpoint of the anterior margin of the foramen magnum

48
Q

What is the opisthion?

A

the midpoint of the posterior margin of the foramen magnum

-Superior point of spinolaminar line

49
Q

How should the IR be placed under the patients head for AP Axial c spine?

A

If the patient is on a spine board, it can be lifted and the IR underneath.
If the patient is not on spine board, it is preferred to have the physician Lift the head

50
Q

Where should the IR be placed for a AP Axial c-spine?

A

top of IR 1-2” above EAM

51
Q

Where is the CR directed for Ap Axial c-spine?

A

15 degrees cephalad and enters MSP slightly inferior to thyroid cartilage

52
Q

Where does the CR exit of a AP axial c-spine?

A

level of C4

53
Q

Should the patients head be moved on a AP odontoid projection?

A

NO

54
Q

What plane is perpendicular to IR for AP open mouth?

A

occlusal plane

55
Q

What is the AP Fuchs method (modified waters) for c-spine do?

A

demonstrates dens within foramen magnum when the open mouth is not possible

56
Q

What must be done to get air-fluid levels for chest?

A

lateral projection in the dorsal decubitus position

57
Q

Where is the CR for chest?

A

MSP perpendicular to T7 (3” inferior to jugular notch)

58
Q

What is the exposure made on for chest? Inspiration or expiration?

A

inspiration

59
Q

How should the grid be for a AP projection of pelvis?

A

horizontal and parallel to MCP to minimize distortion and rotation

60
Q

Where is the CR directed for AP pelvis?

A

MSP, level 2” inferior to ASIS (or 2” superior to pubic symphysis)

61
Q

When taking a pelvis image, what must be reported immediately to physician?

A

if the abdomen becomes distended and firm

62
Q

What is common in pelvic injuries?

A

hemorrhagic shock

-reasses LOC repeatedly

63
Q

Where should the IR be placed for a AP hip?

A

top of IR at level of iliac crest and center to the symphysis pubis

64
Q

Why must the CR be directed at the center of the symphysis pubis?

A

so the surgeon can see entire acetabulum and hip

65
Q

What is the inital examination for hip trauma?

A

AP pelvis for comparison of 2 hips

66
Q

Where should the grid IR be placed for axiolateral cross table lateral Hip?

A

parallel with the femoral neck, centered to the most prominent portion of the grater trochanter and at a level to place the midline of the hip in the midline of the IR

67
Q

Where is teh CR directed for axiolateral cross table hip?

A

horizontal and perpendicualr to th center of the IR

68
Q

When is the modified axiolateral projection of the hip used?

A

patients suspected bilateral hip fractures or limited movement of unaffected limb

69
Q

How should the IR be placed for the modified axiolateral hip?

A

aligned parallel to the femoral neck at a height to place the center the hip on the IR. Tilt the top of the IR back (away from hip) 15 degrees

70
Q

Where is the CR for the modified axiolateral hip?

A

15 degrees posteriorly and aligned perpendicular to the femoral neck and IR

71
Q

Should th physicain review any dorsal decubitus before performing other exams?

A

yes

72
Q

Where should the IR be placed for lateral t spine?

A

top of IR 2” above the patients relaxed shoulders

73
Q

What should be included in lateral t spine?

A

jugular notch to inferior costal margin. Centered at MCP.

T3 or T4 to L1

74
Q

Where is the CR for lateral L spine?

A

MCP at the level of the iliac crests

75
Q

What should all be included for the Lateral L spine?

A

xiphoid to the midsacrum

T12 to sacrum

76
Q

What is common with abdomen injuries?

A

hemorrhagic shock

77
Q

What is the SID for abdomen AP?

A

40”

78
Q

Where is the CR perependicular to for abdomen AP?

A

MCP at the level of the iliac crest

79
Q

Is the exposure on inspriation or expiration for abdomen?

A

expiration

80
Q

What must be included on avdomen projections?

A

diaphragm to pubic sympysis

81
Q

Denstiy and contrast on abdomen must include..

A

liver, kidney, psoas muscle and cortical margins of bones

82
Q

What is lateral decubitius abdomen for?

A

air/fluid levels

83
Q

How long should the patient be in lateral for for abdomen?

A

5 minutes

84
Q

Where is the CR direced for left lateral decubitus for abdomen?

A

entering MSP at a level of 2” above the iliac crests to include diaphragm

85
Q

What is the SID for left lateral decubitus for abdomen?

A

40” SID

86
Q

What are the three trauma skull projections?

A
  • Dorsal decubitus lateral
  • AP or Ap axial (caldwell)
  • AP Axial Townes
87
Q

what can vomiting be a sign of?

A

intracranial injury

88
Q

What projection must be done first before any other skull prjections?

A

Lateral projection. rule out C-spine injury

89
Q

Where is teh CR for lateral dorsal decubitus for Skull?

A

level 2” above the EAM

90
Q

What plane shold the skull the lined up to fr dorsal decub lateral skull?

A

IPL perpendicular to the IR and MSP vertical

91
Q

What plane should be perpendicular for AP skull?

A

OML and MSP perpendicular

92
Q

whre should the CR be for AP skull?

A

Perpendicular to MSP at the nasion

93
Q

what should the plane be fore ap axial skull reverse caldwell?

A

OML and MSP perpendicular to the IT

94
Q

Where should the CR be for AP Axial skull reverse caldwell?

A

CR angled 15 degrees cephalad entering MSP at the nasion

95
Q

What plane is perpendcular for AP axial towne skull?

A

OML or IOML and MSP perpendicular to IR

96
Q

What should be done on a AP axial towne skull if OML or IOML cant be met?

A

CR angle to increased 60 degrees to maintain 30 degrees angle of OML

97
Q

What should the angle of the CR be for AP axial towne skull?

A

30 degrees caudad to OML or 37 degrees to the IOML

98
Q

Where does the CR pass through for Ap axial towne skull?

A

exits the foramen magnum

99
Q

What are the three facial bone projections?

A
  • Lateral dorsal decibitus
  • AP axial caldwell
  • AP acanthioparietal (reverse waters)

(possibly mandible and zygoma)

100
Q

What is the sid for lateral facial bones?

A

40”

101
Q

Which way should the IR face for lateral facial bones?

A

vertical

102
Q

Where should the R be for lateral facial bones?

A

midway between outer canthus and EAM

103
Q

How should the CR be angles for acanthioparietal projections reverse waters for facial bones?

A

CR angled cephalad until it is paralell with MML, enters the acanthion

104
Q

How should AP shoulders be projected?

A

imaged as is

105
Q

How should AP oblique be postioned for shoulder?

A

patients affected side is elevated 45 degrees and supported in position

106
Q

Where should the CR be for shoulder?

A

level of the glenohumeral joint at the center of the proximal humerus

107
Q

What should be done before turning a patient for shoulder projections?

A

c spine images cleared

108
Q

How should AP ankle be positioned?

A

not dorsi flexed

109
Q

How should Ap oblique ankle be postioned (mortise)?

A

15-20 degrees lateromedial angle to the long axis of foot

110
Q

What should be included as much as possible for lateral images of the ankle?

A

distal tib/fib

111
Q

Where is the CR directed for the knee?

A

1/2 inch distal to apex of patella

112
Q

How should the CR be for AP Foot?

A

angle 10 degrees posterior to plantar surface of foot and plae of IR

113
Q

How much should kVp be increased for medium plaster?

A

7 kVp

114
Q

How much kVp should be increased for large plaster?

A

10 kVp

115
Q

How much should fiberglass be increased?

A

4 kVp

Proc (40 decks)

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