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DPT 500 > written practical > Flashcards

written practical Flashcards

1
Q

failure to refer for imaging =

A

non-feasance

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2
Q

who reviews “studies” and gives written explanation of findings? (clinical diagnosis)

A

radiologist

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3
Q

X-ray Technician

A

18 month degree with clinicals
speciality certifications available

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4
Q

general rules / considerations for imaging

A
  • no radiographs for pregnant women
  • some risk for development of cancer with repetitive exposure
  • use of clinical prediction rules & physical exam used to limit exposures
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5
Q

EXAMPLES of clinical prediction rules and physical exam used to limit exposures

A

ottowa ankle rules
non-displaced growth plate fractures

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6
Q

clear, focus initiative to ______ pediatric patients exposure to radiographs

A

limit

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7
Q

what is a radiography?

A

(x-ray)
electromagnetic radiation passed thru a structure

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8
Q

what tissue shows up dark in a x-ray?

A

lass dense tissue (soft tissue)

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9
Q

what tissue shows up bright white in a x-ray?

A

bony tissue

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10
Q

what does an x-ray rule out (R/O) ?

A

fracture
foreign objects
degenerative disk disease
mal-alignments
facet joint dysfunction

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11
Q

lungs appear ________ in x-ray

A

dark

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12
Q

fat appears ________ in x-ray

A

grey

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13
Q

bone appears ________ in x-ray

A

bright white

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14
Q

what can be used during x-ray?

A

contrast agent (dye)
but often reserved for MRI and CT

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15
Q

when do we need an x-ray?

A

primary uses (indications)

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16
Q

considerations for x-ray usage:

A

inexpensive
accessible
quick
generally comfortable

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17
Q

ABCs

A

A - assess general skeletal structure
A - assess general contour

B - general bone density

C- cartilage space

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18
Q

Assess general skeletal structure

A
  • gross size and appearance
  • presence of accessory bones
  • congenital anomalies
  • absence of bones
  • deformity
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19
Q

Assess general contour

A
  • irregular in cortical outlines
  • presence of osteophytes
  • break in continuity of cortex
  • angles in cortex
  • muscles, tendon, ligament attachment
  • previous surgical sites
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20
Q

general bone density

A
  • adequate contrast between bone and surrounding
  • adequate contrast within bone including distinct cortex
  • bone density influenced by age, activity level, disorders
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21
Q

texture abnormalities:

A

altered trabecular appearance is hallmark of disease process

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22
Q

cartilage space:

A
  • well preserved joint space indicates that cartilage is normal thickness
  • joint space identified as “potential space” or “radiographic joint space”
  • specific to the joint and best measured in WB
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23
Q

epiphyseal plate in growing child are . . .

A

cartilaginous

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24
Q

why are epiphyseal plates evaluated?

A

for size comparing skeletal maturity to age

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25
Q

epiphyseal plate borders bound by . . .

A

smooth margin with band of sclerosis

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26
Q

may need _______________ for comparison

A

contralateral films

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27
Q

radionuclide bone scan

A
  • nuclear imaging
  • short-lived radionuclide to assess abnormalities in bone tissue
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28
Q

bone scan

A
  • tracer is injected (emits gamma radiation)
  • circulates through body (30 m - 2 hrs)
  • special camera reveals “hot spots” on bone
  • indications
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29
Q

what are “hot spots” ?

A

areas of increased metabolic activity

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30
Q

what do bone scans rule out?

A

fracture, infections, tumors, arthritis

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31
Q

fluoroscopy

A
  • ionizing radiation
  • allows for “real-time image”
    (used during clinical procedures)
  • indications/uses are similar to x-rays
  • clarity depends on power and type of machine
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32
Q

what does PET stand for?

A

positron emission tomography

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33
Q

what is a PET used for?

A

to examine the cell metabolism and biochemistry of tissue and organs

  • used extensively to identify cancers, thyroid conditions, infections, bleeding
34
Q

what kind of injection for a PET scan?

A

radionuclide injection

35
Q

what does MRI stand for?

A

magnetic resonance imaging

36
Q

what is an MRI?

A
  • applies a magnetic field to the body (body atoms align along magnetic field, releasing radio wave)
37
Q

MRI indications:

A

to image organs, soft tissue, bone, tumors, bleeding, inflammation, infection

38
Q

what kind of imaging is used extensively in orthopedics, ortho-spine & neurology?

A

MRI

39
Q

MRI considerations:

A
  • excessive movement can cause blurry images
  • claustrophobia
  • no radiation
  • cannot have any metal present
  • high cost!!
40
Q

what are the two types of MRIs?

A

T1 & T2

41
Q

T1 weighed image:

A

fluid: low signal intensity (black)

muscle: intermediate signal intensity (grey)

fat: high signal intensity (white)

CNS/brain:
- grey matter: intermediate signal intensity (grey)
- white matter: hyperintense compared to grey matter (white-ish)

42
Q

T2 weighed image:

A

fluid: high signal intensity (white)

muscle: intermediate signal intensity (grey)

fat: high signal intensity (white)

CNS/brain:
- grey matter: intermediate signal intensity (grey)
- white matter: hypointense compared to grey matter (dark-ish)

43
Q

MR arthrogram

A

adds dye into the structure

44
Q

MR arthrogram good for ID of:

A
  • cartilage lesions
  • neuro-trauma
45
Q

ultrasound:

A

uses non-thermal sound wave to image soft tissue structures

clarity depends on machine & level of skill of the technician

46
Q

ultrasound indications:

A
  • image musculoskeletal structures
  • used to guide clinical procedures
47
Q

Doppler US:

A

ID blood flow / obstruction of blood flow (thromboembolism)

48
Q

what does CT stand for?

A

computed tomography

49
Q

CT scan

A
  • ionizing radiation (larger dose than x-ray)
50
Q

CT of the skull & brain (spinal cord) indications:

A

non-contrast (most common)
- numerous: stroke, trauma, headaches. tumors seizures, change in mental status

combination of non-contrast & post-contrast study

51
Q

combination of non-contrast & post-contrast is . . .

A

less common

52
Q

combination of non-contrast & post-contrast is performed when?

A

brain tumors or abscesses are suspected & patient cannot get MRI

  • IV contrast is also given to assess vasculature
53
Q

CT scan of skull/ brain/ spinal cord findings are discussed in terms of __________.

A

densities

54
Q

white

A

hyperdense
- bone, calcium deposits, fresh blood, melanin, contrast

55
Q

grey

A

isodense
- brain parenchyma, glial tumors, subacute blood

56
Q

dark grey

A

hypodense
- CSF, brain edema, fat, chronic blood

57
Q

black

A

hypodense
- air

58
Q

MRI of the brain indications:

A
  • confirmation of stroke
  • assessment of intracranial tumor
  • chronic headache
  • seizure disorder
  • demyelinating disorder
59
Q

GAD =

A

gadolinium (multiple sclerosis)

60
Q

MRI of the brain benefits:

A
  • multiplanar assessment
  • different sequences allow for assessment of different pathology
  • no ionizing radiation (good for children)
61
Q

MRI of the brain limitations:

A
  • much longer study (20-40 minutes)
  • less available
  • issues with claustrophobic patients
  • contraindicated in patients with metallic fragments or implants
62
Q

MRI of the brain findings are discussed in terms of ____________

A

intensities

63
Q

MRI of brain : T1

A

fluid is dark
grey matter is darker than white matter

64
Q

MRI of brain : T2

A

fluid is bright
white matter is darker than grey matter

65
Q

what does FLAIR stand for?

A

fluid attenuation inversion recovery

66
Q

FLAIR is similar to _____, but . . .

A

T2
fluid is “suppressed” and is therefore dark

67
Q

what is FLAIR useful for?

A

assessing edema / inflammation

68
Q

FLAIR involves

A

DWI (diffusion-weighted imaging)
ADC (apparent diffusion coefficient)

69
Q

what imaging can be used for spinal column?

A

x-rays
MRI
CT

70
Q

cervical MRI indications:

A
  • neurologic signs & symptoms referable to the cervical spine
  • soft tissue injury evaluation
71
Q

neurologic signs & symptoms referable to the cervical spine : assessing for . . .

A

disc herniation
cervical stenosis

72
Q

soft tissue injury evaluation : assessing for . . .

A

ligamentous injury
tumors or infections

73
Q

cervical MRI : T1

A

fluid is dark

74
Q

cervical MRI : T2

A

fluid is bright

75
Q

what does STIR stand for?

A

short tau inversion recovery

76
Q

what is STIR?

A

fat suppression technique that is used to assess for soft tissue injuries

77
Q

thoracic / lumbar x-ray confirm / monitor what?

A

scoliosis

78
Q

how many lobes does the right lung have? and what are they?

A

3:
superior
middle
lower

79
Q

how many fissure does the right lung have? and what are they?

A

2
horizontal
oblique

80
Q

how many fissure does the left lung have? and what are they?

A

1
oblique

81
Q

how many lobes does the left lung have? and what are they?

A

2
superior
inferior

DPT 500 (11 decks)

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