Anatomy 114 final

Which rotation of the humerus will result in a lateral position of the proximal humerus? 1. Internal rotation (epicondyles perpendicular to image receptor) 2. Neutral rotation (epicondyles 45° to the image receptor) 3. External rotation (epicondyles parallel to the image receptor) 4. None of the above

Internal rotation (epicondyles perpendicular to image receptor)

Liver in relation to the peritoneal cavity

Intraperitoneal

What is the radiographic examination of the urinary system performed with IV contrast medium called?

Intravenous Urogram (IVU)

telescoping of a section of bowel into another loop, creating an obstruction

Intussusception

What are they looking at on an AP Axial Inlet Projection?

Ischial spines

What bony landmark is located posterior to the acetabulum?

Ischial tuberosity

What landmark is used to locate the lower margin of the abdomen when in the prone position, it is 1-4 cm or 1.5 inches lower than the symphysis pubis?

Ischial tuberosity

What is the first 2/5 after the Duodenum called?

Jejunum

Which part of the small intestine has a feathery appearance when filled with barium?

Jejunum

Which portion of the small bowel is characterized by a feathery appearance?

Jejunum

posterior oblique projection-pelvis (acetabulum)

Judet Method

what projection demonstrates anterior and posterior rims of the acetabulum and ilioischial and iliopubic columns?

Judet method

What structures are retroperitoneal?

Kidneys Ureters Adrenal glands Pancreas C loop of duodenum Ascending and Descending Colon Upper rectum Major abdominal blood vessels (Aorta and inferior vena cava)

What level is the transpyloric plane located?

L1

What level is the transtubercular plane located?

L5

lumbosacral joint

L5-S1 where the sacrum articulates superiorly with the fifth lumbar vertebra

During a single contrast BE, the radiologist detects a possible defect within the left colic flexure. Which of the following projections and/or positions best demonstrates this region of the colon? A. LPO B. AP axial C. RAO D. LAO

LAO

During a single-contrast barium enema, the radiologist detects a possible defect within the right colic flexure. Which of the following projections and/or positions best demonstrates this region of the colon?

LPO

The internal rotation of the humerus will result in a _______ position of the proximal humerus

Lateral

How can you tell the difference between a Scapular Y and Lateral scapula?

Lateral Scapula= arm over chest

Which of the following BE projections and/or positions provides the greatest amount of gonadal dosage to both male and female patients A. AP/PA B. Left lateral decubitus C. Lateral rectum D. Left posterior oblique

Lateral rectum

A patient comes to radiology for a BE. He has a possible fistula extending from the rectum to the urinary bladder. Which one of the following projections and/or positions would best demonstrate the fistula? A. Lateral rectum position B. AP erect projection C. LPO axial projection D. LPO & RPO position

Lateral rectum position

Which projection of the shoulder requires that the patient be rotated 45° to 60° toward the IR from a PA position? 1. Inferosuperior axiolateral projection 2. AP oblique projection 3. Lateral scapula projection 4. None of these

Lateral scapula projection

A medial CR angle of 25-30 degrees is required for the ________ projection

Lawrence/Transaxillary/InfSup Axial shoulder

What joins the transverse colon and the descending colon?

Left colic (splenic) flexure

LAO: Anatomy demonstrated

Left colic flexure/descending colon seen without superimposition left ilium foreshortened left colic flexure seen in profile

What is region C called?

Left hypochondriac

What is region I called?

Left inguinal (iliac)

What is region F called?

Left lateral (lumbar)

During a double-contrast BE, the radiologist suspects a polyp in the ascending colon. Which position would best demonstrate this? A. 45 degrees erect PA projection B. Left lateral decubitis C. Right lateral decubitis D. Supine for AP projection

Left lateral decubitis

extends superiorly from the lesser curvature of the stomach to portions of the liver

Lesser omentum

A smaller portion of peritoneal cavity, located posterior to the stomach

Lesser sac or omentum bursa

Which body landmark should not be visible on a correctly positioned non trauma AP pelvis?

Lesser trochanters

The internal AP shoulder projection demonstrates the _______________ in profile medially

Lesser tubercle

Where is the CR centered for a transthoracic lateral projection for proximal humerus? 1. 1 inch (2.5 cm) inferior to the acromion 2. Level of the greater tubercle 3. Level of surgical neck 4. Midaxilla

Level of surgical neck

What is the CR for a trans thoracic proximal humerus projection?

Level of the surgical neck

What level would the horizontal or transverse plane be for the four abdominal quadrants?

Level of the umbilicus around L4 or L5, Iliac crest on a female

What is the largest solid organ in the body?

Liver

What anatomy can be found in the RUQ of the abdomen?

Liver Gallbladder Right colic (hepatic) flexure Duodenum Head of pancreas Right kidney Right suprarenal gland

Organs within the abdominal cavity that are partially or completely covered by some type of visceral peritoneum that are not infra or retro peritoneal

Liver Gallbladder Spleen Stomach Jejunum Ileum Cecum Transverse Colon Sigmoid Colon

What are the accessory organs for the digestive system?

Liver, Gallbladder, and Pancreas

What ducts empty into the Duodenum?

Liver, gallbladder, and pancreas

What quadrant is the Sigmoid colon in?

Lower left quadrant LLQ

What does the Grashey method demonstrate?

Open glenoid fossa in profile

What type of breathing technique should be used for AP scapula?

Orthostatic breathing

What is the medical term for Ricketts?

Osteomalacia

What projection should be performed to demonstrate a subscromial spur?

PA scapular Y lateral with 10-15 degree caudal angle

The AP humerus requires that the humeral epicondyles are _____ to the IR. 1. set at a 45° angle 2. parallel 3. perpendicular 4. slightly oblique

Parallel

How is the cassette aligned for an axiolateral (Danelius-Miller method) projection?

Parallel to femoral neck

What is the outermost peritoneum that covers that adheres to the cavity wall?

Parietal peritoneum

What are the 2 types of peritoneum called?

Parietal peritoneum, and the Visceral peritoneum

What serves as a pivot to increase the leverage of the quad femoris muscle?

Patella

An image of an AP abdomen demonstrates elongation of the right iliac wing, how should this be corrected?

Patient Is rotated too much

PA Axial Oblique Projection (teufel) CR and position

Patient PA in 35-40 anterior oblique (looking at downside anatomy) CR 12 degrees cephalad @ 1 inch superior to level of greater trochanter

How is patient positioned for the Rosenburg method?

Patient erect Anterior portion of knee touching Bucky with knees flexed 45 degrees

How should a patient be positioned for the Camp-Coventry projection?

Patient prone, flex knee 40-50 degrees

Patient position for hughston method

Patient prone, knee flexed up 50-60 degrees, can use sheet to hold leg

Judet method

Patient semisupine -affected side UP or DOWN -patient 45 degree oblique (use sponge) *if affected side is down* CR 2in distal 2 in medial from down ASIS *if affected side is up* CR 2 in distal to ASIS

Outlet pelvis

Patient supine CR centered 1-2 in distal to greater trochanters CR angled cephalic 20-35 (males) 30-45 (females)

Inlet pelvis

Patient supine CR level of ASIS, centered in the middle CR angled 40 degrees caudal

Clements-Nakayama

Patient supine with affected side near edge of table. Legs fully extended, neutral position IR 2in below level of table IR angled 15 degrees (perpendicular to CR) *Grid* CR centered to femoral neck CR angled 15-20 posteriorly

What additional maneuver must be added to the inferosuperior axial shoulder (Lawrence method) projection to best demonstrate a possible Hill-Sachs defect? 1. Increase medial CR angulation. 2. Angle the CR 10° to 15° downward or posteriorly in addition to the medial angle. 3. Correct Perform exaggerated external rotation of the affected upper limb. 4. Increase abduction of the affected upper limb.

Perform exaggerated external rotation of the affected upper limb.

What is the space or cavity between the parietal and visceral portion of the peritoneum called?

Peritoneal cavity

What is the large serous, double-walled sac like membrane called?

Peritoneum

How much should the CR be angled for AP bilateral knees for a normal sized patient?

Perpendicular to IR

Positioning : The internal projection of the shoulder and proximal humerus is created by..

Placing back of affected palm against the thigh

What type of movement is are the AC and SC joints?

Plane/gliding

Free air or gas in the peritoneal cavity

Pneumoperitoneum

A radiograph for an AP projection with external rotation of the proximal humerus reveals that the greater tubercle is profiled laterally. What should be changed to improve this image for a repeat exposure? 1. Rotate epicondyles so they are perpendicular to the image receptor. 2. Move the patient obliquely 10° to 15° toward the affected side. 3. Rotate the arm to place palm of the patient's hand against the thigh. 4. Positioning is acceptable; do not repeat it.

Positioning is acceptable; do not repeat it.

What is the Alexander method projection performed for?

Possible AC joint dislocation

Abdominal muscle locates near lumbar vertebral column

Psoas major muscle

What is region H called?

Pubic (hypogastric)

What landmark corresponds to the inferior margin of the abdomen but may be embarrassing for you to touch

Pubis symphysis

What quadrant is the liver located in?

RUQ (right upper quadrant)

Quadrants of the Duodenum

RUQ/LUQ

What is the classification of barium sulfate as a contrast media? A. Radiopaque B. Radiolucent C. Isodense D. Negative contrast media

Radiopaque

What is the final 15 cm of the large intestine called?

Rectum

Which of the following structures is NOT considered part of the colon? A. Transverse colon B. Right & left colic flexures C. Rectum D. All of the above are part of the colon

Rectum

A radiograph of an AP clavicle reveals that the sternal extremity is partially collimated off. What should the technologist do? 1. Repeat the AP projection and correct collimation. 2. Make sure the sternal extremity is included on the AP axial projection. 3. Only repeat it if the patient's pain/symptoms involve the sternal extremity. 4. Ask the radiologist whether he or she wants the projection repeated.

Repeat the AP projection and correct collimation.

If organs are only partially covered by the visceral peritoneum and are closely attached to the posterior abdominal wall they called what?

Retroperitoneal

Structures closely attached to the posterior abdominal wall

Retroperitoneal

Situation: During a double-contrast BE procedure the radiologist suspects a polyp in the descending colon. Which position would best demonstrate this?

Right Lateral Decubitus

In which abdominal quadrant is the duodenum located?

Right Upper

What are the 2 vertical planes of the 9 regions called?

Right and left lateral planes

The ascending portion of the colon joins the transverse colon at the: A. Left colic (splenic) flexure B. Right colic (hepatic) flexure C. Sigmoid colon D. duodenojejunal flexure

Right colic (hepatic) flexure

What joins the ascending colon and and transverse colon?

Right colic (hepatic) flexure

RAO: Anatomy demonstrated

Right colic flexure/sigmoid/ascending colon seen without superimposition Right ilium is foreshortened Right colic flexure seen in profile

What is region A called?

Right hypochondriac

What is region G called?

Right inguinal (iliac)

What is region D called?

Right lateral (lumbar)

During a double contrast barium enema, the radiologist suspects a polyp in the descending colon. Which position would best demonstrate this?

Right lateral decubitus

What quadrant is the liver located in?

Right upper quadrant (RUQ)

A radiograph of an AP pelvis projection reveals that the lesser trochanters are readily demonstrated on the medial side of the proximal femurs. The patient is ambulatory but has a history of early osteoarthritis in both hips. Which positioning modification needs to be made to prevent this positioning error?

Rotate the lower limbs 15-20 degrees internally to place the proximal femurs in a true AP position

How should a KUB prone or supine be evaluated for rotation?

Rotation of the iliac crests

What level does the rectum start?

S3

What projection of the scapula should the vertebral and axillary borders be superimposed?

Scapular Y Lateral

Which of the following joints is considered to have a ball and socket (spheroidal) type of movement? 1. Acromioclavicular joints 2. Sternoclavicular joints 3. Bicipital joint 4. Scapulohumeral joint

Scapulohumeral joint

Characteristics of the Duodenum

Shortest/Widest/Most fixed portion

When patient presents with osteoarthritis, how should your technique move?

Should be lowered

The most distal portion of the colon is the:

Sigmoid

What is the S-shaped section of the descending colon called?

Sigmoid colon

Which part of the large intestine is located between the rectum and the descending colon? A. Cecum B. Splenic flexure C. Hepatic flexure D. sigmoid colon

Sigmoid colon

What anatomy can be found in the LUQ of the abdomen?

Spleen Stomach Left colic (splenic) flexure Tail of the pancreas Left kidney Left suprarenal gland

AP Axial Inlet Projection

Staunig method

Which term describes the medial end of the clavicle? 1. Acromial extremity 2. Acromion 3. Correct Sternal extremity 4. Acromial tuberosity

Sternal extremity

What is the expandable reservoir for swallowed food and fluids?

Stomach

Where does the GI tract start?

Stomach

What are the tree digestive organs within the abdominal cavity?

Stomach, small intestines, and large intestines

What is another term for the mid area of the costal surface of the scapula?

Subscapular fossa

What is the name of the large fossa found within the anterior surface of the scapula? 1. Supraspinous fossa 2. Infraspinous fossa 3. Subscapular fossa 4. Glenoid fossa

Subscapular fossa

What are the glands that sit superomedial on the kidneys?

Suprarenal (adrenal) glands

At what stage of respiration should the enema tip be inserted into the rectum? A. During deep breaths B. During shallow breaths C. Suspend inspiration D. Suspend expiration

Suspend expiration

Hip joint classification

Synovial mobility- diarthrodial movement- ball and socket

What type of joint is the patellofemoral joint?

Synovial/saddle

What is the term for the three bands of muscle that pull the large intestine into pouches?

Taenia coli

Osteoarthritis (Degenerative Joint Disease DJD)

normal part of aging process. most common and first evident in weight bearing joints such as the hips. joint cartilage and adjacent bone degenerate, causing pain and stiffness. new growths of bone and cartilage are evident (osteophytes)

largest foramen in the body

obturator foramen

Slipped Capital Femoral Epiphysis (SCFE)

occurs during rapid growth, typical of 10-16 year olds where minor trauma can precipitate development. epiphysis appears shorter and the epiphyseal plate wider w/ smaller margins

should we use gonadal shield on all patients?

only males

What structures should be seen on a KUB/

outline of liver, spleen, kidneys, and air filled stomach and bowel segments and the arch of the symphysis pubis for bladder region MUST include symphysis Pubis

Function of the obturator foramen

passage for nerves and blood vessels for the lower leg

on an AP pelvis the right iliac wing is forshortened, what is the error?

patient is in an LPO position, right side is further from the IR

How should a patient be positioned for the kneeling Holmblad projection?

patient on all fours, CR towards knee crease, have patient lean forward 20-30 degrees

How should patient be positioned for the Beclere method?

patient supine, knee flexed 40-45 degrees, CR perp to lower leg (40-45), 1/2 inch distal to apex of patella

How should patient be positioned for the straddling table holmblad projection?

patient with knee on chair while leaning on X-ray table, CR at knee crease, have patient lean forward 20-30 degrees

imaginary plane that divides the pelvic region into the greater and lesser pelvis?

pelvic brim

what connects the vertebral column and the lower limbs?

pelvis

Is the spleen located posterior or anterior in the abdominal cavity?

posterior

Where is the spleen located?

posterior and to the left of the stomach in the left upper quadrant (LUQ)

what best demonstrates anterior pelvic bone fractures?

posterior oblique pelvis (Judet method)

Where is the pancreas located?

posterior to the stomach and near the posterior abdominal wall, between the duodenum and the spleen

How is the pelvis going to present in an AP axial outlet projection?

pubic and ischial bones are elongated and magnified

For which large muscle does the patella serve as a pivot to increase the leverage?

quadriceps femoris muscle

What quadrant does the large intestine begin in?

right lower quadrant (RLQ)

What quadrant is the Ascending colon in?

right lower quadrant (RLQ)

How is the pelvis going to present in an AP axial inlet projection?

sigmoid colon straightened, ischial spines demonstrated

why is the the angle of the femur head important?

since the head is projected more anteriorly, to gain a true AP projection the lower legs must be rotated 15-20 internally to place the femoral neck parallel to the IR

hip joint classification

snyovial diaarthrodial ball & socket

What is cholelithiasis?

stones in the gallbladder

Osteogenic sarcoma xray presentation

sunburst pattern look

How do you not there is no rotation on a lateral position exam?

superimposition of posterior ribs, and iliac wings

sacroiliac joint classification

synovial ampiarthrodial limited

Sacroiliac joint classification

synovial mobility- amph movement- limited

classification of sacroiliac joint?

synovial /ampiarthrodial

Sacroiliac joint classification/mobility type

synovial/amphiarthroidal

hip joint classification/mobility type

synovial/diarthroidal

if hip trauma is suspected what should you do before rotating the patient?

take AP pelvis -dont move until cleared by doctor

Intussusception

telescoping of the intestines Appearance: mushroom shaped dialation Exam: single/dbl contrast BE

Pelvic Ring Fractures

the nature of a closed ring pelvis is such that, a severe blow or trauma to one side of pelvis can result in a fracture site opposite the side of trauma, requiring a radiographic visualization of entire pelvis.

why do you have to angle more for females on an AP outlet projection of the pelvis?

the pubic arch on females is greater than males

(T or F) An AP pelvis projection using 90 kV and 8 mAs results in less patient dose than a projection using 80 kV and 12 mAs ( for both males and females)

true

T/F Ultrasound, with graded compression, can be used in diagnosing acute appendicitis.

true

True/False pelvis

true- birth canal false-ilium and wings

Volvulus

twisting of the intestine on itself Appearance: corkscrew appearance Exam: single contrast BE

What connects the kidneys to the urinary bladder?

ureters

What is the "romance of the abdomen"

where the head of the pancreas sits in the curve of the C shape of the duodenum

sacroiliac joints

where the right and left iliac bones articulate posteriorly with the sacrum

Is the pancreas part of the endocrine or exocrine secretion system?

Both, endocrine because it secretes insulin into the bloodstream to control blood sugar levels, and exocrine because it secretes digestive juices into the duodenum.

Where does shoulder radiography produce a significant dose to?

Breast and thyroid

Which of the following conditions may lead to an adynamic ileus? A) Small bowel tumor B) Scar tissue within the jejunum C) Peritonitis D) Stricture of ileum due to an inguinal hernia

C

A patient enters the ED with a possible bony defect of the midwing area of the scapula. The patient is able to stand and move the upper limb freely. In addition to the routine AP scapula projection with the arm abducted, which of the following would best demonstrate the involved area? 1. Take an AP apical oblique projection of the shoulder. 2. Take a transthoracic lateral projection of the shoulder region. 3. Correct Have the patient reach across the chest and grasp the opposite shoulder for a lateral scapula projection. 4. Have the patient drop the affected arm behind him or her and take a lateral scapula projection.

Have the patient drop the affected arm behind him or her and take a lateral scapula projection.

True or false: The affected arm should not be abducted for an AP scapula projection.

False

Tor F the lower aspect of the peritoneum is a closed sac in the female?

False, In females, the uterus, uterine tubes, and ovaries pass directly into the peritoneal cavity

female vs male pelvis

Female: wider, 80-85 degree pubis arch Male: narrow, deeper 50-60 pubis arch

most common cause of mechanically based obstruction

Fibrous adhesions

AP Bilateral Frog Leg Pelvis Positioning

Flex knees 90 degrees and abduct femora 40-45 from vertical (20-30 degrees abduction provides least foreshortening in femoral necks but foreshortening in proximal femora)

What are bursae?

Fluid filled sacs that lubricate and surround the joints

What is the common term for idiopathic chronic adhesive capsulitis? 1. Bankart lesion 2. Tendinitis 3. Bursitis 4. Frozen shoulder

Frozen shoulder

what breathing technique should we give for abdominal exams?

Full expiration

What is the pear-shaped sac located below the liver called?

Gallbladder

Where does the liver store its bile?

Gallbladder

What is the entire digestive system called?

Gastrointestinal (GI) tract

Which of the following structures is not part of the proximal humerus? 1. Lesser tubercle 2. Glenoid process 3. Intertubercular sulcus 4. Anatomic neck

Glenoid process

What projection best demonstrates a Bankart lesion?

Grashey

Which of the following shoulder projections best demonstrates the glenoid cavity in profile? 1. Grashey method 2. Clements modification 3. Garth method 4. AP shoulder, neutral rotation

Grashey method

connects the transverse colon to the greater curvature of the stomach inferiorly

Greater omentum

drapes down over the small bowel then folds back on itself to form an apron along the anterior abdominal wall

Greater omentum

The major portion of the peritoneal cavity

Greater sac or peritoneal cavity

What landmark is used instead of the symphysis pubis to locate the inferior margin of the abdomen

Greater trochanter

While attempting to insert an enema tip into the rectum, the technologist experiences resistance. What should be the next step taken by the technologist?

Have the radiologist insert it using fluoroscopic guidance

While attempting to insert an enema tip into the rectum, the technologist experiences resistance. What should be the next step taken by the technologist? A. Retry the insertion using more lubrication B. Ask the patient to try to insert it him/herself C. Have the radiologist insert it using fluoroscopic guidance D. Cancel the procedure

Have the radiologist insert it using fluoroscopic guidance

How do you position a patient to get the lesser trochanters of the femur in profile?

Heels together, toes apart

An enlarged rectal vein is called a: A. hemorrhoid B. Haustrum C. Diverticulum D. Hiatal hernia

Hemorrhoid

Situation: A radiograph of an AP barium enema projection reveals poor visualization of the sigmoid due to excessive superimposition of the sigmoid colon and rectum. How can this area be better visualized on the repeat exposure? 1 Angle the CR 30° to 40° cephalad with AP projection. 2 Increase kV. 3 Take PA projection with the patient in the left lateral decubitus position. 4 Take PA projection with a 30° to 40°cephalad CR angle.

1

Which imaging modality can demonstrate abscesses in the retroperitoneum? 1 MRI 2 Nuclear medicine 3 Sonography 4 Conventional radiography

1

Which of the following statements is not true in regard to a pediatric small bowel series? 1 The transit time for barium through the small intestine is longer than that of an adult. 2 Barium sulfate is the contrast medium of choice. 3 The small bowel series should be scheduled early in the morning. 4 A gonadal shield often cannot be used during the later stages of the study.

1

Which sections of the large intestine will most likely be filled with air with the patient in the prone position during a double-contrast barium enema? 1 Ascending colon, descending colon, and rectum 2 Transverse and sigmoid colon 3 Rectum only 4 Right and left colic flexure and sigmoid colon

1

Where is the CR centered for the bilateral acromioclavicular (AC) joint projection on a single 35 x 43 cm (14 x 17 inch) image receptor? 1/ At the affected AC joint 2. 1 inch (2.5 cm) above the jugular notch 3. At the level of the thyroid cartilage 4. At the sternal angle

1 inch (2.5 cm) above the jugular notch

CR for AC joints

1 inch above the jugular notch

What is the CR for an AP shoulder?

1 inch inferior to coracoid process

What are the four parts of the colon?

1. ascending colon 2. transverse colon 3. descending colon 4. sigmoid colon

parts of the small intestine in descending order

1. duodenum 2. jejunum 3. ileum

Reasons to do an acute abdominal series

1. peritoneal air 2. ascites 3. mass

Is appendicitis more common in men or women?

1.5% more common in men

Cr of lat knee

1/2 distal to medial condyle

CR of AP knee

1/2 inch distal to apex of patella

Where is the central ray centered for an AP projection of the knee?

1/2 inch distal to apex of patella

What type of enema tip should be used for a barium enema on an infant?

10 Fr, flexible silicon catheter

what is the degree of the longitudinal plane of the femur on an average adult?

10 degrees from vertical

The average time to scan the large intestine during a computed tomography colonography is:

10 minutes

angle of the femur neck to shaft on average adult

125 degrees

How long is the small bowel?

15-18 ft

angle of the femur head and neck in relation to the body?

15-20 degrees

how do you angle the CR for Clements-Nakayama Method?

15-20 posterior for horizontal

How many landmarks are used for the abdomen?

7

Which of the following barium enema projections and/or positions provides the greatest amount of gonadal dosage to both male and female patients? 1 AP/PA 2 Lateral rectum 3 Left lateral decubitus 4 AP axial

2

Which of the following conditions may produce the "cobblestone" or "string" sign? 1 Whipple disease 2 Regional enteritis (Crohn's disease) 3 Giardiasis 4 Ileus

2

Why is oral contrast media sometimes given during computed tomography colonography? 1 To determine if a fistula is present 2 To mark or "tag" possible fecal matter 3 To demonstrate possible diverticula 4 To prevent spasm of the large intestine

2

Where is the CR centered for the AP oblique (Grashey method) position for the glenoid cavity? 1. Acromion 2. 2 inches (5 cm) medial and inferior to the superolateral border of shoulder 3. Coracoid process 4. 1 inch (2.5 cm) superior to the coracoid process

2 inches (5 cm) medial and inferior to the superolateral border of shoulder

Where is the CR located for a left lateral decubitus abdomen?

2 inches above the iliac crest

What is the CR for an AP scapula?

2 inches inferior to coracoid process, 2 inches medial to axillary border

What are the structures of the Urinary system?

2 kidneys, 2 ureters, urinary bladder, and urethra

how many radiographs are taken on an acute abdominal series?

2 or 3

The types of digestive movement characteristic of the large intestine include: 1.) Rhythmic Segmentation 2.) Haustral Churning 3.) Mass Peristalsis 4.) Defecation

2,3,4

The average length of time (in hours) it takes barium sulfate to reach the ileocecal valve after entering the stomach is:

2-3

The approximate uncoiled length (in feet) of the small intestine is:

20-23

How much flexion is recommended for a lateral projection of the knee?

20-30

to minimize distortion of the femoral neck for an AP bilateral frog-leg projection, the lower limbs should be abducted:

20-30 degrees

How much should you abduct the leg for the frog leg projection and why?

20-30 degrees for less distortion of the femoral neck

what degree of hip abduction is used on the unilateral frog leg?

20-30 from vertical

How should the CR be angled for an axial outlet projection of a male?

20-35 degrees towards head 1-2 inches distal to trochanter

What is the CR for the Lawrence method?

25-30 degrees to Axilla

What medial central ray (CR) angle is required for the inferosuperior axial shoulder (Lawrence method)? 1. 5° to 10° 2. 40° to 45° 3. 25° to 30° 4. 10° to 15°

25° to 30°

A telescoping, or invagination, of one part of the intestine into another is termed: 1 diverticulosis. 2 volvulus. 3 intussusception. 4 colitis.

3

A twisting of a portion of the intestine upon its own mesentery is termed: 1 Intussusception 2 Diverticulosis 3 Volvulus 4 Hirschsprung disease

3

Situation: A patient comes to radiology for a double-contrast barium enema. The patient cannot lie on her side during the study. Which of the following projections could replace the lateral rectum projection? 1 AP axial 2 LPO axial projection 3 Ventral decubitus 4 Dorsal decubitus

3

The "tapered," or "corkscrew," radiographic sign is often seen with: 1 diverticulosis. 2 neoplasm. 3 volvulus. 4 intussusception.

3

The term describing a double-contrast small bowel procedure is: 1 two-stage small bowel procedure. 2 diagnostic intubation. 3 enteroclysis. 4 None of the above

3

Which of the following conditions would contraindicate the use of a cathartic before a barium enema? 1 Colitis 2 Diverticulosis 3 Obstruction 4 Diverticulitis

3

Which of the following is classified as an irritant laxative? 1 Magnesium citrate 2 Magnesium sulfate 3 Castor oil 4 None of the above

3

Which of the following pathologic conditions is best demonstrated with evacuative proctography? 1 Intussusception 2 Volvulus 3 Rectal prolapse 4 Diverticulosis

3

Which radiographic sign is frequently seen with adenocarcinoma of the large intestine? 1 "Sail" sign 2 Diverticula 3 "Napkin ring" or "apple core" sign 4 Thickened mucosa

3

Which specific aspect of the large intestine must be demonstrated during evacuative proctography? 1 Sigmoid colon 2 Haustra 3 Anorectal angle 4 Rectal ligament

3

Difference between 2 way and 3 way abdomen?

3 way includes a chest X-ray to look for free air under the diaphragm

For AP bilateral upright knees, how much do you rotate legs?

3-5 degrees internally

What is the recommended central ray angulation for an AP projection of the knee for a patient with thick thighs and buttocks (measuring greater than 24 cm)

3-5* cephalad

When performing an AP axial projection of the clavicle on an asthenic patient, What should your angulation be?

30 degrees cranial

CR of Merchant method

30 degrees from horizontal plane (to femur), mid way between patella

How should the CR be angled for an axial outlet projection of a female?

30 to 45 degrees towards head 1-2 inches distal to trochanter

The CR angulation for the AP axial projection of the large intestine is: A. 10-20 degrees caudad B. 30-40 degrees caudad C. 10-20 degrees cephalic D. 30-40 degrees cephalic

30-40 degrees cephalic

what is the angle of the CR for a female AP axial-outlet (Taylor Method) projection?

30-45

How much CR angulation is required for an asthenic patient for an AP axial projection of the clavicle? 1. 15° 2. 30° 3. 45° 4. No CR angulation should be used for this projection.

30°

How much CR angulation is required for the AP axial projection?

30° to 40°

Rotation for abdominal oblique projections

35-45 degrees

A prolapse of the rectum may be diagnosed by a(n): 1 Single-contrast barium enema 2 Enteroclysis 3 Double-contrast barium enema 4 Evacuative proctography

4

A properly positioned LAO for the large intestine will demonstrate the: 1 Right colic flexure and ascending colon 2 Right colic flexure and descending colon 3 Left colic flexure and ascending colon 4 Left colic flexure and descending colon

4

At what stage of respiration should the enema tip be inserted into the rectum? 1 During deep breaths 2 During shallow breaths 3 Suspended inspiration 4 Suspended expiration

4

Which of the following positions best demonstrates the left colic flexure? 1 LPO 2 Left lateral decubitus 3 Left lateral 4 LAO

4

Which one of the following imaging modalities and/or procedures is very effective in detecting the Meckel diverticulum? 1 CT 2 Double-contrast barium enema 3 Sonography 4 Nuclear medicine

4

Why is the PA rather than the AP recommended for a small bowel series? 1 Less gonadal dose for female patients 2 More comfortable for patient 3 Places small intestine closer to film 4 Better separation of loops of small intestine

4

How long is the small intestine?

4.5-5.5 m (15-18 feet)

what degree are the femurs abducted for a bilateral frog leg projection?

40-45

How much do you flex the knee for a lateral projection of femur?

45 degrees

how much is the body obliqued for Judet Method?

45 degrees

The lateral scapula projection requires the patient to be rotated ____ degrees towards the IR for a PA position.

45-60 degrees

What is the recommended central ray placement for a lateral knee position on a tall, slender male patient with a narrow pelvis (without support of the lower leg)?

5 degrees ceph

How much rotation of the toes is there on an AP distal femur projection?

5 degrees internally

How long is the large intestine?

5 ft

how long should a patient be upright or decubitus to demonstrate potential intraperitoneal air?

5 minutes

How much should the CR be angled for AP bilateral knees on a thin patient?

5-10 degrees caudal

What exposure factors do we use for abdominal exams?

70-80 kVp at 40 DIR

What is the SID for an AC joint projection?

72 inches

Prior to having a small bowel series, the patient should remain NPO for:

8 hours

kV range for a KUB of an adult

80 kVp at 40 mAs

What is the recommended kV range for an iodinated, water-soluble barium enema study?

80-90 kvp

The recommended water temperature for a barium sulfate mixture used for most barium enema procedures is:

85 to 90 °F

How many regions are in the abdomen?

9

What is the ideal kV range for a double contrast barium enema?

90-100 kv

Which laxative is classified as a saline type? A) Magnesium citrate B) Magnesium cyanide C) Castor oil D) Barium sulfate

A

What does KUB stand for?

kidneys, ureters, bladder

Where do you center for a Lateral abdomen?

Center IR at level of iliac crest (L4-L5)

Chondrosarcoma

A malignant tumor of the cartilage usually occurs in pelvis and long bones of men 45+ may be removed surgically if not responsive to radiation or chemotherapy.

Which of the following shoulder positions is considered a trauma projection (can be performed safely for a possible fracture or dislocation of the proximal humerus)? 1. AP apical oblique axial (Garth method) projection 2. Inferosuperior axial (Clements modification) projection 3. AP projection-internal rotation 4. None of the above

AP apical oblique axial (Garth method) projection

What ionization chambers for the AEC should be used for a tangential projection for the intertubercular groove?

AEC should not be used, it is tabletop

Which basic projection of a knee best demonstrates the proximal fibula free of superimposition?

AP 45 degree medial oblique

What projection does the anterior and posterior rims of the glenoid cavity need to be superimposed?

AP Oblique/Grashey

If a patient presents with Osgood-Schlatters disease, what would the routine knee examination consist of?

AP and Lat projection of affected knee

A patient enters the ED with multiple injuries including a possible fracture of the left proximal humerus. Which positioning rotation should be performed to determine the extent of the humerus injury? 1. AP neutral shoulder rotation and carefully rotated internally proximal humerus 2. AP shoulder as is; show radiograph to the ED physician before attempting a rotational lateral projection 3. AP and horizontal beam transthoracic lateral shoulder projection 4. AP and apical oblique shoulder without any arm rotation

AP and horizontal beam transthoracic lateral shoulder projection

What positioning rotation should be performed for a patient that presents with a proximal fx of the humerus?

AP and transthoracic lateral

what projection is used to look for posterior displacement of the pelvis? (inward/outward rotation of anterior pelvis)

AP axial inlet

Which alternative landmark can be palpated if unable to locate the coracoid process for the shoulder projection for the obese shoulder? 1. Inferior angle of scapula 2. Greater tubercle of humerus 3. AC joint 4. Lesser tubercle of humerus

AC joint

A patient comes to radiology for treatment of an arthritic condition of the right shoulder. The radiologist orders AP internal/external rotation projections and an inferosuperior axial projection of the scapulohumeral joint. However, the patient cannot abduct the arm for this projection. Which other projection will best demonstrate the scapulohumeral joint space? 1. AP oblique (Grashey method) 2. Scapular Y lateral 3. Transthoracic lateral 4. AP projection-neutral rotation

AP oblique (Grashey method)

What is the first projection when dealing with a trauma hip/femur?

AP pelvis

Which of the following projections can be performed using an orthostatic (breathing) technique? 1. Scapular Y lateral projection 2. Inferosuperior axiolateral projection 3. AP clavicle 4. AP scapula

AP scapula

What projection demonstrates the Lesser tubercle in profile?

AP shoulder with internal rotation

What does a routine KUB exam consist of

AP supine

What is the most common abdominal radiograph?

AP supine often called the KUB (kidneys, ureters, and bladder)

What does a routine Acute abdomen exam consist of

AP supine, AP erect, and PA chest erect

The 2 important positioning landmarks of the ilium?

ASIS Iliac crest

neoplasm

Abnormal growth Appearance: narrowness or tapering of lumen/napkin ring/apple core Exam: dbl contrast BE or CT Colonography

How much clavicle should be included on an AP/AP axial projection

Acromial end to sternal end

What three parts make the Y in a Scapular Y?

Acromion process, coracoid process, inferior angle

Which of the following describes a bowel obstruction caused by immobility of the bowel: A. diverticula B. adynamic ileus C. pyloric stenosis D. ulcerative colitis

Adynamic ileus

What AC projection requires a 15 degree cephalic angle?

Alexander

What should the radiographer do when a patient cannot raise their unaffected arm over their head for a transthoracic projection?

Angle CR 10-15 degrees cephalad

A radiograph of an AP barium projection reveals poor visualization of the sigmoid due to excessive superimposition of the sigmoid colon and rectum. How can this area be better visualized on the repeat exposure?

Angle the CR 30-40 degrees cephalic with AP

What dislocation of the shoulder occurs more frequently?

Anterior

What landmark is found anteriorly and inferiorly from the iliac crest, and is used for positioning the pelvic and vertebral structures?

Anterior superior iliac spine (ASIS)

The rectum ends at the what?

Anus

What is the sphincter muscle at the terminal opening of the large intestine?

Anus

What projection would you use to look for dysplasis of the hip (congenital hip dislocation)?

Ap bilateral frog-leg

What is the garth method used for?

Apical Oblique trauma for possible fx

What is attached to the posteromedial aspect of the cecum?

Appendix (vermiform appendix)

What is the vertical portion of the large intestine above the Cecum?

Ascending colon

What anatomy can be found in the RLQ of the abdomen?

Ascending colon Appendix (vermiform) Cecum 2/3 of Ileum Ileocecal valve

What are the four forms of mesocolon?

Ascending, descending, transverse, and sigmoid or pelvic

The correct order of the segments of the colon, beginning with the cecum, is:

Ascending, hepatic flexure, transverse, splenic flexure, descending, sigmoid

Abnormal accumulation of fluid in the peritoneal cavity of the abdomen

Ascites

What is another term for the AP axial projection taken during a barium enema procedure? A) Sims' position B) Butterfly position C) Chassard-Lapine position D) Smith position

B

Where do you center for a dorsal decubitus?

Center of IR 2 inches above iliac crest

What is a possible radiographic sign for impingement syndrome of the shoulder? 1. Calcified tendons 2. Fluid-filled joint space 3. Fracture of the glenoid rim 4. Bone spurring in acromiohumeral space

Bone spurring in acromiohumeral space

Where do you center for a PA prone abdomen

Center of IR to level of iliac crest

What type of compensating filter is recommended for an AP shoulder projection? 1. Wedge 2. Correct Boomerang 3. Trough 4. Gradient

Boomerang

The scapulohumeral has a _____ type of movement

Ball and Socket

Polyps

Barium filled saclike inward projections Exam: dbl contrast BE; CT Colonography

Ankylosing Spondylitis

Begins with fusion of SI joints and follows with extensive calcification of anterior longitudinal ligament of spinal coloumn. End result is a radiographic characteristic called "bamboo spine" males mostly affected.

The popliteal region is located __________.

Behind the knee

lesser (true) pelvis

Below pelvic brim

Why is the PA rather than the AP projection recommended for a small bowel series? A. less gonadal dose for female patients B. more confortable for patients C. better seperation of loops of small intestine D. places small intestine closer to the IR

Better separation of loops of small intestine

What type of joint is the femoraltibial joint?

Bicondylar

Where do you center for an AP supine KUB

Center of IR to level of iliac crest(L4-L5)

True or false: The Hill-Sachs defect is a fracture of the articular surface of the glenoid cavity.

False

Which of the following liquids is NOT appropriate for patients on a liquid diet in preparation for a colon examination? A. Juice B. Jell-O C. Chocolate milk D. Sweet tea

Chocolate milk

Modified Axiolateral Inferiorsuperior-Possible trauma

Clements-Nakayama Method

What projection is best suited for the patient with limited movement of both lower limbs to demonstrate a lateral perspective of the proximal femur?

Clements-nakayama method

What is the CR for a supine inter tubercular groove projection?

CR 15-20 degree posterior to humerus

AP Pelvis (Bilateral Hips)

CR 2 in below ASIS, centered in middle internally rotate legs 15-20 degrees -lesser trochanter not visible -light field above iliac crest

CR Bilateral AP Frog Leg

CR 3 inches inferior to level of ASIS

AP Hip (Unilateral)

CR 4 inches from ASIS, 2 inches medial (perpendicular to femoral neck) -leg internally rotted 15-20 degrees

CR Axial inlet projection

CR 40 degrees caudal at level of ASIS

Frog-leg

CR 4in down from ASIS, 2 in medial (into crease) Leg abducted 45 degrees

AP Unilateral Hip CR

CR @ femoral neck, about 1-2 inches medial and 3-4 inches distal to ASIS

TRAUMA axiolateral inferosuperior projection: Danelius miller

CR @ perpendictular to femoral neck and IR

AP Bilateral Frog Leg Pelvis (Modified Cleaves) CR

CR Perp at 3 inches below level of ASIS

How is the CR positioned for the Rosenburg projection of the knee?

CR angled 10 degrees towards feet (caudal), at midpoint between knee joints, 1/2 inch below apex of the patella

AP Axial Outlet Projection: Taylor Method CR

CR angled 20-35 degrees cephalic for males CR angled 30-45 degrees for females @ 1-2 inches distal to greater trochanters/symphasis pubis

AP Axial Inlet Projection CR

CR angled 40 degrees caudal @ level of ASIS

CR of Hughston method

CR angled 45 degree towards head into patella joint

bilateral frog-leg

CR centered 3 in below ASIS, middle top of IR at level of iliac crest both knees flexed 90 degrees abduct legs 40-45 from vertical

CR RAO/LAO

CR perp @ 1 inch lateral from medial to side up from table

RPO/LPO CR

CR perp at iliac crest about 1 inch lateral to elevated side

Lateral rectum CR

CR perp at level of ASIS

CR AP Pelvis

CR perp midway between ASIS and the symph pubis. About two inches inferior to level of ASIS

Dani-Miller

CR perpendicular to femoral neck (mid femur) IR perpendicular to CR Internally rotate leg 15-20 if possible *Grid* Cross table, horizontal beam

What type of CR angulation & how much flexion is required for PA axial weight-bearing projection (Rosenberg)?

CR- 10 degrees flexion-45

What is the main pathology that is being looked at for the inter tubercular groove projections?

Calcium deposits

When will the Rosenburg projection of the knee be ordered?

Cartilage damage and degenerative diseases

What is the portion of the large intestine below the ileocecal valve called?

Cecum

A patient comes to the emergency department (ED) with a possible right AC joint separation. Right clavicle and AC joint examinations are ordered. The clavicle is taken first, and a small linear fracture of the midshaft of the clavicle is discovered. What should the technologist do in this situation? 1. Perform the weight-bearing phase as ordered. 2. Reduce the amount of weight that would normally be given to the patient and perform the weight-bearing study. 3. Consult with the ED physician before continuing with the AC joint study. 4. Slowly give the patient more weight to hold until he begins to complain and then complete the AC joint study.

Consult with the ED physician before continuing with the AC joint study

A patient enters the ED with multiple injuries. The physician is concerned about a dislocation of the left proximal humerus. The patient is unable to stand. Which of the following routines is advisable to best demonstrate this condition? 1. AP shoulder and inferosuperior axial projection 2. AP shoulder and 35° to 45° AP oblique (Grashey method) 3. AP shoulder and Neer projection 4. Correct AP shoulder and recumbent AP oblique (scapular Y) projection

Correct AP shoulder and recumbent AP oblique (scapular Y) projection

The anterior surface of the scapula is referred to as the: 1. scapular surface. 2. dorsal surface. 3. supraspinous and infraspinous fossa. 4. costal surface.

Costal surface

What is the anterior surface of the scapula called?

Costal surface

How should the radiographer correct the centering for an image of the supine abdomen that reveals the obturator foramen has been cut?

Cr is too high, bring the bottom of the IR to the level of the greater trochanter

CR for scapular Y lateral

Cr proximal to humerus, 2 inches below top of shoulder

chronic inflammation o f the intestinal wall resulting in bowel obstruction in some patients

Crohn's disease

Adenocarcinoma: 1) Is also known as megacolon 2) May have an apple core appearance on a radiograph 3) May result in bowel obstruction A) 2 only B) 1 and 2 only C) 1 and 3 only D) 2 and 3 only

D

Situation: An infant is brought to the ED with a possible intussusception. Which of the following procedures may actually correct this condition? A Small bowel enema B Small bowel series C Defecography D Barium or air enema

D

Which part of the small intestine is the shortest?

Duodenum

What are the 3 parts of the small intestine?

Duodenum, Jejunum, and Ileum

True or False: A radiograph of the inferosuperior axial projection (Lawrence method) demonstrates the acromion process of the shoulder to be located most superiorly (anteriorly).

False

True or False: During a colostomy barium enema, a double-contrast retention enema tip is used.

False

True or False: Evacuative proctography is most commonly performed on geriatric patients.

False

True or False: For an AP oblique (Grashey method) projection of the shoulder, the CR is centered to the acromion.

False

True or False: For an average adult, the amount of barium ingested is one 16-ounce cup for a small bowel only series.

False

True or False: The sigmoid colon and upper rectum are infraperitoneal structures.

False

True or false: A posterior dislocation of the shoulder occurs more frequently than an anterior dislocation.

False

Which of the following procedures best demonstrates a rectocele? A. Double-contrast BE B. Single contrast BE C. Evacuative proctography D. Enteroclysis

Evacuative proctography

Is the lumen of the digestive tract considered internal or external?

External

What projection is the greater tubercle profiled laterally?

External rotation

Which view and projection of the proximal humerus is represented in the figure? 1. External rotation, anteroposterior (AP) projection 2. Neutral rotation, AP projection 3. Internal rotation, AP projection 4. External rotation, lateral projection

External rotation, anteroposterior (AP) projection

what projection would you use if affected hip can not be moved and a lateral view is needed for a fracture?

Danelius-Miller -Axiolateral Inferosuperior

Axiolateral Inferosuperior Projection-Trauma

Danelius-Miller Method

When a patient presents with osteoarthritis or osteoporosis, what should happen to your exposure factors?

Decrease

A radiograph of a PA oblique (scapular Y) lateral position reveals that the scapula is slightly rotated (the vertebral and axillary borders are not superimposed). The axillary border of the scapula is determined to be more lateral compared with the vertebral border. Which of the following modifications should be made for the repeat exposure? 1. Decrease rotation of thorax. 2. Decrease CR angle. 3. Increase rotation of thorax. 4. Abduct the arm more and flex it at the elbow.

Decrease rotation of thorax

What is a potential risk associated with the use of water-soluble contrast agents, especially for geriatric patients? A. Bowel obstruction B. Cardiac arrest C. Dehydration D. Shock

Dehydration

What is the name of the insertion point for the deltoid muscle located on the anterolateral surface of the humerus? 1. Surgical neck 2. Deltoid protuberance 3. Correct Deltoid tuberosity 4. Intertubercular sulcus

Deltoid tuberosity

What anatomy can be found in the LLQ of the abdomen?

Descending colon Sigmoid colon 2/3 of Jejunum

What structure should always be included on an abdominal radiograph?

Diaphragm

Which of the following conditions is characterized by pouch-like herniations oft he colonic wall? A. Diverticula B. Polyps C. Pyloric stenosis D. Ulcerative colitis

Diverticula

Which projection will best demonstrate an abdominal aortic aneurysm?

Dorsal decubitus

A patient comes to radiology with possible diverticulosis. Which of the following studies is most diagnostic for detecting this condition? A. Single contrast BE B. Double contrast BE C. Evacuative proctogram D. Small bowel series

Double contrast BE

What is the proximal portion of the duodenum called?

Duodenal bulb or cap

What is the first portion of the small intestine?

Duodenum

What is the shortest but widest of the three segments of the small intestine?

Duodenum

What part of the small intestine has the largest diameter? A. duodenum B. ileum C. jejunum D. cecum

Duodenum

Which part of the small intestine has the largest diameter?

Duodenum

Complete or nearly complete blockage of the flow of intestinal contents

Dynamic or mechanical bowel obstruction

T/F Rectal retention enema tips should be fully inflated by the technologist before beginning a barium enema

False

What is region B called?

Epigastric

The ascending colon and upper rectum are intraperitoneal structures A. true B. false

False

A patient enters the ED with a midshaft humeral fracture. The AP projection taken on the cart demonstrates another fracture near the surgical neck of the humerus. The patient is unable to stand or rotate the humerus because of the extent of the trauma. What other projection should be taken for this patient? 1. Scapular Y lateral-AP oblique projection 2. Apical oblique projection 3. Horizontal beam transthoracic lateral projection for humerus 4. Rotational lateral projection for humerus

Horizontal beam transthoracic lateral projection for humerus

The opening between the small intestine and the large intestine is called the: A. Ampulla of Vater B. Greater duodenal papilla C. Ileocecal valve D. Pyloric valve

Ileocecal valve

What connects the Ileum to the large intestine?

Ileocecal valve

What are the distal 3/5 of the small intestine called?

Ileum

Which part of the small intestine makes up three fifths of its entirety?

Ileum

nonmechanical bowel obstruction (adynamic)

Ileus

What specific clinical indications are we concerned with in an acute abdominal series 3 view

Ileus: (non mech. small bowel ovstruction) Ascites: (abnormal fluid accumulation) Perforated hollow viscus :(free intraperitoneal air) Intra abdominal mass postoperative abdominal surgery

What landmark is at L4-L5, and at the level of the midabdomen

Iliac crest

What is the difference between a PA and AP abdomen?

Iliac wings are flipped

What is the largest bone of the pelvic girdle?

Ilium

Subacromial spurring is a common radiographic sign of ???

Impingment syndrome of the shoulder

A radiograph of an AP oblique (Grashey method) projection for the glenoid cavity reveals that the anterior and posterior rims of the glenoid process are not superimposed. Which of the following modifications should produce a more acceptable image? 1. Angle CR 5° to 10° caudad. 2. Angle CR 5° to 10° cephalad. 3. Increase rotation of the body toward the IR. 4. Abduct the arm slightly.

Increase rotation of the body toward the IR.

If the anterior and posterior rims of the glenoid cavity are not superimposed... what should the radiographer to do correct this?

Increase rotation of the thorax

A radiograph of an AP axial projection of the clavicle demonstrates that the clavicle is within the midaspect of the lung apices. What should the technologist do to correct this error? 1. Do nothing; this is an acceptable AP axial clavicle projection. 2. Increase the caudad CR angle during repeat exposure. 3. Increase the cephalic CR angle during repeat exposure. 4. Make the exposure upon complete inspiration.

Increase the cephalic CR angle during repeat exposure.

How is a possible Hill-Sachs defect best demonstrated?

Inferior Superior Axial Shoulder with exaggerated external rotation of affected arm

What landmark is at L2-L3 and is used to locate upper abdominal organs, such as the gallbladder and stomach?

Inferior costal margin

What is a natural landmark for the femoral neck?

Inguinal crease

Gout

Inherited type of arthritis that commonly affects males; uric deposits in joint spaces

What AP projection of the shoulder is the greater tubercle located anterior and the lesser tubercle is medial (in profile)?

Internal

What projection of the shoulder is the lesser tubercle profiled medially?

Internal rotation

Which of the following AP shoulder projections demonstrates the lesser tubercle in profile medially? 1. External rotation 2. Internal rotation 3. Neutral rotation 4. None of the above

Internal rotation

A specific type of double fold peritoneum that extends from the stomach to another organ

Omentum

Where are the kidneys located?

On each side of the lumbar vertebral column

Organs located under or beneath the peritoneum

Lower rectum, urinary bladder and reproductive organs

The spleen is part what system?

Lymphatic

What is the best modality to examine ligament injuries to the knee?

MRI

Which imaging modality can demonstrate abscesses in the retroperitoneum?

MRI

Legg-Clave-Perthes disease usually involves:

Males between 5-10 Years of age -flattened head of femur and appears fragmented due to poor blood supply

Metastatic carcinoma

Malignancy spread to bone via the circulatory, lymphatic systems, or direct invasion

The adductor tubercle is the slightly raised area located on the posterior aspect of the ____________.

Medial condyle of the femur

Where is the esophagus located?

Mediastinum of the thoracic cavity

SITUATION: A projection is performed for the patellofemoral joint w/ the patient supine and the knee flexed 40. The CR is angled 30 caudad from horizontal. The cassette is resting on the lower legs supported by a special device. Which method is being described?

Merchant

What method of the knee requires the use of a special IR holding device?

Merchant method

What patella projection requires a special holding device?

Merchant method

A double fold of peritoneum that loosely connects the small intestine to the posterior abdominal wall

Mesentery

Peritoneum that attaches the colon to the posterior abdominal wall

Mesocolon

Where is the vertical plane located for the four abdominal quadrants?

Midsagittal plane, passing through the umbilicus and symphysis pubis

what projection would you use for a possible hip fracture when the patient has liminted movement?

Modified Axiolateral Inferiorsuperior -Clements-Nakayama

AP Bilateral Frog-Leg Projection-Pelvis

Modified Cleaves Method

what projection would you use to get a lateral view of the hip joint for a non-traumatic injury?

Modified cleaves method -Unilateral Frog-leg Projection

Which radiographic sign is frequently seen with intussusception? A. "napkin ring" or "apple-core" sign B. Thickened mucosa C. "Mushroom-shaped" dialation D. "Beak" sign

Mushroom shaped dialation

Which of the following best demonstrates the coracoacromial arch? 1. Neer method 2. West Point method 3. Fisk method 4. Garth method

Neer method

What AP projection of the shoulder are the epicondyles located 45 degrees to the IR?

Neutral

Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh? 1. Internal rotation 2. Neutral rotation 3. External rotation 4. AP axial

Neutral rotation

Is the gallbladder seen without contrast normally?

No

Is the location of the large intestine the same in a hypersthenic type and a hyposthenic type?

No

Should you see air filling the entire stomach or small intestine on a healthy adult?

No

How much CR angulation should be used for a PA oblique (scapular Y) projection? 1. No CR angle is required. 2. 10° to 15° 3. 20° to 30° 4. 35° to 45°

No CR angle is required.

How far is the enema tip inserted into the rectum for a colon examination? A. No more than 2" B. No more than 3" C. No more than 4" D. No more than 5"

No more than 4"

A patient enters the ED with a possible AC joint separation. The patient is paraplegic; therefore, the study cannot be done erect. Which of the following routines would be performed to diagnose this condition? 1. Non-weight-bearing and weight-bearing types of projections performed with the patient recumbent by pulling down on the shoulders 2. Recumbent AP and AP axial projection of the clavicles to include AC joints 3. AP projections of shoulders with external and internal rotation performed recumbent 4. AP and AP apical oblique projection of the shoulder performed recumbent

Non-weight-bearing and weight-bearing types of projections performed with the patient recumbent by pulling down on the shoulders

Which of the following AP shoulder projections demonstrates the greater tubercle in profile medially? 1. External rotation 2. Internal rotation 3. Neutral rotation 4. None of these

None of these

How much do you rotate limbs internally for a trauma AP pelvis/hip?

None. You do not rotate limbs until you are sure there are not fractures

What modality is the best in detecting Meckel's diverticulum?

Nuc Med

Why is a PA projection of the patella preferred to an AP projection

OID, patella is closer to IR

A referring physician suspects that a subacromial spur may be the cause for a patient's shoulder impingement. She asks the technologist for a projection that would best demonstrate any possible spurs in the suprasinatus outlet. Which of the following projections would accomplish this objective? 1. Tangential projection with 10° to 15° caudad angle 2. Tangential projection with 10° to 15° cephalad angle 3. AP oblique shoulder with 45° caudad angle 4. AP shoulder with 10° to 15° caudad angle

Tangential projection with 10° to 15° caudad angle

What projection should be utilized to demonstrate the intertubercular groove?

Tangential/Fisk

AP Axial Outlet Projection

Taylor Method

what projection would you use to assess trauma to pubic and ischial structures?

Taylor method

What are the other names of the AP axial outlet projection?

Taylor method & Uptilt

what projection is used to view the bilateral pubis and ischium?

Taylor method- outlet pelvis

what must be included on an AP and lateral femur?

knee and hip joint

which projection would best demonstrate an umbilical hernia?

lateral

What projection would best demonstrate a fistula extending from the rectum to the urinary bladder?

lateral rectum

SITUATION: A radiograph of the knee reveals the joint spaces are not equally open & the proximal fibula is superimposed over the tibia. What positioning error lead to this?

lateral rotation of lower limb

What is the highest/most superior portion of the large intestine?

left colic flexure

if the left iliac wing appears elongated on an AP pelvis image what positioning error has occurred?

left side is rotated toward the IR

Where would the transverse colon be on a hyposthenic type?

low in the abdomen

CR Axial Outlet Projection

males- 20-35 degrees towards head females- 30-45 degrees towards head 1-2 inches distal to greater trochanter

Metastatic Carcinoma

malignancy spread to bone by the circulatory of lymphatic system. metastatic tumors are more common than primary malignancies. most commonly presents in red bone marrow sites such as spine, skull, ribs, pelvis, and femora

Ewing's sarcoma

malignant growth found in the shaft of long bones "onion peel" look

For the AP oblique projection of the knee, the ___ rotation best visualizes the lateral condyle of the tibia and the head and neck of the fibula

medial

The sternal extremity is the __________ end of the clavicle

medial

The crescent-shaped fibocartilage disks that act as shock absorbers in the knee joint are called

medial and lateral menisci

Settegast CR

midway between patellofemoral joint, 15-20 degrees from lower leg

Proximal Femur (Hip) Fractures

most common in geriatric patients w/ osteoporosis or avascular necrosis (loss of blood circulation causing cell death) leads to weakening or collapse of weight bearing joints such as the hip and occur w/ only minimal trauma.

Legg-Calve-Perthes Disease

most common type of aseptic or ischemic necrosis. lesions usually involve 1 hip (head or neck of femur) usually ocurs in boy 5-10yrs. limp is usually first clinical sign presents radiographically as a flattened femoral head (may appear fragmented)

Plicae circulares

mucosal folds which increase the surface area in the small bowel to aid in absorption of nutrients

Difference between lateral knee and lateral patella

no angulation, collimation,knee flexed 5-10 degrees

True or False: All of the joints of the shoulder girdle are diarthrodial.

True

True or False: Overhead, radiographic projections are often not taken when using digital fluoroscopy.

True

True or False: The circular staircase, or herringbone pattern, is a common radiographic sign for a mechanical ileus.

True

True or False: The female clavicle is usually shorter and less curved than that of the male.

True

True or False: The height of the enema bag should not exceed 36 inches (91 cm) above the radiographic table at the beginning of the study.

True

True or false: An orthostatic (breathing) technique can be performed for the AP projection of the scapula.

True

True or false: For AC joint weight-bearing studies, patients should not be asked to hold on to the weights with their hands; rather, the weights should be attached to the wrists.

True

True or false: Sonography is effective in the dynamic evaluation of the shoulder joint.

True

True or false: The use of a grid during shoulder radiography will result in higher patient dose over nongrid procedures.

True

True or false? The recommended SID for AP AC joint study is 72 inches (~183cm).

True

How should the tube be angled for the Camp coventry projection of the knee?

Tube should be parallel to lower leg, CR directed to knee joint

How do you get a true AP on hip projections

Turn leg in 15-20 degrees

Which of the following is a severe inflammation of the colon and rectum with loss mucosal lining? A. Diverticula B. Ulcerative colitis C. Enteritis D. Adynamic ileus

Ulcerative colitis

chronic inflammation of the colon

Ulcerative colitis

Which of the following modalities best demonstrates shoulder joint pathology such as rotator cuff tears using dynamic evaluation techniques during joint movements? 1. Ultrasound 2. Magnetic resonance imaging (MRI) 3. Computed tomography (CT) 4. Arthrography

Ultrsound

What is region E called?

Umbilical

Modified Cleaves Method-Hip & Proximal Femur

Unilateral Frog-leg Projection (Mediolateral)

T/F The enteroclysis procedure is indicated for patients with regional enteritis

false

T/F The terms large intestine and colon are synonymous

false

T/F... The "false pelvis" forms the birth canal in the females

false

if the lesser trochaters are clearly seen on an AP pelvis what is the positioning error?

feet need rotated 15-20 degrees internally

Difference between male and female clavicle

female is shorter and less curved

Movements of the hip joint

flexion/extension abduction/adduction medial/lateral rotation circumduction

Depression on the head of femur where a ligament attaches the head into the acetabulum

fovea capitis

Pelvic ring fractures

fx resulting from severe blow to one side of pelvis

Structures of the proximal humerus

greater and less tubercle, intertubercular sulcus, anatomical and surgical neck, head

How does the greater trochanter appear in the frog leg projection?

greater trochanter is superimposed over the femoral neck

What should be in profile for an AP Hip projection?

greater trochanter, femoral neck -lesser trochanter not seen

4 parts of the femur

head neck greater trochanter lesser trochanter

Where would the transverse colon be on a hypersthenic type?

high in the abdomen

important joints of the lower limb

hip joint sacroiliac joint symphysis pubis

4 bones of the pelvis

ilium ischium coccyx pubis

Why is it important for the technologist to review the patient's chart and inform the radiologist before beginning the barium enema examination if a biopsy was performed as a part of a prior sigmoidoscopy or colonoscopy procedure?

The biopsy of the colon may weaken that portion of the colon, which would lead to perforation

What allows kidneys to be seen on an xray?

The fat capsules surrounding them

What 2 muscles should be faintly visible on an abdominal radiograph?

The lateral borders of the 2 Psoas majors

what bones make of the acetabulum?

ilium ischium pubis

what bones make up the obuturator foreman?

ilium ischium

3 divisions of the hip bones

ilium, ischium, pubis

innominate bones

ilium, ischium, pubis

What system is used for locations of anatomy by radiographers most the quadrant system or region system?

The quadrant system

Which kidney sits a bit lower and why?

The right, because of the large liver

The articular facets of the proximal tibia are also referred to as the

Tibial plateau

What is the function of the kidneys?

To filter waste materials and excess water from the blood

Why is oral contrast media sometimes given during computed tomography colonography?

To mark or "tag" possible fecal matter

Where do you place IR on a Lateral Decubitus?

Top of IR at armpit region or Center of IR 2 inches above level of iliac crest

Where do you center for an erect Abdomen?

Top of IR at the level of the axilla, Center of IR 2 inches above iliac crest

During the initial enema tip insertion, the tip is aimed:

Toward the umbilicus

What are the two transverse/horizontal planes called?

Transpyloric and transtubercular planes

Which part of the colon has the greatest amount of potential movement?

Transverse

Which sections of the large intestine will most likely be filled with barium with the patient in the prone position during a double-contrast BE A. rectum only B. right and left colic flexure and sigmoid colon C. ascending colon, descending colon, and rectum D. transverse and sigmoid colon

Transverse and sigmoid colon

Patients who require priority scheduling for studies that require fasting are: emergencies, infants & small children, diabetic patients, and geriatric patients A. true B. false

True

Tor F The lower aspect of the peritoneum is a closed sac and ends above the urinary bladder, separating the reproductive organs in the male?

True

A patient enters the ED with a dislocated shoulder. The technologist attempts to position the patient into the transthoracic lateral projection, but the patient is unable to raise the unaffected arm over his head completely. What can the technologist do to compensate for the patient's inability to raise his arm completely? 1. Perform the Grashey method instead. 2. Use a breathing technique. 3. Increase kV to penetrate through both shoulders. 4. Angle the CR 10° to 15° cephalad.

Use a breathing technique.

A radiograph of a transthoracic lateral projection reveals that it is difficult to visualize the proximal humerus due to the ribs and lung markings. The following analog exposure factors were used: 75 kV, 30 mAs, 40-inch (102 cm) SID, grid, and suspended respiration. Which of the following changes will improve the visibility of the proximal humerus? 1. Make the exposure on second inspiration. 2. Use a compression band to prevent patient movement. 3. Use a 72-inch (183-cm) SID. 4. Use an orthostatic (breathing) technique.

Use an orthostatic (breathing) technique.

A patient comes into radiology for a single contrast barium enema. The patient cannot lie on their side during the study. Which projection could replace the lateral rectum?

Ventral decubitus

What is the peritoneum that covers the organ called?

Visceral peritoneum

A twisting of the intestine on its own mesentery is termed:

Volvulus

The "tapered" or "corkscrew" radiographic sign is often seen with: A. Diverticulosis B. Neoplasm C. Volvulus D. Intussusception

Volvulus

twisting of a loop of intestine, creating an obstruction

Volvulus

metastatic cancer

What disease does this patient present with?

when is a small bowel study complete?

When contrast reaches the Ileocecal valve

What is another name for the "frog leg" AP projection?

Wiggins

Where is the sub scapular fossa located?

Within the anterior surface of the scapula

What landmark is atT9-T10, superior margin of the abdomen

Xiphoid process

Are retroperitoneal structures less mobile?

Yes

If enlarged can the spleen be seen on a plain abdominal radiograph?

Yes, faintly

Colitis

inflammation of the colon Appears in radiographs with thickening of mucosal wall and loss of haustral markings Exam: single or dbl contrast BE

What projection should be performed with a patient that presents with a pelvic ring fx?

inlet and outlet projections

Cecum in relation to the peritoneal cavity

intraperitoneal

Gallbladder in relation to the peritoneal cavity

intraperitoneal

Spleen in relation to the peritoneal cavity

intraperitoneal

ileum in relation to the peritoneal cavity

intraperitoneal

jejunum in relation to the peritoneal cavity

intraperitoneal

sigmoid colon in relation to the peritoneal cavity

intraperitoneal

stomach in relation to the peritoneal cavity

intraperitoneal

transverse colon in relation to the peritoneal cavity

intraperitoneal

ankylosing spondylitis

a form of rheumatoid arthritis that produces calcifications of the longitudinal ligament of spinal column

How long is the pancreas?

about 12.5 cm (6 inches)

Where is the urinary bladder located?

above and behind the symphysis pubis

greater (false) pelvis

above pelvic brim

The slightly raised area located on the posterolateral aspect of the medial femoral condyle is called the ______.

adductor tubercle

Developmental Dysplasia of the Hip (DDH)

aka congenital dislocation of the hip (CDH) caused by conditions present at birth and may require frequent hip radiographs.

Where is the deltoid tuberosity located?

anterolateral surface of the humeral insertion

An abnormal accumulation of the serous fluid in the peritoneal cavity is called what?

ascites

Central ray for a one hour small bowel radiograph

at the iliac crest

How should weights be places for the AC joint weight bearing studies?

attached to the wrists

Why must the central ray be angles 5-7* cephalad for a lateral knee position?

because the medical condyle extends lower than lateral condyle of femur

Where are the right and left lateral planes of the abdominal regions located?

between the midsagittal plane and each anterior superior iliac spine (ASIS)

what does the true pelvis form?

birth canal

What is the ischium divided into?

body and ramus

What are topographic landmarks?

bony landmarks that are easily palpated and used for locating organs not visible from the exterior

Acute abdominal series may show what?

bowel obstruction perforations involving: free intraperitoneal air excessive fluid in abdomen intra-abdominal mass

Three clinical indications for an acute abdominal series

bowel obstructions, ascites, pnemoperitoneum, chrones disease, volvulus, paralytic ileus

most common tumors of the small bowel

carcinoid tumors

symphysis pubis classification

cartilaginous ampiarthrodial limited

Symphysis pubis classification

cartilaginous mobility- amph movement- limited

Union of acetabulum classification

cartilaginous mobility- synarthrodial movement- nonmovable

Acetabulum classification

cartilaginous synarthrodial non-movable

symphysis pubis joint classification/joint type

cartilaginous/limited

Union of acetabulum joint classification/joint type

cartilaginous/synarthroidal

What is the medical term for Runner's knee?

chondromalacia patallae

Ulcerative colitis

chronic inflammation of the colon with presence of ulcers Appearance: Cobblestone/Stovepipe appearance Exam: single/dbl contrast BE

Plain radiographs are taken without the use of what?

contrast

What does the Neer method demonstrate?

coracoacromial arch

The articular facets slope ___* posteriorly a. 25 b. 45 c. 35 d. 10-15

d

Another term for osteoarthritis is: 1. rheumatoid arthritis. 2. bursitis. 3. degenerative joint disease. 4. osteoporosis.

degenerative joint disease

What 3 muscles are the most important in abdominal radiography

diaphragm, and 2 Psoas majors

Avulsion (evulsion) Fractures of the Pelvis

difficult to diagnose if not imaged properly. lower kv (75-85kvp) needed to detect on AP pelvis. usually occurs in adolescent athletes

The tip of the catheter is advanced to the _______ during an enteroclysis.

duodenojejunal junction (ligament of Treitz)

The __________ rotation AP shoulder projection demonstrates the greater tubercle profiled laterally

external

what is an indicator of hip fracture?

external rotation of the foot

air outside the digestive tract

intraperitoneal air