Registry review: POSITIONING 1 & 2
What is the posterior oblique (grashey method) projection of the shoulder?
-35-45degrees oblique -CR perp to IR -CR 2'' inferior and medial from superolateral border of humerus
The spine has ____ curves that arch _____________ and ____________ from the MSP.
-4, Posteriorly, anteriorly
What is the criteria for the lateral-spinal fusion (hyperflextion and hyperextention) projection?
-Fusion site centered -true lateral -optimal exposure factors
What is the criteria for the posterior oblique (Grashy method)?
-Glenoid cavity profiled -scapulohumeral joint centered -exposure factors
What shielding should be used for hip radiographs?
-Gonadal shielding can be used on both male and females for hip if placed correctly. Not commonly used on pelvis exams. Male: Small contact shield, top border at inferior margin of symphysis pubis Female: Ovarian shield for hips and proximal femora
What are the 5 positioning errors for skull work? most common?
1-rotation 2-tilt 3-excessive flexion 4-excessive extension 5-incorrect CR angle most common: tilt and rotation
What are the 3 concentric arcs (arches)?
1-trochlear sulcus 2-outer ridges of capitulum and trochlea 3-trochlear notch of ulna
Which of the following positioning/technical considerations does not apply to a rib study for an injury to the right, lower posterior ribs?
-LPO projection
Maxilla
-Largest immoveable bone of the face. -Two maxilla are united right below the nasal septum -Each maxilla assists in the formation of the mouth, nasal cavity and one orbit -Contain 4 processes (palatine not visible it is part of the hard palate -Articulates with two cranial bones and seven facial bones
Which of the following lumbar spine projections will best demonstrate the extent of a compression fracture?
-Lateral
What is the LAO barium enema criteria?
-Left colic flexure and descending colon are open. -Entire large intestine is demonstrated. -Optimal exposure factors
What is the patient preparation for a Ba Enema?
-Light evening meal prior to exam -Bowel-cleansing cathartics -NPO after midnight (8 hours minimum) -No gum chewing -No smoking -Enema morning of exam
What is the equiptment necessary for single contrast BE in peds?
-Lubricating jelly -Hypoallergenic tape -Gloves -Washcloths and towels -Neonates and infants -#10 French silicone catheter -60-mL syringe
parietoacanthial (waters) for parasinuses?
-MML perpendicular to IR -CR horizontal, to exit at acanthion -Maxillary sinus best demonstrated
parietoacanthial (waters) facial bones projection?
-MML perpendicular to IR -CR perpendicular to IR to exit at acanthion -best demonstrates the bony nasal septum
PA transoral waters for sinuses?
-MML perpendicular to IR -Open mouth -Horizontal CR, exit at acanthion -Allows us to see the sphenoid sinus through the open mouth
What are the 4 types of mesocolon? Why are they named that way?
-Named after the area of colon they connect 1. ascending 2. descending 3. transvers 4. sigmoid or pelvic
Describe the sternum.
-Narrow, flat bone -About 6 in length -Supports clavicles at manubrial angles -Forms sternoclavicular (SC) joints -Provides attachment for costal cartilages of first seven pairs of ribs at lateral borders
criteria for lateral nasal bones?
-Nasal bones centered -No rotation -Optimal exposure factors -Close collimation -The nasal bones, with surrounding soft tissue, anterior nasal spine of the maxilla, and most of the anterior aspects of the cranial cortices, orbital roofs, and zygomatic bones, are included within the collimated field To get good detail, no AEC, small focal spot, low to medium kVp and close collimation are essential
What is the criteria for AP or PA axial and AP or PA axial oblique?
-No rotation -Rectosigmoid area centered -Rectosigmoid demonstrated with less superimposition than PA -Transverse colon and flexures not necessarily included -Elongation of rectosigmoid colon -Optimal exposure factors
How do you rotate the foot for an AP oblique foot radiograph?
30-40degrees medial rotation
There are a total of _______ vertebrae in early life.
33
For a RAO esophogram, how much should the PT be rotated?
35-40 degrees
how many paranasal sinuses are there?
4
What are the bones of the pelvis?
4 bones, -2 hip bones (ossa coxae, and innominate bones) -sacrum -coccyx
The xiphoid process does not become totally ossified until the age of?
40 years
What is the SID for all abdomen x-rays?
40''
What is the SID for the upper limb?
40''
What is the SID for lower extremity radiographs?
40'' ---except for the tib/fib can sometimes be 44-48''
What is the SID for cranial work?
40'' SID
How much rotation should there be for a RAO Upper GI?
40-70 degrees
How much rotation should there be on the PA oblique finger?
45degrees
Boxer's fracture
5th metacarpal fracture
what is the modified axiolateral?
-also called Clements-Nakayama Method -CR 30°-40° mediolateral and 15°-20° posteriorly from horizontal -CR centered to femoral neck
What are the pathologic indications for an Esophagram?
-anatomic anomalies -esophageal reflux -esophageal varices -foreign body obstruction -impaired swallowing mechanism
intervertebral discs are composed of what?
-annulus fibrosus- is the outer, fibrocarilaginous disk -Nucleus pulposus- central, soft mass
What anatomy does the atlas (C1) consist of?
-anterior arch -posterior arch -two lateral masses -two transverse processes
What are the basic projections used for viewing the intercondylar fossa?
PA axial projections: -camp-conventry method -halmbald method special: -AP axial
Mediolateral humerus projection
PT facing the IR and oblique the PT to allow close contact of the humerus with the IR, flex elbow 90degrees, have PT rest the palm of the hand on stomach
PT and part position for PA projection?
PT: prone or supine part: -MSP centered -for 30-min interval, center IR at the level of L2 for delayed images, center IR at iliac crest
Which carpal articulates with the radius and is named because of it's moon shape?
lunate
When in the breathing instructions should the exposure be taken?
make the exposure during a slow deep inspiration --you want the trachea full of air
When and where should gonadal shielding be placed for an abdominal x-ray on a male? female?
male-Below the symphysis pubis, between the tube and the patients gonads female-generally not used, because the gonads are in the area of interest and above the symphysis pubis --so only use if not including that area of interest
what are the 3 parts of the sternum
manubrium, body, and xiphoid process
What is the largest immovable facial bone?
maxilla
When is a medial rotation for AP oblique toes used?
medial oblique: used for digits 1,2, and 3
_________________ is advised for the second digit if patient can get in this position.
mediolateral
Which lateral position is used for a lateral patella?
mediolateral patella
Which lateral position is most common for the foot?
mediolateral, but they are interchangeable, so which ever is most comfortable for the PT you can do
What is the name for normal sized skull?
mesocephalic -has 47 degrees between the petrous pyramids and the msp
when going from a PA or AP erect position to a lateral position what should you do with the IR and CR why
move them down about 1/2'' to 1'' depending on the broadness of the patient so you don't cut off the costopheric angles of the lungs
dorsiflexion
movement of foot up, toward the shin
plantar flexion
movement of the foot down
inversion (varus)
movement of the foot medially
eversion (valgus)
movement of the foot outward
What is ulnar deviation?
moving the hand medially in the anatomic position--5th digit toward ulna ---Uses the scaphoid----
what are the 3 parts of the pharynx
nasopharynx, oropharynx, and laryngopharnyx
The scaphoid is also called _______________.
navicular
Where should the CR be for an AP upper airway
perpendicular at the level of T1-2 (about 1'' above the jugular notch) SID=40
Where should your CR be directed for an AP supine abdomen x-ray?
perpendicular to the iliac crest
What type of immobilization technique should be used for a chest study in a young pediatric patient?
pigg-o-stat
Which carpal lies anterior to the triquetrum and is the smalles carpal that is pea shaped?
pisiform
How do you get the thumb in a lateral position?
place your hand flat and then raise your fingers until your thumb is naturally in a lateral position
What kind of joints are the intercarpal joints?
plane (gliding)
What type of joint are the intercarpal joints?
plane (gliding) joints
The Acromioclavicular is what kind of joint?
plane or gliding
what projection has a 40degree CR angle?
plantodorsal (axial) of the calcaneus
how is rotation determined
posterior ribs should NOT be superimposed --separation of the posterior ribs should only be 1/4''-1/2''
What must you do to achieve a true AP femur?
rotate the feet and entire leg inward about 5degrees so the femoral neck is parallel to the IR
What bones are the carpal bones?
the 'wrist' bones
Which bones are internal?
the 2 palatine bones and the Vomer
Where should the CR be centered to?
the MCP
Impacted Fracture
the bone is broken and the ends are driven into each other
What should a postevac have?
the entire large intestine CR to iliac crest
What should be in profile for an AP unilateral hip radiograph?
the greater trochanter should be in profile --lesser trochanger should only slightly or not at all be seen(if it is in profile it its externally rotated and the neck will be foreshortened)
what is the base of the lungs
the inferior part, rests obliquely on diaphragm -lower in back and sides than front
What is the inner canthus?
the inner corner of the eye
If both feet are together with no rotation what will be visible?
the lesser trochanter
If you externally rotate the leg, what will be visible to know that if was externally rotated?
the lesser trochanter
Acanthiomeatal line
the line form the acanthion (area directly under the nose) to the meatus or EAM
what is the criteria for the tangential projection of the intertubercular groove?
-anterior humeral head profiled -groove profiled between greater and lesser tubericles -exposure factors
What is the joint between the metacarpal bone and the proximal phalangeal bone?
(whatever digit it is)th metacarpo-phalangeal (MCP) Joint
how long is the larynx
1 1/2 to 2 inches long (small)
where does the trachea start and end
C6 to T4 or T5
the lung with fluid should go _____________. While, the lung with air should be___________.
Down; UP fluid=down, against table
which marker should be used for chest
L
Where should the CR be for a lateral decub chest x-ray
horizontal, directed at T7 SID of 72''
the larynx is suspended from what bone
hyoid
the lungs move _____________ during inspiration and move _________________ during expiration.
inferiorly during inspiration superiorly during experation
pleurisy
inflammation of the pleura surrounding the lungs
The outermost layer of the pleura is referred to as what?
parietal pleura
what is the outer layer of the lung's pleural membrane called?
parietal pleura
what is the pharynx
passageway for food, liquids, and air
what are the 4 divisions of the respiratory system
pharynx, trachea, bronchi, lungs
each lung is enclosed in a double-walled serous membrane sac called the ________________.
pleura
what does the bony thorax do
protects what's inside
The right primary bronchus is ____________,___________, and __________ _____________ than the left
shorter, wider, and more vertical
During an AP supine or semierect the CR MUST be perpendicular to ______________.
sternum
What are the 4 body habitus's
sthenic, hyposthenic, asthenic, hypersthenic
What does the "no motion" part of the criteria mean
that there is sharp outlines of the diaphragm and lung markings
what is the 3rd division of the respiratory system
the bronchi
Body Habitus
the common variations in the shape of the human body
the respiratory system starts at what
the larynx
what is the mediastinum
the portion of the thoracic cavity between the lungs, separates the left and right pleural cavities --contains all thoracic structures, except lungs and pleurae
what are the breathing instructions form lateral chest
the same as PA chest, and you take exposure at the end of the second full inspiration when they're told to hold their breath
For a lateral chest x-ray which side should be closest to the IR
the side of interest
what happens if the arms aren't held up far enough
the soft tissue is seen in the x-ray, and covers the top of the lungs
what is the apex of the lungs
the superior portion, reaches above the clavicles
what marks the boundary between the nasopharnyx and the oropharnyx?
the uvula
asthenic
thorax is narrow in width and shallow from front to back, but very long vertically
Why would a Lateral Decub be used?
to determine fluid-air levels
When is AP supine is used?
to determine pathology, NOT for fluid-air levels
what is the purpose of the respiratory system
to exchange gaseous substances between the air and the blood
what is the primary function of the larynx
to produce sound as air passes through
True/False: A chest x-ray is done erect whenever possible
true
when in the breathing instructions do you take the exposure
upon the second full breath, when you tell them to hold their breath
what are the 3 dimensions the lungs move upon respiration
vertically transversely AR diameter
for an erect chest x-ray what are the basic positions used
PA and Lateral
what is the 4th division of the respiratory system?
The lungs
Where should the IR be placed for a Lateral Decub of the chest
about 1'' above the vertebral prominence/C7
pneumothorax
an accumulation of air in the pleural space which usually causes a lung to collapse
how many posterior ribs should you see for a PA chest x-ray
10
criteria for panorex?
-Entire mandible and all teeth demonstrated -No rotation or tilt -Optimal exposure factors
What is the preparation for an Upper GI?
-NPO 8 hr prior to study -no gum chewing -no smoking -pregnancy?
What is Herniated nucleaus pulposes? (HNP)
"slipped disk"
What joint is between a carpal bone and a metacarpal bone?
(Whatever digit it is)th carpo-metacarpal (CMC) Joint
What are the tarsal bones?
(starting posterior lateral to medial) -calcaneous -talus -cuboid -navicular -3 cuneiforms
Where should the CR be for a PA wrist?
-centered in the middle of the wrist - perpendicular to the mid carpal area
Why is erect preferred over recumbent? and PA over AP?
****Erect or horizontal beam to demonstrate any air fluid levels***** To reduce exposure PA as apposed to AP projections should be performed when possible
What is the AP lumbar spine position?
*PA to place the intervertebral disc spaces closer to IR* -Upright will demonstrate the natural weight bearing stance of the spine -PT position: supine or upright -Part Position: shoulders and hips in same horizontal place, arms on chest, reduce lordosis by flexing hips and knees to place lower back closer to table CR: Perpendicular to IR, For 14X17cm IR, enter pt at iliac crest (L4), For 10X12cm IR enter pt at 1.5 above iliac crests (L3)
What is the sacral curvature?
- Second primary curvature ---is convex
What is the patient prep for small bowel series?
-NPO—8 hours -Low-residue diet—48 hours -No gum chewing -No smoking -Ask about pregnancy
What is the AP open mouth projection for a trauma situation?
-CR parallel to lower upper incisors -( base of skull)
What is the Canal of the Sacrum?
- A continuation of the vertebral canal and contains certain sacral nerves
What is the Criteria for the AP open mouth projection?
- Atlas, axis, and dens seen in entirety -C1-C2 zygopophygeal joint space open -Upper incisors superimposing base of skull -No rotation -Optimal exposure factors
What is Spondylosis?
- Is the anterior or posterior displacement of the Pars Interarticularis
What is the Foramina of the sacrum?
- It transmits nerves and blood vessels
What is a cervical curvature?
- Its the first compensatoy Curve. --- It is Concave and Is Lordotic
What is the PA projection of the SI joints?
- PT position: Prone - CR 1 inch medial to the ASIS closest to the IR *SI joint is closest to IR is demonstrated. both sides are examined for comparison*
What is the RAO sternum Projection?
- Patient position:15° to 20° RAO -CR to center of sternum (1 inch or 2.5 cm to left of midline and midway between jugular notch and xiphoid process) -Can use breathing technique to blur lungs. Instruct patient to take slow, shallow breaths during exposure
What is the lateral t-spine projection?
- Pt position: recumbent or upright. left lateral minimizes heart mag. and overlapping of heart on spine. -Part position: long axis of vertebral column aligned horizontally, superimpose hips and knees for true lateral adjust arms -CR: perpendicular to T7 -IF TRAUMA use a horizontal beam (cross-table)
What is the Cervicothoracic later position of the C-spine? (swimmers Lateral)
- Pt position: upright, seated, or standing, in true lateral position - Part position: MCP centered to the mid-line of grid, extend arm closer to the IR above head and rotate humeral head anteriorly, depress shoulders further away from IR, C7-T1 interspace in center -CR: perpendicular to C7-T1 interspace if shoulder away from IR is depressed. IF shoulder can not be depressed, angle the tube 3-5 degrees caudal. -Collimated field: lengthwise collimator needs to be open.
What are some unique features of the Cervical Vertebrae?
- Transverse foramina located on transverse processes -Bifid spinous processes vertebral prominence - we use this as a topographic landmark for a CXR
The vertebral arch is formed by what?
- Two pedicles -two laminas -the above support of four articular processes, two transverse processes, and one spinous process.
When doing ribs below the diaphragm the pr should___________?
- be recumbent and expose on expiration
What is the thoracic curvature?
- is the first primary curve ---it is convex
What is the Lumbar Curvature?
- second compensatory curve ---is is concave and lordotic
What are some T-spine positioning considerations?
- use compensating filter for AP projection -Use a breathing technique for Lateral -Proper part- IR alignment
Comminuted Fracture
-(splintered or crushed)
What are the retroperitoneal organs?
--Organs that are attached to the posterior abdominal wall -Right adrenal gland -Right kidney -Pancreas -Duodenum -Ascending colon -Inferior Vena Cava -Aorta -Descending Colon -Ureter
What are Intraperitoneal organs?
--Organs that lay within the peritoneum -Liver -Gallbladder -Stomach -Spleen -Jejunum -Ileum -Cecum -Transverse and Sigmoid colon
What are Infraperitoneal organs?
--Organs that lie under the peritoneum -bladder -male reproductive organs -lower rectum
AP foot radiograph
--Pt position: Supine or sitting --Part position: Plantar surface flat on IR, long axis of the foot to long axis of IR, --CR: Angle 10 degrees towards the heel directed to the base of the 3rd metatarsal
AP Oblique foot:
--Pt position: supine or sitting --Part position: rotate medially, use support to eliminate motion (obliquing more better demonstrates the tarsals and metatarsals free of superimposition for the foot with an average transverse arch --CR: perp to the IR directed to the base of the 3rd metatarsal
AP stress ankle?
--Used to evaluate joint seperation, ligament tearing or rupturing -Pt: supine is best -Part: position as for an AP, dorsiflex the foot if possible, stress is usually applied by a physician or other health c are worker, plantar surface is turned medially for inversion and laterally for eversion -CR: midway between the malleoli
What is the unilateral frog-leg projection?
--also called the modified Cleaves method -abduct femur 45degrees from vertical --(for best demonstration of femoral head and acetabulum, abduct femur 90degrees form vertical) -CR perp to midfemoral neck
Lateral ankle?
--generally done as a mediolateral, but can be done as lateromedial --Pt: lateral recumbent --Part: Dorsiflex foot if possible, place support under knee to place in a true lateral position --CR: perpendicular to the medial malleolus Lateromedial----harder on pt but easier to obtain a true lateral
How do you take a radiograph of the AC joints?
-1 14x17 cassette -one with and one without weights -SID at 72'' -do not do weights if suspected fracture
What type of CR is required for an AP axial projection of the coccyx?
-10 degrees caudal
What are the floating ribs?
-11-12 because they only attach to the vertebrae
Costo transverse are on _____through _____ ribs
-1;10
costovertebral joints are on ______ thru ____ ribs
-1;12
What is the posterior oblique - Acetabulum (Judet method)?
-2 projections -one with affected side down -recumbent 45degree posterior oblique -CR 2 inches (5 cm) distal and medial to downside ASIS -one with affected side up -CR 2 inches (5 cm) distal to upside ASIS -Perpendicular to IR
What is the criteria for AP lordotic chest
-2/3 of the lungs visible -clavicles and apices of the lungs are visible -clavicles above apices and horizontal -no rotation or motion -exposure factors --ribs should and will appear distorted --long scale contrast to allow lung markings, especially in the area of the apices and upper lung
What is a peds small bowel follow through
-20- to 30-minute intervals -PA or AP projections -Ileocecal region in 1 hour (average) -Postprocedure instructions
What is the follow through for small bowel?
-20- to 30-minute intervals -PA or AP projections -Ileocecal region in 1 hour (average) -Postprocedure instructions
What is the rotation for a lateral oblique foot?
-30degree lateral rotation -CR to base of third MT
What type of CR angle is recommended for an AP axial L5-S1 projection on a female patient?
-35 degree Cephalic
What is the hand position for a PA Oblique hand radiograph? What angle is the hand at?
-45degree angle -hand pronated, palmar surface down, rotate entire hand and wrist 45degrees -keep digits parallel to the IR to prevent foreshadowing of the phalanges and obscuring the IP joints
What is the criteria for a unilateral frog leg
-45° abduction (20°-30° abduction-less distortion of femoral neck) -Entire femoral head, neck, and trochanters centered to IR -Femoral head and neck in profile -Optimal exposure factors
How many lumbar vertebrae are there?
-5
What type of CR angle is recommended for a lateral projection of the lumbar spine if the midabdomen is not supported?
-5-8 degrees caudal
Which degree of rotation will best demonstrate the zygapophyseal joints at the L1-L2 vertebral level?
-50 degrees *45 degrees for L3-L4, and 30 degrees for L5-S1
What are some Cervical Spine positioning considerations?
-60-72 inch SID -small focal spot -shielding of radio sensitive areas -Medium KV range (70-80)
What are the false ribs?
-8-10 because they do not attach directly to the sternum -They attach to the costo-cartilage of the 7th rib
What do you do for a Inferosuperior axiolateral projection of the shoulder?
-AKA Lawrence method -CR 25-30degrees medial to axilla -arm supinated and as close to 90degrees away from body as you can get PT
Another term for the wings of the sacrum is
-ALA
What should be included on a PA hand radiograph?
-ALL the carpals -1'' of the distal radius and ulna
What are the basic ankle projections?
-AP -AP mortise -45degree oblique -lateral
What are the standard to projections?
-AP -Oblique -Lateral
What are the basic projections of the foot? Special projections?
-AP -Oblique -Lateral special: -AP and lateral weight bearing
What are the standard projections of the knee? -special ones?
-AP -oblique -lateral special: -AP weight bearing -PA axial weight bearing (Rosenberg method)
What are the 2 projections you do for a clavicle?
-AP -AP axial
What are the essential projections for SI joints?
-AP -Anterior oblique projections --RPO,LPO -Posterior oblique projections --RAO,LAO
What are the basic projections for a tib/fib radiograph series
-AP -lateral
What are the basic projections for a cranium series?
-AP axial (Towne) -Lateral -PA 15degree (Caldwell), PA 25-30degree, or PA 0degrees special projections: -PA axial (Haas) -SMV (submentovertex)
What are the basic positions for the sacrum and coccyx?
-AP axial sacrum -AP axial Coccyx - Lateral
What are the two alternative projections for the open mouth projection?
-AP fuch method -PA Judd method
What is the basic C-spine routine?
-AP open mouth -AP axial -Bilateral oblique (PA or AP) -Lateral (always first) -Swimmer's Lateral if needed
What is the basic rib routine?
-AP or PA -Unilateral or Bilatera -Axillary portion of ribs—45° anterior or posterior oblique position (rotate spine away from side of interest)
A PT comes in complaining of pain and know known injury to the hip, what radiograph do you do first?
-AP pelvis (true, w/ internatl rotation) -frog-leg of affected hip side
What are the basic projections for a trauma shoulder?
-AP, neutral rotation -Scapular Y -Transthoracic lateral
What is the AP Bilateral frog-leg projection?
-Abduct femora 40°-45° -CR 3 inches (7.5 cm) below level of ASIS -20°-30° abduction-less distortion of femoral neck Patient position Supine Part position for bilateral No rotation of pelvis ASIS equal distance from table top Flex hips and knees Draw feet up as much as possible Abduct thighs equally and maximally Place soles of feet together for support Center IR 1˝ (2.5 cm) above pubic symphysis CR Perpendicular to MSP at level 1˝ (2.5 cm) above pubic symphysis Collimated field Size of IR
What are the 3 joints of the shoulder girdle?
-Acromioclavicular (AC) joint -Scapulohumeral joint -Sternoclavicular (SC) Joint
Criteria for lateral sinuses?
-All four sinuses demonstrated -Cranium not rotated or tilted -Optimal exposure factors -Zygoma and greater wings of the sphenoid are at the center of th exp[osure field The frontal, ethmoid, sphenoid and maxillary sinuses, greater wing of the shpenoid, orbital roofs, sella turcica, zygoma, and mandible are included in the collimated field
What are the parts of the large intestine?
-Anus -Appendix -Ascending colon -Cecum -Descending Colon -Ileocecal valve -Left colic flexure -Rectum -Right colic flexure -Sigmoid colon -Transverse colon
What are the special chest positions
-Ap supine or semierct -Lateral Decub -AP lordotic -Anterior oblique -posterior oblique
What is the criteria for an AP oblique l-spine position?
-Area form lower T-spine to sacrum shown -Z-joints closer to IR open and visible through bodies -T12-L1 and L1-L2 intervertebral joint spaces open -"Scottie dogs" are open -pedicles near center of vertebral body -optimal exposure factors
What are some positioning considerations for ribs?
-Area of interest closest to IR (AP or PA) -Axillary ribs: Rotate spine away from area of interest to elongate -Marking site of injury (?) -Chest study (?)
axiolateral mandible criteria?
-Area of interest demonstrated -Mandible not foreshortened -Optimal exposure factors --If mandible is foreshortened increase the rotation of the skull towards the IR
What is the criteria for AP/PA ribs ?
-Axillary portion of ribs appears elongated. -No motion -Optimal exposure factors
What are the other names for a cross-table lateral hip projection?
-Axiolateral hip -Inferosuperior hip -Danelius-Miller Method
Why do we oblique for a sternum?
-B/C it rotates the sternum from over the thoracic vertebrae
Why is an RAO projection of the sternum chosen over LAO?
-B/C it superimposes the heart shadow over the sternum
What is the criteria for a lateral coccyx projection?
-Coccyx in profile, centered -segment intersperses open -optimal exposure factors
What is the L-spine Routine?
-Basic --AP (PA), oblique (anterior or posterior), lateral, lateral L5-S1 (Spot) -Special --AP axial L5-S1 (Ferguson)
What are the two main parts of a typical vertebra?
-Body (anterior) -Vertebral arch (posterior)
What Supports wall of pleural cavity and diaphragm?
-Bony thorax
What is the sternoclavicular joint criteria?
-Both SC joints and medial ends of clavicles -SC joints seen through ribs and vertebrae -No rotation on bilateral -Slight rotation seen on unilateral
What are technical consideration for the sternum?
-Breathing technique (2 to 3 seconds) -Low kV (65 -75 kV range) -Short but safe SID (Never use SID less than 38 inches or 15 cm.)
How are ribs classified?
-By attachment
What is the criteria for a lateral hyperextention and hyperflextion c-spine?
-C1 to C7 visualized -no rotation -hyperflextion: spinous processes will be separated -hyperextention: spinous processes in close proximity -optimal exposure factors
What is the Criteria for a Lateral C-spine non-trauma?
-C1-C7 demonstrated -Rami of manidble (Jaw bone) not superimposed over C1-C2 -No rotation -optimal Exposure factors - Collimated feild (base of the skull to T1
What is the criteria for the oblique C-spine projection?
-C3 to C7 intervertebral foramina are open and clearly seen (if not open, or clearly seen the pt is not angled right.) -Cervical pedicles well demonstrated -Base of skull not superimosed over C1 -Optimal exposure factors
What is the Criteria for an AP Axial C-spine projection?
-C3-T1 region is demonstrated -no rotation -intervertebral disk spaces are open (if it is not open the angle is wrong) -Base of skull will superimpose C1-C2 -Optimal Exposure factors
What is the criteria for cervicothoracic lateral projection of the C-spine? (swimmers)
-C4 to T3 clearly demonstrated -humeral heads separate -Vertebral rotation to minimum -Optimal exposure factors -compensating filters should be used to compensate for the different thicknesses of the neck and the upper thoracic region
What is the criteria for an AP t-spine?
-C7 to L1 demonstrated -no rotation -vertebral bodies well penetrated -optimal exposure factors
What kind of CR angle should be used for toe radiographs?
-CR 10-15degrees posterior to MTP joint
What is the AP Axial Trauma C-spine position?
-CR 15-20 degrees cephalic -CR to lower thyroid cartilage
PA cranium
-CR 15° (Caldwell) caudal exit at nasion -CR 0° exit at glabella -MSP is aligned perpendicular -IPL is parallel to the IR for a caldwell
AP axial (Towne method)
-CR 30° caudad to OML or 37° to IOML -CR 2½ in (6.5 cm) above glabella -7-8 degree difference between the IOML and OML -MSP is aligned with the long axis of the IR and perpendicular to the IR -MCP is parallel to the IR OML is perpendicular
AP axial (modified towne) for zygomatic arches
-CR 30° to OML or 37° to IOML -CR 1 inch (2.5 cm) superior to glabella (to pass through mid arches) --Difference from what we learned in the skull is the CR is only 1 inch superior to the glabella not 2.5 inches
Plantodorsal (axial) calcaneus radiograph
-CR has a 40degree angle -CR centered to base of 3rd MT to emerge posterior to malleoli -Part: center ankle joint to the IR, dorsiflex foot so plantar surface is perpendicular, use gauze or tape to have the pt pull to keep the foot in position if needed (may be uncomfortable)
What is the alternative AP axial Projection?
-CR is 35-40 degrees cephalic (tip of mandible--base of skull)
What is the Axiolateral hip radiograph?
-CR perp to midfemoral neck -flex knee and hip of unaffected limb to place thigh vertical -rest unaffected leg and foot on a support -no rotation -rotate affected limb 15-20degrees medially -IR should be vertical with upper border in crease above iliac crest -angle lower border away form body until parallel with femoral neck -support IR in position
What is the hip and proximal femur (AP unilateral hip) projection?
-CR perp to midfemoral neck -no rotation of pelvis -true AP, rotate lower limb 15-20 degrees inward --so femoral neck is parallel to IR -top of IR should be at the ASIS
Where should your CR be placed for an AP unilateral hip?
-CR perp to midfemoral neck -top of the light field should be at the ASIS
zygomatic arch SMV projection?
-CR perpendicular to IOML -IOML is parallel to IR CR is midway between the zygomatic arches and 1 ½ inch below the mandibular symphasis If patient is unable to extend their neck the IR and the CR should remain perpendicular to the IOML
SMV projection
-CR perpendicular to IOML and IR -CR 1½ in (4 cm) inferior to mandibular symphysis -may have to adjust the IR and beam so IOML is perp to the IR if pt can't extend their neck enough
Where should the CR be for a lateral toe radiograph?
-CR to IP joint for first digit and PIP (proximal IP) joint for 2nd and 3rd digits
Pediatric Ap chest-recumbent (PA erect when possible)
-CR to midthorax (mammillary nipple line) -no rotation -collimate to chest margins **remember gonadal shielding
For the AP Axial Outlet Projection (Taylor Method) how should the tube be angled for females?
-CR: 35-45degrees cephalad for females CR: centered 1-2 inches distal to the symphysis pubis
Oblique elbow
-CR: perp to the mid-elbow joint -for lateral rotation -supinate the hand and rotate the entire arm so distal humerus and anterior surface of the elbow joint are 45 degrees to the IR (PT will need to lean laterally)
What is the criteria for a lateral calcaneus?
-Calcaneus and talus visualized -No rotation--Open talocalcaneal joint and open tarsal sinus indicate no rotation -Optimal exposure factors
What is the criteria for a lateral forearm?
-Carpals and distal humerus included -Elbow flexed 90° -Head of ulna superimposed over radius -Humeral epicondyles superimposed -Exposure factors
What is the enteroclysis procedure?
-Catheter advanced to duodenojejunal flexure -Thin barium mixture injected -Air or methylcellulose instilled -Fluoro and radiographic images taken -Intubation tube removed
The vertebral column is divided into 5 groups. What are they?
-Cervical (7) -Thoracic (12) -Lumbar (5) -sacrum (5 as kids, 1 as adult) -Coccyx (4 as kids, 1 as adult)
What is the lower GI procedure for ped?
-Clear explanation to parents and patient -Pre-exam -AP supine (KUB) -Fluoroscopy and spot films -Overhead projections -Supine or prone (AP or PA) -Right and left decubitus with double contrast -Postevaluation film -Postprocedure instructions
What curves inferiorly and anteriorly from the articulation with the sacrum?
-Coccyx
What formed by the fusion of three to five rudimentary vertebrae?
-Coccyx
What is the criteria for an AP axial Coccyx projection?
-Coccyx free of superimposition -Region free of gas and feces -No rotation -optimal exposure factors -Short scale contrast -Coccygeal segments are free of superimposition
What are the clinical indications for a Ba Enema?
-Colitis (ulcerative) -Diverticulosis/ diverticulitis -Neoplasms (apple core or napkin ring lesions) -Volvulus (can lead to necrosis) -Intussusception -Appendicitis
Enema insertion tips:
-Communicate with patient. -Wear gloves. -Drain air from enema tubing. -Lubricate enema tip -instruct PT to take deep breaths -expose anal region only -insert slowly and steadily, and gently during expiration -hold in place while helping the pt move to prone or supine position
AP axial TMJ criteria?
-Condyloid processes and TM fossa demonstrated -No rotation -Optimal exposure factors
AP axial mandible criteria?
-Condyloid processes demonstrated and symmetric -No rotation -Optimal exposure factors -Dorsum sellae and the posterior clinoids are seen within the foremen magnum -The entire mandible and the tempromandibular fossae are included in the collimated field
What are the anatomic features of the Coccyx?
-Cornu- horn at the top of the coccyx on the superior/posterior side
What is the criteria for AP fuch method and PA Judd method?
-Dens within foramen magnum -no rotation -correct extension of head -optimal exposure factors -Collimate in
What is the criteria for a PA/Ap Ba enema?
-Entire large intestine demonstrated -Transverse colon filled with barium -No rotation -Iliac ala symetric -Spinous processes and vertebral bodies centered -Optimal exposure factors -Will see superimposition of ascending and descending limbs of the colic flexures -2 IRs may be needed
What is the equiptement needed for single contrast BE for children over 1 yr
-Disposable enema bag -Pediatric flexible enema tip -Do not use latex or inflatable balloon enema tips -Air-contrast enema kit with double line tip
What is the criteria for an AP stress ankle?
-Distal aspect of tibia and fibula demonstrated -Ankle joint to center of collimation field -Optimal exposure factors
What is the criteria for an 45° oblique ankle?
-Distal ⅓ of tibia and fibula demonstrated -Proximal ½ of metatarsals included -Lateral maleolus and the talus should have little or no superimposition. -Collimation should include to the base of the fifth metatarsal -Optimal exposure factors
What is the criteria for an AP ankle?
-Distal ⅓ of tibia and fibula demonstrated -Proximal ½ of metatarsals included -Medial and superior aspect of ankle joint open -Lateral portion of the mortise joint will not be open. -Some superimposition of the distal tibia by the distal fibula and talus is normal.
What is the AP ribs below the diaphragm criteria?
-Eighth to twelfth ribs visualized -No motion -No rotation -Optimal exposure factors
What are the 3 primary functions of the Vertebral Column?
-Encloses and protects the spinal cord -Supports the trunk and Skull -Provides muscle attachment
What the the clinical indications for a small bowel series?
-Enteritis or gastroenteritis -Meckel's diverticulum -Neoplasm -Malabsorption syndrome -Ileus -Mechanical -Adynamic or paralytic
What is the criteria for AP mortise ankle?
-Entire ankle mortise open -Distal ⅓ of tibia and fibula demonstrated -Proximal ½ of metatarsals included -Optimal exposure factors
Hard palate
-Entire area is the hard palate -Left and right palatine processes of the maxilla are solidly joined. -Unless a common congenital affect occurs called a cleft palate which is an opening between the two palatine processes Note the palatine bone which is one of the bones not visible on a frontal or lateral view
What is the criteria for the plantodorsal calcaneus?
-Entire calcaneus visualized: --From tuberosity to joint visualized No rotation --visualized/achieved by: if a portion of the sustentaculum tali appears in profile laterally Optimal exposure factors
What is the criteria for a lateral esophagram?
-Entire esophagus demonstrated -esophagus midway between heart and spine -arms not superimposed on esophagus -true lateral position -optimal exposure factors
What is the criteria for a lateral finger?
-Entire finger and MCP joint demonstrated -Center field at PIP -true lateral position -digit parallel to IR -exposure factors
What is the criteria for a finger?
-Entire finger, min. 1/3 of MCP demonstrated -Center field at PIP joint -No rotation of phalanges -Exposure factors -soft tissue margins -bony trabecular markings
what is the criteria for an AP foot?
-Entire foot visualized -No rotation of metatarsals -MTP joints generally open -Optimal exposure factors
What is the criteria for a medial oblique foot radiograph?
-Entire foot visualized -Third through fifth metatarsals free of superimposition -Tuberosity demonstrated at base of fifth metatarsal -Optimal exposure factors
What is the criteria for a left lateral decub?
-Entire large intestine demonstrated -No rotation -Optimal exposure factors
What is the criteria for the right lateral decub Ba enema?
-Entire large intestine demonstrated -No rotation--evident by ribs and pelvis -Optimal exposure factors -area from left colic flexure to rectum -single-contrast: Ba penetrated -double contrast: air side of interest and should not be over-penetrated
SMV mandible criteria?
-Entire mandible demonstrated -No rotation or tilt -Optimal exposure factors -Sphenoid sinuses at the center of the exposure field -Distances from the mandibular ramus and the body to the lateral cranial cortex is equal on both sides -Vomer, bony nasal septum and the dens are aligned with the long axis of the film
PA mandible criteria
-Entire mandible included -No rotation -Optimal exposure factors -Petrous ridges superimposed over supraorbital margins -mouth closed and teeth together -point midway between the madibular rami is centered on the IR
PA 15 caldwell criteria
-Entire skull visualized -No rotation -Petrous ridges over lower ⅓ of orbits -Optimal exposure factors
What is the criteria for a lateral sternum projection?
-Entire sternum -Manubrium free of superimposition by soft tissues of shoulders -Sternum free of superimposition by ribs -Lower portion of sternum not obscured by breast tissue in female patients
What is the criteria for an RAO sternum projeciton?
-Entire sternum from jugular notch to tip of xiphoid process, Sternum well visible through thorax -Mid Sternum at the center of IR -Sternum free of superimposition by vertebral column -Lateral portion of manubrium and SC joint not overlapped by vertebrae -Sternum projected over heart
What is the criteria for an RAO upper GI?
-Entire stomach and duodenum demonstrated -Body and pylorus barium filled; with no superimposition -Duodenal bulb and C-loop in profile -stomach centered at level of pylorus -Optimal exposure factors
What is the criteria for a right lateral upper GI?
-Entire stomach and duodenum demonstrated -Retrogastric space demonstrated -Vertebrae in true lateral perspective--which shows no rotation -stomach centered at level of pylorus -Optimal exposure factors
What is the criteria for an AP Upper GI?
-Entire stomach and duodenum demonstrated -fundus is Ba filled -no rotation -Double-contrast visualization of gastric body, pylorus, and duodenal bulb -retrogastric portion of duodenum and jejunum
What is the criteria for PA Upper GI?
-Entire stomach and duodenum demonstrated -stomach centered at the level of pylorus -Body and pylorus barium filled, air in fundus -no rotation Optimal exposure factors
What is the criteria for a LPO Upper GI?
-Entire stomach and duodenum demonstrated w/ no superimposition and body of stomach centered -Fundus filled with barium -Optimal exposure factors
What is the criteria for a lateral ankle?
-Entire talus and calcaneus visualized--Distal 1/3 of the tibia and fibula -Tibiotalar joint open -Lateral malleolus superimposed over posterior half of tibia = true lateral -Optimal exposure factors
what is the criteria for an AP tib/fib?
-Entire tibia and fibula demonstrated -Knee and ankle joints demonstrated -Partial superimposition of fibula and tibia at proximal and distal ends -Optimal exposure factors
What is the criteria for a lateral tib/fib leg?
-Entire tibia and fibula demonstrated -Knee and ankle joints demonstrated -Proximal head of fibula superimposed by tibia -Distal fibula superimposed over posterior half of tibia -Optimal exposure factors --occasionally you may need to use 2 IR's to fit to get both joints
How should the epicondyles be if the humerus is in an oblique position?
-Epicondyles at a 45degree angle to the IR -Neutral rotation -used for trauma -palm against the thigh
T/F: The bony thorax has a longer anterior side than posterior?
-False, posterior is longer
What is the criteria for a lateral knee?
-Femoral condyles superimposed -Patella in profile (indicates no rotation) -Patellofemoral joint space open -Optimal exposure factors --To determine rotation look at the superimposition of the fibular head by the tibia. Over rotation=less superimposition, under rotation= more superimposition
What is the criteria for an AP knee?
-Femorotibial joint space open -Knee joint centered to collimation field -Articular facets profiled -May need a CR angle to ensure the articular facets are profiled, if backside is large or not there at all -Optimal exposure factors
What is the criteria for an AP ribs above the diaphram projection?
-First to ninth posterior ribs visualized above diaphragm -No motion -No rotation -Optimal exposure factors
What is the positioning for a lateral mid-distal femur?
-Flex knee 45degrees (unaffected knee behind the affected knee so its out of the way) -lower light field should be 2'' below the knee joint(apex of patella)
PA caldwell criteria?
-Frontal and ethmoid sinuses demonstrated -Petrous ridges in lower ⅓ of orbits -No rotation or tilt -Optimal exposure factors -Distances from the lateral orbit margins to the lateral cranial cortices are equal. -Crista galla and the nasal septum are aligned with the long axis of the film. -Ethmoid sinuses at the center of exposure field -Frontal and ethmoid sinuses and lateral cranial cortices are included in the collimated field
What is the lateral hyperflextion c-spine projection?
-Have pt put chin as close to chest as possible -CR perpendicular to C4 -Collimated field: includes from sella turcica to T1
What does a typical rib consist of?
-Head -Neck -Tubercle -Body
What do you do for a swimmers lateral trauma position (c-spine)?
-Horizontal CR centered to C7-T1
What is the lateral, horizontal beam (trauma) C-spine position?
-Horizontal CR to C4 and center-line to grid -no head or neck manipulation - everything else is the same as lateral non- trauma c-spine - leave all immobilization devices in place -traction can be applied to arms to help depress the shoulders (blanket technique)
What is the Cornu of the sacrum?
-Horn at the base of the sacrum on the posterior side
SMV mandible
-IOML parallel to IR -CR perpendicular to IOML -CR midway between mandibular angles
SMV sinuses?
-IOML parallel to IR -Horizontal CR, between angles of mandible
Oblique inferosuperior (tangential)-zygomatic arch
-IOML parallel to IR -Rotate and tilt skull -15° toward affected side -CR perpendicular to -IR and IOML -CR to arch of interest
what is a panorex?
-IOML parallel to floor -used for dental work
What is the AP axial trauma oblique c-spine position?
-IR remains flat on table -CR angled to 45 degrees -tube is angles 12 degrees cephalic *can not use grid with compound CR angle*
What are the clinical indications for a small bowel series?
-Ileus (small bowel obstruction) -Crohn's disease -Malabsorption syndrome
Pediatric lateral chest position
-Immobilization -Tam-em board -CR to mid-coronal plane, at mammillary line -no rotation --mom at end of table, child facing mom, IR between the 2
What does the LPO demonstrate? RPO?
-LPO demonstrates right colic flexure, and ascending and sigmoid colon -RPO demonstrates left colic flexure and descending colon
What is the peds preparation for a lower GI?
-Infants to 2 years -No prep required -Children 2 to 10 years -Low-residue meal evening before -Laxative (1 tablet) before bedtime -Possible Pedi-Fleet enema -Individuals 10 years of age to adult -Same prep
frontal sinuses
-Inner and outer tables of frontal bone -Rarely symmetric -Number varies, rarely symmetric -don't become aerated before age 6
lateral nasal bones
-Interpupillary line perpendicular to IR -CR perpendicular, centered to ½ inch (1.25 cm) inferior to nasion
What is Sponyloisthesis?
-Is the anterior or posterior displacement of a vertebra or the vertebral column in relation to the vertebrae below --Common in L5-S1 but also can occur in L4-L5
What is the Promontory of the Sacrum?
-It is an anterior ridge of the first segment of the sacrum- helps form the posterior wall of the inlet of the pelvis
What is the AP axial of the intercondylar fossa projection?
-Knee flexed 40° to 45° -CR perpendicular to lower leg -CR centered ½ inch (1.25 cm) distal to apex of patella -No grid needed due to air gap -CR 40-45 degrees cephalic
What is the AP L-spine leg position?
-Knees and hips are flexed
What occupies the posterior abdominal region of our bodies?
-L-spine
What vertebrae's are the largest?
-L-spine, they are the strongest, due to increased load weight, bodies are larger than both cervical and thoracic spines
What is the Criteria for the L5-S1 (spot) position?
-L4,L5-S1 demonstrated and centered -L5-S1 joint space is open -optimal exposure factors
What is the criteria for an AP axial L5-S1 projection?
-L5-S1 joint space demonstrated -Open L5-S1 intervertebral space -Both SI joints penetrated -No pelvic rotation -Optimal exposure factors
What is the lateral scapula position?
-LAO -PT reaches across the body and holds the opposet shoulder to keep humerus out of the exposure field -rotate PT until the scapula is in a true lateral position -CR to mid vertebral border of the scapula
modified parietoacanthial (modified waters)?
-LML perpendicular to IR -OML 55° angle to IR -CR perpendicular, exits at acanthion -Ideal projection to demonstrate possible orbital fractures and foreign bodies in the eye
Lateral skull
-MSP parallel -Interpupillary perpendicular -CR 2 in (5 cm) superior to EAM -IOML perpendicular to the front edge of the IR
SMV sinuses criteria?
-Mandibular condyles anterior to petrous ridges -No rotation or tilt -Correct collimation -Optimal exposure factors -Sphenoid sinuses at the center of the exposure field -Distances from the mandibular ramus and the body to the lateral cranial cortex is equal on both sides -Vomer, bony nasal septum and the dens are aligned with the long axis of the film
Describe the Manubrium?
-Manubrium has jugular notch at superior border -Palpable landmark -Lies at T2-T3 interspace
waters-sinuses criteria?
-Maxillary sinuses demonstrated -No rotation of cranium -Petrous ridges below maxillary sinuses -Optimal exposure factors -Bony nasal septum is aligned with long axis of the film and the infraorbital margins are on the same horizontal plane Frontal and maxillary sinuses and lateral cranial cortices are included in the collimated field
What is radial deviation?
-Moving the hand laterally in anitomical position--1st digit (thumb) toward the radius ---Uses the lunate, triquetrum, pisiform, and hamate---
What is the disadvantage of doing a PA L-spine?
-OID
AP axial mandible
-OML or IOML perpendicular to IR -CR 35° (OML) to 42° (IOML) caudad -CR centered to glabella
PA axial (caldwell)
-OML perpendicular to IR -CR 15° caudad, exits at nasion
AP axial (modified towne) TMJ
-OML perpendicular to IR -CR angled 35° caudad -CR level of TMJ (2 inches [5 cm] anterior to EAM) -An extra 5 degree angle may better demonstrate the Tempromandibular fossae and joint
PA and PA axial mandible
-OML perpendicular to IR -CR perpendicular, to exit at lips -Optional PA axial: CR 20°-25° cephalad to better visualize condyles (heads) and neck
PA caldwell sinuses
-OML perpendicular to IR, 15° tilt -OML 15° from horizontal -Horizontal CR; CR exits nasion -Move the patients head 15 degrees from the OML being horizontal to not distort air fluid levels with a tube angle --Best demonstrates the frontal and ethmoid sinuses
When are neither the lesser or greater tubercles in profile for a humerus x-ray?
-Oblique -neutral rotation
How do the obturator foramen affect rotation?
-Obturator foreamen are symmetric if one is narrower then the other there is rotation. -The larger foreamen is the side rotated down
What are the basic projections of the patella?
-PA -Lateral -tangental -merchant -hughston -settegast
What are the three basic positions for the finger/thumb/hand?
-PA -Oblique -Lateral
what are the 3 main positions for the wrist?
-PA -PA Oblique -Lateral
what is the PA Axial Scaphoid with ulnar deviation position?
-PA -without moving forearm gently evert the hand (move toward the ulnar side) as far as the PT can tolerate -CR angel of 10-15 degrees along the long axis of the forearm toward toward the elbow -center CR 2cm distal and medial to the styloid process
What are the basic projections of the Sternoclavicular joint routine?
-PA -Anterior oblique
What are the Basic Scoliosis series?
-PA (AP)
What are the special scoliosis series?
-PA (AP) )(Ferguson method) -AP (PA) right and left bending
What is the lateral coccyx projection?
-PT and Part position: same as used for sacrum -CR: perpendicular, 3.5 inches posterior and 2 inches inferior to ASIS
lateromedial projection of the humerus
-PT back is against the IR-rotated PT so humerus and shoulder come in contact with the IR, pronate the hand so epicondyles are perpendicular to the IR
How do we reduce scatter for an lateral L-spine?
-Put a lead mat behind the back on the table-top -Lead mat reduces scatter and secondary exposure to digital receptors.
Which will best demonstrate the left zygapophyseal joints of the lumbar spine?
-RAO
What is the Ferguson Method-Scoliosis series projection?
-PT position- Upright, facing upright bucky -Part position- MCP is parallel to bucky, arms abducted and not in the field -IR: Bottom about 1 inch inferior to the iliac crest -CR: perpendicular to IR -First Radiograph is taken how you would take an PA projection -Second PA Radiograph is taken with Pt's convex side 3-4 inches *that elevation must be sufficient to require pt to expend effort to maintain position
What is the lateral sacrum and Coccyx projection?
-PT position: Lateral recumbent, hips and knees flexed for comfort -Part position: Arms at right angle, knees superimposed, support spine with sponge -CR: Perpendicular to level of ASIS and to a point 3.5 inches posterior -have lead behind pt for scatter
What is the AP Axial Coccyx projection?
-PT position: Supine or Prone, choose position that maximizes pt comfort -part position: Same as used for sacrum -CR: Angled 10 degrees caudad (10 degrees cephalic if PA performed), enters MSP at 2 inches superior to pubic symphysis (for PA enter MSP at coccyx -Collimated field: includes entire coccyx
What is the AP Axial SI joints projection?
-PT position: Supine w/ knee support -Part position: align MSP to mid line of the table, ASIS equal distance on both sides -CR: Angle 30-35 degrees Cephalic 30 for males,35 for females; 2 inches below the ASIS
What is the PA (AP) scoliosis series projection?
-PT position: Upright, with arms at side, distribute weight evenly -Part position: Place lower IR border 1-2 inches below illiac crest *to lower pt dose to breast tissue PA is preferred*
The portion of each lamina between the superior and inferior articular processes is termed?
-Pars interarticularis
What is the AP ribs below the diaphragm projection?
-Part position for lower ribs: MSP centered to grid,Crosswise IR with lower border level with iliac crests -Remaining positioning same as for upper ribs -Respiration suspended at end of full expiration for lower ribs,Elevates diaphragm
What is the AP ribs above the diaphragm projection?
-Patient position: Upright or recumbent facing x-ray tube -Part position: for upper ribs MSP centered to midline of grid, Top of lengthwise IR 1.5 inches above upper border of shoulders, Rest hands, palms out, on hips, Or extend arms, flex elbows, and rest hands under head, Shoulders in same transverse plane and rotate forward to move out of ribs -CR:Perpendicular to center to IR -Respiration suspended at full inspiration for upper ribs
What is the anterior oblique projection of the sternoclavicular joint ?
-Patient position: recumbent or upright -Part position:10- to 15-degree RAO or LAO position, Affected side placed closer to IR, SC joint in center,Shoulders in same transverse plane -CR: Perpendicular to SC joint closer to IR,Enters at level of T2-T3 (3 inches distal to C7 and 1-2 inches lateral or toward the joint of intrest) -Respirations suspended at end of expiration *Demonstrates the joint closest to the IR*
What is the PA sternoclavicular joint projection?
-Patient position:Prone, Upright facing vertical Bucky -Part position: MSP aligned to midline of IR, IR centered to spinous process of T3,Shoulders in same transverse plane *For bilateral examination, rest head on chin and adjust MSP of head to vertical *For unilateral projection, turn head toward affected side and rest cheek on table -CR: Perpendicular to center of IR, Enters patient at MSP and T3 -Suspend at end of expiration
what is the Posterior or Anterior Oblique (ribs above diaphragm) projection?
-Patient position:Upright or recumbent -Part position: 45-degree RPO or LPO, Affected side closer to IR (demostrates ribs closest to the IR) For upper ribs, place top of lengthwise IR 1.5 inches above shoulders For lower ribs, place lower edge of IR at level of iliac crests
The eye of the "Scottie dog" represents the ____ of the lumbar vertebrae.
-Pedicle
parietoacanthial waters criteria?
-Petrous ridges below maxillary sinuses -No rotation -Optimal exposure factors -Bony nasal septum is aligned with long axis of the film and the infraorbital margins are on the same horizontal plane -Frontal and maxillary sinuses and lateral cranial cortices are included in the collimated field
pediatric Erect PA chest
-Pigg-o-stat -CR to midthorax (mammillary line) -no rotation
what is the part position for AP supine or semierect
-Place IR in a grid holder if available -Top of the IR is about 1.5'' above the shoulders CR: -perpendicular to the long axis of the sternum --T7 SID should be 40 for supine
What are the basic projections for the sternum?
-RAO -Lateral
The anterior ridge of the body of the first sacral segment is termed
-Promontory
What are the anatomical features of the Sacrum?
-Promontory -Canal -Foramina -Cornu
What is the Lateral C-spine (Non-trauma) projection?
-Pt Position: Upright, seated, or standing -SID: 60-72 inches (less mag, increased sharpness) -Part Position: MCP perpendicular to IR, CR is at C4, shoulders relaxed (use sandbags), Chin elevated and mandible protruded - Respiration: on Expiration -Collimated feild: include sella turcica to top of T1
What is the Anterior and Posterior Oblique Positions for C-spine?
-Pt Position: Upright, seated, or standing in a 45 degree oblique position -Part position: head and body at 45 degree angle from IR. C-spine centered to IR, Chin elevated and protruded SID: 72 Inches -CR: directed to C4 at 15-20 degrees Cephalic/ Caudal (depending on position) -Collimated Field: Includes all seven cervical vertebrae and surrounding soft tissue
What is the lateral L-spine position?
-Pt position: Recumbent or upright (use same for AP) -part position: true lateral with MCP vertical, knees flexed and superimposed, arms with elbows flexed at tight angle to body, place radiolucent support under lower spine to place horizontal if needed -CR: perpendicular to IR, for 35X43 cm IR, enter pt at MCP at illiac crest (L4), for 30X35cm IR, pt at MCP at 1.5 inches above iliac crests (L3) , If spine is not horizontal, angle caudad 5-8 degrees (more for females) -Collimated field: Collimate and use lead behind pt to reduce scatter, need all 5 l-spine ( most of sacrum if using a larger IR
What is the Posterior Oblique projection of the SI joints?
-Pt position: Supine -Part position: 25-30 degree posterior oblique position, IR centered at level of ASIS -CR: perpendicular to IR, Enters pt 1 inch medial to elevated ASIS *The marker should indicate the joint farthest from the IR*
What is the AP Axial sacrum projection?
-Pt position: Supine; may be done prone for pt comfort -Part position: MSP in mid-line of table, ASIS equidistance from table, arms in comfortable, symmetric position out of field, Support knees (if supine) -CR:15 degrees cephalid 2 inches superior to the symphysis pubis
What is the AP Axial c-spine Projection?
-Pt position: Upright or Supine -Part position: shoulders in same plane, MSP aligned with long axis of IR C4 in center of IR, Extend chin to place occlusal plane perpendicular to tabletop SID: 40 inches CR: directed though C4 at 15 degrees cephalad Collimated field: Includes C3 to T2 and all the surrounding soft tissue
What is the PA Judd method?
-Pt position: chin is resting on tabletop -CR: level of mastoid processes, parallel to MML
What is the lateral- spinal fusion (hyperflextion and hyperextention) projection?
-Pt position: in a lateral supine position -part position: Hyperextention-Have pt lean backward and posteriorly extend the thighs and limbs, Hyperflextion- have pt lean forward and draw knees up. -CR: perpendicular to L3
What is the AP Fuch method?
-Pt position: laying on back - Part position: Extend chin until tip is vertical -CR: perpendicular, enters pt on MSP, just distal to chin tip
What is the Oblique L-spine position?
-Pt position: recumbent or upright, use the same position as AP -Part Position: 45-degree posterior oblique position, radiolucent support under elevated side -CR: perpendicular to IR, enter pt 2 inches medial to elevated ASIS at L3 -Collimated field: includes all 5 lumbar and top of sacrum -
What is the AP Right and Left bending- scoliosis series projection?
-Pt position: supine - Part position: keep shoulders lateral, have pt bend to the right and then to the left -CR: perpendicular to the level of the 3rd lumbar vertebrae (1-1.5 inches below the iliac crest)
What is the AP axial L5-S1 projection?
-Pt position: supine (can be done prone for pt comfort, *do caudad angle*) -Part position: MSP centered to IR, Extend lower limbs, or abduct thighs and place vertical -CR: 30(males) 35 (females) angle cephalic, enters pt on MSP at 1.5 inches above pubic symphysis or at the ASIS -Collimated field: includes sacrum and medial borders of ilia
What is the AP Open Mouth projection?
-Pt position: supine/upright -Part position: Align edge of upper incisors and mastoid tip perpendicular to the IR, mouth open as wide as possible, shoulders in same horizontal plane, MSP aligned with long axis of IR SID: 40 inches -CR: midpoint of mouth, Perpendicular Collimated field: Includes from upper incisors to tip of chin, C1 to C2 center of field
What is the difference between the RPO/ LPO vs RAO/LAO (c-spine oblique positions)?
-RPO/LPO: Intervertebral foramina farthest from IR, 15 degree cephalic angle, CR= C4, Worse for the Pt because of thyroid cartilage -RAO/LAO: Intervertebral foramina closest to the IR, 15 degree caudal angle, CR=C4, Better for the Pt
What is the criteria for a lateral rectum?
-Rectosigmoid region demonstrated -No rotation -Optimal exposure factors
What are some L-spine considerations?
-Remove artifacts -Gonadal shielding -PA vs AP -Medium to High KV -SID - 40 Inches
Safety of Ba enema procedure
-Review chart. -Never force enema tip. -Height of enema bag should be no higher than 24 inches above the table. -Verify the water temperature of the contrast media. -Escort patient to the rest room.
What are some T-spine characteristics?
-Rib articulations (facets and demifacets) -12 in number -caudally pointed spinous processes -occupy the posterior thorax
Which zygapophyseal joint is demonstrated with an LAO position of the lumbar spine?
-Right
AP pelvis radiograph
-Rotate limbs internally (nontrauma) -CR midway between level of ASIS and symphysis pubis Patient position - supine Part position MSP of body centered to midline Equal ASIS to table distance on both sides Medially rotate feet and lower limbs 15 to 20 degrees Places femoral necks parallel with IR Do not rotate if trauma or other pathology suspected Upper border of IR 1˝ to 1.5˝ inches (2.5 to 3.8 cm) above crests CR Perpendicular to IR Collimated field Size of IR
axiolateral oblique (modified law method) for TMJ?
-Rotate skull 15° toward IR -CR angled 15° caudad -CR 1½ inch (4 cm) superior to upside EAM
How is rotation determined for an AP axial (Towne method)? Tilt?
-Rotation determined by the symmetry of petrous ridges -Tilt determined by shifting of anterior or posterior clinoids within foramen
When are the images taken during an upper GI/ Small bowel combination?
-Routine upper GI first (note time of first cup ingestion) -Ingest second cup -30-minute interval radiographs -1-hour interval radiographs (if needed) -Spot ileocecal valve (optional)
The anterior superior iliac spine (ASIS) corresponds to the level of the
-S1-S2
What is the Criteria for for an Anterior oblique projection for the sternoclavicular joint
-SC joint of interest in center of image -Manubrium and medial end of clavicle included -Open SC joint space -SC joint of interest adjacent to vertebral column with minimal obliquity -SC joint clearly visible through superimposed rib and lungs
What is the criteria for an AP axial SI joint projection?
-SI joint centered to collimated field -SI joint space and L5-S1 junction open -optimal exposure factors
What is the criteria of a PA projection of the SI joint?
-SI joint of interest is open -ALA of ilium not overlapped -joint in center of image
What is the criteria of a posterior oblique projection of the SI joint?
-SI joint of interest is open -ALA of ilium not overlapped over sacrum -optimal exposure factors
What is the Lateral sternum projection?
-SID:72 inches -Patient position: Upright, seated or standing -Part position: Rotate shoulders posteriorly and lock hands behind back, Center sternum to midline, MSP vertical, Top of IR placed so that upper border is 1.5 inches above jugular notch -CR: Perpendicular to IR,Enters lateral border of sternum at midsternum -Use close collimation to improve image quality -Suspend respirations after deep inspiration
What are the two false, fixed vertebra?
-Sacral -Coccygeal
What is formed by the fusion of 5 sacral segments into curved, triangular bone wedged between iliac bones and pelvis?
-Sacrum
What is the criteria for an AP axial projection of the sacrum?
-Sacrum is not foreshortened and with curve straightened -sacral foramina visualized optimal exposure factors - No rotation (Ala symmetric) -No overlap of pubic bones -short-scale contrast *Improves by close collimation* -Fecal material not overlapping sacrum -sacrum centered and seen in its entirety
What is the criteria for ulnar deviation
-Scaphoid clearly seen without superimposition -10° to 15° CR angle evident when adjacent carpal spaces are open
When do we use long IR's (36-90 cm) and 60" SID
-Scoliosis series
When are the images taken for a small bowel series only?
-Scout radiograph -16 ounces of BaSO4 (note time) -15- to 30-minute radiograph (first) -30-minute interval radiographs -Spot ileocecal valve (optional)
What is the criteria for the tangential sesamoid radiograph?
-Sesamoids free of superimposition -Minimum of three metatarsals seen -Optimal exposure factors
contrast media for a Ba enema
-Single-use, -closed-system kit -Cold vs. room temperature water --USE LUKE WARM WATER, cold water causes spasms and hot will burn the intestinal tissues -Colloidal suspension—mix well before use -Glucagon optional (if spasm occurs) -Topical anesthetic may be added to contrast media
A congenital condition in which the posterior aspects of the vertebrae fail to develop is termed
-Spina Bifida
What is the patient's position for an AP lordotic chest
-Standing about 1' form IR -lean back until shoulders are touching the IR - hands on hips, palms out, shoulders rolled forward
What is the Bony Thorax made up of?
-Sternum -12 pairs of ribs -12 thoracic vertebrae
What is the PT's position for an AP or PA esophagram? -IR? -CR?
-Supine or prone w/out rotation -head turned to the side so they can drink the Ba -IR is placed so that the top is level with the mouth -CR is perp to the midpoint of IR --usually at level of T5-T6
The tubericles of the ribs articulate with _________ and form________ joints?
-T-spine transverse processes; Costotransverse
What is the criteria for a t-spine?
-T1-L1 is demonstrated -intervertebral disk spaces are open -no rotation -optimal exposure factors
What is the criteria for an AP lumbar spine position?
-T11 or T12 to sacrum visualized -No rotation -Collimation width to SI joints -SI joint equidistance from the spine -open intervertebral joints -symmetric vertebrae with spinous processes in the center of bodies -optimal exposure factors
What is the Criteria for a lateral L-Spine position?
-T12 to distal sacrum demonstrated -intervertebral disk spaces are open -intervertebral foramina are open -optimal exposure factors -spinous processes in profile -no rotation --Superimposed posterior margins of bodies -- nearly superimposed iliac crests
axiolateral oblique TMJ criteria?
-TMJ closest to IR demonstrated -Open and closed mouth projections -Optimal exposure factors
What are the breathing instructions for an abdominal x-ray?
-Take a breath in -Blow it out -And hold your breath -take exposure 1 second after "Hold your breath"
How do you tell if there's rotation in an AP mid-distal femur radiograph?
-The femoral and tibial condyles should seem symmetric in size and shape ---if they aren't there is rotation -The outline of the patella will be toward the medial side
Duodenum
-The first portion of the sm intestine adn final part of the UGI system -the shortest and widest 8-10'' long -creates a c-loop -retroperitoneal
AP elbow
-align w/ long axis of the IR -center elbow joint to center of the IR, may have to support hand to reduce motion -CR: perp to the mid elbow joint
The bony thorax includes the ribs, sternum, and?
-Thoracic Vertebra
What is the criteria for an PA (AP) scoliosis series projection?
-Thoracolumbar spine demonstrated -1 to 2 inch iliac crest demonstrated -optimal exposure factors
What is the criteria for the AP right and left bending- scoliosis series projection?
-Thoracolumbar spine demonstrated -vertebral column centered -1 inch iliac crest demonstrated -optimal exposure factors
What is the criteria for the Ferguson-scoliosis series method projection?
-Thoracolumbar spine demonstrated -vertebral column centered -I inch iliac crest demonstrated -optimal exposure factors
How do you do the AP scapula?
-Top of hand on forehead -breathing technique -CR to midscapula
What are some Unique features of the Cervical Vertebrae?
-Transverse foramina located on transverse processes -Bifid spinous processes -We use the vertebral promines for a CXR
What are 2 unique features of the L-spine?
-Transverse processes are smaller that the t-spines -Pars interarticularis - part of the lamina between articular processes
T/F: The bony thorax protects the heart and lungs?
-True
T/F:The left SI joint is open with an RPO projection.
-True
axiolateral TMJ (schuller method)?
-True lateral (in open and closed mouth positions) -CR angled 25°-30° caudad -CR enters ½ inch (1.3 cm) anterior and 2 inches (5 cm) superior to upside EAM.
True or false: The coccyx is roughly the same size of a postage stamp?
-True; 2.5 cm
Bony nasal septum and vomer
-Two bones form the bony nsal septum, the perpendicular plate of the ethmoid and the vomer -Anterior it is cartilage
What does the Urinary system include?
-Two kidneys -Two ureters -One bladder -urethra
What is the lateral elbow criteria?
-all 3 concentric arches visible -olecranon process in profile -appropriate exposure factors
The head of the rib articulates with__________and form ______________joints ?
-Vertebral bodies; costovertebral
Where is the acromioclavicular joint?
-Where the acromion of the scapula articulates with the clavicle
Where is the sternoclavicular joint?
-Where the sternum articulates with the clavicle
What are the T-spine topographic landmarks?
-Xiphoid tip-t9-t10 -lower costal margin-L2-L3 -illiac crest- L4-5 -ASIS- S1-S2 -Symphysis pubis
AP axial zygomatic arch criteria?
-Zygomatic arches centered -No rotation Optimal exposure factors
criteria for lateral facial bones
-Zygomatic bones in center of radiograph -No rotation or tilt -Optimal exposure factors -sella turcica is seen in profile -Rotation: Orbitqal roofs, mandibular rami, greater wings of the sphenoid, external acoustic canals, zygomatic bones and cranial cortices are superimposed
What parts of the scapula can you see in the scapular Y projection?
-acromion -coracoid process -inferior angle -scapular spine -body of scapula
Lateral upper airway criteria
-air-filled trachea and larynx -shoulders not superimposed over trachea -collimation evident, good collimation=more detail -exposure factors
what is the part position for a lateral chest x-ray
-align MCP with the CR and the midline of the IR -Lower CR and IR slightly from PA if needed -CR still at T7
What are the 4 portions of the colon?
-ascending -transverse -descending -sigmoid
When do you see the Z-joints in a L-spine?
-at a 45 degree oblique
What are the basic projections of the mandible?
-axiolateral oblique -PA (or PA axial)
When doing a RIbs above the diaphram the pt should__________________?
-be erect and breathe in
sphenoid sinus
-below sella turcica -asymmetric -may endicate basal skull fracture (sphenoid effusion) -fx if blood or fluid is leaking into the sphenoid sinuses
What are the 3 unique features of the C-spine?
-bifid spinous process -C1 has no body -Three foramina
What is the criteria for the scapular Y projection?
-body of scapula superimposed on end -acromion and coracoid precesses in profile -humeral head and glenoid cavity -exposure factors
What is the AC joint criteria?
-both AC joints demonstrated -no motion -exposure factors -correct markers visible -close collimation
Describe the spinous processes of the T-spine.
-bulky and blunt
How is rotation determined for a PA wrist?
-by looking at the separation of the radial head and ulna, however there may be slight superimposition of the distal radio-ulnar joint
What is the criteria for carpal canal?
-carpal sulcus is open -pisiform and hamate are separated -rounded scaphoid and capitate in profile -exposure factors-will only see bony trabecular of the carpals and the thumb -tunnel like arched arrangement of the carpals --trapezoid is well demonstrated
What is the criteria for a forearm?
-carpals to distal humerus included -humeral epicondyles are in profile -only slight, if any, superimposition of distal radioulnar joint -exposure factors
What is the part position for the AP Lordotic chest
-center MSP -Top of IR 3'' above top of shoulders CR: -CR perp to IR -centered to med sternum (3-4'' below jugular notch) -SID of 72''
What is the posterior oblique criteria
-correct side of thorax elongated -both lungs demonstrated -no motion -optimal exposure factors -due to the increased magnification of the anterior diaphragm lung fields appear shorter and the heart &great vessels appear larger due to increased distance from the IR
What are the most unique features of the T-spine?
-costal facets on posterior, lateral sides of bodies for articulation with head of ribs -facets on transverse processes for articulation with tubercle of ribs (except T11-T12_
How is bone age determined?
-degree of skeletal maturation is determined by appearance size and differentiation of various ossification centers -compared to standards set in the 1930's -different standards for males and females
What does the scoliosis series tell us?
-demonstrates amount/degree of curvature that occurs with force of gravity acting on body -also used to evaluate fixation devices, such as herrington rods -bending studies used to differentiate between primary and compensatory curves
What is the criteria for Oblique toes?
-digits and minimum of distal 1/2 of metatarsal demonstrated -IP and MTP joints appear open -increased concavity on one side of shaft -heads of tarsals not overlapped -exposure factors
What is the criteria for AP toes?
-digits and minimum of distal 1/2 of metatarsals demonstrated -No overlap of soft tissue -IP and MTP joints appear open -optimal exposure factors
What is the criteria for lateral toes?
-digits presented in true lateral position -IP and MTP joints appear open -digits free of superimposition -exposure factors
What is the criteria for a lateral wrist?
-distal radius, ulna, and mid metacarpals demonstrated -center of field at mid carpals -no rotation -exposure factors
what is the criteria for a PA wrist radiograph?
-distal radius, ulna, and mid metacarpals demonstrated -center of field at mid carpals -no rotation -exposure factors
What is the criteria for a PA oblique wrist?
-distal radius, ulna, and mid metacarpals demonstrated -center of field at mid carpals -trapezium (right below the first metacarpal) and scaphoid seen in their entirety -exposure factors
Describe the Xiphoid Process.
-distal, smallest portion -Often deviates from midline -Lies over T10
What should you do if the PT can't completely extend their arm for a AP fully extended elbow?
-do 2 partially flexed projections with the CR still perp to mid-elbow -1 projection with forearm up (humerus parallel to IR) an and 1 with humerus up (Forearm parallel to IR)
What is another name for an AP projection of the foot?
-dorsoplantar projection
lateral elbow position
-elbow at a 90 degree angle -Make sure all of upper extremity is all on the same plane and parallel to IR -CR perp to mid elbow
What is the PT position for a PA wrist?
-elbow flexed 90degrees -hand and wrist resting on the IR-drop shoulder so shoulder, wrist and elbow are all on the same horizontal plane
How is a lateral forearm positioned?
-elbow flexed 90degrees -wrist in true lateral position -CR to mid-forearm -shoulder should be dropped so that the wrist, forearm, elbow, and shoulder are all on the same plane and all parallel to IR
What is the Modified Stecher Method -PA Scaphoid?
-elevate hand 20 degrees using an angle sponge or can clench the fist to bring the hand up 20degrees, gently evert hand to the ulnar side -CR: perp. and directed toward the scaphoid, 2cm distal and medial to styloid process
What type of joint is the 1st-5th MCP joints?
-ellipoloidal (condyloid) type
Where are the sesamoid bones of the foot?
-embedded in the tendons -present near joints -plantar surface of foot
What is the criteria for AP and AP axial clavicle projections?
-entire clavicle demonstrated -4-sided collimation- -exposure factors -axial: more clavicle seen above the ribs
What is the criteria for a RAO esophagram?
-entire esophagus demonstrated (lower neck to its entrance to stomach) & filled w/ Ba -esophagus midway between spine and heart -optimal exposure factors
What is the criteria for a PA Oblique finger?
-entire finger and MCP joint demonstrated -IP and MCP joints open -center field at PIP -exposure factors
What is the criteria for a lateral foot?
-entire foot demonstrated --minimum of 1'' of the tib/fib should be seen -tuberosity of the 5th metatarsal in profile -tibiotalar joint demonstrated -metatarsals superimposed -exposure factors
What is the criteria for a fan lateral hand radiograph?
-entire hand and carpals demonstrated -center of field at 2nd MCP joint -Fingers equally separated -exposure factors
What is the criteria for a PA Oblique hand?
-entire hand and carpals demonstrated -center of field at 3rd MCP joint -adequate separation of phalanges and metacarpals -exposure factors
What is the criteria for a lateral hand radiograph?
-entire hand and carpals demonstrated -center of field at second to fifth MCP joints -phalanges and metacarpals are superimposed -exposure factors
What is the criteria for AP proximal humerus (external rotation)?
-entire humerus demonstrated -greater tubercle in profile -medial and lateral epicondyles in profile -exposure factors -both shoulder and elbow joints need to be visible
What is the criteria for a lateromedial and mediolateral humerus projection
-entire humerus demonstrated -lesser tubercle in profile -epicondyles superimposed -exposure factors
What is the criteria for left lateral chest
-entire lung included -no rotation -arms not superimposed over lungs -full inspiration -no motion -exposure factiors
What is the lateral chest criteria
-entire lungs included -no rotation -chin and arms elevated -correct collimation -no motion -exposure factors
what is the PA Chest analysis criteria
-entire lungs included -no rotation -scapulae removed from lungs -full inspiration -equal collimation from top and bottom -no motion -exposure factors -7th thoracic vertebrae is in the center of the image -both clavicles on same horizontal plane -minimum of 10 rims visible -no chin visible
What is the AP scapula criteria?
-entire scapula demonstrated -lateral border of scapula free of ribs and lungs -exposure factors
What is the criteria for a lateral scapula?
-entire scapula demonstrated -body of scapula in profile in true lateral position -body of scapula totally separated, not superimposed by the ribs -humerus not superimposed over area of interest -exposure factors
What is the criteria for the AP thumb?
-entire thumb (including 1st CMC joint) -Center field at first MCP joint -No rotation fo phalanges -exposure factors
What is the criteria for an oblique thumb?
-entire thumb demonstrated -joints partially open as in 45degree oblique -center of field at first MCP joint -exposure factors
AP forearm -CR placement?
-epicondyles parallel to IR -CR to midforearm
How should the epicondyles be for an AP shoulder w/ internal rotation?
-epicondyles should be perpendicular to the IR
What is the PT position for an AP and lateral weight bearing foot?
-erect -full weight distributed evenly on both feet
how should the patient be standing for an erect lateral position
-erect -left side against the IR -weight distributed equally -arms raised above the head, holding onto elbows if possible, or at least out of the chest area, as high as possible -chin raised
what is the patients position for anterior or posterior oblique
-erect -rotated 45 degrees -anterior or posterior shoulder against IR -Flex arm nearest the IR, hand on hip, palm out -opposite arm raised and hand resting on top of the head or bucky -chin up
What is the positioning for a camp-conventry method (PA axial projection)?
-flex lower leg 40-50degrees -CR: should match the angle of the lower leg, so 40-50 degrees caudal, --centered to the midpopiteal crease
what helps control motion in pediatric patients
-good communication -immobilization -short exposure times
What is the criteria for an AP neutral rotation shoulder?
-greater and lesser tubercles super imposed -scapulohumeral joint centered -exposure factors
What is the criteria for an AP shoulder w/ external rotation?
-greater tubercle profiled laterally -lateral 2/3 of the scapula and clavicle should be visualized -scapulohumeral joint centered -proximal humerus, upper scapula, and clavicle visualized -exposure factors
What are the contraindications for cathartics?
-gross bleeding -severe diarrhea -obstruction -inflammatory lesions
What is a lateral hand radiograph?
-hand in lateral position, with thumb up -extend fingers and thumb, make sure all fingers and the thumb is in a true lateral position
What is a "Fan" Lateral Hand?
-hand is in a lateral position with the thumb up, spread fingers and thumb into a fan shape
What is the lateral hyperextention of the c-spine projection?
-have the pt relax head as far back as possible -CR: C4 -Collimated field: includes from sella turcicia to T1
What bones are included in the shoulder girdle?
-humerus -scapula -clavicle -manubrium of sternum
What 4 bones make up the shoulder girdle?
-humerus -scapulae -clavicle -manubrium of sternum
What is the tangential projection (intertubecular groove) of the shoulder?
-humerus 15-20degrees to CR which is perp to IR --Patient position: PA, standing, supine or leaning over the end of the table, hand supinated, holding the cassette, head turned away from affected side, lead shield between forearm and back of IR, patient leaning forward so Humerus is about 10-15 degrees from vertical
What is the Carpal Canal projection?
-hyperextension of the wrist -CR angle of 25-30 degrees -rotate hand and wrist 10degrees toward radius -fingers should be 90degrees to the forearm
What are the special c-spine projections?
-hyperflextion and hyperextention laterals -AP (fuch method) and PA (Judd method) for odontoid
How do you take a radiograph of the sesamoid bones?
-in a tangential projection!! -prone PT position is preferred/ but can be done supine -Prone---dorsiflex the foot so the plantar surface forms about a 15-20 degree angle, let the 1st digit rest on the IR to hold the position, long axis of the foot needs to be vertical -Supine: use a long strip of gauze or tape to pull the pts first digit back -CR: perp to the IR, tangential to the posterior aspect of the first MTP joint
What needs to be included for an AP humerus?
-include both the shoulder and the elbow joints
Where is the IPL?
-interpupillary line(IPL) -it's the line that goes across the face through the middle of the eyes/orbitals
What is the anatomy like on C7?
-it is also called the vertebra prominence because of its long, prominent spinous process - typical to join with T-spine
What does a lateral oblique foot demonstrate?
-it is an alternant position -demonstrates the base of first MT and medial tarsals
How should the femoral necks be in an AP pelvis radiograph?
-it should NOT be foreshortened/without superimposition
What needs to be included in a lateral mid-distal femur?
-knee joint (minimum) -distal 2/3 of the femur -superimposed anterior surface of the femoral condyles --inferior surface of the femoral condyles not superimposed due to divergent rays -patella in profile --open patella femoral joint
What needs to be included in the AP mid-distal femur radiograph?
-knee joint --(won't appear open due to the divergent rays) -distal 2/3 of the femur
What are the basic projections for the facial bone routine?
-lateral -parietoacanthial (waters) -PA axial (caldwell)
What is the criteria for a lateral sacrum and coccyx projection?
-lateral profile of sacrum centered -no rotation -optimal exposure factors
What is the criteria for the inferosuperior (lawrence method) projection?
-lesser tubercle profiled anteriorly -humeral head and glenoid fossa profiled -exposure factors
What is the criteria for an AP shoulder w/ internal rotation?
-lesser tubercle profiled medially -scapulohumeral joint centered -proximal humerus, upper scapula, and clavicle visualized -exposure factrors
esophagus
-long muscular tube -functions to convey food an saliva from laryngopharynx to stomach -lies in MSP -about 10'' long -originates at C6 -passes through diaphragm at T10 -Joins stomach at esophagogastric junction at T11
Describe the Body of the sternum.
-longest portion -4 inches -Joined to manubrium at sternal angle -Sternal angle is palpable and lies at T4-T5 interspace
What are the arches of the foot? -why do we have them
-longitudinal arch -transverse arch purpose: designed to provide strong shock absorbing support for the body weight
What are the exposure factors for the forearm?
-low to medium kV (50-70) -short exposure time -small focal spot
What are the clinical indications of the upper GI series
-peptic ulcer -hiatal hernia -diverticula -gastritis -tumor -bezoar
hat are the technical factors for the shoulder girdle?
-medium kV (70-80) -use grid -high mA/Low exposure time -small focal spot -AEC (center chamber) -40-44 SID (except for AC joints they're 72 SID
patella
-moves downward as the lower leg is flexed -larges sesamoid bone -popiteal surface is on the posterior aspect of the distal femur -inferior or axial view demonstrates the relationship of patella to patellar surface -size: 2'' or 5cm in diameter -apex is pointed downward, base is superior border -anterior surface is rough and posterior is smooth -only articulates with femur (not the tibia at all)
What are the openings in the orbit?
-obtic forame -sphenoid shrut -superior orbital fissure -inferior orbital fissure
When are fat stripes/pads visible? and where?
-on the radius/1st digit side -outside synovial sac but in the joint capsule -only visible by pathology or trauma to area--indication of disease or significant injury -changes in the fat pads/stripes results in fluid accumulation (effusion) within a joint
What is the position for PA Oblique wrist?
-palm down, rotate wrist and hand laterally 45degrees, use wedge support or flex fingers support
Osteomeatal conplex
-pathways of communication between the frontal, maxillary and ethmoid sinuses that allow for drainage -If obscured can lead to sinus infection or sinusitis
Pediatric erect lateral chest position
-pigg-o stat -CR to midthorax-mammillary line -no rotation -collimate carefully
What projections are done for radiographs of the calcaneus?
-plantodorsal (axial) -lateral
What are the radiographers responsibilities for an esophagram?
-prepare fluoro room -prepare contrast media -obtain clinical history -explain procedure
what are the subdivisions of the bronchial tree
-primary bronchi-right&left -secondary bronchi-right has 3 left has 2 -bronchioles-smaller branches coming off of the secondary bronchi -terminal bronchioles-terminated in very small air sacs called alveoli
What needs to be included in an AP unilateral hip radiograph?
-proximal 1/3 of femur -greater trochanter in profile(lesser should not or only slightly visible) -Entire long axis of femoral neck without foreshortening -acetabulum -total existing orthopedic "hardware" if applicable
What is the criteria for a transthoracic lateral- proximal humerus criteria
-proximal humerus seen clearly seen -humeral head and glenoid cavity seen -humeral head in neutral rotation -exposure factors
If the joint is not open and the pedicle is anterior on body in an AP oblique L-spine position, what positioning error was made?
-pt is not rotated enough
If joint is not open and pedicle is posterior on body, in an AP oblique L-spine position, what positioning error was made?
-pt is rotated to much
What is the Lateral L5-S1 (spot) position?
-pt position: Lateral recumbent -Part Position: MCP perpendicular to the IR, Hips extended, Superimposed knees (may be slightly flexed), have elbows flexed, places arms at right angle to body, support lower spine in horizontal position in same manner as for lateral projection. -CR: Perpendicular to coronal plane, 2 inches posterior to ASIS and 1.5 inches inferior to illiac crest. --Most of the time we angle 5-8 degrees caudad. 5 degrees for male, 8 for females. -Collimated Field: Includes all of L5 and S1
What is the positioning for an LAO esophagram?
-recumbent 35-40 degrees LAO -Align IR and evevated side of PT about 2'' lateral to MSP --CR enters perp to midpoint of IR and 2'' lateral to MSP at level T5-T6
What is the PT's position for a lateral esophagram? CR positon?
-recumbent right or left (PT should be facing you) -arms forward -MCP centered --CR enters perp to midpoint of IR --enters PT on MCP at level T5-T6
Which special projection demonstrates the hill-sachs defect?
-same as inferiosuperior axial (lawrence method) except with exaggerated rotation, with thumb down and posteriorly about 45degrees
What kind of joint is the 1st CMC joint?
-sellar (saddle) joint
What are 2 important things to keep in mind when radiographing the shoulder?
-shield radiosensitive areas -use close collimation
What are the 3 parts of the temporal bone?
-squamous portion, which is also quit thin and the most vulnerable portion of the entire skull to fracture -mastoid portion -petrous portion, where the petrous ridges are
What projection is done to determine bone age?
-standard AP projection of the left hand and wrist -for children 1-2 yr old they often do an AP left knee too
What are the basic projections for the zygomatic arch routine?
-submentovertex (SMV) -oblique inferosuperior (tangential) -AP axial (modified towne)
What are the 3 borders of the scapula?
-superior border -medial (ventral) -lateral (axillary)
what is the patient's position for an AP supine or semierect position
-supine, in possible, place the head of the cart at an upright position -roll shoulders forward
what are the breathing instructions the technologist should give the patient for a chest x-ray
-take a breath in -blow it out -take a deep breath in -and hold it
What needs to be visualized for an axiolateral hip radiograph?
-the entire femoral head, neck(w/out overlap from greater trochanter), and acetabulum --only a small amount of greater trochanter on anterior and posterior surface of proximal femur -grid lines should NOT be seen
Where should the CR be for an AP (mid-distal) Femur
-the lower edge of the light field should be 2'' below the knee joint (apex of patella)
How do you tell if there is rotation of a pelvis?
-there is rotation if one ilia is larger than the other --it is rotated toward the larger side (ex. if the right side is larger then it is rotated toward the right) -you can also look at the obterater foramen, they should be equal in size, open the same amount, if they aren't then there is also rotation
what are the 4 structures of the mediastinum
-trachea -esophagus -thymus gland -heart and great vessels
When is and what is the horizontal beam transthoracic lateral humerus?
-trauma -demonstrates entire humerus without rotation -unaffected limb raised over head -CR to mid aspect to involved humerus -breathing technique
mediolateral Foot
-true lateral -CR to mid-cuneiform (base of 3rd MT) -plantar surface perpendicular to IR -only use a tube angle for BIG feet PT position: lateral recumbent with knee flexed, place opposite limb behind the injured limb, dorsiflex the foot if possible, place support under knee to ensure the plantar surface is perpendicular, long axis of the foot to long axis of the IR unless it won't fit that way
What is the Frog Lateral mid-proximal femur
-true lateral -proximal femur not superimposed -affected side down, knee flexed, PT roll back about 15 degrees to prevent superimposition from opposite thigh -place upper IR light field line at the level of the ASIS
Why do we use EAM (external Acoustic Meatus) for a topographic landmark?
C1 is approximately one inch below
What is bone age?
-used to evaluate degree of skeletal maturation -becomes a concern if chid's development is well behind or well advanced of peers
Why would we take an x-ray of a neck?
-usually on peds patients -for soft tissue of the neck -used to rule out epiglottitis which can be life threatening or to look for a foreign object
What are the 2 options for modified Stecher method -PA Scaphoid
-with and without ulnar deviation 1:hand elevated, ulnar deviation, no CR angle 2: hand elevated 20degrees, no ulnar deviation or CR angle
What are the topographic landmarks used for the abdomen? Where do they corespond with?
-xiphoid process=T9-T10 -Inferior costal magin L2-L3 -Iliac crest L4-L5 -ASIS-Anterior Superior Iliac Spine --prominent protuberance found on the ilium -greater trochanter
For Upper GI preparation, how long should and infant younger than 3 months be NPO for prior to the procedure? -Children 3 months to 5 years? -Children 5 years and older?
-younger than 3 months= NPO 3 hr -3m to 5 yr= NPO 4 hr -5yr and older= NPO 6 hr
What are the organs of the digestive tract?
1-Oral Cavity 2-Pharynx 3-Esophagus 4-stomach 5-small intestine 6-large intestine
For pediatric abdomen where should the CR be directed?
1'' above the umbilicus
how many facial bones are there?
14
what are the 3 divisions of the chest anatomy
1- bony thorax 2- respiratory system 3- mediastinum
What are the true ribs?
1-7 because they attach directly to the sternum
What are the pathologic indications for an acute abdomen series?
1-Ileus 2-Ascites 3-Intraabdominal mass 4-Postop (abdominal surgery)
What are the 3 positioning principles of a trauma PT for AP forearm?
1. Part parallel to IR 2. CR 90degrees to part and IR 3. Correct CR centering
_____ to_________ are typical cervical vertebrae.
C3 to C6
What type of CR angle is required for an RAO projection of the c-spine?
15 degrees caudal
Neck projects anteriorly ____________ degrees.
15-20
How much should you rotate the toes and entire leg inward for the AP unilateral hip? -Why do we do this?
15-20degrees -b/c so the femoral head is parallel to the IR
How much do you angle the CR for an AP axial clavicle?
15-30degrees depending on body hatitus
Most prominent area of the Adams apple is at what level?
C5
What digit is the thumb?
1st
How many posterior ribs should be seen above the diaphragm for a well-inspired PA chest projection?
10
What is the kVp for upper GI? --exposure time?
100-125 for single contrast 90-100 for double contrast w/ short exposure times
What size cassette do you use for the AP unilateral hip?
10X12 --unless the PT has previously had a orthopedic surgery, then you need to include all of the "hardware" and may need to go to a 14X17
What angle should be used for an AP foot radiograph?
10degree angle, angled posteriorly/cephalic
What is the recommended kV range for an adult chest radiograph
110-125kV
Which of the following ribs is classified as a floating rib?
11th rib
What joint is between the distal and proximal phalange bones of the thumb?
1st metacarpo-phalangeal (MCP) joint
The first sm bowel image should be taken centered where? after that?
1st-2''above iliac crest after-at iliac crest
What are the 3 sections of the small intestine? And, their length?
1st-Duodenum, the shortest and widest 2nd-Jejunum, 2/5th of the small intestine 3rd-Ileum, 3/5 of the small intestine
What kind of joint is the CMC joint of the 1st digit? 2nd-5th digits?
1st-saddle 2nd-5th-plane(gliding joints)
Where should you project your CR for a left lateral decub?
2'' above the iliac crest
How many phalanges does the thumb have?
2--distal and proximal
What are the 2 and 3-way acute abdomen series?
2-way: AP supine, AP erect or left lateral decub (must include diaphragm 3-way: AP supine, AP erect, PA chest
There are ______ true, movable vertebra.
24
The IV pole that has the Ba contrast on it should be no higher than _____ inches above the level of the _____.
24; anus
How many bones are in the foot?
26 bones
What is the total number of bones in the adult vertebral column?
26; 33 in kids
How many bones are in the had and wrist?
27
Only the Radius articulates with _____ carpal bones, the ____________ and __________. These create the ___________ joint.
2; scaphoid; lunate; radiocarpal
How many parts are there to the sternum?
3 parts -Manubrium - most superior (lies at the T2-T3 interspace) -Body-longest portion—joins to the Manubrium at the sternal angle—sternal angle is at the T4-T5 interspace -Xiphoid process - most inferior-often deviates from the midline—lies over T10
What is the typical kVp for abdominal x-rays?
70-80 kVp
What is the Minimum SID for erect chest radiography?
72'' or 183cm
what is the recommended SID for chest x-rays
72'' or 183cm
How many cranial bones are there?
8
What is the sattegast method for the patella?
90° flexion CR 15° to 20° from lower leg
The Transverse colon is classified as an ______________ structure. A:Intraperitoneal B:Retroperitoneal C: Infraperitoneal D: Extraperitoneal
A
Which of the following is NOT one of the accessory organs for digestion? A:Spleen B:Pancreas C:Liver D:Gallbladder
A
What is ileus?
A nonmedical bowel obstruction --usually b/c of lack of intestinal mobility
What type of CR angle is used for the AP projection of the foot? A:10° posterior B:5° posterior C:15° to 20° posterior D:35° posterior
A:10° posterior
What is a scout radiograph?
A KUB
What is spina bifida?
A congenital condition in which the laminae fail to fuse.
What needs to be ruled out before attempting the frog-leg projections?
A fracture
Which position can replace the RAO sternum for the trauma patient who cannot lie prone or stand?
level of T2-T3
What type of CR angle is required for the AP semiaxial projection for the apices of the lungs? A. None; CR is perpendicular to IR B. 15° to 20° cephalad C. 15° to 20° caudad D. 5° to 8° cephalad
A.
What type of CR angle is required for the AP axial "outlet" projection for a male patient? A: 20° to 35° cephalad B: 30° to 45° cephalad C: 45° to 60° cephalad D: 40° caudad
A: 20° to 35° cephalad
What is the LML?
lips-meatal line (LML) -from top lip to EAM
What is the joint classification of the symphysis pubis? A: Amphiarthrodial B: Synarthrodial C: Diarthrodial D: The symphysis pubis is fused; therefore it is not an actual joint
A: Amphiarthrodial
Which of the bones of the pelvic girdle is the largest? A: Ilium B: Ischium C: Pubis D: Coccyx
A: Ilium
What is the positioning error for a parietoacanthial projection if the petrous ridges are within the maxillary sinuses? A-Excessive flexion B-Excessive extension C-Rotation of the skull D-Tilt of the skull
A-Excessive flexion -Under extension
Which of the following projections will best demonstrate a possible Hill-Sachs defect? A-Inferosuperior axial projection with exaggerated external rotation B-Superoinferior axial (Hobbs modification) C-Posterior oblique (Grashey method) D-Tangential projection (Fisk modification)
A-Inferosuperior axial projection with exaggerated external rotation
The anterior nasal spine is an aspect of the ____ bone. A-Maxillary B-Zygomatic C-Mandibular D-Inferior nasal conchae
A-Maxillary
A wavelike series of involuntary muscular contractions that propel solid and semisolid materials through the alimentary tract is termed _____. A-Peristalsis B- Rhythmic segmentation C-Deglutition D-Mastication
A-Peristalsis
Which of the following upper GI projections will best demonstrate the retrogastric space? A-Right lateral B-RAO C-LPO D-PA
A-Right lateral
Which aspect of the skull is most vulnerable to fracture? A-Squamous portion of temporal bone B-Petrous portion of temporal bone C-Orbital plate of frontal bone D-Squamous portion of occipital bone
A-Squamous portion of temporal bone -a very thin bone
Which of the following projections will best demonstrate the rectum during an air-contrast barium enema? A-Ventral decubitus B-Left lateral decubitus C-Right lateral decubitus D-Dorsal decubitus
A-Ventral decubitus
How much is the elbow flexed for a trauma axial lateral projection (Coyle method) to demonstrate the coronoid process? A:45° B:80° C:60° D:90°
B:80°
What is the Pigg-O-Stat?
A restraint device for children/babies so they stay still for the procedure -used for erect chest and abdomen -bicycle like seat -side body clamps -IR holder mount -swivel base -adjustable lead shield with markers -extra set of smaller body clamps
What is the Tam-Em-Board?
A restraint device used for babies/children so they stay still for the procedure --used for recumbent chest, abdomen, and upper and lower limbs
If a patient lies supine during an upper GI series, where would most of the barium settle within the stomach? A- In the fundus B-In the body C- In the body and pylorus D-In the body and C-loop of the duodenum
A- In the fundus
The typical adult's small intestine (intact) measures _____. A-23 feet or 7 meters B-15 to 18 feet or 4.5 to 5.5 meters C-5 feet or 1.5 meters D-10 feet or 3 meters
A-23 feet or 7 meters
What type of CR angle is required for a PA axial (Haas method) projection of the skull? A-25° cephalad B-30°caudad C-37° caudad D-15° caudad
A-25° cephalad
The midline point at the junction of the upper lip and the nasal septum is called A-Acanthion B-Nasion C-Glabella D-Mentum
A-Acanthion
Which paranasal sinus is the last one to develop? A-Ethmoid B-Sphenoid C-Frontal D-Maxillary
A-Ethmoid
The interphalangeal (IP) joints are classified as: A: Ginglymus B: Plane C: Ellipsoidal D: Sellar
A. Ginglymus
Which of the following projections would best demonstrate a possible elevated fat pad near the elbow joint? A: Lateral B: AP C: AP partially flexed D: Acute flexion-Jones method
A: Lateral
How is the cassette aligned for an axiolateral (Danelius-Miller method) projection? A: Parallel to femoral neck B: Parallel to greater trochanter C: Perpendicular to iliac crest D: Parallel to long axis of femoral shaft
A: Parallel to femoral neck
Which of the following bones of the foot is fractured most often? A:Base of the fifth metatarsal B:Navicular C:Distal fifth phalanx D:Third cuneiform
A:Base of the fifth metatarsal
The sustentaculum tali is found on the A:Calcaneus B:Talus C:Base of the fifth metatarsal D:Cuboid
A:Calcaneus
That is the t-spine routine?
AP and Lateral
What are the basic shoulder projections?
AP w/ external and internal rotation
What are the 3 main projections for the thumb?
AP, Oblique, Lateral
What is the criteria for weight bearing AP foot?
AP: -bilateral feet demonstrated (if doing bilateral) -phalanges and MTs not rotated lateral: -entire foot demonstrated -plantar surfaces of MTs superimposed -exposure factors
Fluoroscopy
Ability to view and record anatomy in motion (evaluate function and form) --live x-ray
What does Kyphosis means?
Abnormal condition characterized by increased convexity of the thoracic spine curvature. (Humpback)
what is the lower limb joint classification?
All but one joint of the lower limb is classified as synovial, diathroidal. One exception is the distal tibiofibular joint which is classified as a fibrous joint, amphiarthrodal
For a abdomen x-ray, what clothing should be removed when changing into a gown?
All clothing in the area of interest, underwear must be removed, bras may stay on
What kind of joint is the alveoli and teeth?
Alveoli and Teeth Fibrous (gomphosis subclass) Synarthrodial (immovable)
The intervertebral joints are classified as?
Amphiarthrodial
What additional measure can be taken if the pt cannot depress the shoulders delinquently for the swimmers lateral position?
Angle the CR 3-5 degrees caudal
To minimize distortion of the femoral neck for an AP bilateral frog-leg projection, the lower limbs should be abducted: A: 10° to 15° B: 20° to 30° C: 45° D: 90°
B: 20° to 30°
LPO upside criteria?
Anterior rim and posterior ilioischial column demonstrated
Epicondyles are parallel to IR, and greater tubercle lateral in profile and lesser tubercle is anterior in which position?
Ap proximal humerus/external rotation
If you can't palpate to find the iliac crest, what should you do?
Ask the patient to help you, "Can you help me find the top of your hip bone please?" Sometimes it's easier for them to touch themselves than you poking around
What bone has a conical process, called the dens or odontoid, on upper, anterior of body?
Atlas, C1
The ulnar notch is located at the: A: Medial aspect of the distal radius B: Distal end of the ulna C: Proximal end of the ulna D: Proximal end of the radius
B: Distal end of the ulna
Another term for the patellar surface of the distal femur is A:Capitellum B:Intercondylar fossa C:Meniscus D:Intercondylar sulcus
B:Intercondylar fossa
A pathologic condition in which twisting of a loop of intestine creates an obstruction is termed: A-Intussusception B-Volvulus C-Ascites D- Adynamic ileus
B
The Pancreas is classified as a ______________ structure. A:Intraperitoneal B:Retroperitoneal C: Infraperitoneal D: Extraperitoneal
B
How much must the skull be rotated from a lateral position to best demonstrate the body of the mandible for the axiolateral oblique projection? A-10°-15° B-30° C-45° D-None. Keep the skull in a true lateral position
B-30
The width of the dolichocephalic skull is less than ____of the length. A-65% B-75% C-80% D-90%
B-75%
What is the name of the process of the mandible in which the lower teeth are embedded? A-Frontal process B-Alveolar process C-Body D-Mental symphysis
B-Alveolar process
The glabella is located on the _______ cranial bone. A-Parietal B-Frontal c-Occipital D-Sphenoid
B-Frontal
The palatine process is an aspect of the ____ bone. A-Lacrimal B-Maxillary C-Palatine D-Zygomatic
B-Maxillary
Where is the CR centered for a PA projection of the second digit? A. DIP joint B. PIP Joint C. MCP joint D. CMC joint
B-PIP joint
Which aspect of the large intestine is best demonstrated with the RAO projection? A-Cecum B-Right colic flexure C-Left colic flexure D-Descending colon
B-Right colic flexure
Which one of the following projections will best demonstrate the proximal esophagus? A- Right lateral B-Swimmer's lateral C-RAO D-LAO
B-Swimmers lateral
Which bony landmark should NOT be visible on a correctly positioned AP pelvis (nontrauma)? A: Greater trochanter B: Lesser trochanter C: Ischial spines D: Ischial tuberosity
B: Lesser trochanter
A common term for osteomalacia is A:Paget's disease B:Rickets C:Gout D:Runner's knee
B:Rickets B=bone softening
The third carpal bone on the proximal row (from the lateral aspect of wrist) is the: A: Hamate B: Triquetrum C: Trapezoid D: scaphoid
B: triquetrum
The articular facets making up the tibial plateau slopes posteriorly at A:5° to 8° B:10° to 20° C:25° to 30° D:35° to 45°
B:10° to 20°
When should you NOT use (its contraindications) BaSO4? water-soluble Iodinated contrast media?
BaSO4: -pre-surgical patients -perforated hollow viscus -large intestine obstruction Iodine: -young or dehydrated patients -sensitivity to iodine
what is the most common contrast for the alimentary canal?
Barium sulfate (BaSO4) -It's non soluble in water, and doesn't chemically react with the body
What is the basic abdominal position for x-ray? special?
Basic - Ap supine (KUB) special - lateral decub (ap) - AP erect - Dorsal decub lateral
What is the basic TMJ routine?
Basic -AP axial (modified Towne) -Axiolateral 15° oblique (modified Law) -Axiolateral (Schuller) -Tomography
What is the basic paranasal sinus routine?
Basic Lateral PA Caldwell Parietoacanthial (Waters) Submentovertex (SMV)
Why is the RAO position preferred over the LAO for an esophagram?
Because of the increased visibility between the vertebrae and the heart
Why do we angle for an AP axial?
Because of the lordotic curvature
Why do we use a tube angle on the AP axial c-spine?
Because the intervertebral foramen are naturally at a 15 degree angle
Where should you as the tch stand during a fluro procedure?
Behind the radiologist, or at the head of the PT, or even just take a step back, but whenever possible DONOT stand next to radiologist as that's where you'll receive the most radiation
Where is the glabella?
Between your eyebrows and slightly up
What is a blowout fracture?
Blowout-caused by something hitting the eye straight on-floor of orbit rupture, inferior rectus is forced through the fx into the maxillary sinus
What needs to be include in a forearm radiograph for it to be acceptable?
Both joints! -the wrist and elbow joint
Describe the Pedicle.
Bottom is concave to form the vertebral notches.
Simple fracture (fx)
Broken bone, skin intact simple(closed)
How do we know what position the patient is in when we use barium?
By where the barium sits
The sigmoid colon is located in the _______ quadrant. A: RUQ B: LUQ C: LLQ D: RLQ
C
What is the preferred length of time a patient should lie on his or her side prior to a lateral decubitus projection? A- 5 minutes B- 5 to 8 minutes C-10 to 20 minutes D-25 to 30 minutes
C
Where is the CR centered for an AP erect abdomen projection as part of an acute abdomen series? A-At iliac crest B-ASIS C-1 to 2 inches (5 cm) above iliac crest D-At xiphoid process
C
Which of the following upper GI projections will demonstrate the duodenal bulb in profile? A- AP B- PA C- RAO D- Right lateral
C- RAO
What type of CR angle is required for the axiolateral (Schuller method) for the TMJs? A-15° caudad B-20° caudad C-25°-30° caudad D-45° caudad
C-25°-30° caudad
What type of CR angle is required for the AP axial "butterfly" projection? A-10°-15° cephalad B-20°-30° caudad C-30°-40° cephalad D-35°-45° caudad
C-30°-40° cephalad
How much CR angle is required for the AP axial projection of the skull if the IOML is perpendicular to the IR? A-25° B-30° C-37° D-40°
C-37°
What is the angle between the OML and the plane of the IR for a well-positioned parietoacanthial projection? A-20° B-23° C-37° D-55°
C-37°
How much is the CR angled for an AP axial projection of the mandible if the IOML is perpendicular to the IR? A-30° B-35° C-42° D-45°
C-42°
There is a ___ difference between the orbitomeatal and infraorbitomeatal lines. A-2° to 3° B-5° C-7° to 8° D-10° to 12°
C-7° to 8°
The posterior aspect of the bony orbit is termed the _____. A-Base B-Hiatus C-Apex D-Ramus
C-Apex
Which cranial bone makes up an aspect of the bony nasal septum? A-Sphenoid B-Temporal C-Ethmoid D-Frontal
C-Ethmoid
The tragus is located on the A-Lateral border of the orbit B-Point above the superciliary arch C-External ear D-Bridge of the nose
C-External ear
Pouches or sacculations found along the mucosal wall of the large intestine are termed _____. A-Villi B-Plicae circulares C-Haustra D-Taenia coli
C-Haustra
What is the longest segment of the small intestine? A-Duodenum B-Jejunum C-Ileum D-Cecum
C-Ileum
In which abdominal quadrant would the sigmoid colon be located primarily? A-RUQ B-RLQ C-LLQ D-LUQ
C-LLQ
The widest portion of the entire skull is located between the: A-Glabella and bregma B-Bregma and lambda C-Parietal tubercles D-Greater wings of the sphenoid
C-Parietal tubercles
What passes through the optic foramen? A-Blood vessels B-Rectus muscle C-Retina D-Second cranial nerve
C-Retina
Lacrimal is derived from a word meaning ____. A-Water B-Oil C-Tear D-Duct
C-Tear
The jugular foramen are located on the _____ bone. A-Occipital B-Sphenoid C-Temporal S-Ethmoid
C-Temporal
Which cranial bone houses the organs for hearing and equilibrium? A-Ethmoid B-Sphenoid C-Temporal D-Occipital
C-Temporal
Which of the following bones makes up most of the lateral wall of the orbit? A-Maxillary B-Lacrimal C-Zygomatic D-Vomer
C-Zygomatic
What type of CR angle is required for the Gaynor-Hart Method? A.None CR is perp to IR B.5-15degrees C.25-30degrees D.45degrees
C.25-30dgrs
Where is the CR centered for an AP pelvis projection? A: Level of iliac crest B: Level of ASIS C: Midway between ASIS and symphysis pubis D: Level of symphysis pubis
C: Midway between ASIS and symphysis pubis
Where is the pronator fat stripe located? A:Anterior to the elbow joint B:Posterior to the elbow joint C: Anterior to the distal radius D: Anterior to the radial head
C: anterior to the distal radius
How much is the ankle rotated medially for an AP mortise projection? A:5° B:10° C:15° D:25°
C:15° 15-20dgrs
ow much is the CR angled for a plantodorsal axial projection of the calcaneus? A:20° B:30° C:40° D:45°
C:40°
The knee joint is classified as A:Sellar B:Ginglymus C:Bicondylar D:Plane
C:Bicondylar
What is the strongest and largest of the tarsal bones? A:Navicular B:Cuboid C:Calcaneus D:Talus
C:Calcaneus
The depression or pit located at the center of the femoral head is the: A:Acetabulum B:Femoral fossa C:Fovea capitis D:Ossa coxa
C:Fovea capitis
What is the AP Axial inlet projection?
CR 40degrees caudad at level of ASIS
What is the CR angle for weight bearing of an AP foot? -where is it centered?
CR at a 15degree angle posterior -- centered to the base of MTs or at the middle of the 2 feet at the level of the base of the metatarsals
lateral sinus projection
CR midway between outer canthus and EAM
Trauma AP 0degrees
CR parallel to OML CR to glabella -pt supine
CR for lateral facial bones?
CR perpendicular, centered to zygoma
For a PA finger, where should the the CR be centered?
CR to PIP
Where should the CR be centered for a humerus radiograph?
CR to midhumerus
For the AP Axial Outlet Projection (Taylor Method) how should the tube be angled for males?
CR: 20-35degrees cephalad for males -CR centered 1-2'' distal to symphysis pubis
What is the order of stomach parts from most superior to inferior?
Cardiac notch, fundas, body, greater curvature, lesser and greater curvature, pyloric portion, pyloric orifice
What type of CR angle is required for an AP projection of the knee if the distance from ASIS to tabletop is 21 cm? A:0° angle B:3° to 5° caudad C:3° to 5° cephalad D:15° cephalad
Chart on page 242 about CR angle for the AP knee-most of the time it will be 0 A:0° angle
What anatomy should be visualized in an AP Supine Abdomen?
Symphysis pubis, outline of psoas muscles, kidneys, lower liver
Coccygeal vertebra fuse into the?
Coccyx
What is the mnemonic to remember the tarsal bones?
Come --- calcaneus To --- Talus Colorado --- cuboid Next -- navicular 3 Christmases --- 3 cuneiforms
Greater Omentum
Connects the transverse colon to the greater curvature of the stomach inferiorly
The tapered end of the solid spinal cord is?
Conus medullaris
The inside margin of the rib, containing the blood vessels and nerves, is called the?
Costal Groove
What is another term for the mid area of the costal surface of the scapula? Subscapular fossa Infraspinous fossa Supraspinous fossa Scapulohumeral surface
Costal surface is on anterior side Subscapular fossa Infraspinous fossa-posterior side below the spine or crest Supraspinous fossa-posterior side above the spine or crest Scapulohumeral is a joint not a surface
What 2 large abdominal muscles extend next to the lumbar spine and are indicators of a well-exposed KUB? A:Rectus abdominis B:Quadratus lumborum C: Erector spinae D: Psoas major
D
Which of the following projections will best demonstrate intraperitoneal free air? A- KUB B-Dorsal decubitus C-Right lateral decubitus D-PA chest
D
How much rotation of the body is required for the LPO position during an upper GI? A- 10°-20° B-20°-25° C- 25°-30° D- 30°-60°
D- 30°-60°
Which of the following structures is located on the distal humerus? A- Styloid process B- Olecranon process C- Coronoid process D- Capitulum
D- Capitulum Styloid process is on the distal ulna Olecranon and coronoid process is on the proximal ulna
The IV pole/enema bag is no farther than ___ above the table for the beginning of a barium enema procedure. A-40 inches (100 cm) B-72 inches (180 cm) C-12 inches (30 cm) D-24 inches (60 cm)
D-24 inches (60 cm)
The angle between the midsagittal plane and the long axis of the petrous portion of the temporal bone in the brachycephalic skull is A-45° B-40° C-38° D-47° or greater
D-47° or greater
The opening between the epitympanic recess and the mastoid portion of the temporal bone is called the A-Attic B-Antrum C-Eustachian tube D-Aditus
D-Aditus
What structure helps to create the C-loop of the duodenum? A-Tail of pancreas B- Liver C-Stomach D-Head of pancreas
D-Head of pancreas
The older term "Antrum of Highmore" describes the _____. A-Nasal cavity B-Ethmoid sinuses C-Sphenoid sinuses D-Maxillary sinuses
D-Maxillary sinuses
Which chest projection/position should be performed to demonstrate a pneumothorax in the left lung if the patient cannot stand? A. AP supine B. Left lateral decubitus C. AP lordotic D. Right lateral decubitus
D-RIGHT lateral decub ari up
Which region(s) of the large intestine would be barium filled during a double-contrast BE with the patient lying prone? A-Ascending and descending colon B-Rectum only C-Cecum only D-Transverse and sigmoid colon
D-Transverse and sigmoid colon
Which facial bone forms an aspect of the bony nasal septum? A-Nasal B-Maxillary C-Ethmoid D-Vomer
D-Vomer
Which of the following facial bones is unpaired? A-Maxillary B-Palatine C-Lacrimal D-Vomer
D-Vomer And the mandible
Sutural or Wormian bones are most often found A-Within the lateral masses of ethmoid bone B-Within the inner and outer tables of the frontal bone C-Within the petrous bone of the temporal bone D-Within the lambdoidal suture
D-Within the lambdoidal suture
What are the elbow's fat stripes/pads? When and how can you see them?
D-posterior fat pad C- Anterior fat pad E- Supinator fat stripe --To see them the elbow must be 90degrees, in a true lateral position, and usually only visible during trauma or b/c of pathology
Which of the following projections is best suited for the patient with limited movement of both lower limbs to demonstrate a lateral perspective of the proximal femur? A: Taylor method B: Danelius-Miller method C: Judet method D: Clements-Nakayama method
D: Clements-Nakayama method
Which of the following bony landmarks is located posterior to the acetabulum? A: ASIS B: Ischial tuberosity C: Iliac crest D: Ischial spine
D: Ischial spine
The most frequently fractured carpal bone is the : A: trapezium B: pisiform C: capitate D: scaphoid
D: scaphoid
Which of the following positions would best demonstrate a Lisfranc injury? A:AP mortise ankle projection B:Tangential sesamoid bone projection C:Patellofemoral joint projection D:AP weight-bearing foot projection
D:AP weight-bearing foot projection
A benign, neoplastic bone lesion caused by a consolidated overproduction of bone at a joint is called A:Gout B:Osteogenic sarcoma C:Reiter syndrome D:Exostosis
D:Exostosis
What are the 3 joints of the fingers?
DIP, PIP, MCP
Which chest projection/position should be performed to demonstrate a pleural effusion in the right lung if the patient cannot stand? A. AP supine B. Left lateral decubitus C. AP lordotic D. Right lateral decubitus
D. Right lateral decub pleural effusion is fluid, fluid side down
Which of the following is NOT a mediastinal structure? A.) Thymus gland B.) Esophagus C.) Trachea D.) Epiglottis
D.) Epiglottis
What are the most important muscles in the abdomen to radiography?
Diaphragm and left and right psoas muscles
What joint is between a middle and distal phalange bone?
Distal interphalangeal (DIP) joint
What is the merchant bilateral patella method?
Done with some type of leg support. Pt: supine, with knees flexed 40 degrees over the end of the table, cassette placed below the knees resting on the legs about 12 inches below the knees CR: 30 degrees from horizontal, directed midway between the patellae SID of 48 inches is recommended
AP axial (Towne method) criteria
Dorsum sellae projected within foramen magnum Entire skull visualized No rotation or tilt Petrous ridges symmetric Optimal exposure factors
mesentery
Double fold of the peritoneum that loosely connects the small intestine to the posterior abdominal wall.
What quadrant(s) is the duodenum in? -Jejunum? -Ileum? -Ileocecal valve?
Duodenum-RUQ & LUQ Jejunum- LUQ & LLQ Ileum- RUQ, RLQ, & LLQ Ileocecal valve: RLQ
How can you tell the difference between a male and female pelvis?
Female: -pelvis is wider, ilia are more flared and more shallow from front to back -pubic arch is >90 -inlet is larger and more round Male: -narrower, deeper and ilia are less flared -pubic arch is <90 -inlet is more narrow and oval or heart shaped
What is the mortise?
Frontal view-Formed by three bones. Tibia, fibula and the Talus Lateral malleolus=lateral Medial malleolus=medial **Form a socket called the Mortise where the Talus fits
ankle joint
Frontal view-Formed by three bones. Tibia, fibula and the Talus Lateral malleolus=lateral Medial malleolus=medial Form a socket called the Mortise where the Talus fits Lateral ----Distal fibula over posterior half of tibia on a true lateral
What are the parts of each phalanx?
Each phalanx has a head (distal end), a body (shaft), and a base
What is the criteria for a LAO esophagram?
Entire esophagus demonstrated --filled with Ba Esophagus midway between spine and hilar region Optimal exposure factors
What is the critera for an AP esophagram?
Entire esophagus visible through superimposed thoracic vertebrae No rotation Optimal exposure factors
What is the criteria for the modified axiolateral hip?
Entire femoral head, neck, and trochanters centered to IR Femoral head and neck in profile Optimal exposure factors
lateral skull
Entire skull visualized Cranium seen without rotation or tilt Correct flexion and extension of skull Optimal exposure factors
SMV criteria
Entire skull visualized Mandibular condyles anterior to petrous pyramids No rotation or tilt Optimal exposure factors
Trauma AP 0degrees criteria
Entire skull visualized No rotation Petrous ridges superimpose superior orbital regions. Optimal exposure factors
Which of the following technical considerations does not apply to a rib study for an injury to the left, upper anterior ribs?
Exposure upon expiration
Lesser Omentum
Extends superiorly from the lesser curvatures of the stomach to the liver
TRUE/FALSE: Patients with an allergy to latex should be exposed only to natural latex gloves and enema tips.
FALSE!
TRUE/FALSE: The rectum is part of the colon.
FALSE!! It is NOT part of the colon
T/F: A hypersthenic patient requires greater rotation of the sternum for the RAO projection as compared with a sthenic patient.
False
True/False: Lateral chest x-rays must be done with the patient erect and standing on their feet.
False! they can be done sitting up straight in a wheelchair or on the bed for a number of reasons
T/F: Ribs decrease in length from 1-7, than increase to the 12th
False, Increases in length from 1 to 7, then decreases to twelfth
Tor F: for a lateral projection of the c-spine, the exposure is initiated during full inspiration of the lungs.
False, on expiration
True or False: The vertebral column is located in the anterior trunk?
False: Posterior trunk
True or False: Doing a PA L-spine will lower the ovarian dose by 90-100 percent
False; 25-30 percent
What position best demonstrates the phalanges?
Fan lateral
What does the Jejunum look like on a x-ray with contrast?
Feather like
A fracture of adjacent ribs, in two or more places, caused by blunt trauma and associated with underlying pulmonary injury is called?
Flail chest
How do you know if you have extensive extension or flexion?
Flexion and extension of the c-spine will affect where the petrous ridges lie in relationship to other anatomy
PA/AP: Which is preferred for had radiographs?
PA --palmar surface down
When do you do a mediolateral radiograph of the toes?
For the 4th and 5th digits CR to PIP joint
What is the purpose/job of the peritoneum?
Forms folds that bins the abdominal organs together and to the wall of the abdomen
Barton's Fracture
Fracture and dislocation of the posterior lip of the distal radius involving the wrist joint
What is the alimentary canal?
From the mouth to the anus Mouth, pharynx, esophagus, stomach, small intestine, large intestine, terminates at anus
which bones make up the base of the orbit?
Frontal (orbital plate), zygoma, and maxilla
Which bones are part of the skull cap (calvaria)?
Frontal bone, right parietal, left parietal, occipital
What kind of joint is the elbow?
Ginglymus (hinge) allows for flexion and extension -proximal radioulnar joint is part of the elbow joint-trochodial (pivot) type joint **allows for pronation and supination ---Overall, the elbow is a synovial (freely moveable) joint
1st-5th IP joints have which type of joint?
Ginglymus (hinge) type
What is the GML?
Glabellomeatal line (GML) -from the glabella to the EAM
What are haustra? and where are they located?
Haustra are series of pouches (formed by Tainiae coli) along the large intestine
What projection is done for the proximal femur?
Hip and proximal femur - AP unilateral hip
what should you say when you hand them a gown
I need you to remove all of your clothing from the waste up; including any jewelry or piercings you may have.
When is an AP wrist projection performed?
IF PT can't do the PA position --it also can be taken to better demonstrate the intercarpal spaces and the wrist joint--but it is NOT standard
orbit orientation
If orbitalmeatal line is parrallel to the floor the orbit will project upward 30degrees and toward the MSP 37 degrees Imprtant because to image the optic foreamen the patients chin should be extended 30 degrees and head rotated 37 degrees
Where should the marker be placed for an abdominal x-ray?
In the lower right corner, in pelvic area--It's okay if its on pelvic/hip bone areas as long as it isn't in the anatomy of interest
When taking radiographs of large OR wet plaster casts, what should you do?
Increase mAs by 100% or increase kV by 8-10
When taking radiographs of a fiberglass cast, what should you do?
Increase mAs by 25%-30% or increase kV by 3-4
What is the Inion?
Inion is the prominent bump at the back of the inferoposterior portion of the skull, you can feel it on the back of your skull
What is the criteria for the camp- coventry (PA axial prjection)?
Intercondylar fossa in profile No rotation Articular facets and intercondylar eminence well visualized Optimal exposure factors
What is the criteria for the patella merchant method?
Intercondylar sulcus and patella visualized Patellofemoral joint spaces open patella in profile Optimal exposure factors
What joint is in the proximal phalange of the first digit?
Interphalangeal (IP) Joint
The articulation of the vertebral notches form_________________ _______.
Intervertebral foramina
What should you make sure you do when you have the PT ready and the radiologist comes into the room
Introduce the PT to the DR
Why is Gonion/ Jaw bone is used as a topographic landmark?
It is at the level of C3
What is the Occlusional Plane?
It is formed by placing the biting surfaces of the teeth together
Which organs are in the Left Lower Quadrant (LLQ)?
LLQ: -Descending colon -sigmoid colon -2/3 of jejunum
Which position can replace the RAO sternum for the trauma patient who cannot lie prone or stand?
LPO
What is the criteria for the LPO and RPO Ba enema?
LPO position: -Entire colon -Right colic flexure less -superimposed or open as compared to AP -Ascending colon, cecum, and -sigmoid colon RPO position: -Entire colon -Left colic flexure and -descending
Which organs are located in the Left Upper Quadrant (LUQ)?
LUQ: -Spleen -stomach -Left colic flexture -Tail of pancreas -Left kidney -left suprarenal gland
Nasal and lacrimal bones
Lacrimal ( word derived from tear) bone is closely associated with the tear ducts
The "Adam's Apple" is formally referred to as what?
Laryngeal prominence
What is the criteria for a lateral and medial oblique elbow?
Lateral: -Radial head, neck, and tuberosity in profile -Lateral epicondyle and capitulum in profile Medial: -Oblique Coronoid process in profile -Trochlea and medial epicondyle in profile
Transverse processes project ________ and a little _________ from the junction of the laminae and pedicels.
Laterally, posteriorly
What are the accessory organs of the digestive system?
Liver, Bladder, Pancreas
What does the "contrast" mean?
Long-scale of contrast should be used, in order to see lung markings throughout the heart shadow and upper lung areas
An abnormal increased "sway-back" spinal curvature is termed?
Lordosis
Where should the CR be centered for a oblique and a lateral thumb?
MCP joint
What should be moved out of the way on someones' body for a chest x-ray
long hair, sometimes breasts, O2 tubing, gown straps
baseball (mallet) fracture
Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. Although it is also known as "baseball finger," this injury can happen to anyone when an unyielding object (like a ball) strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. As a result, you are not able to straighten the tip of your finger or thumb on your own.
AP oblique knee
Medial rotation: -rotate entire body and leg internally -45degree medial rotation -CR: 1/2'' distal to apex of patella ****lateral oblique is the same thing except you rotate laterally
medial vs lateral oblique knee
Medial: --proximal tibiofibular joint open --fibula is NOT superimposed under tibia, fib head & neck will be clearly visualized --patella superimposing the medial femoral condyle Lateral: --fibula superimposed over midtibia --patella will be superimposing the lateral femoral condyle
What is the MML?
Mentomeatal line (MML) -from the mental point (tip of the chin to the) EAM
How do you find the head and neck of the femur for CR placement?
Method 1=1st determine the midline between the ASIS and sympysis --neck 2.5" head 1.5" distal form the midline Method 2 (because you may not always be able to locate the symphysis=1-2 inches medially and 3-4 inches inferior
axiolateral oblique postioning to minimize superimposition
Methods to minimize superimposition of opposite mandibular body: -Employ a combination of tilt on the head and CR angle not to exceed 25°. (Example: Angle the CR 10° and add 15° of head tilt.) OR -Employ 25° cephalad angle toward the IR with no head tilt.
How much Ba+ should be given to a NB-1yr old? -1-3 yr? -3-10 yr? -over 10?
NB-1yr old= 2-4 oz -1-3 yr= 4-6oz -3-10 yr= 6-12 oz -over 10= 12-16 oz
How do you tell if there's rotation for a lateral wrist?
No rotation is obtained when the ulnar head is superimposed by the distal radius and proximal 2-5 metacarpals should be superimposed
PA axial (haas method)
OML perpendicular CR 25° cephalic CR exit 1½ in (4 cm) superior to nasion --Alternative projection from AP axial for patients who can't flex their neck enough
When should a PA thumb be done?
ONLY if an AP can't be done by the PT
The superior articular processes receive the condyles of the _________ bone.
Occipital
What is the OML?
Orbitomeatal line (OML) -from the corner of the eye to the EAM
What is another name for the calcaneus?
OsCalcis
What is the positions for a lateral wrist radiograph?
PT: seated at the end of the table elbow flexed 90degrees Part: thumb up, make sure the wrist is in a true lateral position with fingers flexed, can use support to eliminate motion CR: perp to the mid carpal area
What is the space between the two parietal and visceral peritoneum called?
Parietal cavity
Which peritoneal covering adheres to the cavity wall? How many layers is it?
Parietal, two layers
what is the part and CR position for anterior and posterior oblique? Respiration?
Part: -center PT to the IR -top of IR 1'' above C7 CR: -perp to T7 -SID 72'' Resp.: taken at end of second full inspiration
What is the part position for lateral and AP upper airway? CR?
Part: -center upper airway to the IR -rotate shoulders posteriorly, clasp hand behind back -raise chin -look straight ahead -top of the film at the external auditory meatus EAM CR: -perpendicular -level of C6-7 -SID 72''
What is the criteria for the lateral patella?
Patella and knee joint in center of collimation field Patella in true lateral --patella is in profile Optimal exposure factors
What is the criteria for a PA patella?
Patella centered to collimation field No rotation Optimal exposure factors --Decrease in OID gives patella more detail
criteria for modified parietoacanthial (waters)?
Petrous ridges projected in lower ⅓ of maxillary sinuses Orbital floors not distorted No rotation Optimal exposure factors
PA axial caldwell criteria
Petrous ridges projected into lower ⅓ of orbits No rotation Optimal exposure factors Distances from the lateral orbit margins to the lateral cranial cortices are equal. Crista galla and the nasal septum are aligned with the long axis of the film. Ethmoid sinuses at the center of exposure field Frontal and ethmoid sinuses and lateral cranial cortices are included in the collimated field
2nd-5th CMC joint has what type of joint?
Plane (gliding) type
What kind of joint is the sternoclavicular?
Plane or gliding
The second to fifth MCP joints are classified as: A: Ellipsoidal B: Gingylmus C: Plane D: Trochoidal
a. B=IP, elbow C=intercarpals and CMC D=proximal radioulna
Spinous process is most________.
Posterior
RPO downside criteria?
Posterior rim and anterior ilioischial column demonstrated
Spinous process projects ____________ and _________ from junction of both laminae.
Posteriorly and inferiorly
Laminae projects _________ and _________ from pedicles.
Posteriorly and medially
AP ankle
Pt: supine Part: center ankle joint to the long axis of the IR in the center of the IR, leave in natural position, make sure in a true AP (don't expect the inter malleolar line will be parallel---the lateral maleolus will be about 15 degrees more posterior) CR: perpendicular to a point midway between the malleoli
AP mortise of the ankle?
Pt: supine Part: internally rotate entire leg and foot about 15-20 degrees until the --inter malleolar line is parallel to the IR CR: midway between malleoli
What are the carpal bones?
Proximal Row: bottom: (lateral to medial) Trapezium, trapezoid, capitate, hamate Top row: (lateral to medial) Scaphoid, lunate, triquetrum, pisiform
What is the criteria for an AP unilateral hip and proximal femur projection
Proximal ⅓ of femur included Hip joint space and acetabulum visualized Lesser trochanter not visible or only slightly visible Total existing orthopedic prosthesis demonstrated Optimal exposure factors
What is the AP t-spine projection?
Pt position: supine or upright, shoulders in same plane, arms by side -Part position: If supine reduce kyphosis by flexing hips and knees to place thigh vertical; If upright, wight should be equally distribute on both feet -CR: Enters pt halfway between jugular notch and xiphoid process; T7 (3-4 inches below jugular notch)
What is the PA Patella position?
Pt: Prone Provide support to eliminate direct pressure to the patella, intercondylar line should be parallel to the IR CR: perpendicular to mid-patella area (popliteal crease)
What is the Holmbald method?
Pt: kneeling on all fours on x-ray table, supporting body weight on opposite knee, ask pt to lean forward 20-30 degrees. CR: perpendicular to the IR and lower leg directed to the midpopiteal crease
mediolateral tib/fib?
Pt: lateral recumbent Part: place leg in an lateral position, dorsiflex foot, ensure knee and ankle joint is 1-2 inches from the edge of the IR, most of the time the IR needs to placed diagonally CR: perpendicular to the midpoint of leg, SID may be increased to 44 or 48 inches to include more of the body part
what is the positioning for a mediolateral patella?
Pt: lateral recumbent position, affected side down Part: place leg in a true lateral position, flex knee ONLY 5 - 10 degrees (more flexion could displace fracture fragments) --CR-CR perpendicular to distal femoropatellar joint
mediolateral calcaneus projection
Pt: lateral recumbent, place opposite leg behind Part: Center calcaneous to the center of the film, plantar surface perpendicular to the IR, dorsiflex foot so plantar surface is at a right angle to the leg CR: 1 inch inferior to the medial malleolus (easily palpated bone of the distal tibia)
What is the hughston method for the patella?
Pt: prone, IR placed under the knee, flex knee about 55 degrees (change from the above slide) Part: CR: 15-20 degrees from the long axis of the lower leg directed to the mid femoropatellar joint
AP 45° oblique ankle?
Pt: supine Part: Dorsiflex if possible so the plantar surface is 80 -85 degrees from the IR ---internally rotate 45 degrees CR: midway between malleoli
AP tib/fib
Pt: supine Part: place leg in an AP position, dorsiflex foot, ensure knee and ankle joint is 1-2 inches from the edge of the IR, most of the time the IR needs to placed diagonally, CR: perpendicular to the midpoint of leg, SID may be increased to 44 or 48 inches to include more of the body part
AP knee
Pt: supine Part: rotate internally to bring the intercondyle line parrallel to the IR CR: parallel to tibia plateaus, centered 1/2'' distal to apex of patella
mediolateral knee
Pt: supine (Horizontal beam for patients who can't flex knee) Lateral recumbent with affected knee down. Place opposite knee behind or in front of affected knee (you will see both methods in clinical) Part: rotate knee until in a true lateral position, flex knee 20-30 degrees CR: 5-7 degree cephalic, 1 in distal to the medial epicondyle
RAO= the ____________ side has elongated ribs. LAO= the ______________ side is elongated.
RAO=left LAO=right
why is body habitus important to radiographers
because habitus determines size, shape, and position of organs of the thoracic and abdominal cavities
Why is the left lateral most common
because it more truly demonstrates the heart without as much magnification because the heart primarily lays on the left side
Which organs are in the Right Lower Quadrant (RLQ)?
RLQ: -Ascending colon -appendix -cecum -2/3 of ileum -Ileocecal valve
What organs are in the Right Upper Quadrant (RUQ)?
RUQ: -Liver -Gallbladder -Right colic flexure -Duodenum (C-loop) -Head of pancreas -Right kidney -Right suprarenal gland
The ______________ kidney is usually slightly lower than the other because of the presence of the liver.
Right
Where is the Right colic flexure? Left? Sigmoid portion?
Right colic flexure- sharp angle at ascending and transverse colon left colic flexure- sharp angle at junction of transverse and descending; MOST SUPERIOR IN THE ABDOMEN Sigmoid portion- forms S shaped loop and ends at rectum at level of third sacral segment
How can rotation and tilt be determined for a lateral skull?
Rotation cause distortion of the sella turcica and situates one of the mandibular rami, greater wings of the sphenoid, external acoustic canals, zygomatic bones, and anterior cranial cortices anterior to the other on the lateral projection—can be hard to distinguish which way the head is rotated---patients tend to rotate towards the IR -Tilt-Can be distinguished by looking at the orbital roofs, the greater wings of the sphenoid, the external acoustic canals, the zygomatic bones, and the inferior cranial cortices---one will demonstrated superior to the other
Rotation and tilt determination for caldwell
Rotation-difference from lateral orbital margin to lateral cranial cortex different and the distance from the crista galli to the lateral cranial cortex greater on one side than the other -No tilt if the upper and lower margins of the orbits are parallel/ Patients face is rotated away from the side demonstrating the greatest distance Dens, nasal bone, sagittal suture in the midline
PA transoral waters sinuses criteria?
S-phenoid sinus visualized -Frontal and maxillary sinuses also included -No rotation or tilt -Petrous ridges below maxillary sinuses -Optimal exposure factors
What type of exposure time is used for abdominal x-rays?
SHORT
Sacral vertebrae fuse into the?
Sacrum
Where is the sagittal suture?
Sagittal separates the two parietal bones in the middle
What is the difference between AP lordotic an AP semiaxial lordotic?
Semiaxial, the PT is supine and the tube is angled, not the PT's body like in normal lordotic semiaxial, can be supine or erect, the body just is straight, and the tube is angled
Criteria for PA axial (haas method)
Similar to AP axial except Dorsum sellae appears larger within foramen magnum Magnification of occipital bone evident Optimal exposure factors No rotation=symmetric petrous ridges No tilt=anterior clinoids within the middle of foramen magnum
What is the AP supine & semierect criteria?
Similar to PA except: -heart appears larger -Air-fluid levels not defined -frequently not a complete inspiration (8-9) ribs -3 posterior ribs seen above the clavicles -if more are present the CR is NOT perp. to sternum
What anatomy is included in the lower GI?
Small intestine, large intestine, anus
Omentum
Specific type of double folded peritoneum that extends from the stomach to another organ
What is the joint classification for the scapulohumeral joint? Trochoidal Plane Bicondylar Spheroidal
Sperodial Sternoclavicular and acromioclavicular joints are both plne or gliding joints
What cranial bone houses the organs for hearing and balance?
Squamous part of the temporal bone
why is the right lung shorter and broader than the left
because of the presence of the liver
what structures does the bony thorax include
Sternum, clavicles, scapulae, 12 pairs of ribs, and 12 thoracic vertebrae
What is the stomach and intestine locations for the sthenic body habitus?
Stomach: J-shaped Doudenal bulb/GB: L1-L2 Large Intestine: L colic flexure high
Where is the barium in the large intestine for a supine position? Prone position?
Supine- Ba is in the ascending and descending colon Prone- Ba in transverse and sigmoid colon
For a supine position, where is the barium? Prone? Erect?
Supine--fundus is most posterior, Ba+ sits there, air goes to bottom of stomach Prone-- Ba+ settles in the body and pyloric area, while air is in the fundus Erect-- Pyloric portion is filled with Ba+, and the air rises
What is SOG?
Supraorbital groove -depression above the eyebrows
What is the SOM?
Supraorbital margin
What kind of joint is the sutures?
Sutures Fibrous, synarthrodial (immovable)
What are sutures?
Sutures are membrane covered spaces that fill in shortly after birth -usually do not close completely until 12 or 13 years old
What are the 4 cranial sutures? Junction points?
Sutures: -coronal -lamboidal -squamosal -Sagittal Junctionpints -asterion -bregma -lambda -pterion
The sternocostal joint of the first rib is classified as
Synarthodial
The trachea extends from C6 to approximately ___________.
T5
TRUE/FALSE: Gonadal shielding should be used for upper extremities too.
TRUE
TRUE/FALSE: Shielding should be sued for an RAO upper GI, for both men and women.
TRUE
TRUE/FALSE: The greater trochanter is in profile and the lesser trochanter can not be seen; the leg is internally rotated.
TRUE
TRUE/FALSE: The pubic arch of the male pelvis forms an acute angle (<90°)?
TRUE
TRUE/FALSE: the distal radius will cross over the ulna when the hand is pronated.
TRUE
TURE/FALSE: The terms large intestine and colon are synonymous.
TRUE
True/False: For a left lateral decub position the left posterior ribs should demonstrate more length than the right.
TRUE
True/False: The left bronchus is smaller in diameter than the right but is approximately twice as long.
TRUE
True/False: The pharynx is a common passageway for both food and respiration
TRUE
The axiolateral oblique (modified Law) projection for TMJ requires a CR angle of 15° caudad and a 15° downward rotation of the skull from a lateral skull position. True False
TRUE -15 degree rotation from lateral and a 15 degree caudal angle
True/False: The diaphragm must be present for a lateral decub?
TRUE; the diaphragm is required for all upright abdomen x-rays
What do you need to do to get the room ready for an upper GI study for pediatric PT?
Table horizontal Sheet on table Feeding bottle and nipple Feeding catheter and syringe Suction and oxygen Immobilization devices
The AP Axial outlet projection is also called what?
Taylor method
What is the TMJ
Temporomeandibular Joint -only moveable joint in the skullcondyle head of the mandible fits into the tempomandibular fossa of the temporal bone
why is the left lateral decub preferred?
because the interabdomenal air will be visualized along the lower level of the liver
What angle is the one that requires us to rotate the feet inward for positioning of the pelvis in order to place the femoral neck parallel to the IR for a true AP?
The anterior angle
Where is the bregma junction?
The bregma junction pint is where the sagittal suture meets the coronal suture
What is the expanded terminal end of the esophagus called?
The cardiac Antrum
Why do we angle the tube 5° to 7° cephalic for a lateral knee?
because the medial condyle extends lower or more distally than the lateral when the femoral head is vertical --why we angle so we get the condyles to be superimposed
For an AP w/ external rotation of the shoulder where should the epicondyles be in relationship to the IR?
The epicondyles should be parallel to the IR
Where is the Superciliary ridge (arch)?
The eyebrows
Where is the nasion?
The dip in your nose
Where is the acanthion?
The dip in your upper lib below your nose
The _______is composed of small, irregular bones.
Vertebrae
_________ is centered in the MSP.
Vertebral Column
Where are the phalanges?
The finger bones, after the metacarpals
Where is the Lambda Junction point?
The lambda junction point is where the sagittal suture meets the lamboidal suture
What does the LAO barium enema best demonstrate?
The left colic flexure and descending colon
What do Cervical Vertebrae Occupy? How many are there?
The neck region, and 7
Mesocolon
The peritoneum that attaches the colon to the posterior abdominal wall
Visceral peritoneum
The peritoneum that covers the organs themsleves
What is the first organ of the digestive system?
The stomach
Where should the CR be centered to for a hand?
The third MCP joint
What other system is found in the abdomen that includes the kidneys?
The urinary system
___________ forms the central axis of the skeleton.
Vertebral Column
Where is the Asterion junction pint?
There's 2 of them: they're the junction point where the squamosal suture and the lamboidal suture meet on both lateral sides of the head
Where is the pterion junction point?
There's 2 of them: The pterion junction point is where the coronal suture meets the squamosal suture
C1 has no__________?
Vertebral body
How is tilt determined for a SMV projection? Rotation?
Tilt=distance from mandibular ramis and body to the lateral cranial cortex on both sides are equal Rotation=vomer, nasal septum and dens aligned with long axis of exposure field
Axiolateral oblique mandible positioning? positioning to avoid distortion
To avoid distortion of the area of interest, -Head in true lateral position best demonstrates ramus. -30 rotation toward IR best demonstrates body. -45 rotation best demonstrates mentum. -10 to 15 rotation best provides a general survey of mandible.
What is always important when giving contrast to a PT?
To note the TIME!
What is the function of a Ba Enema?
To study the form and function of the large intestine and detect any abnormalities
What is the Coyle Method?
Trauma Axial lateromedial projection -one projection with CR @ 45deg and elbow at 90deg flexion --used for radial head -one projection with CR @ 45deg and elbow at 80deg flexion --for coronoid process --NEED to increase exposure factors by 4-6kV b/c of the CR angle
What is a tripod fracture?
Tripod-cause by a blow to the cheek causin the zygoma to break in the places
T/F: The first rib is the shortest/broadest?
True
T/F:The anterior ends of the ribs do not attach directly to the sternum?
True
T/F:The ideal, general position for a study of the ribs below the diaphragm is recumbent.
True
True or False: PA is not how we commonly do an L-spine, but it does open up the disc spaces because the vertebrae are naturally parallel to the Beam.
True
What is the true pelvis?
True pelvis: inside the brim of the pelvis also called the lesser pelvis false pelvis: outside the brim of the pelvis, also called the greater pelvis
T or F: the t-spine curvature is classified as a primary curve.
True, it is the first primary curve
For the AP axial (Towne method) under angulation of the CR will project the dorsum sellae where?
Under angulation of the CR will project the dorsum sellae above the foramen magnum-tuck chin and make sure OML is aligned perpendicular Over angulation will project the anterior arch of C1 into foramen magnum
What can you do instead of angling the tube for a toe projection?
Use a 15degree wedge, and have the CR perp to the IR --CR still directed to the MTP joint
Which facial bones don't have a pair?
Vomer and the mandible
What is another contrast used when Barium sulfate is not an option
Water-soluble iodinated contrast indications: -perforated viscus -pre-surgical procedure -possible perforated bowel
When is a left lateral decub performed
When the PT can't stand
How is the patient positioned for a Lateral Decubitus (AP)?
When the patient is laying on their side, arms above the head, back against the IR, knees flexed slightly
How do you tell if there's rotation on an abdominal x-ray?
You look at the iliac wings, if one wing is larger than the other, the patient is rotated towards the side with the bigger iliac wing.
Ethmoid sinuses
Within lateral masses of ethmoid bone Three collections Communicate with sphenoid sinus and nasal cavity -Three collections= anterior, middle and posterior but they all intercommunicate
Maxillary sinuses?
Within maxilla Above upper teeth Air-fluid levels visible -Only sinuses that are part of the facial bone structure -2 sinuses
Nasal Conchae
Within the nasal cavity There are 3 pair superior and middle are part of the ethmoid bone and the inferior is a facial bone all itself Note the cribiform plate and the crista galli in the lateral view help to separate the cranium fro the facial bone mass
oblique inferosuperior zygomatic arches criteria
Zygomatic arches well demonstrated No superimposition Optimal exposure factors -No superimposition of the parietal bone or mandible
SMV zygomatic arches criteria?
Zygomatic arches well demonstrated in profile Zygomatic arches symmetric No rotation Optimal exposure factors -Contrast and density should be enough to demonstrate the zygomatic arches
Colles' fracture
a bone fracture in the distal end of the radius
epiphyseal fracture
a break at the location of the growth plate, which can affect growth of the bone
what is the trachea
a fibrous, muscular tube with 16-20 C-shaped cartilaginous rings in its walls for strength lies in midline, anterior to esophagus
what is the epiglottis
a flap at the top of the larynx that opens and closes to keep food & water out of the respiratory system --covers trachea while swallowing
An AP Upper GI in the Trendelenburg position best demonstrates what?
a hiatal hernia
what is the carina
a hooklike process on the last cartilage of the trachea --where the trachea bifurcates into left and right bronchus
For all upright abdomen x-rays, how long should the patient stay in that position before taking the x-ray?
a minimum of 5 minutes, preferably 10-20 minutes
What is the cecum?
a pouch-like portion below the junction of the ileum and colon; the largest in diameter --the appendix is attached to its posteromedial side
What does Concave means?
a rounded inward surface like a cave
What does Convex means?
a rounded outward surface
cathartics for a Ba Enema
a substance that produces frequent, soft or liquid bowel movements
How much is the femur angled in the anatomical position?
about 10degrees
What is the angle of the femur body, longitudinal?
about 10degrees
What is the angle of the femur neck to shaft?
about 125degrees
What is the anterior angle of the femur?
about 15-20degrees
What is the AML?
acanthiomeatal line (AML) -from acanthion to EAM
The sacrum and coccyx should be aligned with what?
aligned with the pubis symphysis
what bones does the sphenoid articulate with?
all 7 cranial bones
which sinuses intercommunicate with each other and the nasal cavity
all of them
What does the dorsal decub best demonstrate?
an abdominal aortic aneurism
what is ascites?
an abnormal accumulation of serous fluid in peritoneal cavity --best demonstrated with upright images
where is the pronator fat stripe?
anterior to distal radius
What can be done to minimize OID for a PA wrist projection?
arch the hand
what bones does the temporal bone articulate with
articulates with parietal, occipital and the sphenoid bones -houses the petrous ridges
what bones does the ethmoid articulate with?
articulates with the frontal and sphenoid bones -lies primarily below the floor of the cranium
Where should the CR be for a lateral upper airway x-ray
at C6-7
Where is the CR projected for a fan lateral hand?
at the 2nd MCP joint
Where should the CR be centered for toe radiographs?
at the MTP joint
Where are the 2 indentations in the esophagus?
at the aortic arch and as it crosses the left primary bronchus
When should the exposure be made for an abdominal x-ray?
at the end of the expiration
When in the breathing instructions should a lateral decub chest x-ray be taken
at the end of the second full breath
when should the exposure be taken for AP supine or semierect
at the end of the second full inspiration
Where does the esophagus meet the stomach?
at the esophagogastric junction at T11
For the lower extremity when do we start using grids?
at the knee
Where is the IR and CR centered for Ba enemas?
at the level of the iliac crests
which position best demonstrates the mandible?
axiolateral oblique
Why can't you use the AP supine to determine fluid levels in the lungs
b/c when a patient is laying down the fluid spreads out and it looks like the whole lung is filled with fluid even if there's only a little bit a fluid in the lung
Why is the erect projection preferred over recumbent?
bc it shows air-fluid level
Where is the scaphoid fat stripe?
below the 1st digit
incomplete fracture
bone is not broken all the way through
What is the name for a larger than average sized skull?
brachycephalic -greater than 47degrees from petrous pyramids to msp
contusion
bruise, without fracture
The intervertebral foramen are formed by?
by the inferior vertebral notch and the superior vertebral notch
How do we see the esophagus on an x-ray?
by the use of Barium
How are decub's named?
by which side the pt is laying on, but we mark the side that's up
An injury of the anteroinferior aspect of the glenoid labrum is termed: a-Hill-Sachs defect b-Impingement syndrome c-Bankart lesion d-Subluxation
c-Bankart lesion
Which of the following AP proximal shoulder projections will demonstrate the lesser tubercle in profile? a-External rotation b-Neutral rotation c-Internal rotation d-None of the above
c-Internal rotation
What anatomy of the shoulder is best demonstrated with a tangential projection (Fisk modification)? a-Clavicle b-Proximal humerus c-Intertubercular groove d-Glenoid cavity
c-Intertubercular groove
Which tarsal bone is also referred to as the heel bone?
calcaneus
which tarsal bone is the largest and strongest?
calcaneus
what carpal articulates with the third metacarpal?
capitate
What are the joints between the carpals and metacarpals?
carpometacarpal (CMC)
What kind of joint is the symphysis pubis joint?
cartilaginous ------> amphiarthroidal w/ limited movement
what kind of joint is the union of the acetabulum joint?
cartilaginous ------> synarthrodial w/ immovable movement
hemothorax
collection of blood in the pleural cavity
Always ____________ to patient size.
collimate
What is most important when doing pediatric exams?
communication between you and the parent and child so everyone knows what's going on
smith's fracture
complete fracture of distal radius with palmar displacement
The large intestine must be _____________ ___________ for a Ba enema.
completely empty
sthenic hyposthenic
considered average sthenic is 50% of the population hyposthenic is 35% of the population
where is the coronal suture?
coronal separates the frontal bone from the two parietals
How much is the body rotation for a posterior oblique position (Grashey method)? a-5° to 8° b-10° to 15° c-20° to 25° d-35° to 45 °
d-35° to 45 °
Which of the following humeral structures is most distal? a-Anatomic neck b-Greater tubercle c-Lesser tubercle d-Surgical neck
d-Surgical neck Greater tubercle is most proximal
Which of the following scapular structures is most posterior? Coracoid process Glenoid cavity Scapular notch Acromion
d. Acromion Coracoid process is most anterior
Lateral decub should have what kind of contrast?
low contrast, should be able to see vertebrae and ribs faintly through the heart shadow
what is the size of the trachea
diameter= about 1/2'' length=4-5'' posterior aspect is flat
The _____________ to the _____________ should be included on a pediatric patient for an abdomen x-ray.
diaphragm to the symphysis pubis
Dislocation
displacement from the joint
What are the metacarpal bones?
distal (towards the tip of the fingers) from the carpals -between the carpals and phalanges
The Upper GI studies are used to study the __________ _____________, _____________, and _________________. And to detect abnormal anatomic and ____________ conditions.
distal esophagus, stomach, duodenum functional
What should you do in a trauma situation and you need to get a lateral mid-distal femur?
do a cross-table lateral
What is the name for a smaller than average sized skull?
dolichcephalic -less than 47degrees from petrous pyramids to msp
The anterior portion of the foot is also called what? posterior part?
dorsum surface plantar
What kind of joint is the wrist?
ellipsoidal joint
When should the exposure be taken for a RAO Upper GI?
end of expiration, just tell them to hold their breath.
During what part of the breathing instructions should the exposure be made for an AP lordotic chest
end of the second inspiration
how should the patient be positioned for the chest x-ray
erect, facing the upright bucky, feet hip width apart, chin up, hands on lower hips w/ palms out, elbows partially flexed, shoulders rotated forward & depressed down
The ____________ connects the pharynx to the stomach, part of the digestive system.
esophagus
An upper GI commonly follows an __________________.
esophogram
AP proximal humerus is what kind of rotation?
external rotation
true or false: the pharynx is part of the respiratory system
false! its part of the digestive system
Anterior obliques-side of interest is _____________ from the film.
farthest
_________ is the longest and strongest bone in the body.
femur
what is the flexion of a lateral hand radiograph?
fingers with the thumb slightly touching the first finger or 2nd digit
How much rotation should there be for an AP oblique toe radiograph of the second digit? --of the 4th digit?
first- third digits: 30-45degrees fourth & fifth digits: 45degrees
What are fontanels?
fontanels are where sutres join slower in ossification
When is a lateral rotation for AP oblique toes used?
for the 4th and 5th digits
When do you do a lateralmedial toe radiograph?
for the digits 1, 2, and 3
compound (open) fracture
fracture in which part of the broken bone protrudes through the skin
How do Pedicles project?
from posterior part of the body
What 4 facial positioning features are in aline with the MSP?
from top to bottom: glabella, nasion, acanthion, mental point
which two bony landmarks must be superimposed for an AP open mouth projection??
front incisors and base of skull
Which bones does the parietal bone articulate with?
frontal, occipital, temporal, sphenoid and the opposite parietal bone -parietal makes up the majority of the skull cap
what is the most important shielding for a chest x-ray
gonad
What carpal articulates with the fourth and fifth metacarpals?
hamate
what is on the palmar (anterior) side of the Hamate?
hamulus --it projects from the palmar surface--you can feel it on the anterior medial side of your wrist
What are the 4 primary parts of the femur?
head, neck, greater trochanter, and lesser trochanter
When would we do a lateral of cervicothoracic (swimmers)?
if the top third of T1 is not demonstrated
When should you NOT rotate the foot and leg inward to allow the femoral neck to be parallel to the IR?
if there is a possible fracture
When are the epicondyles perpendicular to the IR?
in a lateromedial and mediolateral humerus projections
when is the sinus tarsi (tarsal sinus) seen on a radiograph?
in a true lateral position
What are the 9 regions of the abdomen?
in order from 123 456 789 1-right hypochondriac 2-epigastric 3-left hypochondriac 4-right lateral(lumbar) 5-umbilical 6-left lateral (lumbar) 7-Right Inguinal (iliac) 8-Pubic (hypogastric) 9-left inguinal (iliac)
To prevent superimposition of the radius over the ulna the forearm is always positioned how?
in the AP projection with the hand supinated (palm up)
When taking radiographs of small to medium dry plaster casts what should you do?
increase mAs by 50%-60% OR increase by 5-7kV
If in a AP Axial Outlet Projection (Taylor Method) radiograph the obturator foramina are foreshortened what should you do?
increase the CR angle
What is the IOM?
infraorbital margin
What is the IOML?
infraorbitomeatal line (IOML) (Reid's base line) -from just below the eye to the EAM
What are vertebra separated by?
intervertebral disks, composed of fibrocartilage. It functions as cushions.
What is scoliosis?
is a condition of an abnormal lateral curvature of the spine.
The symphysis pubis ____________ needed for the erect abdomen.
is not
For the AP bilateral frog leg projection how should the trochanters be?
lesser trochanter: -equal in size -on medial side of femur greater trochanter: -superimposed over femoral neck
For the AP axial inlet projection how should the ischial spines appear? -pelvic inlet?
ischial spines should be demonstrated and equal -pelvic inlet should be centered
Nursemaid's (jerked) elbow
it is caused by sudden jerking the child's arm with straight elbow. The child elbow ligaments (annular ligament) are too elastic and loose, so it causes the radius subluxation.
How do you get the thumb in the PA oblique position?
just lay your hand flat on a flat surface, and your thumb is automatically in an oblique position
what should you do if they refuse to take out a piercing
just put it in the notes that they refused to take it out
Mandible
largest of the facial bones only moveable bone in the adult skull, originate as 2 bones and at age one become 1 Angle or gonion divides it into 2 parts anterior=body posterior=ramus Alveolar process or ridge extends along the entire bottom and are where the lower teethe are rooted into the mandible Mental foramina serve as a passage for the mental artery, the vein and the nerve the innervates the lower lip Ramus terminates at the u (mandibular notch)
the pharynx contains the __________ which is part of the respiratory system
larynx
What is the basic nasal bone routine?
lateral and parietoacanthial (waters)
When is the lesser tubercle medial in profile
lateral proximal humerus with internal rotation
What does a left lateral decub demonstrate?
lateral side of ascending colon and medial side of descending colon
For a PA Upper GI the CR should be centered to the __________ of the MSP B/C the ______________ isn't in the middle of the abdomen.
left; stomach
The soft, semigelatinous inner part of the intervertebral disk is termed?
nucleus pulposus
Where should the marker be placed in a lateral decub
on the side up and an indication of the patient is in a decub position
What is the outer canthus?
outer corner of the eye
How do you find where the CR should be on a patient for a PA chest x-ray? AP?
palpate to find the vertebrae prominens, and then measure with your finger spread from thumb to pinky. The CR should be 7'' for female and 8'' for male from the prominens. find in relation to finger spread jugular notch and 4 finger widths is used for AP
For lateral nasal bones: MSP is ______________. IOML is _______________ to the front edge of the image receptor.
parallel; perpendicular
For a lateral finger, the finger should be _____________ to the IR. With the thumb ______.
parallel; up
which position best demonstrates the bony nasal septum?
parietoacanthial (waters)
subluxation
partial dislocation
What joint is between a proximal and middle phalange?
proximal interphalangeal (PIP) joint
What are the different phalange bones?
proximal, middle, distal
What is the purpose of a Ba Enema? -What contrast is used?
radiographic examination of the large intestine and uses double-contrast using air and Ba
The __________ is always on the thumb side; and the __________ is always on the pinky side.
radius; ulna
What does Lordosis means?
refers to an abnormal anterior concavity of the lumbar spine. (swayback)
Which bones does the frontal bone articulate with?
right and left parietals, the sphenoid, and the ethmoid, also articulates with 8 facial bones
Which bones are part of the floor?
right temporal, left temporal, sphenoid, ethmoid
how many lobes does each lung have
right-3 left-2
What is the interior surface of the stomach called?
rugae
sprain
rupture or tearing oc connective tissue
Which carpal is most frequently fractured?
scaphoid
Which carpal is the most lateral and articulates with the radius?
scaphoid
What is the largest wrist bone?
scaphoid --larges in the proximal row
Where is the squamosal suture?
separates the inferior junction of the two parietals with their temporal bones
Where is the lamboidal suture?
separates the parietals from the occipital
The patient's arms should be at the pateint's ____________. And there should be ______________ under their knees for support.
side, pillow
joints of the foot
similar to the hand except a T instead of a C for tarsal instead of carpal
what position should the PT be in for the insertion of a enema tip?
sims- laying on left side, right leg flexed and up/ in front of left , roll forward 35-40 degrees
The fingers should be spread apart ____________ for a PA hand radiograph.
slightly
What does the small intestine do in digestion function? large intestine?
small intestine- digestion, absorption (nutrient, H2O, salts, proteins), reabsorption (95% of H2O and salts) large intestine-some reabsorption of water and inorganic salts, ABSORPTION OF VIT B&K AND AMINO ACIDS, produced by bacterial action and releases gases, and ELIMINATION
The scapulohumeral is what kind of joint?
spheroidal or ball & socket
Upper GI series
study the form and function of the distal esophagus, stomach and duodenum
Esophagram (or barium swallow)
study the form and function of the pharynx and the esophagus
What are the parts of the hip bone?
superior to inferior -ilium -acetabulum -pubis -ischium all fuse together at the acetabulum but are separate bones as children
What is the SOG
supraorbital groove-depression located above each eyebrow -corresponds with the floor of the anterior fossa
What are sutures
sutures are the fibrous joints of the cranium -immovable synarthroidial
what kind of joint is the hip joint?
synovial -----> diarthroidial w/ spheroidal movement
What kind of jjoint is the sacroiliac?
synovial ----> amphiarthroidal w/ limited movement
The radiocarpal joint is enclosed by the __________.
synovial capsule
What kind of joint is the TMJ?
synovial, diarthrodial (freely movable) Bicondylar
The sternal angle corresponds to the vertebral level of?
t4 t5
What tarsal bone is the second largest and is part of the ankle joint?
talus
What kind of projection is the merchant method?
tangential
The carpal Canal projection is also called what?
tangential, inferosuperior projection, and Gaynor Hart Method
When should the exposure be taken for a right lateral Upper GI?
tell them to hold their breath, and then it should be taken
What system is the spleen apart of? But, it's located in what part of the body?
the lymphatic system, and located in the abdomen
What is the auricle?
the outer part of your ear
Where is the patella in relationship to the knee joint?
the patell a is 1/2 inch above the knee joint
What is the serous sac like structure that lines the abdominal cavity?
the peritoneum
Where should the petrous ridges be for a PA projection of the facial bones?
the petrous pyramids are projected directly into the orbits which demonstrate very little facial bone detail -by extending the neck in the parietoacanthial projection it removes the petrous pyramids from the facial bone area (projected below the maxillary sinuses)
The RAO Ba enema best demonstrates what?
the right colic flexure, ascending colon, and sigmoid colon
The two main parts of a typical vertebra enclose a space called what?
the vertebral foramen (houses the spinal cord)
What is important for the small bowel radiographs?
time markers
Where is your mental point?
tip of your chin
what are Anterior & posterior obliques used for
to find pathology, in the trachea and mediastinum
Where should the CR be positioned for the PA Oblique finger?
to the PIP joint
What is the TEA?
top of ear attachment
A lumbar rib is an example of a/an?
transitional Vertebae
What carpal bone articulates with the first metacarpal?
trapezium
Which carpals are 4 sided?
trapezium and trapexoid
What carpal articulates with the second metacarpal?
trapezoid
which carpal has 3 articular surfaces and articulates anteriorly with the pisiform, distal to the ulna?
triquestrum
TRUE/FALSE:The use of automatic exposure control (AEC) is not recommended for the AP projection of the scapula.
true
What bones does the occipital bone articulate with?
two parietals, two temporals, the sphenoid, and the atlas
A small bowel series generally follows a __________________ series. and requires ________ __________.
upper GI; oral contrast
What is the patient's position for lateral and AP upper airway
upright (seated or standing) if possible or lateral recumbent
What is important to remember when doing toe radiographs?
use number markers to be sure they know what toe you are radiographing
What is the AP Lordotic chest x-ray used for?
used to rule out calcifications and masses behind the clavicles
hypersthenic
very broad and deep from front to back, but shallow vertically
what is the inner layer of the lung's pleural membrane called?
visceral pleura
When do we see the zygapopyseal joints on a c-spine? T-spine?
when it is in a true lateral position; 70 degree oblique
When are the intervertebral foramen seen on a c-spine image?
when you have a 45 degree oblique projection --LPO= right intervertebral foramen --RPO = Left --LAO= Left --RAO= right
For an esophogram, when should the exposure be taken?
while the PT is swallowing
Where is the Gonion (angle)?
your jaw bone
