A&P 120: Ch 3-4 Exam 2

Radoiocarpal Joint

- major joint of the wrist - lies between proximal carpals and radius/ulna

technical considerations that are essential when performing abdomen studies on a young pediatric patient

- motion prevention - short exposure times - reduction in kVp and mAs based on measured part thickness.

Base of metacarpal 1

-A

Radius-radial deviation

-A

The 5th CMC joint

-A

Thumb (1st) Metacarpal

-A

Thumb (hyper extended wrist)

-A

Trochlear Sulcus

-A

radial tubercle

-A

radial tubercle LLO

-A

radial tuberosity

-A

scaphoid

-A

scaphoid -xray

-A

disease or conditions that the acute abdomen series is most commonly used for:

-Ascites -Fibrous Adhesions - Crohn's Disease -Intussusception -Volvulus -Ileus

Head of Radius

-B

Lunate

-B

Outer ridges of capitulum and trochlea

-B

Proximal Phalanx of 2nd Digit

-B

Radial head

-B

Radial neck LLO

-B

Trapezium (hyper extended wrist)

-B

lunate (x-ray)

-B

scaphoid-radial deviation

-B

Capitellum

-C

Head of the 5th metatacarpal

-C

Radial Head LLO

-C

Trapezium-radial deviation

-C

Triquetrum (x-ray)

-C

Trochlear Notch of Ulna

-C

scaphoid (hyper extended wrist)

-C

trapezium (lateral wrist)

-C

Iliac Crest (lateral)

-C -Level of L4-L5, Vertebral Interspace

capitulum

-C AP Elbow

4th metacarpophalangeal joint

-D

Pisiform

-D

Pisiform (x-ray)

-D

Trapezoid (hyper extended wrist)

-D

Trapezoid- Radial deviation

-D

capitulum LLO

-D

lateral epicondyle

-D

scaphoid Lat Projection of Wrist

-D

ASIS (lateral)

-D -found by locating Iliace Crest, then palpating anterior Lt and inferiority until prominent projection of "bump" feel. -landmark commonly used for positioning of pelvic and vertebral structures, secondary landmark for general abdominal positioning

lateral epicondyle of humerus

-D AP Elbow

Head of proximal phalanx of fifth digit

-E

Lunate lat projection

-E

Radial Fossa

-E

Trapezium (x-ray)

-E

base of first metacarpal-radial deviation

-E

capitate (hyper extended wrist)

-E

trapezium

-E

greater trochanter (lateral)

-E - A bony prominence on the proximal lateral side of the thigh, just below the hip joint.

Coronoid fossa of humerus

-E AP Elbow

Important factors to consider for geriatric abdomen

-Extra radiolucent padding under -blankets to keep patients warm - careful breathing instructions - possible assistance when helping patient move to required position

Base of middle phalanx of digit 4

-F

Coronoid Fossa (drawing)

-F

Trapezoid (x-ray)

-F

base of first metacarpal

-F

capitate-radial deviation

-F

coronoid process Medial Oblique Rt

-F

hamate (hyperextended wrist)

-F

trapezoid

-F

symphysis pubis (lateral)

-F - anterior junction of two pelvic bones - can be palpated with patient in supine position -corresponds to inferior margin of abdomen

medial epicondyle of humerus

-F AP Elbow

Capitate (x-ray)

-G

DIP of 4th digit

-G

Hamulus of the hamate bone (hyper extended wrist)

-G

Trochlea Rt Medial Oblique Elbow

-G

capitate

-G

hamate-radial deviation

-G

ischial tuberosity (lateral)

-G - can be used to determine lower margin on PA abdomen with patient in prone -bears most of the weight of the trunk when one is seated

Trochlea (medial aspect)

-G AP Elbow

Olecrenon process rt medial oblique

-H

Triquetrium (hyper extended wrist)

-H

Trochlea (Drawing)

-H

hamate

-H

hamate (x-ray)

-H

pisiform-radial deviation

-H

coronoid tubercle

-H AP Elbow

Coronoid Tubercle (drawing)

-I

Pisiform (hyper extended wrist)

-I

olecranon process

-I

Trochlear Sulcus (Groove) (drawing)

-J

lunate-radial deviation

-J

olecrenon fossa

-J

coronoid process (drawing)

-K

radial head

-K

ulna-radial deviation

-K

reason the right kidney is found in a more inferior position than the left kidney

-presence of the liver occupying the majority of the right upper quadrant of the abdomen

organs that would be found on an average sthenic patient in the left upper quadrant (LUQ)

-spleen -stomach -left colic (splenic) fixture -tail of pancreas -left kidney -leftsuprarenal gland

Reason why it is important to keep the affected digit parallel to the IR for the PA oblique and Lateral Projections

-to prevent distortion of the phalanx-to prevent distortion of the joints-to demonstrate small, non displaced fractures near the joint

Oral Cavity

1

Minimum inches the forearm should be included radiographically for a PA of the hand

1 in, 2.5 cm

What is the recommended overlap when using two landscape-placed image receptors for an AP projection of a supine abdomen of an obese patient?

1-2 inches

Pertinent factors that help reduce image distortion during upper limb radiography

1. Part should be parallel to plane of IR. 2. CR should be 90° or perpendicular to part and IR, unless a specific CR angle is indicated. 3. CR should be directed to correct centering point

Two radiographing criteria used to determine whether rotation is present on the PA projection of the digits

1. Symmetric appearance of both sides of the shafts of phalanges and distal metacarpals2. Equal amounts of tissue on each side of the phalanges

Grids are used if the body part measures greater than:

10 cm

Angle of the CR during the PA axial scaphoid projection with central ray angle and ulnar flexion

10-15 degrees proximal

Number of phalanges

14 total in each hand -3 each finger -2 in thumb

Number of phalanges in both hands

14 total in each hand -3 each finger -2 in thumb

Degree of CR required for a Bennett Fracture

15 degrees proximal

small intestine length

15-18 ft

What type of CR angle is required for the AP axial projection (modified Robert's method)?

15° proximal

How many exposures (minimum) are required for the AP elbow acute flexion study?

2

Pharynx

2

Thumb has this number of phalanges

2

Amount the hand and wrist are elevated from the IR for the modified Stecher method

20 degrees

Amount the central ray angulation to the long axis of the hand is required for the carpal canal (tunnel) projection

25-30 degrees

What type of CR angle is required for the tangential (Gaynor-Hart method) projection?

25° to 30°

Number of bones in hand and wrist

27

Esophagus

3

Number of fossa in the Distal Humerus

3

Stomach

4

Most common SID for upper limb radiography

40 to 44 inches (100 to 110 cm)

Amount of rotation that is required for oblique projection of wrist

45 degrees

Number of metacarpals in palm

5

Small Intestine

5

minimum time frame that a patient should be placed in the decubitus position

5 minutes

What is the minimum amount of time a patient should be upright before taking a projection to demonstrate intra-abdominal free air?

5-10 minutes

Large Intestine

6

best set of exposure factors for upper limb radiography

64 kVp. 200 mA, 1/20 second, small focal spot, and 40 inch (100 cm) SID

3 to 5 cm (1 to 2 inches)

What is the recommended overlap when using two landscape-placed image receptors for an AP projection of a supine abdomen of an obese patient?

Erect AP abdomen

What specific position best demonstrates the condition Ascites?

Dorsal decubitus

Which decubitus position best demonstrates possible aneurysms, calcifications of the aorta, or umbilical hernias?

Left lateral decubitus (free air best visualized in upper right abdomen in area of liver)

Which decubitus position of the abdomen best demonstrates intraperitoneal air in the abdomen?

Left lateral decubitus abdomen; air is seen best in upper right abdomen near the liver.

Which decubitus position of the abdomen best demonstrates intraperitoneal air in the abdomen? Why?

80-85 kV, grid, 40-inch (102-cm) SID

Which of the following exposure considerations would be most ideal for an AP abdomen of an average-sized adult using a digital radiographic system?

PA, erect chest for free air under diaphragm

Which of the following projections requires a kV setting of 110 to 120?

Short exposure times, high-speed image receptor, reduced kV and mAs

Which of the following technical considerations is essential when performing abdomen studies on a young pediatric patient?

Two way abdomen: AP supine abdomenal & left lateral decubitus.

Which positioning routine should be used for an acute abdominal series if the patient is too ill to stand?

Two-way abdomen; AP supine abdomen, and left lateral decubitus

Which positioning routine should be used for an acute abdominal series if the patient is too ill to stand?

Lateral position

Which projection best demonstrates a possible aortic aneurysm in the prevertebral region of the abdomen?

PA chest

Which projection of the three-way acute abdominal series best demonstrates free air under the diaphragm?

Hypersthenic body type

Which type of body habitus might require two landscape-aligned image receptors to be taken if the entire abdomen is to be included?

To increase the room for expansion of the abdominal organs within the abdominal cavity

Why is it recommended to take abdominal radiographs at the end of patient expiration?

Due to greater OID of Kidney on PA

Why may the PA projection of a KUB generally be less desirable than the AP projection?

Increased object image receptor distance (OID) of kidneys on PA

Why may the PA projection of a KUB generally be less desirable that the AP projection?

To allow intra-abdominal air to rise or abnormal fluids to accumulate

Why should a patient be placed in the decubitus position for a minimum of 5 minutes before exposure?

Computed tomography (CT)

With the use of iodinated contrast media, ___ is able to distinguish between a simple cyst and a tumor of the liver

Situation: A patient with a possible Barton fracture enters the emergency room. Which positioning routine should be performed to confirm the diagnosis?

Wrist

Situation: A patient with a possible Smith fracture enters the emergency room. Which positioning routine should be performed to confirm this diagnosis?

Wrist and forearm

Acute Abdominal Series

XRAY w/ 3 different types of images -supine KUB -upright AP or decubitus abdomen -PA or AP chest

Topographical landmarks of abdomen

Xiphoid Tip, inferior costal margin, Iliac Crest, ASIS, Greater Trochanter, symphysis pubis, ischial tuberosity

Three way acute abdominal series; AP supine, erect abdomen, PA chest projection.

A patient with a possible dynamic ileus enters the emergency room. The patient is able to stand. The physician has ordered an acute abdominal series. What specific positioning routine should be used?

Alternative projection that best demonstrates intercarpal joint spaces and wrist joint

Anteroposterior (AP) projection (with the hand slightly arched)

Central Ray should be at this level to ensure the diaphragm is included on an erect abdomen projection,

Approximately 2 inches above level of iliac crest

Radiographic procedure that uses contrast media injected into the joint capsule to visualize soft tissue pathology of the wrist and shoulder joints

Arthrography

Inferior Costal Rib Margin

B (Level of L2-L3) Used to locate upper abdominal organs, such as the gallbladder and stomach

Inferior Costal Margin (Lateral)

B - Level of L2-L3 -landmark used for locate upper abdominal organs like the Gallbladder and stomach

A KUB radiograph shows that the gonadal shielding is superior to the upper margin of the symphysis pubis. The female patient has a history of kidney stones. What is the next step the technologist should take?

Because the patient may have renal calculi in the distal ureters and urinary bladder, gonadal shielding cannot be used.

Type of fracture is best demonstrated with a modified Robert method

Bennett Fracture

A patient comes into the ER with the history of Crohn disease. An acute abdomen series is ordered on this patient. Which of the following is the reason for this order?

Bowel Obstruction -aka: regional enteritis, chronic inflammation of intestinal wall that results in bowel obstruction.

Iliac Crest

C -level of L4-L5 Verterbra interspace

used to evaluate patients with acute appendicitis

CT is considered the ideal imaging modality to demonstrate an abscess or thickened wall surrounding the inflamed appendix

Largest of the carpal bones

Capitate

Located on distal humerus

Capitulum

CMC is located between these two structures

Carpal and metacarpal

Situation: A patient with a history of carpal tunnel syndrome comes to the radiology department. The orthopedic physician suspects that bony changes in the carpal sulcus may be causing compression of the median nerve. Which special projection best demonstrates this region of the wrist?

Carpal canal position (Gaynor-Hart method)

The base of phalanges articulates with this

Carpals

Steve Left The Party

Carpals of the proximal Row: Scaphoid, lunate, triquetrum, pisiform

Exams that the diaphragm must be motionless during exposure of

Chest or abdomen

Which of the following technical factors is essential when using computed radiography to ensure a high-quality image is produced?

Close collimation

collimation margin for an adult abdomen

Collimation on the top and bottom for adults should be adjusted directly to the margins of the IR, allowing for divergence of the x-ray beam.

The process that the Coronoid fossa accommodates

Coronoid process of ulna when flexed

Situation: A pediatric patient with a possible radial head fracture is brought into the emergency room. It is too painful for the patient to extend the elbow beyond 90° or to rotate the hand. What type of special (i.e., optional) projection could be performed on this patient to confirm the diagnosis without causing further discomfort?

Coyle Method

Which of the following will demonstrate the radial head and coronoid process on patient who cannot extend the elbow for the oblique elbow positions?

Coyle method

anterior superior iliac spine

D -found by locating the iliac crest, then palpating anteriorly and inferiorly until a prominent projection or "bump" is felt

This is located between distal and Middle phalanx

DIP

Joints in fingers from distal to proximal

DIP, PIP, MCP, and CMC

Expiration

Exposure for an AP projection of the abdomen should be taken on ___ (inspiration or expiration)

Symphysis pubis:

F -the fibrocartilaginous union of the anterior pubic bones

capitulum of humerus

articulates with head of radius (lateral)

exposure considerations that would be most ideal for an AP abdomen of an average-sized adult using a digital radiographic system

Faintly demonstrate the lateral borders of the psoas muscles, lower liver margin, kidney outlines, and the transverse processes of the lumbar vertebrae.

Because the liver margin is visible in the right upper quadrant of the abdomen, it is not necessary to place a right or left anatomic side marker on the cassette before exposure

False

True/False: Because the liver margin is visible in the right upper quadrant of the abdomen, it is not necessary to place a right or left anatomic side marker on the cassette before exposure.

False

True/False: The hand(s) is(are) placed in a true PA position when using the Brewerton method.

False

True/False: The umbilicus ("belly button") is a reliable, alternative landmark to use for the obese patientFalse

False

True/False: Placing multiple images on the same digital IP is recommended as long as close collimation is applied for each projection.

False. It is recommended that only one projection be placed on a digital IP. The anatomy should be centered on the IP.

True/False: The patient best controls peristalsis by holding his or her breath during exposure.

False. Short exposure time best controls peristalsis

True/False: For a KUB, it is accepted practice to indicate the side of the body during postprocessing after the exposure has been completed. The liver is always on the right side of the body

False: pat could have sinus invertus

Preferred lateral position of the hand that best demonstrates the phalanges without excessive superimposition

Fan lateral

Has three joints

Fingers

PIP joint for

Fingers

Location CR is centered for an AP projection of the thumb

First metacarpophalangeal (MCP) joint

KUB must include this to ensure the bladder is seen

KUB must include the symphysis pubis

A patient comes to the radiology department with a clinical history of ascites. The patient is unable to stand or sit erect. Which of the following projections best demonstrates this condition?

LLD: left lateral decubitus

begins in the right lower quadrant at the junction of the small intestine and the ileocecal valve

Large Intestine

Mesentary

Large folds formed by peritoneum that bind abdominal organs

Peritoneum

Large serous double wallets sac like membrane

the decubitus position of the abdomen that best demonstrates intraperitoneal air in the abdomen

Lateral Decubitus (Ap Projection)

positioning routine that should be used for an acute abdominal series if the patient is too ill to stand

Lateral Decubitus replaces erect

Two Way KUB Decubitus Positions

Lateral Decubitus, Dorsal Decubitus

Elbow projection that best demonstrates: Olecranon process in profile

Lateral Elbow

Two bony landmarks that are palpated to assist with positioning of the upper limb

Lateral and medial epicondyles

Olecranon & trochlea notch in profile and 1⁄2 radial head superimposed by ulna is the image criteria for the:

Lateral elbow

Lateral projection of the hand that best demonstrates a possible foreign body in the palm of the hand

Lateral in extension

Nine regions of abdomen Left Lateral Plane 3,6 & 9

Left Hypochondriac, Left Lateral, and Left Inguinal

Situation: A patient with a possible perforated bowel caused by trauma enters the ER. The patient is unable to stand. Best projection that demonstrates any possible free air within the abdomen:

Left lateral decubitus

Which specific decubitus position of the abdomen should be used in an acute abdomen series if the patient cannot stand?

Left lateral decubitus

level that the top of the 14- × 17-inch (35- × 43-cm) IR is at on an erect abdomen projection

Level of the axils

level that thw central ray (CR) is centered to dor a supine AP projection of the abdomen

Level of the iliace crest, perpendicular to and directed to center of IR

AP supine abdomen, AP erect abdomen, (or lateral decubitus) PA erect chest.

List the projections commonly performed for an acute abdominal series or three-way abdomen.

AP supine, AP erect or lateral decubitus abdomen, PA erect chest

List the projects commonly performed for an acute abdominal series or three-way abdomen series?

Accessory Organs of Abdominal Cavity

Liver, Gallbladder, pancreas, spleen

Intraperitoneal Organs

Liver, gallbladder, stomach, jejum, ileum, cecum, transverse and sigmoid colon

What scale of contrast is recommended for visualization of the abdominal structures on an abdominal x-ray?Long scale

Long scale

KVP range for upper limb

Lower to medium kVp (60 to 80—digital)

Metacarpals

Makes up the palm

Location of coronoid tubercle

Medial aspect of coronoid process

MCP is located between which two structures

Metacarpal and proximal phalanx

A sesamoid bone is frequently found adjacent to the _____ joint of the thumb.

Metacarpophalangeal

Situation: A patient with a possible fracture of the trapezium enters the ER. The routine projections do not clearly demonstrate a possible fracture. Which other special projection can be taken?

Modified Robert's method

Number of abdominal regions

Nine

Situation: A patient comes to the radiology department for a hand series to evaluate early evidence of rheumatoid arthritis. Which special position can be used in addition to the routine hand projections to evaluate this patient?

Norgaard method - ball catcher's position

radial head and neck (x ray)

O

The coronoid process of the ulna should be in sharp profile on the

Oblique elbow with medial rotation

he capitulum of humerus, radial head and neck are demonstrated on the

Oblique elbowwith lateral rotation

Alternative name for the mesentery

Omentum

Distal radioulnar location

On the ulnar notch on radius and head of ulna

Projection that this image represents

PA Radial deviation

projection of the three-way acute abdominal series that best demonstrates free air under the diaphragm

PA chest

Projection of thumb that is achieved naturally by placing the palmar surface of the hand in contact with the IR

PA oblique

special projection of the wrist that best demonstrates the interspaces on the ulnar side of the wrist between the lunate, triquetrum, pisiform, and hamate bones

PA projection with radial deviation

Modified Stecher Method

PA scaphoid- ulnar deviation (toward ulna), scaphoid is shown, palm down on 20 degree sponge, CR at scaphoid( 3/4 inch distal and medial to styloid process)

Fracture that is not demonstrated in a routine wrist

Pott

Elbow projection that best demonstrates: Olecranon process seated in olecranon fossa

Pronated (palm down)

How the diaphragm remains motionless during exams

Proper breathing instructions on inspiration or expiration

Structure that is formed by the Olecranon process and trochlear notch that allows for a hinge like movement

Proximal Ulna Correlation

Place the CR is centered for a PA oblique projection of the second digit

Proximal interphalangeal (PIP) joint

name of abdominal region that contains the rectum

Pubic (Hypogastric)

abdominal quadrants

RUQ, LUQ, RLQ, LLQ

Accommodates radial head when flexed

Radial Fossa

Proximal Radioulnar articulation location

Radial notch of ulna and head of radius

Proximal radioulnar location

Radial notch on ulna and head of radius

three fossa's of distal humerus

Radial, coronoid, and olecranon

Has styloid process and the ulnar notch articulates with the head of the ulna

Radius (thumb side)

Bones that separate with supination and cross with hand rotation

Radius and ulna

articulates directly with scaphoid and lunate only

Radius directly

Reason why for a KUB, that it is not accepted practice to not place a marker on the IR, even though the liver is always on the right side.

due to conditions such as situs inversus/visceral inversion where the organs are on opposite sides of the body

Proximal portion of duodenum

duodenal bulb or cap

First portion of the small intestine

duodenum

the three parts of the small intestine

duodenum, jejunum, ileum

Fat pads around elbow joint are valuable diagnostic indications if these three technical/position requirements are met with lateral position

elbow must be flexed 90°, in a true lateral position, and optimum exposure techniques

type of joint movement for the metacarpophalangeal of the second to fifth digits

elliposoidal

Specific position for a patient with a possible dynamic ileus, the patient is able to stand. The physician has ordered an acute abdominal series.

erect images of PA chest or erect AP Abdomen

this is located in the mediastinum of the thoracic cavity

esophagus

positioning error involved if a majority of the carpal bones are superimposed in a PA oblique wrist projection

excessive lateral rotation

structures seen on a properly exposed KUB of a average sized patient

faint lateral borders of the psoas muscles, lower liver margin, kidney outlines, and the transverse processes of the lumbar vertebrae

T/F: Trauma or infection makes the anterior fat pad more difficult to see one a lateral

false

True/False: For an adult abdomen, a collimation margin must be visible on all four sides of the radiograph.

false

True/False: The image receptor should be placed in portrait alignment for an abdomen study on an obese patient

false

Gonadal shielding may be impossible for studies of the lower abdominopelvic region for this type of person

females

In an erect anatomic position, structure of the upper limb is considered most inferior or distal

head of ulna

The most important muscles in abdominal radiography

hemidiaphragm and psoa's

Kind of joint that the finger is

hinge

Joint Movement of Elbow (humeroulnar and humeroradial)

hinge/ginglymus

The 3 articulations of the elbow joint

humeroulnar, humeroradial, proximal radioulnar

Bone of upper limb that contains Coronoid process

humerus

junction of the small and large intestine

ileocecal valve

longest part of the small intestine

ileum

condition that is demonstrated radiographically as distended, air-filled loops of the small bowel

ileus

An important anatomic landmark that is commonly used to locate the center of the abdomen is the:

iliac crest

Rotation can be determined on a KUB radiograph by the loss of symmetric appearance of

iliac wings

symmetric loss of this structure determines rotation on a kidney, ureter, and bladder (KUB) radiograph

iliac wings, obturator foramina, ischial spines, and outer rib margins

Bariatric patient second projection location

image lower abdomen, IR will slightly overlap of 1-2 inches (3-5 m), with the bottom of the IR placed at Symphysis Pubis

Bariatric patient first projection location

image the upper abdomen (top of IR at the level of the xiphoid process)

the reason why a PA projection of a KUB is generally less desirable than the AP projection

increased object-image receptor distance (OID) if kidneys are of primary interest

Elbow Fat Pads and Stripes

indicates a radial head fracture; seen on lateral view

Bursitis

inflammation of a fluid-filled sac in a joint (bursa)

what CT uses to distinguish between a simple cyst and a tumor of the liver

iodinated contrast media

Radiographic Appearance of ileus and exposure factor

large amounts of air in entire dilated small and large intestine with air fluid levels visualized - decrease, depending on severity of distention (- or - - )

Radiographic Appearance of volvulus and exposure factor adjustment

larger amounts of air tapered or "corkscrew" appearance, with air-filled distended region of intestine - slight decrease (-)

Elbow projection that best demonstrates: Trochlear notch in profile

lateral

projection that best demonstrates a possible aortic aneurysm in the prevertebral region of the abdomen

lateral

The radius and ulna can be separated through

lateral rotation of the elbow, 40-45 degrees

Projection that best demonstrates pronated fat stripe

lateral wrist

he distal radius and ulna should be totally superimposed on which of the following

lateral wrist

this is located near the first intercostal space

left hemi-diaphragm

Region of the abdomen that contains the spleen

left hypochondriac

Lesser Omentum

lesser curvature of stomach to liver

scale of contrast that is recommended for visualization of the abdominal structures on an abdominal x-ray

long scale

Automatic exposure control (AEC) systems are designed to optimize

mAs

structure that helps stabilize and support the small intestine

mesentery

structures that connects the small intestine to the posterior abdominal wall

mesentery

Location of olecranon process

near end of the ulna, the bone in the forearm, and it forms the pointed portion of the elbow.

Which of the following alternative imaging modalities is most effectively used to evaluate GI motility and reflux?

nuclear medicine

time when gonadal shielding should not be used during abdomen radiography

obscures essential anatomy

The two beak-like processes on the proximal ulna

olecranon and coronoid process

Deep depression on the posterior aspect of the distal humerus

olecrenon fossa

What is a fat pad?

pad of fat located around joints for protection and cushion

Three accessory organs

pancreas, liver, gallbladder

abdominal structures not visible on a properly exposed KUB

pancrease

Placement of long axis of the anatomic part being imaged

parallel to the long axis of the IR

Another term describing a nonmechanical bowel obstruction is:

paralytic ileus

The double-walled membrane that lines the abdominopelvic cavity

parietal peritoneum

KUB Clinical Indications: AP Supine Abdomen

pathology of bowel obstruction, neoplasms, calcifications, ascites, and scout image for contrast media studies of abdomen

the primary cause for involuntary motion in the abdomen

perisaltic action of the bowel

The double-walled membrane lining the abdominal cavity is called the:

peritoneum

Mesocolon

peritoneum that attaches the colon to the posterior abdominal wall

An obese patient comes to the radiology department for a KUB. The radiograph shows that the symphysis pubis is included on the image, but the upper abdomen, including the kidneys, is cut off. Next step for the technologist:

Repeat the exposure -use: two 35 × 43 cm IR's placed in landscape orientation.

Type of structure pancreas is classified as

Retroperitoneal

terms for organ relationship

Retroperitoneal, Infraperitoneal, Intraperitoneal

Right lateral Plane of Abdomen Regions 1, 4, and 7

Right Hypochondriac, Right Lateral, Right Inguinal

Retroperitoneal Organs

Right adrenal gland, right kidney, Pancreas, Duodenum, Ascending Colon, IVC, Aorta, Descending Colon, Ureter

A radiograph of an AP elbow projection demonstrates total separation between the proximal radius and ulna. What must be done to correct this positioning error on the repeat exposure?

Rotate upper limb medially

Iliac wings, Obturator foramina (if visible), ischial spines, outer rib margins

Rotation can be determined on a kidney, ureter, and bladder (KUB) radiography by the loss of the symmetric appearance of

A radiograph of an AP projection of the abdomen shows that the right iliac wing is wider than the left. Name the positioning error.

Rotation toward the right

To Take Carolyn Home

Rt Carpals Distal Row: Trapezium, Trapezoid, Capitate, Hamate

Thumb joint

Saddle

Most commonly fractured carpal bone

Scaphoid

Arthrography is a radiographic study of:

Soft-tissue structures within certain synovial joints

Skier's Thumb

Sprain or tear of the ulnar collateral ligament

Retroperitoneal

Structures closely attach to posterior abdomen, behind peritoneum

Infrapertioneal

Structures located under or beneath the peritoneum

Elbow projection that best demonstrates: Capitulum and lateral epicondyle in profile

Supinated (palm up)

Forearm rotational movements

Supination of hand and pronation of hand

Position the hand should be in for an AP elbow projection

Supine

Elbow fat pads become visibility when trauma cause this to push fat pads out of normal position

Synovial fluid

xiphoid process corresponds with this vertebral level

T9-T10

scaphoid

carpals not seen clearly in the projection

Triquetrum

Third carpal bone on the proximal row (from lateral aspect of wrist)

Number of phalanges one digits 2 through 5

Three

First MCP for

Thumb

First Metacarpal

Thumb

CMC joint

carpometacarpal joint

saclike portion of the large intestine below the ileocecal valve

cecum

acute abdomen series is most commonly performed to evaluate and diagnose:

conditions or diseases related to bowel obstruction or perforation

what the duodenum is filled with when it looks like the letter C

contrast medium

Parietal Peritoneum

covers the walls of the abdominal cavity

2 inches (5 cm) above iliac crest; axilla

To ensure the diaphragm is included on an erect abdomen projection, the central ray should be at the level of ___, which places the top of the 35 x 43 cm (14 x 17 inch) IR at the level of the ___.

2 inches above the iliac crest; Axilla

To ensure the diaphragm is included on an erect abdomen projection, the central ray should be at the level of_____, which places the top of the 14x17 IR at the level of the _____.

Forms the first Carpometacarpal joint

Trapezium & first metacarpal (thumb)

A radiograph of a PA oblique of the hand shows that the third, fourth, and fifth metacarpals are superimposed. Correction for this positioning problem on the repeat exposure:

decrease obliquity of the hand

Has a styloid process and the head articulates with the ulnar notch on radius to form a distal radioulnar joint

Ulna (little finger side)

The preferred imaging modality for examining the gallbladder quickly is

Ultrasound

modality used to evaluate patients with acute appendicitis

Ultrasound

the correct name for the abdominal region found directly in the middle of the abdomen

Umbilical

A KUB radiograph on a large hypersthenic patient shows that the entire abdomen is not included on the 14- × 17-inch (35- × 43-cm) IR. What can be done to correct this on the repeat radiograph?

Use two image receptors placed in landscape orientation.

ileocecal valve

Valve at the junction of the small and large intestines

Careful breathing instructions

Voluntary motion can best be prevented by ___ to the patient.

A pathologic condition in which twisting of a loop of intestine creates an obstruction is termed:

Volvulus

Patient breathing. Patient movement during exposure.

What are the two causes of voluntary motion?

Free air in the intra-abdominal cavity rises to this level in a patient who is in the erect position for an erect abdomen projection

diaphragm

If the PA chest projection is not performed for the acute abdomen series, centering for the erect abdomen projection must include the:

diaphragm

Separates abdominal cavity from thoracic cavity

diaphragm

Amount of metacarpals that should be included for a PA projection of the digits

distal metacarpal

Radiographic Appearance of fibrous adhesions

distended loops of air filled small intestine

Radiographic Appearance of Crohn's Disease

distended loops of air filled small intestine (cobblestone appearance)

Shape of Diaphragm

dome shaped/umbrella

Omentum

double fold peritoneum that extends from the stomach to another organ, connects organs

Use the shortest exposure time possible

What is the best mechanism to control involuntary motion?

Peristaltic action of the bowel

What is the primary cause for involuntary motion in the abdomen?

type of movement for intercarpal joint

plane

Free air or gas in the peritoneal cavity is:

pneumoperitoneum

Cecum

portion of the large intestine below the ileocecal valve

location of pancreas to the stomach

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

Position the hand should be in for an AP medial rotation of oblique elbow position

pronated

The proximal radius will cross over the ulna when the hand is

pronated

Joints that permit the forearm to rotate during pronation

proximal radioulnar joint and distalradioulnar joint

Appearance of forearm, radiographically, if pronated for PA projection:

proximal radius crosses over the ulna

Digits 2-5 have 3 phalanges

proximal, middle, distal

muscles that are located laterally to the lumbar vertebrae

psoas major muscles

Ligament of the wrist that extends from styloid process of the radius to lateral aspect of scaphoid and trapezium bones:

radial collateral

Bones of the forearm that are located on the lateral (thumb side), in the anatomical position:

radius

medial rotation of the elbow super imposes

radius and ulna

Osteoporosis

reduction in the quantity of bone or atrophy of skeletal tissue

name of group of organs that are located posteriorly to the serous membrane lining of the abdominopelvic cavity

retroperitoneal

trapped air is easier to penetrate than

soft tissue with x-rays

A patient comes in the ER with possible gallstones. The patient is in severe pain. Which of the following imaging modalities or projections provides the quickest method for confirming the presence of gallstones?

sonography

preferred imaging modality for examining the gallbladder quickly

sonography/ultrasound

Peritoneal Cavity

space between visceral and parietal peritoneum

abdominal organ not associated with digestive system

spleen

organs of the lymphatic system

spleen, thymus, tonsils

expandable reservoir for swallowed food and fluids

stomach

three digestive organs within the abdominal cavity

stomach, small intestine, and large intestine

structure that is at about the same level as the prominence of the greater trochanter

superior border of the symphysis

Visceral Peritoneum

the inner layer of the peritoneum that surrounds the organs of the abdominal cavity

Radiographic Appearance of Pneumoperitoneum

thin, crest shaped, radiolucency under dome of right hemidiaphragm on erect abdomen

area of shielding for females where the top of the gonadal shield is placed at or slightly above

top of an ovarian shield should be at or slightly above the level of ASIS, and the lower border should be at the symphysis pubis

Greater Omentum

transverse colon to greater curvature of stomach

The third carpal bone on the proximal row (from the lateral aspect of wrist) is the:

triquetrium

Criteria for evaluating a true lateral position of the elbow are the appearance of three concentric arcs:

trochlear sulcus, capitellum, and medial aspect of trochlea

Image receptor alignment for an abdomen study on an obese patient

two exposures of the abdomen with a landscape alignment

lateral borders of these two muscles should be faintly visible on a diagnostic abdominal image of a small to average-sized patient when correct exposure factors are used

two psoas major and minor muscles faintly visible

endocrine glands that are superomedial to each kidney

two suprarenal (adrenal) glands

A chronic disease involving inflammation of the large intestine is:

ulcerative colitis

Bones of the forearm, in the anatomical position, that are located on the medial side:

ulna

Which will demonstrate the carpals on the medial side?

ulna

Name of two special turning/bending positions of the hand and wrist that demonstrate medial and lateral aspects of the carpal region:

ulnar and radial deviation

Movement that is most commonly performed to detect fracture of scaphoid bone

ulnar deviation

Most abdominal projections are taken:

upon expiration

The kidneys are connected to the bladder by way of the:

ureters

General rule for collimation for upper limb radiography

visible on all four sides if the IR is large enough to allow this without cutting off essential anatomy

Intraperitoneal

within the peritoneal/abdominal cavity

Type of CR angle required for AP axial projection (Brewerton Method)

• Angle CR 15° proximally, toward ulna, directed to the third MCP joint.

Five ligaments in addition to the ulnar and radial collateral ligaments that are important in stabilizing wrist joint

• Dorsal radiocarpal ligament • Palmar radiocarpal ligament • Triangular fibrocartilage complex (TFCC) • Scapholunate ligament • Lunotriquetral ligament

principal exposure factors for abdominal images

• Medium kVp of 70 to 85 • Short exposure time • Adequate mAs based on part thickness

Hand position in relation to IR for AP Axial (Brewerton)

• Supinate hand and place at the center of the IR

coronoid tubercle (x ray)

K

A child goes to radiology for an abdomen study. It is possible that he swallowed a coin. The ER physician believes it may be in the upper GI tract. Identify the routines would best identify the location of the coin.

KUB and lateral abdomen. With any foreign body study, two projections 90 degrees opposite are recommended to pinpoint the location of the foreign body.

A radiograph of an AP projection of an average-size adult abdomen was produced using the following exposure factors: 100 kVp, 400 mA, 1/10 second, grid, and 40-inch (100-cm) SID. The overall density of the radiograph was acceptable, but the soft tissue structures, such as the psoas muscles and kidneys, were not visible. Which adjustment to the technical considerations enhances the visibility of these structures on the repeat exposure?

-KV too high -lower it o 70 and 80 kV (analog) or 80 +/− 5 (for digital systems). -The milliamperage and exposure time can be altered to maintain the density

radial neck

-L

coronoid process on oblique elbow

-M

radial tuberosity of lateral elbow

-M

A radiographic image of an AP projection of the abdomen demonstrates motion. The following exposure factors were selected: 78 kVp, 200 mA, 2/10 second, grid, and 40-inch (100-cm) SID. The technologist is sure that the patient did not breathe or move during the exposure. Cause of blurriness and correction needed for repeat exposure:

-May be caused by involuntary motion. -Increase the milliamperage and decrease the exposure time (e.g., 400 mA at 1/10 second).

Capitulul (x ray)

-N

Double outer ridges of capitulum and trochlea (capitulum being the smaller of the two areas and trochlea the larger)

-N

second cmc joint

-N

Trochlear sulcus of lateral elbow

-O

first cmc joint

-O

trochlear sulcus

-O

six organs of the digestive system

-Oral cavity -Pharynx -esophagus -Stomach -Small intestine -Large intestine

Condition or disease where the Erect Chest or Erect Abdomen are the most common Radiographic Exams

-Pneumoperitoneum

organ(s) that would be found on an average sthenic patient in the right lower quadrant (RLQ)

-ascending colon -appendix -cecum -2/3 of ileum -ileoceccal valce

reason it is recommended to take abdominal radiographs at the end of patient expiration

-better visualization of abdominal structures -prevent potential voluntary motion - diaphragm must rbe perfectly motionless

triquetrium (carpal)

-c

organ(s) that would be found on an average sthenic patient in the left lower quadrant (LLQ)

-descending colon -sigmoid colon -2/3 of jejunum

radial epicondyle LLO

-e

triquetrium-radial deviation

-i

Trochlea (x ray)

-l

Organs that would be found on an average sthenic patient in the right upper quadrant (RUQ)

-liver -gallbladder -right (hepatic) fixture -duodenum (c-loop) -head of pancreas -right kidney -right suprarenal gland

Appearance of fat pad of elbow is not visible radiographically, suggest:

-normal elbow • Visible when trauma causes synovial fluid to push this out of normal position • Appearance indicates non-visible fracture & joint effusion

trochlea notch lateral elbow

-p

Three accessory organs of digestion located in the abdominal cavity

-pancreas -liver -gallbladder

Situation: A patient has a Colles fracture reduced, and a large plaster cast is placed on the upper limb. The orthopedic surgeon orders a postreduction study. The original technique, used before the cast placement, involved 60 kVp and 5 mAs. How should the exposure factors be altered with a large plaster cast?

68-70kVp

Pancrease

7

Exposure factors for KUB Analog/Digital kVp

70-80

exposure factors that are ideal for abdominal radiography (for a sthenic adult)

78 kV, grid, 40-inch (102-cm) SID

Liver

8

Number of Carpal Bones

8

Number of carpals in wrist

8

Ir size for thumb projection

8x10 or smallest available

Spleen

9

Radius

A

Xiphoid Process

A

Xiphoid process of sternum (lateral)

A (lateral) - Level of T10 Midline marker for superior level of liver

1) No 2) KUB should include the symphysis pubis to ensure bladder is seen. 3) Center CR to MSP at iliac crest.

A KUB radiograph reveals that the symphysis pubis was cut off along the bottom of the image. Is this an acceptable radiograph? If it is not, shy not? How can this problem be avoided for the repeat exposure if needed?

The ER physician suspects that a patient has a kidney stone. The patient is sent to the radiology department to confirm the diagnosis. Specific routine to rule out kidney stone is:

A KUB would be performed with the correct exposure factors to visualize the possible stone.

KUB and lateral abdomen

A child goes to radiology for an abdomen study. It is possible that he swallowed a coin. The ER physician believes it may be in the upper GI tract. Which routine would best identify the location of the coin?

Repeat the exposure using two 14x17 IRs, crosswise with a 2 inch overlap to include the entire abdomen

A hypersthenic patient comes to the radiology department for a KUB. The radiograph reveals that the symphysis pubis is included but the upper abdomen, including the kidneys, is cut off. What is the next step the technologist should take?

Special positioning method that can be performed to demonstrate a Bennett Fracture

A modified Roberts method

A bedside portable left lateral decubitus abdomen should be used to demonstrate fluid levels in the abdomen.

A patient in intensive care may have developed intra-abdominal bleeding. The patient is in critical condition and cannot go to the radiology department. The physician has ordered a portable study of the abdomen. What specific projection can be used to determine the extent of the bleeding?

Reason it is important to keep long axis of digit parallel to IR

All of the above

Two way acute abdominal series; AP supine abdomen (KUB), and left lateral decubitus.

A patient with a possible perforated duodenal ulcer enters the emergency room. The ER physician is concerned about the presence of free air in the abdomen. The patient is in severe pain and cannot stand. What positioning routine should be used to diagnose this condition?

Patient was rotated in a slight RPO position. The downside ilium will look wider.

A radiograph of an AP abdomen reveals the left iliac wing is more narrowed than the right. What specific positioning error caused this.

Exam that demonstrates borders of psoas major muscles

AP Abdomen (KUB)

markers seen

AP KUB Description of possible error of Anatomic side markers:

Elbow projection that best demonstrates: Radial head and tuberosity without superimposition

AP Oblique Elbow with Lateral Rotation

Elbow projection that best demonstrates: Coronoid tubercle

AP Oblique: medial rotation

Most common exam of abdomen

AP Supine

Three way KUB: acute abdomen series

AP Supine Abdomen, AP Erect Abdomen, PA erect Chest

symphysis pubis is cut off from image

AP Supine KUB Description of possible error of Anatomy demonstrated:

indicate psoas muscles

AP abdomen (KUB)

Situation: A patient with a trauma injury enters the ER with an evident Colles fracture. Which positioning routine should be used to determine the extent of the injury?

AP and lateral forearm projections to include the wrist

Which of the following projections/routines would best demonstrate a Bennett's fracture?

AP axial projection (modified Robert's method)

A patient comes to the radiology department with a clinical history of pneumoperitoneum. The patient is able to stand. Projections that best demonstrates this condition:

AP erect abdomen

A patient with a possible ileus enters the emergency room. The physician orders an acute abdominal series. The patient can stand. Which specific position best demonstrates air/fluid levels in the abdomen?

AP erect abdomen

Hand supinated, entire arm on same plane, and humeral epicondyles parallel to IR are used for the:

AP forearm

projections commonly performed for an acute abdominal series or three-way abdomen series

AP supine abdomen, AP erect abdomen, and a PA chest projection

Location of digestive tract

Abdominal cavity

Joint Effusion

Accumulated fluid in the joint cavity

Clinical indications that require a decrease in manual exposure factors

Advanced Osteoperosis

CR location for a PA projection of digit 2

Affected PIP joint

free intraperitoneal air

Air outside the digestive tract

A patient comes from the ER with a large distended abdomen caused by an ileus. The physician suspects that the distention is caused by a large amount of bowel gas that is trapped in the small intestine. The exposure factors for a KUB on an average, healthy adult is 76 kVp, 30 mAs. Should the technologist change any of these exposure factors for this patient? (Automatic exposure control [AEC] is not being used.)

Decrease the mAs. Because trapped air is easier to penetrate than soft tissue with x-rays, reducing the mAs will prevent overexposing the radiograph.

3 muscles visualized during abdomen x ray

Diaphgram, right PSOAS muscle, and left PSOAS muscle

3 important muscles of abdominal cavity

Diaphragm and the two PSOAS muscles

Fingers and thumbs are called

Digits

Called numeral condyle

Distal Humerus

Finger Joints names

Distal Interphalangeal Joint, Proximal Interphalangeal Joint, Metacarpalphalangeal Joint, and Carpometacarpal Joint

decubitus position that best demonstrates possible aneurysms, calcifications of the aorta, or umbilical hernias

Dorsal Decubitus (Rt or Lt Lateral)

Situation: A patient with a clinical history of a possible umbilical hernia comes to the radiology department. The KUB is inconclusive. Additional projection that can be undertaken to help confirm the diagnosis:

Dorsal decubitus

Intestine that is the shortest and widest

Duodenum

first portion of the small intestine

Duodenum

greater trochanter

E -A bony prominence on the proximal lateral side of the thigh, just below the hip joint.

appearance of this indicates non visible fracture and joint effusion

Elbow fat pad

kind of joint the wrist is

Ellipsoid

Type of joint that the radiocarpal joint is

Ellipsoidal

type of joint movement of radiocarpal articulation

Ellipsoidal/Condyloid

Nine regions of Abdomen Central Plane 2, 5, and 8

Epigastric, Umbilical, and Pubic (hypogastric)

term for the radiographic study of the entire urinary system

Excretory or Intravenous Urogram

Ulnar Deviation or Ulnar Flexion

Flexion toward ulna

Radial deviation or radial flexion

Flexion towards radius

guidelines that should be followed with digital imaging of the abdomen

Four-sided collimation, Exposure factors, post-processing evaluation of exposure indicator

Bennett Fracture

Fracture at base of first metacarpal

ischial tuberosity (PA)

G -receives the weight of the body when sitting

structure that stores and releases bile

Gallbladder

Kind of joints the IP joints are

Ginglymus

The interphalangeal (IP) joints are classified as:

Ginglymus (hinge)

Females

Gonadal shielding for ___ may be impossible for studies of the lower abdominopelvic region

ASIS; symphysis pubis

Gonadal shielding for females involves placing the top of the shield at or slightly above the level of the ___, with the bottom at the ___.

It obscures essential anatomy

Gonadal shielding should not be used during abdomen radiography if:

Hooklike process extending anteriorly from the hamate

Hamulus (hamular process)

Distal radius crosses over the ulna when this is pronated

Hand

Brewerton method

Hand - AP Axial -Area Covered: Phalanges and metacarpal heads Pathology shown: To show erosions of the metacarpal heads and the bases of the phalanges from rheumatoid arthritis

Bones of upper limb are divided into 4 groups

Hand and wrist, forearm, arm, shoulder girdle

All phalanx have 3 parts

Head, body, and base

Supinator Fat Pad

I

iliac crest of ilium

Identify the structures labeled on this (AP) KUB radiograph: A

thoracic vertebrae (12)

Identify the structures labeled on this (AP) KUB radiograph: B

PSOAS left

Identify the structures labeled on this (AP) KUB radiograph: C

cocyx

Identify the structures labeled on this (AP) KUB radiograph: D

pubic symphysis

Identify the structures labeled on this (AP) KUB radiograph: E

ischial tuberosity of ischium

Identify the structures labeled on this (AP) KUB radiograph: F

topographic landmark found at L4-L5 vertebral interspace

Iliac Crest

Technical Factors for Fiberglass casts:

Increase 3 to 4 kVp

Technical factors for small to medium dry plaster casts:

Increase 5 to 7 kVp

Technical Factors for large plaster casts:

Increase 8 to 10 kVp

Major disadvantage of performing a PA projection of the thumb rather than an AP

Increased OID (to include base of first metacarpal, thumb must be raised)

topographic landmark that is found at the level of L2-L3

Inferior costal (rib) margin

A radiograph of an AP oblique-medial rotation shows that the coronoid process is not in profile and the radial head is not superimposed over the ulna. What specific positioning error was involved?

Insufficient medial rotation

The telescoping of a section of bowel into another loop is called:

Intussusception

Trochlea of x ray image

J

Situation: A patient is referred to radiology with a possible injury to the ulnar collateral ligament. The patient complains of pain near the first MCP joint. Initial radiographs of the hand do not indicate any fracture or dislocation. Which special projection can be performed to rule out an injury to the ulnar collateral ligament?

PA stress (Folio method) projection

Routine projection that best demonstrations scaphoid fat pad:

PA wrist

projection that requires a kVp setting of 110 to 125 for acute abdomen series

PA, erect chest for free air under diaphragm

Positioning routine for second through fifth digits of the hand

PA/ PA oblique/ lateral • Pronate hand with fingers extended • Center and align long axis of affected finger with long axis of IR • Separate adjoining fingers from affected finger

This is located between prox and middle phalanx

PIP

Posterior wall of abdomen is formed by these muscles

PSOAS

Two large abdominal muscles that extend parallel to lumbar spine and arte indicators of a well exposed KUB

PSOAs

two large muscles found in the posterior abdomen adjacent to the lumbar vertebra that are usually visible on an anteroposterior (AP) radiograph

PSOAs major and minor

Abdomen Radiography Image should demonstrate optimal density and include:

PSOAs muscles, Lower Liver border, and Transverse Process of Lumbar Spine

Carpal Tunnel Synrdrom

Painful disorder of hand and wrist from compression of the median resulting nerve

Which of the following abdominal structures is not visible on a properly exposed KUB?

Pancreas

Explanation of how exam went wrong: error on radiograph of an AP abdomen shows the left iliac wing is more narrowed than the right.

Patient was rotated into a slight right posterior oblique (RPO) position. (The downside ilium will appear wider.)

Positioning modifications that should be used for a study for the second digits to reduce distortion for: Lateral Position

Perform a thumb down lateral (mediolateral projection) to decrease OID

Positioning modifications that should be used for a study for the second digits to reduce distortion for: PA Oblique Projection

Perform the medial oblique rather than lateral oblique to decrease OID

double-walled membrane lining the abdominal cavity

Peritoneum

3 parts of metacarpals are similar to this

Phalanges

2 or more fingers are named

Phalanges (pleural)

A digit consists of separate bones that are called this

Phalanx

Proximal Radioulnar joint articulation joint movement

Pivot

A radiograph of a lateral projection of the elbow shows that the epicondyles are not superimposed and the trochlear notch is not clearly seen. What must be done to correct this positioning error during the repeat exposure?

Place humerus/forearm in same horizontal plane.

Situation: A patient enters the ER with a possible foreign body in the dorsal aspect of the wrist. Initial wrist radiographs are inconclusive in demonstrating the location of the foreign body. What additional projection can be performed to demonstrate this region of the wrist?

Tangential projection - carpal bridge projection

Reason why the AP thumb is recommended instead of PA

The AP position produces a decrease in OID and increased resolution

A KUB with correct exposure factors.

The ER physician suspects a patient has a kidney stone. The patient is sent up to the radiology department to confirm the diagnosis. What specific positioning routine would be used to rule out the presence of a kidney stone?

Iliac crest

The central ray is centered to the level of the ___ for a supine AP projection of the abdomen

two parts of the body common to the respiratory system and the digestive system

The oral cavity (mouth) and the pharynx (oropharynx and laryngopharynx)

Situation: A patient with a possible perforated duodenal ulcer enters the emergency room. The ER physician is concerned about the presence of free air in the abdomen. The patient is in severe pain and cannot stand. Name the positioning routine that should be used to diagnose this condition.

The two-way acute abdomen series: AP supine abdomen and left lateral decubitus

this often proves to be an inaccurate landmark on a bariatric patient

The umbilicus ("belly button")

Smith Fracture

The volar displacement of the distal fragment of the radius; sometimes called a reversed Colles fracture.

CR location placed for a PA projection of hand

Third MCP joint

Location CR is centered for a PA of the hand

Third MCP joint

Situation: A patient has a routine elbow series performed. The AP projection indicates a possible deformity or fracture of the coronoid process. However, the patient is unable to pronate the upper limb for the AP oblique-medial rotation projection because of an arthritic condition. What other projection could be performed to demonstrate the coronoid process?

Trauma axial lateral projection - Coyle method for coronoid process

Name of the articular part of the distal humerus and similar structure on the lateral aspect of humerus

Trochlea, Capitulum

Large concave depression that articulates with the trochlea of humerus

Trochlear Notch

The third of three arcs of the true lat elbow, that is part of the ulna:

Trochlear notch of the ulna (pink)

three arcs of the true lat elbow, first and smallest:

Trochlear sulcus (yellow)

Elbow joint itself is a hinge but the prox radioulnar joint is

Trochoidal (pivot

True/False: A radiolucent pad should be placed underneath geriatric patients for added comfort

True

True/False: A tall asthenic patient may require two 35- X 43-cm (14 X 17 inch) image receptors placed portrait if the entire abdomen is to be includedTrue

True

True/False: The Brewerton method requires a CR angle of 15º proximal

True

Situation: A patient with a dislocated elbow enters the ER. The patient has the elbow tightly flexed and is careful not to move it. Which specific positioning routine can be used to determine the extent of the injury?

Two AP projections with acute flexion and a lateral projection

Number of exposures a hypersthenic patient may require

Two Exposures, IR is CW, and Images overlap (2 in above and 2 in below)

Number of exposures that may be needed for an extremely tall hyposthenic patient

Two, IR is LW, and images over lap (2 in above and 2 in below)

Osteomyelitis

a local or generalized infection of the bone and bone marrow, resulting from a bacterial infection that has spread to the bone tissue through the blood

number of inches that the lower margins of the ischial tuberosities are below or distal to the symphysis pubis.

about 0.4 to 1.5 inches (1 to 4 cm)

Positions that best demonstrate patient with a history of ascites

acute abdomen series: AP supine abdomen, AP erect abdomen, and a PA chest projection

Radiographic Appearance of Intussusception and exposure factor

air filled coiled spring appearance - decrease (-)

Location of coronoid and radial fossae

anterior aspect of distal humerus

appearance of proximal radius and ulna change as the elbow and distal humerus

are rotated or positioned obliquely either medially or laterally

An abnormal accumulation of fluid in the abdominal cavity is called:

ascites

conditions that is demonstrated radiographically as general abdominal haziness

ascites

respiration when the exposure for an AP projection of the abdomen should be taken

at the end of the expiration (about 1 second delay after to allow involuntary motion of bowel to cease)

Infraperitoneal Organs

bladder, male reproductive organs, lower rectum

Middle Phalanx 2nd digit

bone or joint of the right hand: H

PIP of digit 2

bone or joint of the right hand: I

Distal Phalanx of 1st digit

bone or joint of the right hand: J

IP of 1st digit

bone or joint of the right hand: K

1st MCP joint

bone or joint of the right hand: L

head of first metacarpal

bone or joint of the right hand: M

Two causes of voluntary motion

breathing and movement

type of body habitus might require two landscape-aligned image receptors to be taken so the entire abdomen is included

broad hypersthenic patient

Intermediate double arc, of the true lat elbow, consisting of the outer ridges of: (A) the smaller arc: (B) the larger arc:

capitulum, trochlea (green)

interphalangeal joint movement

flexion and extension (hinge/ginglymus)

Carpal Canal

formed by anterior concave surface of carpals where major nerves and tendons pass through it

Bennett fracture

fracture of the base of first metacarpal

Ellipsoidal joints classification and movement directions

freely movable, or diarthrodial, and allow movement in four directions

medical prefix for stomach

gastro

Radiographic Appearance of Ascites

general abdomen haziness

Lead shielding age requirements

good practice is to provide shielding for all patients

structure that is a double fold of peritoneum that connects the transverse colon to the greater curvature of the stomach

greater omenteum

To identify the inferior margin of the abdomen, the technologist can palpate the symphysis pubis or:

greater trochanter

Brewerton Method commonly used to evaluate early signs of:

rheumatoid arthritis at the second through fifth metacarpophalangeal (MCP) joints

attached anteriorly to the fifth rib and posteriorly at the level of the tenth rib

right hemi-diaphragm

quadrant that the large intestine begins in

right lower quadrant

A radiograph of the carpal canal (inferosuperior) projection shows that the pisiform and hamulus are superimposed. What can be done to correct this problem on the repeat exposure?

rotate wrist laterally 5-10 degrees

elongation of iliac wing indication

rotation in that direction

Carpometacarpal of first digit joint movement

saddle -greates range of movement: flexion, extension, abduction, adduction, circumduction, opposition, and some degree of rotation

Two important fat stripes/bands around wrist joint:

scaphoid and pronator

Ulnar deviation with 15° proximal CR or 20° elevation of the hand is used for the:

scaphoid projection

Carpal Bones Names

scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate

Exposure time for upper limb radiography

short exposure time

Which of the following factors best controls the involuntary motion of a young, pediatric patient during abdominal radiography?

short exposure time

True/False: The patient best controls peristalsis by holding his or her breath during exposure.

short exposure time best controls peristalsis

best mechanism to control involuntary motion

shortest exposure time possible

Focal spot commonly used for upper limb radiography

small focal spot

Margins visualized for correctly exposed radiographs:

soft tissue margins for fat pad visualization and fine trabecular markings of all bones being radiographed

topographic landmark that corresponds to the inferior margin of the abdomen and is formed by the anterior junction of the two pelvic bones

symphysis pubis

type of patient that may require two 14- × 17-inch (35- × 43-cm) image receptors placed portrait so the entire abdomen is included.

tall hyposthenic or asthenic

Intussusception

telescoping of the intestines