Chapter 7 Femur and Pelvic Girdle ****, Pediatric Positioning Chapter 16 self test, Bontrager Chapter 16, Ch 14: Urinary System & Venipuncture self test only, bontrager ch. 14, Chapter 13 Lower Gastrointestinal System: Self Test, Lower GI System - Ch...

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What is the other name for AP bilateral or unilateral frog-leg?

Modified Cleaves method

Movement type of 6th through 10th interchondral joints (between anterior 6th through 10th costal cartilage)

Movable - diarthrodial (plane or gliding)

Movement type of the 1st through 12th costovertebral joints

Movable - diarthrodial (plane or gliding)

Movement type of the 1st througth 10th costotransverse joints (between ribs and transverse processes of T vertebrae)

Movable - diarthrodial (plane or gliding)

Movement type of the 2nd through 7th sternocostal joints (between 2nd and 7th ribs and sternum)

Movable - diarthrodial (plane or gliding)

Name the type of iodinated contrast media from the characteristics listed: (Ionic- Non-ionic) Possesses low osmolality; Produces a less severe contrast media reaction; Does not contain a cation; creates a near isotonic solution

Nonionic

Inherited condition that produces very fragile bones

Osteogenesis imperfecta

Condition which can develop as a postoperative complication following open heart surgery

Osteomyelitis

Name of the small foramina found in the sacrum

Pelvic Sacral Foramina

Bilateral radiolucent lines across bones in misalignment of SI joints

Pelvic ring fracture

a patient comes to the radiology deptmartment for a cervical spine series. an AP "open mouth" radiograph indicates that the base of the skull and lower edge of the front incisors are superimposed, but the top of the dens is not clearly demonstrated. what should the tech do to demonstrate the upper portion of the dens.

AP fuchs or PA judd method

Two projections which require Pt to empty urinary bladder prior to exam

AP of sacrum and coccyx

conventional radiographic examination for jefferson fx

AP open mouth C1-C2, tomography-following lateral proj.

LPO

Position that produces a radiograph showing the fundus filled with barium, but duodenal bulb filled with air in profile

Patient with possible Jefferson fracture. Which position best demonstrates this type of fracture?

AP open mouth. Horizontal lateral must be taken first and cleared.

Projections which should be performed for an injury to the anterior aspect of the ribs

AP or PA and Anterior or Posterior Oblique

Projections and centering for an outpatient with an order for follow up study for L3 compression Fx

AP or PA and collimated lateral projections with CR 2" above the iliac crest

Situation: A patient with hip pain from a fall enters the ER. The physician orders a left hip study. When moved to the radiographic table, the patient complains loudly about the pain in the left hip. Which positioning routine should be used fort his patient?

AP pelvis and axiolateral (inferosuperior) left hip. The AP pelvis radiograph should be taken intially without leg rotation; radiogrpahs need to be reviewed by a doctor before any attempt of an internal rotation.

Young patient with clinical history of SCFE. Which projections are most often taken with this condition?

AP pelvis and bilateral frog-leg (modified Cleaves)

Situation: A patient has just been moved to his hospital room after a bilateral hip replacement surgery. The surgeon has ordered a postoperative hip routine for both hips. Which specific positioning routine should be used? (The patient can be brought to the radiology department).

AP pelvis and modified axiolateral (Clements-Nakayama method)

how does the AP skull project the petrous ridges? AP reverse caldwell? AP townes? which projection allows for visualization of the entire orbit?

AP skull: petrous ridges superimpose the superior orbital margin AP reverse caldwell: petrous pyramids are projected into the lover 1/2-1/3 of orbits AP townes: petrous pyramids are projected below the inferior orbital margin ** AP townes allow visualization of entire orbit

what is the imaging sequence for UGI?

AP, L lateral, LPO, RPO, R lateral, PA

Situation: a patient with a clinical history of spondylolisthesis of the L5-S1 region comes to the radiology department. What basic and special projections should be included in this study?

AP, Lateral Lumbar, Lateral spot (L5-S1), Ap Axial Spot (L5-S1)

Basic and special projections for an outpatient with clinical Hx of spondylolisthesis of the L5-S1

AP, lateral, L5-S1 spot lateral, and Right and Left 30° oblique positions

Which exam is associated with Intussusception?

Abdomen

Describe or Define: Osteogenesis imperfecta

Abnormally soft bones

Type of radiographic technique required for an injury to the region of the 8th or 9th rib (above or below diaphragm)

Above the diaphragm

Where do the three divisions of the hip bone fuse at and at what age is the fusing process?

Acetabulum; midteens

The pubic arch on the average male pelvis is an (acute or obtuse) angle that is (greater than or less than) 90°.

Acute, less than

What type of contrast media is recommended for reducing an intussusception?

Air for the pneumatic reduction of intussusception

40-70 degrees

Amount of body rotation required for the RAO position during an upper GI on a sthenic patient

What is the kV range (analog and digital) for a pediatric study of the upper limb?

Analog - 55-65 kV Digital - 60-70 kV

A true allergic reaction to iodinated contrast agents is classified at this type of a reaction

Anaphylactic reaction

Which one of the following commercial contrast media would be used during an evaluative proctogram? Hypaque Gastrogafin Gastroview Anatrast

Anatrast

Situation: An AP projection taken during a retrograde cystogram reveals that the symphysis pubis is superimposed over the floor of the bladder. What can be done to fix this on the repeat?

Angle the CR more caudally to project the symphysis pubis inferior to the bladder

Correction to be made for an SI series which fails to show the inferior portion of the joints

Angle to CR 15°-20° cephalad

Pathologic condition which usually requires an increase in manual exposure factors

Ankylosing Spondylitis

Inflammatory condition that is most common in males in their 30's

Ankylosing Spondylosis

Early fusion of SI joints and "bamboo spine"

Ankylosing spondylitis

Which pathologic indication may result in the early fusion of the sacroiliac (SI) joints?

Ankylosing spondylitis

The kidneys lie on the ___________ surface of each psoas major muscle

The end of the rib that is most inferior

Anterior sternal end

Where would the femoral neck be located from the midpoint of the imaginary line created by two landmarks (ASIS and symphysis pubis)?

Approximately 2.5 in (3 to 5 cm) below midpoint of the line.

Location of area of interest (pain) for either AP or PA rib projections

Area of pain against the IR

When should a chest exposure be initiated for a crying child?

As the child fully inhales and holds his or her breath

fourth portion of duodenum

Ascending portion of duodenum

Ileum

Aspect of small intestine that is the smallest in diameter but longest in length.

fundus

Aspect of the stomach that will fill with air when the patient is prone

Primary or Assisting technologist? Initiates exposures

Assisting technologist

Primary or Assisting technologist? Processes the images

Assisting technologist

Primary or Assisting technologist? Sets exposure factors

Assisting technologist

CR at the level of which structure/landmark: AP supine abdomen (older children)

At level of iliac crest

Rotation of the spine required to properly elongate and visualize the axillary aspect of the ribs with respect to the area of interest

Away from the area of interest

Most lateral portion of a rib where it essentially curves the most

Axillary portion (angle of rib)

Which of the following procedures can be performed to evaluate children for attention deficient hyperactivity? A. Spiral/helical CT B. Functional MRI C. 3-D ultrasound D. Nuclear medicine

B. Functional MRI

Situation: A 2-year old child comes to the radiology department for a routine chest examination. While removing the child's shirt, you notice a human bite mark on the upper arm. What should you do next? A. Call hospital security B. Inform the supervisor or physician C. Interview the parent about the injury D. Interview the child about the injury

B. Inform the supervisor or physician

Which skull positioning line is placed perpendicular to the IR for an AP Towne 30-degree caudal projection of the skull? A. IOML B. OML C. MML D. AML

B. OML

Situation: A 3-year-old child comes to the radiology department for and erect abdomen examination. He is unable to remain still for the exposures. Which immobilization device should be used for this patient? A. Tam-Em board B. Pigg-O-Stat C. Plexiglas hold-down paddle D. Have another technologist hold child

B. Pigg-O-Stat

Which of the following conditions is a common clinical indication for performing pelvic and hip examinations on a pediatric (newborn) patient? A.)Osteoporosis B.)Developmental dysplasia of hip (DDH) C.)Ankylosing spondylitis D.)Osteoarthritis

B.)Developmental dysplasia of hip (DDH)

Which of the following projections is recommended to demonstrate the superoposterior wall of the acetabulum? A.)AP axial inlet B.)PA axial oblique C.)Axiolateral inferosuperior D.)Modified axiolateral

B.)PA axial oblique

radiographic apperances : elevated or indented floor of bladder

BPH

Describe or Define: Epiglottitis

Bacterial infection can lead to closure of the upper airway

Modification of the lumbar spine series for a Pt with a clinical Hx of severe kyphosis

Basic lumbar spine projections should be performed erect

RAO

Best position to visualize the esophagus in a radiograph

Which single radiographic position provides a lateral projection of bilateral lower limbs for the non-traumatic pediatric patient?

Bilateral frog-leg

Which method is often performed to evaluate a pediatric patient for a congenital hip dislocation?

Bilateral modified Cleaves

Term for the long middle aspect of the sternum

Body / Corpus / Gladiolus

What are the two aspects of the ischium?

Body, ramus

Best imaging modality for Osteoporosis

Bone Densitometry

At what age can most children be talked through a radiographic examination without purposeful immobilization? A. 1 year B. 18 months C. 3 years D. 5 years

C. 3 years

Which of the following conditions contraindicates the use of laxatives before a contrast media procedure? A. Gastritis B. Blood in stool C. Appendicitis D. Diverticulosis

C. Appendicitis

What is meconium? A. Pancreatic enzymes B. Blood & lymph C. Dark green secretion of the liver & intestinal glands mixed with amniotic fluid D. Pus and dead blood cells

C. Dark green secretion of the liver & intestinal glands mixed with amniotic fluid

Which of the following projections of the abdomen best demonstrates the prevertebral region? A. AP supine KUB B. PA prone KUB C. Dorsal decubitus abdomen D. AP erect abdomen

C. Dorsal decubitus abdomen

The drug that can be given as part of the premedication protocol before an iodinated contrast media procedure

Prednisone

What is the one feature of all thoracic vertebrae that make them different from all other vertebrae?

Presence of facets for articulation with ribs

Primary or Assisting technologist? Positions the tube and collimates

Primary technologist

What part of the hip bone possesses a slightly movable joint?

Pubis

Definition of a flail chest

Pulmonary injury caused by blunt trauma to two or more ribs

Bacterial infection of the kidney

Pyelonephritis

Preferred position for a study of the sternum

RAO

Which oblique position, the LAO or RAO, best demonstrates the ascending colon and right colic flexure?

RAO

Recommended positioning routine for Pt with pectus excavatum

RAO and Lateral sternum (possibly a chest exam as well)

Situation: A patient comes to radiology with a clinical history of pectus excavatum. What positioning routine would best demonstrate the condition?

RAO and lateral sternum (possibly a chest examination as well)

During a barium enema, a possible polyp is seen in the left colic flexure. Which of the following projections will best demonstrate it?

RPO

Situation: A patient comes to the ER with a left, lower, posterior rib injury. A unilateral rib study is ordered. The patient is unable to stand due to multiple injuries. What are the basic projections taken for this patient?

Recumbent AP and LPO positions

Routine of the ribs to be performed for a Pt with trauma to the left lower anterior ribs

Recumbent PA (or AP if Pt cannot do prone) and RAO (or LPO) on expiration

PA axial oblique (Teufel method) demonstrates distortion of acetabulum. Patient rotated 35° to 40° toward affected side, CR angle 20° cephalad. Modifications for repeat?

Reduce CR angle to 12° cephalad

The absence of a functioning kidney

Renal agenesis

Hypernephroma is another term for what?

Renal cell carcinoma

The condition that may produce hydronephrosis

Renal obstruction

What kind of mechanical digestion takes place in the small intestine?

Rhythmic segmentation (churning) Peristalsis

mastoid tip

vertebra prominens

C7-T1

Best imaging modality for compression fractures of the lumbar spine

Describe or Define: Wilms' tumor

Cancer of the kidney of embryonic origin

Chest or Upper/lower limb radiographic procedure: Cystic fibrosis

Chest

Routine that is always performed if a pulmonary injury is suspected

Chest Study

Ileus

Circular staircase or herringbone sign

cholesterol

Concentrated levels of this may lead to gallstones

Enlarged thyroid at birth

Congenital goiter

Two common terms for the classic metaphysical lesion (CML), which may indicate child abuse, are:

Corner fx and bucket-handle fx

Another name for the sacral horns

Cornu

Medially facing surface of the rib containing arteries, veins and nerves

Costal groove

Describe or Define: Hemoptysis

Coughing up blood

Chronic inflammatory condition of small intestine

Crohn's disease

A common condition in children between the ages of 1 to 3, caused by a viral infection

Croup

Which pathologies is best demonstrated with a radiographic chest procedure?

Cystic fibrosis and Hyaline membrane disease

Which of the following radiographic routines and/or procedures best demonstrates Osgood-Schlatter disease? A. Barium enema B. AP & lateral hip C. Upper GI D. AP & lateral knee

D. AP and lateral knee

Positioning error shown during AP lumbar spine with SI joints not equidistant from the spine, and the Right ala of sacrum appears larger

Rotation to the Pt's Right

What does the ear of the Scotty dog represent?

SAP

Epiphyses appear shorter and epiphyseal plate wider

SCFE

Fracture involving the epiphyseal plate

Salter-Harris fracture

The PA axial oblique (Teufel method) or posterior oblique (Judet method) can be taken to demonstrate aspects of the acetabulum more completely

Situation: A patient entered ER with a pelvis injury due to a motor vehicle accident. The initial AP pelvis projection demonstrates a possible defect or fracture of the left acetabulum. No other fractures are detected and the patient is able to move comfortably. What additional projection can be taken to demonstrate a possible acetabular fracture?

It is soft tissue from the unaffected thigh. This leg must be flexed and elevated high enough to keep it from superimposing the affected hip.

Situation: A radiograph of an axiolateral (inferosuperior) projection of a hip demonstrates a soft tissue density that is visible across the affected hip and acetabulum. This artifact is obscuring the image of the proximal femur. What is the most likely cause of the artifact, and how can it be prevented from showing up on the repeat exposure?

AP pelvis and axiolateral left hip. The AP pelvis radiograph should be taken initially without leg rotation; the radiograph must be reviewed by the physician and checked for fractures or dislocations before attempting an internal rotation of the left leg for the axiolateral (inferosuperior) projection

Situation: A patient with hip pain from a fall enters the emergency room. The physician orders a left hip study. When moved to the radiographic table, the patient complained loudly about the pain in the left hip. Which positioning routine should be used for this patient?

Yes. Any orthopedic appliance or prosthesis must be seen in its entirety in both projections.

Situation: A portable AP and lateral hip study is ordered for a patient who is in recovery following hip replacement surgery. The radiograph of the AP hip reveals that the upper portion of the acetabular prosthesis is slightly cut off but is included on the lateral projection. Should the technologist repeat the AP projection? Why or why not?

Ensure that the central ray is centered to near the midline of the grid cassette and that the face of the cassette is perpendicular to the CR.

Situation: A radiograph from a modified axiolateral projection reveals excessive grid lines on the image, which also appears underexposed. What can be done to avoid this problem during the repeat exposure?

At the first meeting between the technologist and the patient (accompanied by an adult), which of the following generally should NOT be discussed? A. Introduce yourself B. Take the necessary time to explain what you will be doing. C. Discuss the possible forceful immobilization that will be needed in the child will not cooperate. D. Describe the total amount of radiation the patient will receive with the specific exam if it has to be repeated because of a lack of cooperation. E. All of these steps must be taken.

D. Describe the total amount of radiation the patient will receive with that specific exam if it has to be repeated because of lack of cooperation

If the technologist suspects child abuse, he or she should: A. Ask the parent when the abuse occurred B. Report the abuse immediately to the necessary state officials as required by the state C. Refuse to do the examination or touch the child until a physician has examined the patient D. Do none of the above

D. Do none of the above

By increasing kV and __________, the dose can be reduced to the pediatric patient during a helical CT scan. A. mA B. Region of body scammed C. Scan resolution D. Pitch ratio

D. Pitch ratio

Situation: Which radiographic procedure is often performed for pyloric stenosis? A. Barium enema B. Evacuative proctography C. Enteroclysis D. Upper GI

D. Upper GI

What is the optimal amount of hip abduction for the unilateral "frog-leg" projection to demonstrate the femoral neck without distortion? A.)45 degrees from vertical B.)90 degrees from vertical C.)10 degrees from vertical D.)20 to 30 degrees from vertical

D.) 20 to 30 degrees from vertical

Correction to be made for an SI joint study at 35° LPO and RPO with perpendicular CR, if joints are not open and upper iliac wings are nearly superimposing the joints

Decrease rotation of the body for obliques to no more than 25°-30° with CR centered to the upside SI joint

What kind of mechanical digestion takes place in the esophagus?

Deglutition (swallowing) Peristalsis (waves of muscular contractions)

Two particular facets found on the thoracic vertebrae are called

Demifacets

Definition of Pectus Extravatum

Depressed sternum due to congenital defect

Repeat the exposure using a 20º to 25º cephalad central ray angle. (It will separated the greater trochanter from the femoral neck)

Situation: A radiograph of a unilateral frog-leg (modified Cleaves) projection reveals that the greater trochanter is superimposed over the femoral neck. Based on the AP hip projection, the radiologist suspects a nondisplaced fracture of the femoral neck. What can the technologis do to better define this region?

NO. It is an acceptable image because the lesser trochanters should not be visible at all or only minimally on a well-positioned AP hip projection.

Situation: A radiograph of an AP hip reveals that the lesser trochanters are not visible. Should the technologist repeat the projection? ___________ If yes, what should be modified to improve the image during the repeat exposure?

The patient is rotated toward the left-left posterior oblique (LPO)

Situation: A radiograph of an AP pelvis reveals that the right iliac wing is foreshortened as compared with the left side. Which specific positioning error has been made?

Rotation of pelvis toward the patient's left. The elevated or upside obturator foramen will become more narrowed as compared to the opposite side.

Situation: A radiograph of an AP projection of the pelvis demonstrates that the left obturator foramen is narrowed and the right one is open. What is the specific positioning error present on this radiograph?

Axiolateral projection (Danelius-Miller method)

Describe how the radiographer should perform a hip series on a cognitively impaired pt who presents with extreme hip pain?

Metformin is a drug given to patients with this disease

Diabetes

Epiphysis, Diaphysis, or Epiphyseal plate? Occurs before birth

Diaphysis

Epiphysis, Diaphysis, or Epiphyseal plate? Primary centers

Diaphysis

Giardiasis

Dilation of the intestine with thickening of circular folds

Other than preventing artifacts in the bowel, what is the other reason that solid food is withheld for 4 hours before a pediatric IVU?

Diminish the risk for aspiration from vomiting

Describe or Define: Osteochondrosis

Disease of epiphyseal and growth plate

Descending colon

Distal part, also called the iliac colon

Ideal arm position for a projection of the erect lateral sternum

Drawn back

Common bile duct

Duct formed from the common hepatic duct and cystic duct

Pancreatic duct

Duct of Wirsung

pancreatic duct

Duct of Wirsung

Proper use of a lead blocker mat which improves image quality

During lateral lumbar x-ray, place mat behind Pt about 1 inch posterior of edge of collimated light field

The pathologic indication that is an example of a congenital anomaly of the urinary system

Ectopic kidney

Ribs at which the bony thorax is the widest at the lateral margins

Eighth (8th) or Ninth (9th) ribs

Positioning error during AP sacrum which shows the sacrum foreshortened and foramina are not open

Either insufficient cephalad CR angle or CR angle was in wrong direction (caudal)

Best positions and lumbar spine series for outpatient with clinical Hx of spondylolysis

Either posterior or anterior oblique lumbar spine projections (over AP or PA) will demonstrate advanced spondylolysis

Secondary centers of ossification of the long bones are called __________.

Epiphyses

Routine of the ribs to be performed for a Pt with trauma to the right upper anterior ribs in the ER (Pt is able to sit up)

Erect PA and LAO (or RPO) position on inspiration

True or False: Gonadal shielding can be used for males for the axiolateral (inferiosuperior) projection of the hip.

False

True/False: A PA axial oblique (RAO) barium enema projection is an optional projection to demonstrate the right colic flexure.

False

True/False: For a hypersthenic type of patient, a 35- X 43-com (14- X 17-inch) IR placed lengthwise and centered correctly generally includes the entire barium-filled large intestine on one IR.

False

True/False: Multiphase CT examinations are necessary for most pediatric studies

False

True/False: Natural latex-based gloves are safe to be worn by all technologists.

False

True/False: Parental assistance for skull radiography is preferred rather than using head clamps and a mummy wrap on a pediatric patient.

False

True/False: A well-inspired, erect chest radiograph taken on a young pediatric patient visualizes only six to seven ribs above the diaphragm.

False (9 to 10)

T/F The automatic exposure control (AEC) system is recommended for sternum and rib routines if the center chamber is used.

False (AEC is generally not recommended for rib routines due to the need for high-contrast, optimum detail exposures, which can generally be better achieved manually)

True/False: The technologist is responsible for reporting potential signs of child abuse to the police

False (the technologist should report to the radiologist or supervising technologist)

True/False: Clothing, bandages, and diapers generally do not need to be removed from the regions being radiographed on pediatric patients because they do not cause artifacts on the radiographs (as long as metallic fasteners are not present).

False (these items may cause artifacts and should be removed)

True/False: The transit time of the contrast media for reaching the cecum during a small bowel series on a 3-year-old child is approximately 2 hours.

False (usually 1 hour)

Classification of the 11th and 12th ribs

False and floating

Formed primarily by the ala of the ilium

False pelvis

Greater pelvis

False pelvis

T/F A breathing technique is recommended for studies of the sternoclavicular joints.

False. Exposure is made with suspended respiration upon expiration.

True/False: The barium enema is recommended to diagnose acute appendicitis.

False; ultrasound is recommended to diagnose acute appendicitis

A 2-year-old child comes to radiology for a cervical spine series. The child is unable to hold still for the projections even with immobilization. Which of the following individuals should be asked to hold the child if present?

Father wearing protective apron

Iliac wings that are more flared

Female

Larger and more rounded inlet

Female

Obtuse pubic arch (greater than 90°)

Female

What gender type appears wide and contains a more flared ilia on a pelvic radiograph?

Female

What gender type appears with the pubic arch angle of 110 degrees on a pelvic radiograph?

Female

Rib that articulates with the upper lateral aspect of the manubrium of the sternum

First (1st) rib - anterior sternal end

HOw is the unaffected leg positioned for the axiolateral hip projection?

Flexed and elevated to prevent it from becoming superimposed over affected hip.

What distinguishes a floating rib from a false rib

Floating rib contains no cartilage

rugae

Folds of the stomach mucosa

Which physical sign may indicate that a patient has a hip fracture?

Foot is rotated externally

Regional enteritis (Crohn's)

Form of inflammatory disease of the GI tract

Ascending colon

Found between the cecum and transverse colon

What is the small depression located in the center of the femoral head called?

Fovea Capitis

1. Contaminated food 2. Contaminated water 3. Person to person contact

Giardiasis is a condition acquired through____.

CR at the level of which structure/landmark: AP skull

Glabella

What are the major functions of the greater pelvis and the lesser pelvis?

Greater Pelvis: Supports the lower abdomen organs and fetus. Lesser Pelvis: Forms actual birth canal

What is the correct term for the condition involving a slipped disk?

HNP herniated nucleus pulposus

Correction to be made if a patient's breasts are obscuring the sternum after a lateral projection of the sternum

Have Pt bring the breasts to the side - hold them in this position with a wide bandage

male pelvis

Heart-Shaped/Oval Inlet. Acute Pubic Arch. Iliac wings that are less flared.

Condition which requires a chest routine to be included along with a study of the ribs

Hemothorax

Most common pathology at the level of L4-L5 which usually results in sciatica

Herniated Nucleus Pulposus (HNP)

Best exposure time for an oblique position of the sternum

High - 3-4 seconds with breathing technique

AKA congenital megacolon

Hirschsprung disease

Projections designed to measure anteroposterior movement at the site of a spinal fusion

Hyperextension and hyperflexion lateral projections

What does the front of the Scotty dog represent?

IAP

What part of the hip bone contains the posterior superior iliac spine (PSIS)?

Ilium

List three divisions of the hip bone.

Ilium Ischium Pubis

Movement type of the 1st sternocostal joint

Immovable - synarthrodial

Movement type of the 1st through 10th costochondral unions (between costocartilage and ribs)

Immovable - synarthrodial

15 - 18 ft (4.4 - 5.5m)

In a person with good muscle tone the lenth of the entire small intestine is _______.

Change in SID which is advantageous for AP and lateral projections of the lumbar spine

Increasing from 40" to 44" or 46"

Colitis

Inflammatory condition of the large intestine

Specific foramina which is demonstrated by the Lateral position

Intervertebral Foramina

What is formed where the superior and inferior vertebral notches joined

Intervertebral Foramina

The 2 classes of iodinated contrast media used for urinary studies

Ionic and Nonionic

What osteolytic metastases of the ribs look like on an x-ray

Irregular bony margins

Which structure is considered as the most posterior? (Ischial spine, ASIS, synthesis pubis, acetabulum)

Ischial spines

Which bony landmark is found on the most inferior aspect of the posterior pelvis?

Ischial tuberosity

What part of the hip bone has the lesser sciatic notch?

Ischium

What is the advantage of using 90 kV rather than a lower kV range for hip and pelvis studies with an analog imaging system on younger patients?

It reduces patient dose.

What is the names for the upper most border of the manubrium?

Jugular notch Suprasternal notch Manubrial notch

Which radiographic technique or method is performed to radiographically study congenital clubfoot?

Kite method

And abnormal or exaggerated thoracic spinal curvature with increased concavity is called

Kyphosis

At what level is the inferior costal margin found?

L2 - L3

Vertebral level of the lower costal margin

L2-L3

Vertebral level of the iliac crest

L4-L5

Position which will best demostrate the right axillary ribs

LAO

Position or projection of the lumbar spine which best demonstrates a possible compression fracture

Lateral

Which position of the thoracic spine best demonstrates the intravertebral foramina?

Lateral position

number on bones coccyx

where is the CR for an AP projection of the lumbar spine with a 30x35 cm/11x14" IR?

1.5" above iliac crest and MSP

Three (3) structures found within the costal groove of each rib

1.Artery 2.Vein 3.Nerve

Two (2) most diagnostic projections of a Pt in the ER on backboard from MVA with portable study of the sternum ordered

1.LPO 2.Horizontal beam lateral - may use 15°-20° mediolateral CR angle if Pt cannot assume oblique position

Three (3) points which must be included in a patient's clinical history before a rib series

1.Nature of the trauma or Pt complaint 2.Location of rib pain or injury 3.Whether or not the Pt has been coughing up blood

Best projection for an ER Pt with possible L3 compression Fx

Lateral, may include a coned-down spot AP/PA and lateral of the L3 region

SI joint which is visualized in the RPO position

Left

Two (2) basic projections or positions which should be performed for an injury to the right anterior ribs

1.PA 2.LAO - these elongate the right axillary rib region

Two (2) chest pathologic conditions that may result from a rib injury

1.Pneumothorax 2.Hemothorax

Three (3) Structures that make up the bony thorax

1.Sternum 2.Thoracic Vertebra 3.12 pairs of ribs

Which ribs do not have costotransverse joints?

11th and 12th

What size of analog image receptor should be used for an adult bilateral frog-leg projection?

14 x 17 landscape

What is the average degree of rotation for an RAO position of the sternum?

15 -20 degrees

The angle the needle is advanced into the vein during venipuncture

15 deg for gelco to 30 for butterfly

CR angulation must be used w/ a posterior oblique projection of the cervical spine.

15 degree cephalad

List the four bones of the pelvis

Left hip bone (ossa coxae innomate bone) Right hip bone (ossa coxae innomate bone) Sacrum Coccyx

for the CR to pass through and "open" the intervertebral spaces on a 45 degree posterior oblique proj. of the cervical vertebrae, what CR angle is required

15 degree cephalad

How much is the IR tilted for the modified axiolateral of the hip?

15 degrees from vertical

During life, how long is the entire small intestine?

15 to 18 feet (4.5 to 5.5 m)

The modified axiolateral (Clements-Nakayama method) projection requires the CR to be angled how many degrees posteriorly from horizontal?

15 to 20 degrees

Amount of obliquity (more or less) required for a frontal view of the sternum on a hypersthenic patient

15* (Less obliquity)

Amount of rotation to be used for the oblique position of the sternum for a large or deep-chested patient

15°

CR angulation required for an AP projection of the sacrum for a typical male Pt

15° Cephalad

Anterior oblique projection of the cervical spine-PA

15° caudad

Posterior oblique projection of the cervical spine-AP

15° cephalad

Average degree of rotation for RAO sternum

15°-20°

1. aortic arch 2. left primary bronchus

2 structures that create the 2 indentations seen along the lateral border of the esophagus

The Pigg-O-Stat can be used effectively for an erect PA and lateral chest from infancy to approximately _________ years of age.

2 to 4

where is the central ray centered for a AP projection of the sacrum?

2" superior to pubis symphysis, MSP, with 15 degree cephalic angle

CR centering for an AP coccyx

2" superior to the symphysis pubis

how much rotation of the body is required for an oblique position of the thoracic spine from a true lateral position

20 degree from lateral position

Typically the timing sequence during an IVU when the oblique projections are taken

20 minutes following injection

Specific lumbar joint which is demonstrated with the LPO position

Left zygapophyseal Joints

Specific lumbar joint which is demonstrated with the RAO position

Left zygapophyseal joints

Amount of obliquitiy (more or less) required for a frontalview of the sternum on an asthenic patient

20* (More obliquity)

Images are taken at ____ intervals for a small bowel series on a pediatric patient.

20- to 30-minute intervals

what CR angle must be used with AP axial-vertebral arch proj

20-30 caudad

What type of central ray angle is required when using the AP axial for outlet "Taylor method" for a male patient?

20° to 35° cephalad

Angle of each SI joint obliquity

25°-30°

Rotation of the body required for oblique positions of the SI joints

25°-30°

number on bones vertebral column

What is the maximum height of the barium enema bag above the tabletop before the beginning of the procedure?

3 feet (for pediatric patients)

What are three distinctive features of all cervical vertebrae that make them different from any other vertebrae?

3 foramina Bifid spinous processes Overlapping vertebral bodies

Recommended NPO fasting before the pediatric contrast media procedure: 2-month-old upper GI

3 hours

Average breast dose range for an anterior oblique rib projection

3 mrad

The height that the tourniquet should be placed above the puncture site

3 to 4 inches (8 to 10 cm)

Location of CR centering for an AP projection of the ribs for an injury located above the diaphragm

3-4 inches below the jugular notch at the level of T7

what degree of rotation from supine is required to place the kidneys parallel to the IR

30 degree

Situation: Before the beginning of an IVU, the radiologist requests a nephrogram be taken as part of the study. At what point of the study should this projection be taken?

30 seconds to 1 minute following the start of the bolus injection

Amount of increase in percentage of female midline gonadal dose in AP over PA due to anterior location of ovaries

30% more in AP

Amount of rotation required to properly visualize the zygapophyseal joints at the L5-S1 level

30°

How much is the pelvis and/or thorax rotated for a PA axial oblique ( Teufel method) for acetabulum?

35° to 40° toward affected side

Age at which the most distal aspect of the sternum ossifies

Minimum SID for Sternum due to radiation safety

40 inches (minimum 15" between Pt skin and collimator)

How many degrees are the femurs abducted (from the vertical plane) for the bilateral frog-leg projection?

40 to 45

When will the Scotty dog be visualized?

45 degree oblique

Amount of rotation needed for an oblique projection of the axillary ribs

45°

Degree of obliquity required for a projection of the general lumbar spine

45°

The intravertebral foramina for the cervical spine lie at a what angle to the mid sagittal plane?

45°

the American college of rad recommends that metformin be withheld for __ hours after contrast medium procedure and resumed only if kidney function is again determined to be within normal limits

number on bones lumbar

Amount of gonadal dose given for rib projections

Less than 1 mrad (so low it's not listed on the dose charts for rib projections)

What gender type appears to have a narrow ilia that are less flared on a pelvic radiograph?

Male

What gender type appears with pubic arch angle of 75 degrees on a pelvic radiograph?

Male

Where is the CR centered for a PA and lateral pediatric chest projection

Mammillary (nipple) level

CR at the level of which structure/landmark: AP, PA, or lateral chest

Mammillary (nipple) line

Where is the CR centered for a PA and lateral pediatric chest projection

Mammillary (nipple) line

How is barium instilled into the large bowel for a barium enema study of an infant?

Manually & slowly, 60 mL syringe & #10 French flexibly silicone catheter

List the 3 parts of the sternum

Manubrium, body, xiphoid process

What kind of mechanical digestion takes place in the oral cavity?

Mastication (chewing) Deglutition (swallowing)

Describe or Define: Meconium aspiration

May develop during stressful births

hiatal hernia

A portion of the stomach protruding through the diaphragmatic opening

A. What is the minimum kV for an AP abdomen projection of a newborn with a grid? B. A grid is required for a pediatric AP abdomen if the abdomen measures more than ___________ cm.

A. 70 kV B. 10 cm

Situation: A child come to the radiology department with possible croup. Which of the following procedures best demonstrates this condition? A. AP and lateral upper airway B. Erect abdomen C. PA and lateral chest D. Sinus series

A. AP and lateral upper airway

Other than gonadal shielding, what three safeguards can be used to reduce the patient dose during pediatric procedures?

A. Close collimation B. Low-dosage techniques C. Minimum number of exposures

Which of the following modalities is most effective in detecting signs of autism? A. MRI B. Ultrasound C. Spiral CT D. Nuclear medicine

A. MRI

Which of the following conditions is caused by inflammation of the inner lining of the larger or small bowel, resulting in tissue death? A. NEC B. Intussusception C. CHD D. Meconium ileus

A. NEC

Which of the following imagining modalities can be used on a newborn to assess hip joint stability during movement of the lower limbs? A.)Sonography B.)Computed tomography C.)Magnetic resonance imaging D.)Nuclear medicine

A.)Sonography

Describe or Define: Hyaline membrane disease

AKA Respiratory distress syndrome

which AP proj of the cervical spine demonstrates the entire upper cervical spine w/ one single proj.

AP "wagging jaw" proj (ottonello method)

Situation: A patient with an injury to the right lower posterior ribs comes to the emergency room. She is unable to stand. List the positioning routine that would be performed for this patient. Include breathing instructions.

AP and RPO performed recumbent. Suspend upon expiration.

Follow up study for clay shovelers fracture. Which spine projections best demonstrate this fracture?

AP and lateral C-spine projections

Which radiographic projections (and methods) are performed for the infant with congenital clubfeet?

AP and lateral feet, Kite method

Location of CR centering for the oblique and lateral projections of the sternum

Midsternum - midway between the jugular notch and the xiphoid process

Where is the central ray placed for an AP pelvis projection?

Midway between ASIS and symphysis pubis

Which exam is associated with Premature closure of fontanelles?

Skull

What imaging modality has replaced the procedure cephalopelvimetry?

Sonography (ultrasound)

Condition that is best diagnosed using prenatal ultrasound

Spina Bifida

Congenital defect in which the posterior elements of the vertebrae fail to unite

Spina Bifida

Condition where the posterior aspects of the vertebra fail to develop

Spina bifida

Describe or Define: Myelocele

Spinal cord protrudes through an opening

Hepatopancreatic sphincter

Spincter of Odi -relaxes to allow bile into the duodenum when levels of CCK increases in bloodstream

where should the CR be placed for a cervicothoracic lateral (swimmer's) position

T1; one inch (2.5 cm) above the jugular notch anteriorly, or level of vertebra prominens posteriorly

At what level is the jugular notch found?

T2 - T3

Jugular notch

T2-T3

jugular notch

T2-T3

At what Vertebral level is the sternal angle found?

T4 - T5

Sternal angle

T4-T5

sternal angle

T4-T5

3" to 4" below jugular notch

1. Quadrate lobe 2. Caudate lobe

The 2 additional (minor) lobes of the liver

1. time 2. distance (most effective) 3. shielding

The 3 cardinal principles of radiation protection

1. nasopharynx 2. oropharynx 3. laryngopharynx

The 3 divisions of the pharynx

1. RAO 2. Left lateral 3. AP

The 3 most common basic or routine projections for an esophagram

1. intake/digestion of food 2. absorb digested food, water, & vitamins 3. eliminate unused material as waste

The 3 primary functions of the digestive system

1. to store bile 2. to concentrate bile 3. to contract when stimulated in order to release bile into the duodenum

The 3 primary functions of the gallbladder

Ascending portion

The 4th and final segment of the duodenum

35-40 degrees cephalad

The CR angle required for the PA axial projection for a hypersthenic patient during an upper GI

Which radiographic sign can be evaluated to determine whether rotation is present on a PA projection of the sternoclavicular joints?

The SC joints are equal distance from the midline of spine

Pyloris of stomach and C-loop

The aspect of the GI tract that is best demonstrated with an RAO position during an upper GI

100-125 kV

The average kV range fro an esophagram & upper GI when using barium sulfate (single contrast study)

90-100 kV

The recommended kV range for a double-contrast upper GI projection

Fovea capitis

The small depression near the center of the femoral head or a ligament is attached is called the

falciform ligament

The soft-tissue structure that separates the right and left lobes of the liver

The inner, posterior triangular aspect of the bladder that is attached to the floor of the pelvis

Trigone

T/F A hand routine for a 7 year old would be the same as for an adult patient

True

T/F Psychologic maltreatment is one of the six categories of child abuse.

True

True or False: The unaffected foot during an axiolateral (inferosuperior) projection can be burned if allowed to rest on the collimator.

True

True/False: A hand routine for a 7 year old would be the same as for an adult patient

True

True/False: A piece of lead vinyl can be placed beneath the child's lower pelvis during conventional fluoroscopy to reduce the gonadal/mean bone marrow dose.

True

True/False: A radionuclide study for vescourethral reflux provides a smaller patient dose compared with a fluoroscopic voiding cystourethrogram.

True

True/False: A small balloon retention catheter may be placed within the stoma of the colostomy to deliver contrast media during a barium enema.

True

True/false: the lumbar possesses a concave posterior spinal curvature.

True

Cavity

True pelvis

Forms the actual birth canal

True pelvis

Found below the pelvic brim

True pelvis

Lesser pelvis

True pelvis

What distinguishes a true rib from a false rib

True ribs connect to the sternum by their own costocartilage False ribs connect to the sternum via the costocartilage of the seventh (7th) rib

True or False: Any orthopedic device or appliance of the hip should be seen in its entirety on an AP hip radiograph.

True.

True or False: Both joints must be included on an AP and lateral projection of the femur even if a fracture of the proximal femur is evident.

True.

True or False: Geriatric patients are often more prone to hip fractures because of their increased incidence of osteoporosis.

True.

Name for the aspect of the ribs which articulates with the transverse process of the thoracic vertebrae

Tubercle

Name of the process on the rib that articulates with the vertebrae

Tubercle

Minimum number of projections needed for AP of the sacrum and Coccyx

Two - different CR angles needed (lateral can be combined)

modality: major advantage of no ionizing rad. useful for neuro sx procedures (shunt placement/intracranial structures on infants with open fontanels) used to dx congenital hip dysplasia and pyloric stenosis used on children with sickle cell anemia to image blood vessels and vascular spasm to dx CVA. allows dx of genetic abnormalities

re abuse: beneficial for visceral damage (hemorrhage) with the added benefit of no radiation

caused by bacteria, viruses, fungi, or parasites. bacterial infections in newborns involving the bladder and urethra most common in M, but after age 1, more common in F. most common cause is the vesicoureteral reflux

UTI

Positioning error shown if the x-ray of an RAO sternum shows part of the sternum superimposed over the thoracic spine

Underrotation of the patient

How many degrees is the upper margin of the greater trochanter from the superior border of the symphysis pubis and ischial tuberosity?

Upper margin of the greater trochanter is approx. 1 inch (2.5 cm) degrees above level of superior border of the symphysis pubis and the ischial tuberosity is about 1 1/2-2 in. (4 to 5 cm) degrees below.

Chest or Upper/lower limb radiographic procedure: Kohler's disease

Upper/lower limb

Chest or Upper/lower limb radiographic procedure: Talipes

Upper/lower limb

Three factors which will help with a young female outpatient who has had repeated exposures for scoliosis study and is concerned about radiation

Use higher kV, Perform PA rather than AP, Use breast shields

Name of the most posterior end of the rib

Vertebral end

Name of the posterior end of the rib

Vertebral end

Location (end) of the rib cotaining the neck and the head

Vertebral end (posterior)

A VCUG on a child is most commonly performed to evaluate for __________________ and is generally scheduled to be completed BEFORE an IVU or ultrasound study of the kidneys.

Vesicoureteral reflux

A backward flow of urine from the bladder into the ureters and kidneys is called ___________.

Vesicoureteral reflux

1. Cecum 2. Colon 3. Rectum 4. Anal canal

What are the 4 major sections of the large intestines?

1. Peristalsis 2. Haustral churning - squeezing into the next group of haustra 3. Mass peristalsis - every 24 hours 4. Defecation

What are the 4 movements throughout the large intestines?

1. Ascending colon 2. Hepatic (right colic) flexure 3. Transverse colon 4. Splenic (Left colic) flexure 5. Descending colon 6. Sigmoid colon

What are the 4 sections and 2 flexures of the colon?

Ossa coxae and innominate bones

What are two additional terms used for the right and left hip

Compensating filter

What device should be used for an axiolateral projection of the hip to equalize density of the hip region

Rectal ampulla

What dilated portion of the rectum is located anterior to the coccyx?

A small bowel series (SBS) radiographic examination combined with an upper gastrointestinal (UGI) radiographic examination

What is a small bowel follow-through?

S3 and is about 4.5 in. long.

What is the anatomical landmark where the rectum is found?

1. Internal diameter of the large bowels is greater 2. Large bowel contains taeniae coli & haustra 3. Large bowel is located along the periphere of abdomen while small bowel is located centrally

What is the major differences between the large and small bowels?

Amphiarthrodial

What is the mobility of the symphysis pubis?

Plicae circulares

What is the older term for the mucousal folds found within the jejunum?

Annular carcinoma

What it the most common form of carcinoma found in the large intestine?

12 degrees cephalad

What type of CR angle is used for a PA axial oblique projection

15 to 30 minutes after ingesting contrast medium

When is the first radiograph generally taken during a small bowel series?

When gonadal shielding should not be used during studies of the lumbar spine, sacrum, and coccyx

When shielding could obscure essential anatomy

When is the urinary reflux most likely to occur during a VCUG?

When the bladder is full and when voiding

To the posteromedial surface of the cecum

Where is the vermiform appendix usually attached?

AP Axial (INLET/OUTLET) OR JUDET Method (Posterior Obliques)*

Which additional projection can be performed on a possible pelvis ring fx? (WS)*

AP Axial Inlet Projection*

Which additional projection can be performed to demo. an injury to the symphysis pubis?*(WS)

Small intestine

Which aspect of the GI tract is primarily responsible for digestion , absorption, and reabsorption?

large intestine

Which aspect of the GI tract is responsible for the synthesis and absorption of vitamins B and K and amino acids?

Anorectal angle

Which aspect of the large intestine must be demonstrated during evacuative proctography?

1.Timing of the procedure is necessary 2. May be performed as a double contrast media study 3. An enterolyctic procedure

Which conditions pertains to the radiographic study of small intestines?

Ileum

Which division of the small intestine is the longest?

Duodenum

Which division of the small intestine is the shortest?

Left colic (splenic) flexure

Which flexture of the large intestine usually extends more superiorly?

Sonography (Ultrasound)

Which modality is used to assess joint stability during movement of the lower limbs on infants

Which modality will best demonstrate a possible pelvic ring fracture

Suspensory muscle of the duodenum (ligament of Treitz)

Which muscular band marks the junction between the duodenum and jejunum?

ischial tuberosity

Which of the following bony landmarks is located posterior to the acetabulum?

Pa axial oblique

Which of the following projections is recommended to demonstrate the superposterior wall of the acetabulum

1. Cecum 2. Transverse colon 3. Sigmoid colon

Which parts of the colon is found more anteriorly?

1. Ascending colon 2. Descending colon

Which parts of the colon is found more posteriorly?

Osteoarthritis

Which pathologic indication has a hallmark sign of spurring and narrowing of joint space

Pelvic ring fracture

Which pathologic indication shows bilateral radiolucent lines across bones and misalignment of SI joints

Ankylosing Spondylitis (AS)

Which pathologic indication shows early fusion of SI joints and bamboo spine

DDH (developmental dysplasia of the hip)

Which pathologic indication shows increased hip joint space and misalignment

Foot rotated externally

Which physical sign me indicate that a patient has a fracture

Ileum

Which portion of the small intestine has the smoothest internal lining and does not present a feathery appearance when barium filled?

Evacuative proctography

Which procedure uses the thickest mixture of barium sulfate?

Bilateral modified Cleaves

Which projection or method is often performed to evaluate a pediatric patient for congenital hip dislocation

Axiolateral (Danelius-Miller)*

Which projection provides the greatest amount of gonadal dose for a male pt?*

Transverse colon & sigmoid colon

Which structures will fill with air during a double contrast barium enema with the patient supine ?

Cecum & rectum

Which two aspects of the large intestine are not considered part of the colon?

1. Regional enteritis (Crohn's) 2. Malabsorption

Which two pathological conditions are best evaluated through an enteroclysis procedure?

Infants younger than 2 years.

Which type of patient usually experiences intussusception?

Disorder of proximal small intestine

Whipple's disease

Proximal small intestine

Whipple's disease is a rare disorder of the _________, that causes malabsorption

RAO position places the esophagus between the vertebral column & the heart

Why is RAO preferred over LAO for an esophagram?

to mark or "tag" fecal matter

Why is oral contrast medium sometimes given during a CTC?

Makes it a True AP and the lesser trochanters will not be visible.*

Why must the lower limb be rotated 15-20 degrees internally for an AP hip/pelvis projection?*

Pt build which may require CR angulation and support under the waist in order to open the intervertebral joint spaces during lateral lumbar spine projection

Wide pelvis and narrow thorax

Cecum

Widest portion of the large intestine

Tumor that usually occurs in children younger than 5

Wilms' tumor

Best position for the spine of a scoliosis Pt in lateral

With the sag or convexity of the spine closest to the IR

Most distal portion of the sternum

Xiphoid Process

Patient in motor vehicle accident experiencing neck pain. Not wearing collar. Should tech take a horizontal beam lateral projection and have it cleared before proceeding with study?

Yes, possible fracture. Dr. should examine horizontal lateral to clear for remaining projections.

Should a gonadal shield be used for a hip study on a young male patient?

Yes. Top of shield should be placed at the inferior margin of symphysis pubis.

NO. The entire prosthetic must be visible on both AP and Lateral Views!*

Your lateral projection of the hip prosthetic device reveals that the proximal end is cut, but was demo. on the AP image, acceptable??*

AP Pelvis & Frog-Leg (cleaves)*

Your patient presents with chronic pain of left hip. What projections should the radiographer proceed with?*

Joint made up by the ear and front leg of the "Scottie Dog" best seen in the oblique position

Zygapophyseal

Which joints are found between the superior and inferior articular processes?

Zygapophyseal joint

rule out esophageal varices

a patient with clinical history of cirrhosis of the liver with acute GI bleeding comes to the radiology department. what may be the most likely reason that and esophagogram was ordered for this pt

Total sternum length for an average adult

about six (6) inches

urinary pathologic term: renal agenesis

absence of a functioning kidney

most common form of short-limbed dwarfism. condition results in decreased bone formation in growth plates of long bones. UE/LE are short with normal torso length

achondroplasia

mastication

act of chewing

deglutition

act of swallowing

urinary pathologic term: micturition

act of voiding

decrease patient rotation to 40 degrees for an astenic patient

an UGI series is performed on an asthenic patient. a radiograph of the RAO shows that the duodenal bulb and C-loop are not in profile. The tech rotated the patient 70 degrees. What modification can be made on the repeat exposure

which type of reaction is a true allergic response to iodinated contrast media

anaphylactic reaction

a condition characterized by regions or areas of subcutaneous swelling caused by allergic reaction to food or drugs is termed

angioedema

cercicothoracic lateral position demonstrates superimposition of the humeral heads over the upper thoracic spine. because of an arthritic condition, the patient is unable to rotate the shoulders any farther apart. what can be done to seperate the shoulder

angle CR 3-5 degree caudad

a form of RA

ankylosing spondylitis

outer and inner asepcts of the intervertebral disk

annulus fibrosus and nucleus pulposus

Which region of the large intestine must be visualized during an evacuative proctogram study?

anorectal angle

Barium swallow

another term for esophagogram

for most IVU, veins in the ____ are recommended for venipuncture

antecubital fossa

May be caused by cutting off blood supply to it or infection

appendicitis

short column of bone found between the superior and articular processes in a typical cervical vertebra

articular pillar

the following strcutres is best demonstrated with an AP axial vertebral arch proj.

articular pillars (lateral masses) of cervical spine

mechanical obstruction. most common in small kids when foreign objects are swallowed/aspirated into air passageway of bronchial tree

aspiration

most common in kids, generally caused by anxiety/allergies. airways are narrowed by stimuli that do not affect airways in normal lungs. breathing is labored and lungs may result in increased radiodensity in the lungs

asthma

which type of pt is a likely candidate for the premedication procedure before a contrast study

asthmatic pt

when does the timing for an IVU exam start

at start of injection of contrast media

where is the CR centered for an AP axial projection for L5-S1?

at the ASIS, MSP angle is 30-35 degrees

where is the metaphysis located?

at the ends of the diaphysis

what other diseases can aspiration cause?

atelectasis and bronchiectasis

alternative names for C1

atlas

congenital conditon that requires sx b/c opening to an organ is absent. such as: imperforate anus

atresias

30-40 ml

average capacity of the adult gallbladder

alternative names for C2

axis

urinary pathologic term: urinary reflux

backward return flow of urine

Which of the following imaging modalities/procedures is often performed to diagnose and may treat an intussusception? barium enema enteroclysis nuclear medicine scan CT

barium enema

when do most primary centers of bone formation appear?

before birth

Pathology of the sternum is most commonly due to:

blunt trauma

center portion of sternum

body

two main parts of a typical vertebra are the

body and vertebral arch

intravenous contrast media may be administered by either

bolus injection and drip infusion

what is the older term for glomerular capsule

bowman capsule

Mueller maneuver

breathing exercise where patient exhales then tries to inhale against a closed glottis - for diagnoasis of esophageal reflux

fundus

broadest portion of gallbladder

greater curvature

broder along the lateral side of the stomach

contractions of muscle within the walls of the bronchi and bronchi0les, producing a restriction of air passing through them is called

bronchospasm

common bile duct

carries bile from the cystic duct to the duodenum

develops as child learn to hold head erect

cervical spine

hepatopancreatic sphincter

circular muscle fibers adjacent to duodenal papilla

two important benefitis of an SID longer than 40-44 inches for lateral cervical spine proj

compensate for increased OID and reduce magnification

urinary pathologic term: anuria

complete cessation of urinary secreaton

anterior wedging and loss of vertebral body height are characteristics of

compression fracture

lesser curvature

concave border along the medial side of the stomach

cholelithiasis

condition of gallstones

Another term for the CML injury is:

corner fracture.

which two things can be done to produce equal density along the entire thoracic spine for the AP proj. (especially for a patient with a thick chest )

correct use of anode-heel effect; use of compensating (wedge) filter

iodinated contrast media used for urography: ionic

creates a hypertonic conditon in the blood plasma

primarily seen in kids 1-3 years old. caused by viral infection. evidenced by labored breathing and harsh dry cough frequently accompanied by fever

croup

the modified body of C2 is

dens or odontoid process

AP Pelvis*

describe the projection which a radiographer will perform first on any type of pelvis/hip Trauma?*

retroperitoneal

describes the position of the c-loop of the duodenum and pancreas in the body

inferiorly and anteriorly

describes the way the body of the stomach curves from the fundus of the stomach

pyloric sphincter

developmental problems with this portion of the pyloris are common in babies and causes them to spit up a lot

Which type of health condition may restrictt the use of glucagon during a barium enema?

diabetes

metformin hydrochloride is a drug that is taken for the management of

diabetes mellitus

which one of the following compounds is a common anion found in ionic contrast media

diatrizoate or iothalamate

dysphagia

difficulty swallowing

urinary pathologic term: oliguria

diminished amount of urine being excreted

Inflammation of small herniations of the intestinal wall

diverticulitis

Condition of small herniations present along the intestinal wall

diverticulosis

Jagged or sawtooth appearance of the intestinal wall

diverticulosis

What distinguishes a floating rib from a false rib?

does not posses costocartilage

How should the arms be positioned for an erect lateral projection of the sternum?

drawn back

cystic duct

duct connected directly to gallbladder

ulcer

during an UGI the radiologist reports that she see a "lucent-halo" sign in the duodenum. What form of pathology did the radiologist see

Valsalva maneuver, and for esophageal reflux

during an esophagogram the radiologist asks the pt to try to bear down as is having a bowel movement. What is the maneuver called and why did the radiologist make the request

Sliding hiatal hernia

during an esophagogram, the radiologist remarks that Schatzki's ring is present. Which condition or disease process is indicated by the presence of this radiographic sign?

normal kidney that fails to ascend into the abdomen but remains in the pelvis

ectopic kidney

in addition to notifying a nurse or a physician when contrast media has extrasvasated into the soft tissue, what should the tech first do to increase reabsortion

elevate the affected extremity or use a cold compress followed by a warm compress.

hepatopancreatic ampulla

enlarged chamber in distal aspect of common bile duct

choledocholithiasis

enlargement or narrowing of the biliary ducts due to the presence of stones

Inflammation of the small intestine

enteritis

A patient has a clinical history of regional enteritis. Which of the following procedures is most often performed for this condition?

enteroclysis

the leakage of contrast media from a vessel into the surrounding soft tissue is called

extravasation (infiltration)

T/F: it is possible to shield females for an AP projection of the sacrum or coccyx if the gonadal shields are correctly placed.

false

if close collimation is used during conventional(analog) radiography of the spine, the use of lead maskig (blockers) is generally not required

false

tip of the odontoid process does not have to be demonstrated on the AP "open mouth" proj. because it is seen on the lateral proj.

false

the zygapophyseal joints of all cervical vertebrae are visualized only in a true lateral pos.

false ( between C1-C2 visualized on frontal or AP proj. )

T/F: Ankylosing spondylitis usually requires an increase in manual exposure factors?

false - none

true/false: tissue inflammation from extravasated contrast media peaks 1-2 hours after the incident.

false peaks 24-48 hours after extravasation

true/false: vasovagal reactions are not considered life threatening

false.

true/false: the efferent arterioles carry blood to the glomeruli

false. (afferent)

true/false: the brodney clamp is used for male and female retrograde cystourethrograms

false. used only for males

T/F: the female gonadal dose is approximately equal for either AP or PA projections of the lumbar spine

false: 20-30% less dose

gastric canal

formed by rugae along the lesser curvature of the stomach - funnels fluids directly from the body of the stomach to the pyloris

Dilation of the intestine with thickening of the circular folds

giardiasis

inflammation of the capillary loops of the glomeruli of the kidneys

glomerulonephritis

What drug can be added to the barium sulfate mixture to minimize intestinal spasm during a barium enema?

glucagon

False pelvis

greater pelvis, formed primarily by the ALA of ilium, supports the lower abdominal organs

fracture through the pedicles and anterior arch of C2 with forward displacement upon C3

hangman's fx

the following conditions is a common pathologic indication for an IVU

hematuria

condition involving a "slipped disk" is correctly referred to as

herniated nucleus pulposus (HNP)

Which aspect of the small intestine is considered the longest?

ileum

for the lateral L5-S1 projection, the CR is parallel to the _______________ plane.

interiliac plane

true pelvis

lesser pelvis, cavity, forms actual birth canal, found below the pelvic brim..

bile

liquid substance that aids in digestion and is manufactured in the liver and stored in the gallbladder

contrast media reactions: pulmonary edema

local

lesser curvature

location of the angular notch of the stomach

Apple-core lesion

neoplasm

String sign

regional enteritis

the kidneys and ureters are located in the ____ space

retroperitoneal

"Gastro"

stomach

alternative names for C7

vertebra prominens

Volvulus

"Beak Sign"

Change in manual exposure factor? Idiopathic juvenile osteoporosis

(-)

Change in manual exposure factor? Osteogenesis imperfecta

(-)

Change in manual exposure factor? Osteomalacia

(-)

True

(T or F) Fluoroscopy is sometimes used during a small bowel series to visualize the ileocecal valve.

False - 24 hours

(T or F) It takes approximately 12 hours for barium sulfate in a healthy adult, given orally to the reach the rectum.

Amount of rotation of the thorax recommended for an anterior oblique of the sternoclavicular joints

10°-15° from PA

Numbered pairs of ribs that are classified as floating

11th through 12th ribs

number on bones thoracic

What type of CR angle is required for the PA axial oblique (Teufel method) for acetabulum?

12° cephalad

The large joint space between C1 and C2 is called the

Atlantoaxial joint

Congenital defect in which the opening to an organ is missing

Atresia

Specific oblique position best demonstrates the left sternoclavicular joint adjacent to the spine

LAO

Which one of the following positions or projections will best demonstrate the right axillary ribs?

LAO

A patient is unable to lie prone on the radiographic table during a barium enema. Which specific projection best demonstrates the right colic flexure?

LPO

Alternate position if Pt cannot assume recumbent RAO

LPO

Lower rectum

Name the Infraperitoneal structures of the lower abdomen.

The microscopic unit of the kidney

Nephron

An abnormal drop of more than 2 inches, or 5 cm, in the position of the kidneys when the patient is erect.

Nephroptosis

Which structure makes up the inner aspect of the intervertebral disk?

Nucleus pulposus

Patient position angle which best demonstrates the lumbar zygapophyseal joints

Oblique (30°-50°)

The best course of action for a patient experiencing a mild level contrast media reaction

Observe & reassure patient

Describe or Define: Ileus

Obstruction caused by lack of contractile movement of the intestinal wall

Which exam is associated with CHD?

Pelvis & Hips

Which exam is associated with Legg-Calve-Perthes disease?

Pelvis & Hips

Positioning error shown when spinous processes are not midline to the vertebral column and distortion of the vertebral bodies is present (AP lumbar spine)

Rotation of the spine

Vertebral level of the ASIS

S1-S2

xiphoid process (tip)

T9-T10

Situation: A radiograph of an AP pelvis shows overall that hte image is underexposed (underpenetrated). The following analog factors wree used; 80 kV, 40 in SID, Bucky, and AEC with the center chamber activated. Which of these factors should be changed to produce increased image density?

When using AEC chambers for an AP pelvis projection, the left and right ionization chambers must be activated. The center chamber is over the less dense pelvic cavity (underexposed image)

Situation: A radiograph of an AP pelvis reveals that overall the image is underexopsed (underpenetrated). The following factors were used: 80kV, 40in SID, Bucky, and AEC with the center chamber activated. Which one of these factors should be changed to produce a darker and more diagnostic image?

When using automatic exposure control (AEC) for an AP pelvis projection, the left or right ionization chambers must be activated. The center chamber is over the less dense pelvic cavity, which may lead to an underexposed image.

Schatzki's ring

a radiographic sign caused by a sliding hiatal hernia which is a ring-like constriction at the distal esophagus

chyme

a semiliquid mass of partially digested food that passes from the stomach through the pyloric sphincter into the duodenum

Young and dehydrated

What type of patients should be given extra care when using a water soluble contrast medium?

High density barium and air or methylcellulose

What types of contrast media are used for a enteroclysis?

Not enough cephalad CR angle. Males: 20-25 Females: 30-45*

What will cause the obturator foramina to appear foreshortened on the Taylor Projection?*

When the contrast medium passes through the ileocecal valve

When is a small bowel series deemed completed?

AP axial of the cervical spine, a plane thorugh the tip of the mandible and ____ should be parallel to the angled CR

base of skull

enlargement of prostate gland

benign prostatic hperplasia

where is the pars interarticularis found?

between superior and inferior articular processes

"Chole"

bile

"Cysto"

bladder

hematemesis

blood in vomit

where does squeezing of the thorax allow for fx at?

costovertebral and costotransverse joints

deformity of the skull caused by premature closure of skull sutures. most common type involves the sagittal suture and results in elongation of the skull

craniostenosis

presence of multiple fx in the healing stage

healing fx

projections is considered a "functional study" of the cervical spine

hyperextension and hyperflexion lateral position

10 contraindications that may prevent a pt from having a contrast media procedure

hypersensitivity to iodinated contrast media, anuria, multiple myeloma, diabetes mellitus, severe hepatic or renal disease, congestive heart failure, pheochromocytoma, sickle cell anemia, pt on metformin or similar medication, and renal failure acute or chronic.

form of intestinal obstruction that IS NOT a mechanical obstruction, but rather an obstruction caused by lack of contractile movement of the intestinal wall.

ileus

What are the three divisions of the hip bone?

ilium, iscnium, and pubis.

What type of movement does the first sternocostal joint have? Plane (gliding)-diarthrodial or Immovable- synarthrodial

immovable- synarthrodial

urinary pathologic term: retention

inability to void

Hyposthenic/Asthenic

includes the low and vertical stomach with the duodenal bulb at the level of L3-L4

iodinated contrast media used for urography: non-ionic

is a near-isotonic solution

The part of of the intestine with a "feathery" and "coiled spring" appearance when filled with barium is the:

jejunum

abnormal, or exaggerated, "sway back" lumbar curvature is called

lordosis

radiographic apperances : abnormal rotation of kidney

malrotation

body

middle aspect of gallbladder

Does an asthenic patient require a little more or a little less obliquity than a hypersthenic patient in the RAO position of the sternum?

barium sulfate

most common radiopaque contrast medium used in the GI system

spiral valve

mucosal folds in the cystic duct

neoplasm

new tumor growth that can be benign or malignant

imaging modality is ideal for dectecting early signs of osteomyelitis

nuc med

esophageal reflux

older term for GERD

which two processes move urine through the ureters to the bladder

peristalsis and gravity

trapped vegetable fiber in the stomach

phytobezoar

multiple cysts in one or both kidney

polycystic kidney disease

urinary pathologic term: pneumouria

presence of gas in urine

emulsification of fats

primary function of bile

iodinated contrast media used for urography: non-ionic

produces less severe reactions

bacterial infection of the kidneys. most commonly associated with vesicoureteral reflux of urine from the bladder back to the kidneys

pyelonephritis

overgrowth in the muscles of the pylorus causing a narrowing/blockage at the pylorus/stomach outlet that occurs in infants, resulting in repeated/forceful vomiting

pyloric stenosis

cholecystocholangiography

radiographic examination of both the gallbladder and the biliary (bile) ducts

esophagram or barium swallow

radiographic examination of the pharynx and esophagus

upper GI

radiographic study of the distal esophagus, stomach, and duodenum

hyaline membrane disease. one of the most common indicators for infant chest xray. alveoli/capillaries of the lung are injured/infected, resulting in leakage of fluid/blood into alveolar spaces. increased density in the lungs in a granular pattern

respiratory distress syndrome

Which specific positioning error is present when the left iliac wing is elongated on an AP pelvis radiograph?

rotation toward left side

Which specific positioning error is present when the left obturator foramen is more open than the right side on an AP pelvis radiograph?

rotation toward right side

mucousal folds

rugae

fx involving epiphyseal plates. classified based on location of the fx and involvement of anatomy. there are 9 total classifications, but 1-5 are most common

salter-harris fx

abnormal lateral curvature of the spine

scoliosis

in which department are most retrograde urograms perfomred

surgery in or outpatient facility

What is the name for the band of muscular tissue found at the junction of the duodenum and jejunum?

suspensory ligament of the duodenum

Stove-pipe appearance of colon

ulcerative colitis

the opening, or passageway, for the spinal cord is

vertebral (spinal) canal

"Angio"

vessel

iodinated contrast media used for urography: non-ionic

will not significantly increase the osmolality of the blood plasma

cancer of the kidneys of embryonal origin. usually occurs in kinda under 5. MOST common abd cancer in infants/kids. typically only involves 1 kidney

wilm's tumor

What is the most distal aspect of the sternum?

xiphoid process

most inferior aspect of sternum (landmark)

xiphoid process

normal B.U.N levels for an adult should range between

8-25 mg/100 mL

rhythmic segmentation

A churning or mixing activity present in the small intestine

Adenocarcinoma

Apple core sign

Name of the section of cartilage that connects the anterior end of the rib to the sternum

Costocartilage

Premature closure of the skull sutures

Craniostenosis

What are the two important radiographic landmarks found on the ilium?

Crest of the ilium (iliac crest) and the Anterior Superior Iliac Spine (ASIS)

At approximately what age does the epiphysis of the fibular apex first become clearly visible? A. 1 or 2 years old B. 3 or 4 years old C. 5 or 6 years old D. 12 years old

D. 12 years old

What type of CR angle is used for a PA axial oblique (Teufel) projection? A.) 15 degrees cephalad B.)1 to 20 degrees cephalad C.)5 degrees caudad D.)12 degrees cephalad

D.)12 degrees cephalad

How much obliquity of the body is required for the posterior oblique projection? A.)None (central ray is perpendicular) B.)20 degrees C.)30 degrees D.)45 degrees

D.)45 degrees

Epiphysis, Diaphysis, or Epiphyseal plate? Continues to change from birth to maturity

Epiphysis & Epiphyseal plate

How can the lower thoracic vertebrae be identified?

Evident by facets for articulation with ribs on upper three, but not on lower two.

AP open mouth projection of c spine demonstrates the upper incisors superimposed over top of dens. Positioning errors?

Excessive flexion of skull

T/F A pediatric patient should not have solid food 8 hours before an IVU.

False

T/F It is the responsibility of the technologist to make the determination if child abuse has occurred and then report it to law enforcement.

False

T/F The Pigg-O-Stat can be employed for pediatric skull procedures.

False

T/F The mummifying technique is highly effective for immobilization of the lower limbs of children.

False

True/False: Latex enema tips should be used for barium enemas for children younger than 1 year of age.

False (Latex tips should not be used because of possible allergic response to latex)

Best position during exam for an outpatient with clinical Hx of spondylolisthesis at L5-S1

Lateral L5-S1 position would demonstrate degree of forward displacement of L5 onto S1

Radiologic position which best demonstrates the intervertebral foramina

Lateral Position

Aspect of the sternum containing the jugular notch

Manubrium

Recommended NPO fasting before the pediatric contrast media procedure: Infant lower GI

No prep required

AKA Rickets

Osteomalacia

Diverticulum

Outpouching of the mucousal wall

Situation: A radiograph of a RPO position taken during an IVU reveals that the left kidney is foreshortened & superimposed over the spine. What is the positioning error?

Overrotation of the body will foreshorten the kidney and superimpose it over the spine

Positioning error to correct when an RAO sternum shows the width of the sternum foreshortened and the sternum is shifted away from the spine and out of the heart shadow (hypersthenic Pt)

Overrotation of the sternum, only need to rotate 15° for large or barrel-chested Pt

Alternate projection to be taken if Pt cannot lie on their back for an AP sacrum

PA (prone) with 15° caudal CR angle

Projections to be performed for a unilateral rib study (ER Pt with right upper anterior rib injury)

PA and LAO - upright if possible

Best exam for an ER Pt with a coccyx injury who cannot lie on his back or stand

Perform PA rather than AP and reverse the CR angle from caudal to cephalad

Best practice to minimize "fogging" on lateral lumbar spine, sacrum or coccyx (other than collimation)

Placing a lead blocker mat on the table behind the Pt

Position that produces a radiograph showing the fundus filled with barium

What is the other name for an AP axial for pelvic "outlet" bones?

Taylor

Bucky slot shield (at end of table)

The device that greatly reduces exposure to the technologist from the fluoroscopic x-ray tube

common hepatic duct

The duct formed by the union of the left and right hepatic ducts

C5-6 to T11

The esophagus extends from:

Duodenal bulb or cap

The first part of the superior portion of the duodenum

What forms the costovertebral joint?

The head of the rib and the body of the thoracic vertebra

Umbilicus

The initial insertion of the rectal enema tip should be pointed toward the _______

Right

The largest lobe of the liver

Transverse colon

The longest aspect of the large intestine

Adenocarcinoma

The most common form of carcinoma in the esophagus

What is the largest foramen in the skeletal system?

The obturator foramen of the pelvis

duodenal bulb

The part of the upper GI tract that is a common site for ulcer disease

lateral

The projection taken during an upper GI that will best demonstrate the retrogastric space

It forces the barium sulfate against the mucosa for better coating

The purpose of the gas with a double-contrast media technique

Reason why it is impossible to visualize the sternum with a direct PA or AP projection

The spine would superimpose - requires slight rotation

Which radiographic structures are evaluated to determine rotation on a PA projection of the chest?

The sternoclavicular joints and lateral rib margins should be equidistant from the vertebral column

Lidocaine

To minimize spasm during a barium enema, ________ can be added to the contrast mixture.

Reason why it is beneficial to lay a lead blocker mat behind the Pt spine during lateral lumbar projections

To prevent secondary scatter from reaching IR which increases radiographic "noise"

Reason why a single lateral projection of the sacrum and coccyx should be taken rather than separate laterals

To reduce gonadal dose to Pt

Reason for the recommended SID for lateral projection of the sternum

To reduce magnification created by a long SID

With what injury do we use Axiolateral/inferosuperior (Danelius-Miller) projection?

Trauma

With what injury do we use the Modified axiolateral (Clements-Nakayama method)?

Trauma

With what type of injury do we use the AP axial for pelvic outlet (Taylor method)?

Trauma

The axiolateral (inferosuperior) projection is designed for what type of situations?

Traumatic

T/F A technologist's attitude is one of the more important factors in making a pediatric procedure a success.

True

T/F Fear and combative resistance from a young child are common initial responses to a radiographic procedure.

True

The AP obliques (JUDET) ~RPO and LPO~*

Which positions will best demonstrate the ilioischial column and iliopubic column of the pelvis?*

LPO recumbent

a radiograph of an UGI is no labeled correctly, the technologist is unsure of what position was performed. a double contrast GI study was completed with all position recumbent. barium in the fundus and air in the body and pylorus and the duodenal bulb in profile

AP performed recumbent

a radiograph taken during a double contrast UGI demonstrates that the fundus is barium filled and the body is air filled. What position does this radiograph represent

waste

bile after it passes the cystic duct

two most common types of needles used for bolus injection of contrast media

butterfly and over-the-needle-catheter

what should the tech do first when a pt is experiencing either a moderate or a severe level contrast media reaction

call for medical assistance.

Distance

cardinal principle most effective in reducing exposure to the technologist

true/false: the bevel of the needle needs to be facing downward during the actual puncture into a vein

false. (facing upward)

true/false: the radiologist is responsible for documenting all aspects of the venipuncture procedure in the pt's chart

false. the tech or person performing the venipuncture is responsible

exposure factors used during a CT procedure can be adjusted to compensate for a decrease or increase in body size according to

height and weight

blood in the urine. caused by various conditions such as: kidney/bladder cancer, kidney stones, kidney cysts, sickle cell disease

hematuria

patient with a possible cervical spine injury enters the ER. the patient is on a backboard. which proj of the cervical spine should be taken first

horizontal beam lateral projection

fusion of the lower poles of kidneys during the development of the fetus

horse shoe kidney

35-40 degrees

how much rotation should be used for an RAO esophagogram projection

15-20 degrees internally*

how should the radiographer rotate the lower limbs so that the lesser trochanters will not be visualized on an AP pelvis?*

a patient who has been in a MVA enter the ER. the basic proj of the cervical spine reveals no subluxation (partial dislocation) or fracture. the physician wants the spine evaluated for whiplash injury. which additonal proj. would best demonstrate this type of injury

hyperextension and hyperflexion lateral positions

bones become less dense/more fragile in kids/young adults

idiopathic juvenile osteoporosis

when should the judd or fuchs method be performed

if unable to demonstrate the upper portion of the dens w/ the AP "open mouth" proj.

Which aspect of the small intestine possesses the small diameter?

ileum

What type of movement does the third costochondral union have? Plane (gliding)-diarthrodial or Immovable- synarthrodial

immovable- synarthrodial

iodinated contrast media used for urography: ionic

incorporates sodium or meglumine to increase solubility of the contrast media

contrast media reactions: vomiting

mild systemic

The neonate is defined as a child:

newly born.

vitamins

nutrient not digested

spiral valve

series of mucosal folds in cystic duct

chyme

term that describes food once it is mixed with gastric secretions in the stomach

1. gallbladder 2. stomach

the 2 abdominal organs most dramatically affected in relation to location, by body habitus

primary curve

thoracic spine and sacrum

Why is the PA rather than the AP recumbent position recommended for small bowel series?

to allow the separation of the loops of the intestine

Which one of the following structures is intraperitoneal?

transverse colon

many geriatric patients have a fear of falling off the radiographic table

true

inferior

which of the following is not a recognized lobe of the liver

head of pancreas and the C-loop of the duodenum

which two structures create the romance of the abdomen

a majority of the esophagus is superimposed by the spine

why is the AP projection of the esophagus not a prefered projection for the esophagus series

which two landmarks can be palpated to locate the kidneys

xiphoid process and iliac crest

the ear and front leg of the "Scottie dog" make up the ___________ joint, best seen in oblique position.

zygapophyseal

the following is found between the superior and inferior articular processes

zygapophyseal joints

(Q) Parallel to femoral neck.

(Q) How is the cassette aligned for an axiolateral (Danelius-Miller) proj.?

(Q) Males between 5-10 yo.

(Q) Legg-Calve Perthes disease usually involves...

(Q) 20-30 degrees

(Q) To minimize distortion of the femoral neck for an AP bilateral frog-leg projection, the lower limbs should be abducted...

(Q) 20-35 degrees cephalad

(Q) What type of CR angle is required for the AP axial "Outlet" Projection for a male pt?

(Q) Clements-Nakayama Method

(Q) Which of the following projections is best suited for the patient with limited movement of both lower limbs to demo. a lateral perspective of prox. femur?

(Q) 35-40

(Q) how much is the affected side rotated for the PA axial oblique (Teufel Method.)?

fovea capitis

(Q) the depression or pit located

At the first meeting between the technologist and the patient (accompanied by an adult), which of the following generally should NOT be discussed?

. Describe the total amount of radiation the patient will receive with that specific exam if it has to be repeated because of lack of cooperation

If a child is suspected by the technologist, he or she should:

. Report the abuse immediately to your supervisor

Classic metaphyseal lesion (CML) is a fracture involving the:

. metaphysis.

Which central ray (if any) is used for posterior oblique projections of the acetabulum (Judet method)?

0 degrees (perpendicular)

The normal range of creatinine in an adult

0.6 to 1.5 mg/dl

the normal creatinine level for an adult should range between

0.6-1.5 mg/dL

For a young pediatric small bowel study, the barium normally reaches the ileocecal region in _____ hour.

What is the average transit time for the barium to reach the ileocecal valve during a pediatric small bowel study?

1 hour

CR at the level of which structure/landmark: AP abdomen (infants and small children)

1 inch above umbilicus

Where is the CR centered for a KUB on a 3 month old infant?

1 inch above umbilicus

five step for imaging sequence for a routine IVU

1 min. nephrogram or nephrotomgraphy, 5 mins full KUB, 10-15 mins full KUB, 20 mins RPO and LAO, and postvoid erect AP or erect PA

Where is the CR centered for an erect abdomen on a small child?

1" above the umbilicus

CR centering for an oblique projection of the SI joints

1" medial from upside of ASIS

CR centering for an AP lumbar spine with an 11X14 cassette

1"-1 1/2" above the iliac crest

What must be included on the lower margin of the cassette in a scoliosis series

1"-2" below the iliac crest

Briefly describe the four steps for "mummifying" a child

1. Place the sheet on the table folded in half or thirds portrait. 2. Place patient in the middle of sheet with the right arm down to the side. Fold sheet across the patient's body and pull sheet across the body, keeping the arm against the body. 3. Place the patient's left arm along the side of the body and on top of the sheet. Bring the free sheet over the left arm to the right side of the body. Wrap the sheet around the body as needed. 4. Pull the sheet tightly so that the patient cannot free arms.

List three safeguards to help reduce repeat exposures during pediatric procedures

1. Proper immobilization 2. Short exposure times 3. Accurate manual technique charts

Two (2) specific oblique positions which can be used to elongate the left axillary portion of the ribs

1.RPO 2.LPO - these elongate left axillary ribs and shifts the spine away from the injury site

Minimum number of rib pairs that must be demonstrated on an acceptable radiograph (PA cxr)

10 posterior ribs

Situation: A routine chest study reveals a possible lesion near the right sternoclavicular joint. A PA projection of the sternoclavicular joints is taken, but the area of interest is superimposed over the spine. What specific position can be used to better demonstrate this region?

10 to 15 degree RAO will project the right SC joint adjacent to the spine.

How much rotation of the thorax is required for the anterior oblique projection of the sternoclavicular joints?

10 to 15 degrees

Typical skin dose range of the lateral projection of a scoliosis series for a small to average female

1000-1200 mrad

A routine chest study reveals a possible lesion near the right SC joint. On PA of the SC joint, the area of interest is superimposed over the spine - Name the position which would better demonstrate this region

10°-15° RAO will project the right SC joint adjacent to the spine

AP axial projection of cervical spine

15° to 20° cephalad

the most common size of needle used for bolus injections on adults is

18-22 gauges

Superior portion

1st portion of the duodenum which begins at the pylorus of the stomach

Numbered pairs of ribs that are classified as True

1st through 7th ribs

What is the average length of time in a routine small bowel series for the barium to pass through the ileocecal sphincter (healthy adult)?

2 hours

The CR and image receptor should be centered approximately ______________ higher for the 15- or 30- minute small bowel image than for the later images.

2 inches

1. C-loop of duodenum 2. head of pancreas

2 structures that create the "romance of the abdomen"

CR centering for AP sacrum projection

2" superior to symphysis pubis

for the small bowel follow thru, what is the time interval that the abdomen images are taken at?

20-30 mins

Where is the central ray placed for a bilateral frog-leg (modified Cleaves method) projection?

3 inches below the level of ASIS (1 inch above symphysis pubis)

1. parotid (largest) 2. submandibular 3. sublingual

3 pairs of salivary glands that are accessory organs of digestion associated with the mouth

Fundus, body, neck

3 parts of the gallbladder

1. esophagus 2. inferior vena cava 3. aorta

3 structures that pass through the diaphragm

Difference in height between the two ends of a rib

3 to 5 inches

At what age can most children be talked through a radiographic examination without purposeful immobilization?

3 years

each sacroiliac joint opens obliquely ______________ degrees posteriorly

The specific body position that will place the right kidney parallel to the IR

30 Left posterior oblique LPO

The kidneys lie at a ____________ angle in relation to the coronal plane

30 degree

The amount of time the venipuncture site should be cleaned with an alcohol wipe before the needle insertion

30 seconds

the angle of the mid-lumbar spine zygapophyseal joints in relation to the midsagittal plane is

30-50 degrees; upper=50, lower = 30

Degree of obliquity required for an oblique projection of the L5-S1 level of the spine

30°

How much is the CR angled to the OML for an AP axial (town) projection of a pediatric skull?

30°

CR angle required for an AP Axial L5-S1 projection on a male Pt

30° Cephalad

Patient position angle to best demonstrate the lower zygapophyseal joints

30° Oblique

How much rotation of the body is required for the LAO position during a barium enema?

35 to 45 degrees

the total capacity for the average adult bladder is

350-500 ml

CR angle recommended for the AP Axial projection of the SI joints on a female Pt

35° Cephalad

CR angulation to be used for an AP Axial L5-S1 on a female Pt

35° Cephalad

Minimum distance for the skin to be below the collimator in order to minimize patient dose for an RAO projection of the sternum

38 inches

the most reported abuse occurs in children under ___________, with the highest victimization rates in children under _________

3; 1

Horizontal portion

3rd portion of the duodenum which curves back to the left to join the final segment

Recommended NPO fasting before the pediatric contrast media procedure: 1-year-old upper GI

4 hours

The NPO fasting period for a 6-month old infant before an upper GI is:

4 hours

Recommended NPO fasting before the pediatric contrast media procedure: Pediatric IVU

4 hours (solid food)

1. superior portion (includes duodenal bulb) 2. descending portion 3. horizontal portion 4. ascending portion

4 parts of the duodenum

1. breathing exercises 2. water test 3. compression paddle technique 4. toe touch maneuver

4 radiographic tests that may be performed to detect signs of GERD

What is the minimum SID for radiography of the sternum? (Note: This is a radiation safety concern.)

40 in (100 cm). There must be a minimum of 15 inches (38 cm) between the patient's skin and the collimator.

Angle of the midlumbar spine zygapophyseal joints in relation to the MSP

45°

The amount of time a patient must be withheld from taking metformin following an iodinated contrast media procedure

48 hours

what type of CR angulation should be used for the lateral L5-S1 projection if the waist is not supported?

5-8 degree caudal angulation

how much rotation of the spine is required to demonstrate the zygapophyseal joint space between L1-L2?

50 degrees

Technical factors for an AP/PA pediatric chest: SID, AP supine chest:

50 to 60" (127 to 153 cm)

What is the kV range for a pediatric study of the upper limb?

50-60 kV

Degree of obliquity required for an oblique projection at the T12-L1 level

50°

Patient position angle to best demonstrate upper zygapophyseal joints

50° Oblique

Rotation of the spine required to demonstrate the zygapophyseal joint space between L1-L2

50° from the plane of the table

CR angle required for a lateral projection on a Pt with a wide pelvis and narrow thorax

5°-8° Caudal

CR angulation to be used for lateral L5-S1 if the waist is not supported

5°-8° caudal

What is the recommended amount of barium administered to an infant who is having an upper GI?

6-12 ounces

Recommended SID for a lateral projection of the sternum

60-72 inches

what is the recommended SID for a lateral proj. of the cervical spine

60-72 inches

What range of kV should be used for ribs above the diaphragm?

65 to 70 kV

What is the average breast dose range for each of the following projections? A posterior oblique rib projection and an anterior oblique projection.

66 mrad (50 to 100 range) ; 3 mrad (2 to 5 range)

Ideal kV range for demonstrating an injury to the ribs below the diaphragm

70kVp-80kVp (medium)

Technical factors for an AP/PA pediatric chest: SID, PA erect chest:

72" (183 cm)

Technical factors for an AP/PA pediatric chest: kV range?

75 to 85 kV

What is the minimum amount of time a patient needs to remain NPO before a small bowel series?

8 hours

The normal range of a patient's BUN

8 to 25 mg/100 ml

Which of the following digital system kV ranges is recommended for a lateral projection of the pediatric chest?

80 to 90

What kV range is generally used for a lateral chest?

80-85 kV

What temperature is recommended for barium enema mixtures?

85* - 90*

what type of catheter is used for VCUG?

8F feeding tube

Numbered pairs of ribs that are classified as false

8th through 12th ribs

Patient position angle which best demonstrates the intervertebral foramina

90° Lateral

Appendix

A blind pouch inferior to the ileocecal valve

Valsalva maneuver

A breathing technique where the patient takes in a deep breath and bears down as if having a bowel movement

rhythmic segmentation

A churning or mixing activity present in the small bowel

duodenal papilla

A common site for impation or lodging of gallstones

Diverticulitis

A condition of numerous herniations of the mucousal wall of the large intestine is called______.

achalasia (AKA cardiospasm)

A condition where peristalsis is reduced along the lower 2/3 of the esophagus - esophagogastric sphincter cannot relax during swallowing - causes dilation of the esophagus

What is pectus carinatum?

A congenital defect with an anterior protrusion of the lower sternum -pigeon chest / breast

What is pectus excavatum?

A congenital defect with an depressed sternum - funnel chest

What is Osteoarthritis?

A degenerative joint disease

What is Ankylosing spondylitis?

A disease producing extensive calcification of the longitudinal ligament of the spinal column.

Describe or Define: Neonate Graves' disease

A form of hyperthyroidism

Celiac disease

A form of sprue

Pelvic ring fracture

A fracture resulting from a severe blow to one side of the pelvis

What is a pelvis ring fracture?

A fracture resulting from a severe blow to one side of the pelvis.

A geriatric patient with an extremely rotated lower limb may have:

A fractured proximal femur

Fractured proximal femur

A geriatric patient with an externally rotated lower limb may have

Situation: A radiograph of an AP axial projection for anterior pelvic bones shows that the pubic and ischial bones are not elongated sufficently. The following analog factors were used for this study; 86 kV, 7 mAs, Bucky, 20 to 30 degrees central ray cephalad angle, and 40 inch source image receptor distance (SID). The female patient was placed in a supine position on the table. What must be changed to improve the quality of the image during the repeat exposure?

A greater CR angle is required. Female patients require a CR angle of 30-45 degrees.

What is metastatic carcinoma?

A malignancy spread to bone via the circulatory and lymphatic systems or direct invasion.

What is chondrosarcoma?

A malignant tumor of the cartilage of hip

Therapeutic intubation

A procedure to alleviate postoperative distention of a small intestine obstruction is called ___________

duodenal papilla

A protrusion into the duodenum

Left rotation (LPO)*

A radiograph of an AP pelvis reveals that the right iliac wing is foreshortened as compared with the left side. What specific positioning problem is present on this radiograph?*

Volvulus

A twisting of a portion of the intestine on its own mesentary

bolus

A wad of food going down

Which of the following CR angulations places the petrous ridges in the lower one-third of the orbits with an AP reverse Caldwell projection of the skull? A. 15 degrees cephalad to OML B. 15 degrees caudad to OML C. CR perpendicular to OML D. 30 degrees cephalad to OML

A. 15 degrees cephalad to OML

How much barium should be administered to each of the following patients for an upper GI series? A. Infants B. Adolescents

A. 30-75 mL B. 480 mL

The NPO fasting period for a 6-month old infant before an upper GI is: A. 4 hours B. 3 hours C. 1 hour D. 6 hours

A. 4 hours

Situation: A child comes to the radiology department with a clinical history of Kohler's bone disease. Which of the following radiographic routines demonstrates this condition? A. Foot B. Shoulder C. Lumbar spine D. Cervical spine

A. Foot

List five conditions that contraindicate the use of laxatives or enemas in preparation for a lower GI study

A. Hirschsprung disease B. Extensive diarrhea C. Appendicitis D. Obstruction E. Dehydration (patients who cannot withstand fluid loss)

A device with an adjustable type of bicycle seat and two clear plastic body clamps is called (A) ___________ and is is most commonly used for (B) ___________.

A. Pigg-O-Stat B. Erect chest & abdomen studies

List the three possible roles for the parent during a pediatric procedure

A. Serve as an observer in the room to lend support and comfort to the child. B. Serve as a participator to assist with immobilization. C. Remain in the waiting room, and do not accompany the child into the room.

Beyond radiography, what other imaging modality is used to diagnose congenital hip dislocations in the newborn? A. Sonography B. CT C. Nuclear medicine D. MRI

A. Sonography

Which of the following imaging modalities is most effective in diagnosing pyloric stenosis in children? A. Sonography B. Spiral/helical CT C. Functional MRI D. Nuclear medicine

A. Sonography

List the two important general factors that produce a successful pediatric radiographic procedure

A. Technologist's attitude and approach to a child. B. Technical preparation of the room.

When adhesive tape is used to immobilize a child (if not placed directly over the parts to be radiographed), what two methods are used to prevent the adhesive tape from injuring the skin?

A. Twisting the tape so that the adhesive surface is not against the skin. B. Placing a gauze pad between the tape and the skin.

A VCUG on a child is most commonly performed to evaluate for (A) ___________ & is generally scheduled to be completed (B) _________ (before or after) an IVU or ultrasound study of the kidneys.

A. Vesicoureteral reflux B. before

A malignant tumor of the kidney common in children under the age of 5 years is: A. Wilms' tumor B. Adenocarcinoma C. Ewing's sarcoma D. Teratoma

A. Wilms' tumor

Which type of pathology is best demonstrated with the posterior oblique (Judet method)? A.)Acetabular fractures B.)Anterior pelvic bone fractures C.)Proximal femur fractures D.)Femoral neck fractures

A.)Acetabular fractures

Which of the following modalities will best demonstrate a possible pelvic ring fracture? A.)CT B.)Nuclear medicine C.)MRI D.)Sonography

A.)CT

Two positions or projections that will project the dens in the center of the foramen magnum

AP Fuchs method, PA Judd method

Which projection should be taken first and reviewed by a radiologist before attempting to rotate the hip into a lateral position (if trauma is suspected)?

AP Pelvis

Two (2) rib projections which should be performed for an injury to the right posterior ribs

AP and RPO (to shift spine away from area of interest)

Positioning and breathing routine for an ER Pt with injury to right lower posterior ribs who cannot stand

AP and RPO performed recumbent on expiration

Which of the following radiographic routines and/or procedures best demonstrates Osgood-Schlatter disease?

AP and lateral knee

Which projections are frequently performed during a VCUG on a pediatric patient?

AP and oblique positions (LPO and RPO)

Situation: A physician orders a study for inlet and outlet projections of the pelvis. Which projections could be performed to meet this request?

AP axial for pelvic "outlet" (Taylor method), AP axial for pelvic "inlet" posterior oblique (Judet method).

What is the name of a special projection of the pelvis used to assess trauma to pubic and ischial structures?

AP axial outlet projection (Taylor method)

AP pelvis shows possible fracture's involving lower anterior pelvis. Physician asked for another projection to better demonstrate area of pelvis. Which projection should be taken?

AP axial outlet projection (Taylor method) will elongate the pubis and ischium and define this region more completely.

Which method is used to evaluate the pelvic inlet for possible fractures?

AP axial projection

a patient enters the ER with a posible cervical spine fracture, but the initial projections do not demonstrate any gross fracture or subluxation. after reviewing the initial radiographs, the Er physician suspects either a congenital defect or fracture of the articular pillars of C4. he wants an additional proj taken to better see this aspect of the vertebrae. which additional proj can be taken to demonstrate the articular pillars of C4

AP axial vertebrae arch (pillar) proj

a patient comes to the ER with a possible jefferson fracture. other than a lateral proj or a CT scan, what specific radiographic proj will best demonstrate this type of fracture

AP open mouth proj. the patient's mouth must be carefully opened without any movement of the cervical spine

Which position or projection best demonstrates the zygapophyseal joints between C1 and C2?

AP open mouth projection

Situation: A very young child comes to the radiology department with a clinical history. of DDH. What is the most common positioning routine for this condition?

AP pelvis and bilateral "frog-leg" (modified Cleaves method)

Routine for elderly Pt with advanced osteoporosis, both upper and lower posterior rib studies ordered

AP, RPO, LPO - All positions upright, on inspiration (upper ribs), on expiration (lower ribs) - Lower kV for osteoporosis

What two bony landmarks need to be palpated for hip localization?

ASIS and Symphysis Pubis (or greater trochanter if institution does not permit it)

Which exam is associated with Meconium ileus?

Abdomen

Which exam is associated with NEC?

Abdomen

RUQ

Abdominal quadrant containing the gallbladder

Amount of thyroid dose decrease for an anterior oblique rib projection verus a posterior oblique rib projection

About 1/3 or 33% less

Virtual colonoscopy

Another term for CT colonography (CTC) is ____________

Complete cessation of urinary secretion by the kidneys

Anuria

The veins that are not normally selected for venipuncture during an IVU

Axillary

Which radiographic procedure is commonly performed for epiglottitis? A. Sinus series B. AP & lateral upper airway C. CT of the chest D. Functional MRI

B. AP & lateral upper airway

Where is the CR centered for a lateral projection of the pediatric skull? A. At the EAM B. Midway between the glabella & inion C. 1" above the EAM D. 3/4" anterior & superior to the EAM

B. Midway between glabella and inion

Which central ray angle is required for the AP axial-outlet (Taylor method) projection for a female patient? A.)15 to 25 degrees caudad B.)30 to 45 degrees cephalad C.)20 to 35 cephalad D.)None (central ray is perpendicular)

B.)30 to 45 degrees

Name for the upper broad aspect of the coccyx

Base

What size should the IR be for a skull routine on a 6-year-old patient?

Base selection on the size of the anatomy (10 x 12 if the skull in near adult size)

How many degrees does the lower limb need to be rotated to place the femoral neck parallel to the plane of the image receptor to achieve a true AP projection?

Because of the alignment between the femoral head and pelvis the lower limb needs to be rotated 15 to 20 degrees internally.

Under what circumstances should a pregnant patient have an IVU performed

Benefit outweighs the risk

Location of the pars interarticularis

Between the superior (SAP) and inferior articular processes (IAP)

Where is the gonadal shielding placed for a bilateral hip study on a female pediatric patient?

Between the umbilicus and just above the pubis

Most common cause of pathology of the sternum

Blunt Trauma

Advantage of performing breathing technique for radiography of the sternum

Blurs lung markings and ribs, which improves the visibility of the sternum

Sign that shows there is no rotation on a PA SC projection (properly done)

Both SC joints are equal from the midline of the spine

Breathing instructions for RAO Sternum

Breathing Technique to maximize visibility

Which one of the following breathing instructions should be employed for an RAO position of the sternum to maximize visibility of it?

Breathing technique (if patient is cooperative)

What is the name of the imaginary plane that separates the false from the true pelvis?

Brim of pelvis/pelvic brim

At approximately what age does the skeleton reach full ossification? A. 12 years old B. 18 years old C. 25 years old D. 40 years old

C. 25 years old

Situation: A child comes to radiology with a clinical history of talipes equinovarus. Which of the following positioning routines and/or methods is often performed for this condition? A. Coyle method B. Erect AP knee projections C. AP and lateral foot - Kite method D. AP and lateral hip

C. AP and lateral foot - Kite method

Situation: A child comes to the radiology department with a clinical history of Legg-Calve-Perthes disease. Which of the following projections best demonstrates this condition? A. PA and lateral chest B. Supine and erect abdomen C. AP and lateral hip D. AP and lateral bilateral lower limbs

C. AP and lateral hip

Which of the following clinical indicators applies to a pediatric skull series? A. Osteomyelitis B. CHD C. Craniostenosis D. Hyaline membrane disease

C. Craniostenosis

Which one of the following techniques helps to remove the scapulae from the lung fields during pediatric chest radiography? A. Make exposure on the second inspiration B. Extend the chin C. Extend the arms upward D. Place arms behind the patient's back

C. Extend arms upward

Situation: A young child is sent to the radiology department for a skull series. The guardian states that she is willing to hold her child during the exposures; however, the guardian is 8 months pregnant. What should the technologist do next? A. Place a 0.5-mm lead apron on the guardian and allow her to hold her child. B. The technologist should hold the child during each exposure and have the guardian wait outside. C. Have another (non-radiology) health professional hold the child and have guardian wait outside the room. D. Have a radiography student hold the child and have the guardian wait outside the room.

C. Have another (non-radiology) health professional hold the child and have guardian wait outside the room.

Functional MRI has been used to detect disorders in all the following conditions except: A. Autism B. Tourette's syndrome C. Hydrocephalus D. Attention deficient hyperactivity disorder

C. Hydrocephalus

The most suitable immobilization device for erect chests and/or the abdomen is the: A. Posi-Tot B. Tam-Em Board C. Pigg-O-Stat D. Hold-em Tiger

C. Pigg-O-Stat

Which immobilization device or method should be used for an erect 1-year-old chest procedure? A. Tam-Em board B. Hold-down paddle C. Pigg-O-Stat D. Parent holding child

C. Pigg-O-Stat

Which of the following conditions can be diagnosed prenatally with sonography? A. Tourette's syndrome B. Vesicoureteral reflux C. Spina bifida D. Autism

C. Spina bifida

Which of the following devices will improve overall visibility of the proximal hip demonstrated on an axiolateral (inferosuperior) projection? A.)Small focal spot B.)6:1 grid C.)Compensating filter D.)Shadow shield

C.)Compensating filter

How is the pelvis (body) positioned for a PA axial oblique (Teufel) projection? A.)PA with 45 degrees rotated away from affected side B.)Prone or erect PA--no rotation C.)PA 35 to 40 degrees toward affected side D.)AP with 40 degrees away from affected side

C.)PA 35 to 40 degrees toward affected side

Which of the following factors does not apply to an axiolateral (inferosuperior) projection of the hip on a male patient? A.)IR parallel to femoral neck B.)80 to 90 kV C.)Use of gonadal shielding D.)Use of a stationary grid

C.)Use of gonadal shielding

gonion

Thyroid cartilage

C4-C6

thyroid cartilage

C4-C6

which region of the spine must be demonstrated with a cervicothoracic lateral (swimmer's) position

C5-T3

Vertebra prominens

C7-T1

Procedure which will open the mid-to-lower intervertebral joint spaces on a female with a wide pelvis during a lateral lumbar spine (Pt already supported mid-aspect of lumbar spine with sponge blocks)

CR angled to 5°-8° Caudal

Alternative imaging modality to be performed if repeat PA projections of the SC joints do not clearly demonstrate them

Which modality is recommended for a teardrop burst fracture?

modality: demos slight differences in tissue density. head scans for: blood clots, edema, neoplastic processes. high resolution for chest pathology (parenchymal edema)

re abuse: visualizes visceral damage (abd/head/skeletal fx), useful for dx brain injury from abuse and symptoms of SBS

Two modalities that are reducing the amount of myelograms performed due to accuracy and efficiency

CT and MRI

Other imaging options available to study the sternum if routine RAO and lateral radiographs do not provide sufficient information

CT or Nuclear Medicine

An example of a vasovagal reaction

Cardiac arrhythmias

Movement type of the 1st sternocostal joint (between 1st rib and sternum)

Cartilagenous, synarthrodial

Classification, mobility, and movement type for lumbar intervertebral joints

Cartilaginous, Amphiarthrodial (slightly movable), No movement type

What is the classification, mobility, and movement type of the Symphysis pubis?

Cartilaginous; Amphiarthrodial; Limited

What is the classification, mobility, and movement type of the Acetabulum (union)?

Cartilaginous; Synathrodial; Nonmovable

Ionization chamber to be used when using AEC for either a lateral lumbar spine or L5-S1 projection

Center chamber

What radiographic exam was performed to measure the fetal head in comparison with the maternal pelvis to predict possible birthing problems?

Cephalopelvimetry

Which position or projection demonstrates the lower C and upper T spine (C4 to T3) in a lateral perspective?

Cervicothoracic lateral "swimmers"

Fracture of the vertebral body caused by hyperflexion force

Chance Fracture

Describe or Define: Hirschsprung disease

Characterized by the absence of rhythmic contractions of the large intestine

Chest or Upper/lower limb radiographic procedure: Atelectasis

Chest

Chest or Upper/lower limb radiographic procedure: RDS

Chest

Which exam is associated with Atelectasis?

Chest

Which exam is associated with Bronchiectasis?

Chest

Which exam is associated with Cystic fibrosis?

Chest

Which exam is associated with Hemoptysis?

Chest

Which exam is associated with Hyaline membrane disease?

Chest

An avulsion fracture of the spinous processes of C6 through T1 is called

Clay shoveler's fracture

What is the other name for Modified axiolateral?

Clements-Nakayama

Two things which can be done to reduce the high amounts of scatter reaching the IR during lateral sacrum/coccyx projections

Close collimation and placing a lead mat blocker behind Pt's back

Which two things can be done to minimize the effects of scattered radiation on lateral projections of the thoracic and lumbar spine?

Close side collimation Lead mat on tabletop

Ideal placement of the area of interest with relation to the IR for injuries to the anterior aspect of the ribs

Closest to the IR

Regional enteritis (Crohn's)

Cobblestone appearance

Formal term for the tail bone

Coccyx

What technical factors are most important in producing a high-quality CR image? Decrease SID, Min use of grid, decrease kV, or Collimate.

Collimate as closely as possible

Meckel's diverticulum

Common birth defect found in the ileum

Giardiasis

Common parasitic infection of the small intestine

Fracture that is characterized by anterior wedging and loss of of vertebral body height

Compression Fx

A type of fracture that rarely causes neurologic deficits

Compression fracture

Describe or Define: Atresias

Condition characterized by the absence of an opening in an organ

Barrett's esophagus

Condition of erosion in lower part of esophagus caused by changes in cells due tho the presence of stomach acid that could result in esophageal cancer

Describe or Define: Hypospadias

Congenital defect in the male urethra

Describe or Define: Talipes equinus

Congenital deformity of the foot

Side of the spine which should be elevated for the second exposure for the Ferguson scoliosis series (Pt stands on a block with one foot)

Convex side of the spine

Two common terms for the classic metaphyseal lesion (CML), which may indicate child abuse, are:

Corner fracture and Bucket-Handle fracture

Which of the following procedures can be performed to diagnose possible genetic fetal abnormalities? A. Nuclear medicine fetal scan B. Spiral/helical CT C. Functional MRI D. 3-D ultrasound

D. 3-D ultrasound

How much is the CR angled to the OML for an AP axial (town) projection of a pediatric skull? A. 15 degrees B. None C. 25 degrees D. 30 degrees

D. 30 degrees

Which of the following procedures or projections should be performed for a possible meconium ileus? A. IVU procedure B. AP supine abdomen C. Upper GI series D. Acute abdomen series

D. Acute abdomen series

Situation: Which radiographic procedure is often performed for Hirschsprung disease? A. Upper GI B. MRI C. Cystourethrography D. Barium enema

D. Barium enema

Situation: a newborn is diagnosed with RDS. Which one of the following procedures is commonly performed for this condition? A. Abdomen B. Functional MRI C. CT of head D. Chest

D. Chest

Which of the following imaging modalities is effective in detecting signs of attention deficit hyperactivity disorder (ADHD)? A. CT B. Sonography C. Nuclear medicine D. Functional MRI

D. Functional MRI

Which of the following is NOT the name of a known commercially available immobilization device? A. Posi-Tot B. Tam-Em Board C. Pigg-O-Stat D. Hold-em Tiger

D. Hold-em Tiger

Which of the following imaging modalities is most sensitive in diagnosing early signs of metastatic carcinoma of the pelvis? A.)Sonography B.)Computed tomography C.)Magnetic resonance imaging D.)Nuclear medicine

D.)Nuclear medicine

Increased hip joint space and misalignment

DDH

What is the the other name for Axiolateral (inferiosuperior)?

Danelius-Miller

Exposure correction to be made if an RAO sternum is difficult to visualize due to excessive density (too white)

Decrease kVp to 65 for higher contrast and to prevent sternum overpenetration

Correction to be made if downside pedicle and zygapophyseal joints are posterior to the vertebral body on an oblique lumbar spine projection

Decrease rotation of the body and spine

Correction to be made for an LPO lumbar spine revealing downside pedicles towards the posterior aspect of the vertebral bodies

Decrease rotation of the spine

Describe or Define: Achondroplasia

Decreased bone formation at growth plates

What kind of mechanical digestion takes place in the pharynx?

Deglutition (swallowing)

Primary centers of bone formation (ossification) involving the midshafts of long bones are called _________.

Diaphysis

Situation: A radiograph from a modified axiolateral projection of the hip shows excessive grid lines on the image, which also appears underexposed. What can be done to avoid this problem during the repeat exposure?

Ensure that the CR is centered to near the midline of the grid cassette the face of the IR is perpendicular to CR

Criteria for the radiographic evaluation of the oblique sternum

Entire sternum should lie over the heart shadow and be adjacent to the spine

Bacterial infection of the upper airway that may be fatal if untreated

Epiglottitis

Epiphysis, Diaphysis, or Epiphyseal plate? Space between primary & secondary centers

Epiphyseal plate

Epiphysis, Diaphysis, or Epiphyseal plate? Secondary centers

Epiphysis

Positioning error committed if the pedicles are projected too far posterior with a 45° oblique position of the lumbar spine

Excessive rotation

Which one of the following techniques helps to remove the scapulae from the lung fields during pediatric chest radiography?

Extend arms upward

The typical physical sign for a possible hip fracture is the _________ of the involved foot.

External rotation

T/F: a lead blocker mat for lateral positions of the lumbar spine should not be used with digital imaging.

FALSE

TRUE or FALSE: About 50 % of the glomerular filtrate processed by the nephron is reabsorbed into the kidney's venous system

FALSE

TRUE or FALSE: The gonadal dose for the AP postvoid projection is higher for male patients than for female patients

FALSE

TRUE or FALSE: The retrograde ureterogram will demonstrate the ureters, renal pelvis, & major & minor calyces

FALSE, primarily the ureter

T/F Female caregivers of childbearing age should never be allowed to stay in the room to assist with the procedure.

False

True/False: The radiographic contrast on a pediatric abdominal radiograph is high compared with that of an adult abdominal radiograph.

False (contrast is low)

True/False: Battered child syndrome (BCS) is the current term for child abuse

False (correct term is 'nonaccidental trauma' or NAT)

True/False: Parents should never be in the radiographic room with their child

False (may be permissible with proper lead shielding if not pregnant)

True/False: Bony landmarks in infants are easy to palpate and locate.

False (most bony landmarks are non-existent in infants)

True/False: Small retention enema tips can be used on infants during a barium enema to help barium retention.

False (retention tips should not be used on small children)

True/False: It is important to place the foot into true AP and lateral positions when performing a clubfoot study.

False (take two projections 90 degrees from each other)

True/false: the thoracic spine possesses facets for rib articulations and bifid spinous processes.

False - C-spine possesses bifid spinous processes

True/false: the carotid artery and certain nerves pass through the cervical transverse foramina.

False - vertebral artery and vein

Supports the lower abdominal organs

False pelvis

T/F Gonadal shielding should only be used in supine positions because of the difficulty in keeping the shield in place.

False, shielding should be used in all positions, using tape when necessary

True/false: HNP most frequently develops at the L2-L3 vertebral level

False- most common at L4-L5

True or False: The soft-tissue of an obese patient is indicative of the actual size of the bony pelvis.

False.

True/false: centering for the AP pelvis projection is 1 inch superior to the symphysis pubis.

False. Midway between ASIS and symphysis pubis

True/false: the modified axiolateral (Clements-Nakayama method) is classified as a non-traumatic lateral hip projection.

False. Possible trauma projection

True/False: The small sacculations found within the jejunum are called haustra.

False; large intestine

True/False: Gonadal shielding should only be used in supine positions because of the difficulty in keeping the shield in place.

False; shielding should be used in all positions, using tape when necessary

which projection or method is designed to demonstrate the degree of scoliosis deformity between the primary and compensatory curves as apart of a scoliosis study?

Ferguson method

The small depression near the center of the femoral head where a ligament is attached is called the

Forvea capitis

cardiac notch

Found along superior aspect of fundus

Number of vertebral attachments per rib

Four (4)

Peristalsis

Four types of digestive movements occurring in the large intestines. Which one of these movement types also occurs in the small intestines.

With long SID, what are two positioning techniques used to lower the shoulder to visualize C7 to T1 for lateral projection of C-spine?

Full expiration Patient hold 5-10 lb in each hand

Caused by a flagellate protozoan

Giardiasis

What is the alternative term for the greater and lesser pelvis?

Greater Pelvis: False pelvis; Lesser Pelvis: True Pelvis

How is the x-ray tube aligned for a lateral projection of the chest if the patient is on a Tam-Em board?

Horizontally

2 hours

How long does it usually take to complete an adult small bowel series?

23 ft (7m)

How long is the average small bowel if removed and stretched out during autopsy?

2 cups (16 0z.)

How much barium sulfate is generally given to an adult patient for a small bowel-only-series?

Situation: A radiograph of an axiolateral (inferosuperior) projection shows that the posterior aspect of the acetabulum and femoral head were cut off of the bottom of the image. The emergency room physician requests that the position be repeated. What can be done to avoid this problem on the repeat exposure?

If possible elevate patient at least 2 in (5 cm) by placing sheets or blankets beneath pelvis.

What part of the hip bone contains the Anterior superior iliac spine (ASIS)?

Ilium

LUQ & LLQ

In which two abdominal quadrants would the majority of the jejunum be found?

Correction to be made on an AP Axial coccyx if the distal tip is superimposed over the sumphysis pubis

Increase CR angle to separate coccyx from the symphysis pubis

Correction to be made if an RAO sternum is difficult to see due to excessive lung markings superimposed over the sternum

Increase exposure time - Decrease mA to allow for more blurring of the lung markings

Reason for maintaining at least 40" SID during sternum radiography

Increase in patient dose, especially skin dose

angular notch

Indentation found along lesser curvature

What is another term for the outlet of the true pelvis?

Inferior aperture

The renal veins connect directly here

Inferior vena cava

Describe or Define: Kohler's bone disease

Inflammation of navicular in the foot

Describe or Define: NEC

Inflammation of the inner lining of the intestine

appendicitis

Inflammation of the vermiform appendix is called_____.

A 2-year old child comes to the radiology department for a routine chest examination. While removing the child's shirt, you notice a human bite mark on the upper arm. What should you do next?

Inform the supervisor or physician

Lateral

Into which position is the patient placed for imaging during the evacuative procedure

Polyps

Inward growth extending from the lumen of the intestinal wall.

Name the type of iodinated contrast media from the characteristics listed: (Ionic- Non-ionic) Dissociates into 2 separate ions once injected, uses a salt as its cation; parent compound is a carboxyl group; less expensive; creates a hypertonic condition in blood plasma

Ionic

What part of the hip bone possesses a large tuberosity found at the most inferior aspect of the pelvis?

Ischium

Characteristic that makes a rib a true rib

It attaches to the sterum anteriorly by its own cartilage

Why is tape not recommended, for immobilization purposes, to be place directly on children?

It can damage the skin

Characteristic that makes a rib a floating rib

It has no anterior attachment in the bony thorax

Reason for using only RAO for a study of the sternum

It places the sternum over the heart to provide a uniform background for added visibility of the sternum

What is the disadvantage of using 90 kV for hip and pelvis studies with an analog imaging system especially for older patients with some bone mass loss?

It reduces radiographic contrast.

Why gonadal shielding cannot be used for a female Pt during AP sacrum or coccyx

It would obscure essential anatomy since ovaries are located near the lower lumbar spine

Schatzke's ring

Its presence indicates a possible sliding hiatal hernia

What is the other name for a posterior oblique of the acetabulum?

Judet method (Up is down; Down is up; Upside=posterior and DOWNside= anterior)

Which projection of C-spine demonstrates the left intravertebral foramen?

LAO

What other position can be used for the sternum if the patient cannot assume the recumbent RAO position?

LPO

Other positions to be performed if the patient cannot assume a prone position for the RAO sternum

LPO - oblique supine position

Position to be performed for ER Pt with multiple MVA injuries. Pt can move but not lie prone or stand. Sternum study ordered

LPO and horizontal beam lateral positions

Situation: A patient is brought into the ER with multiple injuries due to a MVA. The patient can move but cannot stand or lie prone because of this injuries. A sternum study is ordered. What positions should be performed for this patient?

LPO and horizontal beam lateral positions.

Technical factors for an AP/PA pediatric chest: IR - portrait or landscape?

Landscape

Two characteristics that differentiate a lumbar vertebra from either cervical or thoracic

Large vertebral body and large blunt spinous process

Compared with the spinous processes of the cervical and thoracic spine, Lumbar spinous processes are:

Larger and more blunt

Meckel's diverticulum

Larger diverticulum of the ileum

The drug that may be given to minimize the risk for acute renal failure following a contrast media procedure

Lasix

Where is the CR centered for a KUB on an 8 year old child?

Level of iliac crest

CR centering for AP and lateral lumbar spine projections

Level of the iliac crest

T10

Level where the esophagus pierces the diaphragm

Sigmoid colon

Lies in pelvis but possesses a wide freedom of motion

Routine for ER Pt on backboard with blunt chest trauma with suspected flail chest

Limited rib series will indicate which ribs are Fx and determine flail chest - oblique positions may not be possible due to backboard

Which sign indicates that the proximal femur's are in position for a true AP projection?

Limited visibility of the lesser trochanter in profile

Duodenum, jejunum, ileum

List the 3 divisions of the small intestine is descending order, starting with the widest division

1. Plastic tip 2. Rectal retention 3. Air-contrast retention

List the 3 types of enema tips commonly used. (all are single-use & disposable)

1. Prevents contents of the ileum from passing too quickly into cecum 2. Prevents reflux back into the ileum

List the two functions of the ileocecal valve.

Ideal range for mA exposure factors as they apply to an oblique position of the sternum

Low

Ideal range for kV exposure factors as they apply to an oblique position of the sternum

Low - 65kVp - 70kVp

kV range for projections of ribs above the diaphragm

Low to medium - 65-70kVp

Which vertebral level does the solid spinal cord terminate?

Lower border L1

Topographic landmark which corresponds with L2-L3

Lower costal margin

Exposure changes which improve contrast but increase Pt dose during lumbar radiography

Lower kV and higher mA

4 lobes of the liver

MAJOR - left lobe, right lobe MINOR - quadrate lobe, caudate lobe

Best imaging modality for a Pt with a clinical Hx of HNP

MRI

Best imaging modality for soft tissues of the lumbar spine

MRI

Best imaging modality for structures within the subarachnoid space

MRI

imaging modality is used to detect subtle tissue changes following a renal transplant

MRI

modality: major disadvantage is long exam times. sedation recommended for kids. used for T-spine and cardiac eval. useful for staging tumors and pediatric seizures. functional studies: dx brain diseases/disorders such as ADHD, tourettes, and autism

MRI

re abuse: assists in assessing soft tissue and CNS damage, but is not ideal b/c of the length of the exam

MRI

the following alternative imaging modalities is not routinely being used to diagnose renal calculi

MRI

What gender type appears as a heart-shaped pelvic inlet on a pelvic radiograph?

Male

Describe or Define: Pyloric stenosis

May result in repeated, forceful vomiting

Usually consist of numerous small lytic lesions

Metastatic carcinoma

Where is the central ray placed for an AP unilateral frog-leg projection?

Midfemoral neck

Where is the CR centered for a lateral projection of the pediatric skull?

Midway between glabella and inion

CR centering for an AP projection of ribs below the diaphragm

Midway between xiphoid process and lower rib cage margin

What is proximal hip fracture?

Most common fracture in old patients because of high incidence of osteoporosis or avascular necrosis.

How can rib fractures be a radiographic indication of child abuse?

Multiple and posterior fractures are an indication of a child being held up under the axillae and shaken

Clinical indicators that apply for an AP abdomen (KUB)

NEC, Intussusception, Foreign body localization, Hepatomegaly, Appendicitis

production of hormones

NOT a function of the GI system

vallecula

NOT a salivary gland

Cecum Transverse colon Sigmoid colon Jejunum Ileum

Name the Intraperitoneal structures of the lower abdomen.

Ascending colon Descending colon Upper rectum C-loop of duodenum

Name the retroperitoneal structures of the lower abdomen.

The projection best demonstrates the renal parenchyma? when should it( they) be taken?

Nephrogram Taken immediately after injection

Second most common form of cancer in children younger than 5 years of age

Neuroblastoma

Second-most common form of cancer in children younger than 5 years of age

Neuroblastoma

Neoplasm

New growth

AP hip shows that the lesser trochanter is not visible. Should technologist repeat projection?

No. It's acceptable because the lesser trochanter should not be visible or only slightly visible on proper PA projection

Technical factors for an AP/PA pediatric chest: Grid/non-grid?

Non-grid

With what injury do we use the AP bilateral "frog-leg" (modified Cleaves method)?

Non-trauma

With what injury do we use the Unilateral "frog-leg" (modified Cleaves method)?

Non-trauma

Which of the following terms is commonly applied in describing child abuse?

Nonaccidental trauma N A T Battered child syndrome B C S is the older term

AEC chambers to be activated for sternum and rib routines

None - AEC not as accurate as manual exposure controls for detail

What type of CR angle is required for the Judet method?

None. CR is perpendicular

Radiograph of lateral T spine shows intravertebral foramina and intravertebral joints spaces not clearly demonstrated. Positioning errors?

Not keeping spine parallel to the IR or rotation of the spine

What is congenital dislocation?

Now referred to as developmental dysplasia of the hip

modality: used for organ fxn studies. ids occult fx and fx healing stages

Nuc Med

re abuse: useful in assessing healing bone, used in conjunction with xray if multiple fx are found

Nuc Med

Best imaging modality for inflammatory conditions such as Paget's disease

Nuclear Medicine

Best radiographic modality to provide a more diagnostic image of rib metastases

Nuclear Medicine (better than MRI)

Which imaging modality is not normally performed to rule out a HNP? CT, Myelography, MRI, or Nuc Med.

Nuclear medicine

Alternate imaging modality other than radiographic studies for Pt with widespread metastases involving the bony thorax

Nuclear medicine bone scan

Ileus

Obstruction of the small intestine

What is the largest foramen in the body?

Obturator foramen

Excretion of a diminished amount of urine in relation to fluid intake

Oliguria

Two positions required for a Scoliosis series in either AP or PA

One erect and one recumbent for comparison

Innominate bone is another name for

One half of pelvic girdle Hip bone Issa coxae

With proper collimation, the fraction of breast dose for a PA scoliosis series versus AP scoliosis series

One tenth

Unilateral frog-leg (modified Cleaves) demonstrates for shortening of the femoral neck. Unsure if there is a defect within the anatomic neck. What can be done to minimize distortion of the neck during repeat?

Only abduct the femurs 20° to 30° from the vertical rather than 45° to minimize distortion of the femoral neck

OCG

Oral Cholangiogram

What are the two additional terms used for the right and left hip bones?

Ossa coxae and innominate bones.

Hallmark sign of spring and narrowing of joint space

Osteoarthritis

Term for a proliferative bony lesion of increased radiographic density

Osteoblastic

Group of diseases affecting the epiphyseal plate

Osteochondrosis

Which of the following pathologic indications requires a significant decrease (up to 50%) of manual exposure factors?

Osteogenesis imperfect

AP projection of pelvis demonstrates left obturator foramen is narrowed and right one is open. Positioning error?

Rotation of pelvis toward patient's left. The elevated-upside RT obturator foramen will become more open as compared to opposite side-downside

Positioning error shown when a lateral sternum reveals anterior ribs are superimposed over the sternum

Rotation of the upper body from a true lateral position will cause superimposition of the ribs over the sternum

A radiograph of a lateral sternum reveals that anterior ribs are superimposed over the sternum. Which specific positioning error led to this radiographic outcome?

Rotation of the upper body from a true lateral will cause the ribs to be superimposed over the sternum.

Visible rotation in the SI joints during AP lumbar spine projection

SI joints are equidistant from the spine

Brachycardia (< 50 beats/min) is a symptom of this type of reaction

Severe reaction

Which of the following factors should be the first consideration in controlling motion for the pediatric patient?

Short exposure time

Duodenum

Shortest aspect of small intestine

Hot flashes are classified as what

Side effect

Posterior oblique projections (Judet method) will demonstrate possible pelvic ring and acetabular fractures and AP axial "outlet" and AP axial "Inlet" projections will demonstrate possible fractures involving the ischium and pubis.

Situation: A patient enters the emergency room with a possible pelvic ring fracture. The AP pelvis projection is inclusive on the extent and location of the fracture(s) What additional pelvis projection(s) can be taken on this patien to demonstrate possible pelvic fractures? (More than one correc answer is possible).

AP pelvis and modified axiolateral-Clements-Nakayama method

Situation: A patient has just been moved to his hospital room after a bilateral hip replacement surgegy. The surgeon has ordered a postoperative hip routine for both hips. which specific positioning routine should be used? (The patient can be brought to the radiology department.)

List the correct positioning considerations for a study of the ribs above the diaphragm. Breathing instructions; kV range; General body position.

Suspended inspiration, low to medium kV (65-70), erect (if patient is able)

What is the name of the joint found between the superior rami of the pubic bones?

Symphysis pubis

What is the classification, mobility, and movement type of the Sacroiliac?

Synovial; Amphiarthrodial; Limited

What is the classification, mobility, and movement type of the hip joint?

Synovial; Diarthrodial; Ball and Socket

False

T/F - A cleaning bowel prep is not required before a CTC

True

T/F - A special tapered enema tip is inserted into the stoma before a colostomy barium enema.

False

T/F - An example of an irritant cathartic is magnesium citrate

True

T/F - Any stool retained in the large intestine may require postponement of a barium enema study.

False

T/F - Because of the density and amount of the barium within the large intestine, computed tomography should not be used during a barium enema.

True

T/F - Both computed tomography and sonography may be performed to aid in diagnosing appendicitis.

False

T/F - Intestinal polyps and diverticula are very similar in structure

True

T/F - Synthetic latex enema tips or gloves do not cause problems for latex-sensitive patients

False

T/F - The barium enema is a commonly recommended procedure for diagnosing possible acute appendicitis.

False - 24 in.

T/F - The enema bag should not be more than 36 in. (92 cm) above the table top before the beginning of the procedure.

True

T/F - The technologist should review the patient's chart before a barium enema to determine whether a sigmoidoscopy or colonoscopy was performed recently.

True

T/F -Volvulus occur more frequently in males than females

True

T/F digital fluoroscopy does not require the use of IR cassettes

False, greater curvature

T/F the lateral margin of the stomach is called the lesser curvature

False, in the stomach

T/F the numerous mucosal folds found in the small bowel are called rugae

True

T/F water soluble contrast agents pass through the Gi tracts faster than barium sulfate

Which thoracic vertebrae do not possess a facet for the costotransverse joint?

T11 and T12

specific thoracic vertebrae are classified as typical thoracic vertebrae

T5-T8

3-4 inches (8-10 cm) below jugular notch

At what vertebral level is the xiphoid process found?

T9 - T10

Vertebral level of the xiphoid process

T9-T10

T/F: kV range of 90-100 can be used for a lateral L5-S1 projection when using DR.

TRUE

T/F: the efficiency of CT/MRI of the spine is reducing the number of myelograms being performed

TRUE

T/F: the pelvis must remain as stationary as possible when position for the hyper-extension and hyper-flexion projections.

TRUE

TRUE or FALSE: Adult forms of polycystic disease are inherent

TRUE

TRUE or FALSE: Bladder carinoma is 3 times more common in males than females

TRUE

TRUE or FALSE: The Loop of Henle & collecting tubules are located primarily in the medulla of the kidney

TRUE

TRUE or FALSE: The patient should void before the IVU to prevent diltution of the contrast media in the bladder

TRUE

Proper marking for the sites of injury when performing a rib series

Tape a small metallic "BB" over the site of injury

Intussusception

Telescoping of one part of the intestine into the other

What is the other name for a posterior axial oblique of the acetabulum?

Teufel

1. salivary glands 2. pancreas 3. liver 4. gallbladder

The 4 accessory organs of digestion

1. RAO 2. PA 3. Right lateral 4. LPO 5. AP

The 5 most common basic or routine projections for an upper GI series

1. oral cavity 2. pharynx 3. esophagus 4. stomach 5. duodenum & small intestine 6. large intestine 7. anus

The 7 major components of the alimentary canal

Situation: A patient enters the ER with a pelvic injury resulting from a motor vehicle accident. The initial AP pelvis projection demonstrates a possible defect or fracture of the left acetabulum. No other fractures are detected and the patient is able to move comfortably. What additional projections can be taken to demonstrate a possible acetabular fracture?

The PA Axial Oblique (Teufel method) or posterior oblique (Judet method) can be used to demonstrate aspects of the acetabulum more completed.

Body & pyloris of stomach + duodenal bulb

The aspect of the upper GI tract that will be filled with barium in the PA (prone) position

5ft (1.5m)

The average length of the large intestine is ______.

4 sections, 2 flexures

The colon is divided into ____sections and has _____ flexures.

cholelithiasis

The condition of having gallstones

double contrast

The term enteroclysis describes what type of a small bowel study?

Duodenojejunal flexure

The tip of the catheter is advanced to the ___during an enteroclysis

What forms the costotransverse joint?

The tubercle of the rib and the transverse process of the thoracic vertebra

Cecum

The widest portion of the large instestine is the _____.

Haustra

These pouches, or sacculations, seen along the large intestine wall are called________.

Which divisions of the spine is described as possessing a primary curves?

Thoracic, sacral

Lateral C-spine demonstrates zygapophyseal joint space not superimposed. Positioning errors?

Tilt and or rotation of the spine

Vertebral level of the symphysis pubis

Tip of the coccyx

T/F For a bone survey of a young child, both limbs are commonly radiographed for comparison

True

T/F The technologist is the one who should make the decision whether a parent remains in the radiographic room during a procedure.

True

T/F There should be no attempt to straighten out the abnormal alignment of the foot during a clubfoot study

True

T/F: all children do not reach sense of understanding at the same age

True

T/F: gauze and tape will appear as an artifact

True

True or False: AN AP pelvis projection using 90 kV and 8 mAs results in less patient dose than a projection using 80 kV and 12 mAs (for both males and females).

True

True or False: The Lauenstein/Hickey method for the unilateral "frog-leg" will produce distortion of the femoral neck.

True

True or False: The central ray for the AP pelvis projection is approximately 2 inches inferior to the level of the ASIS.

True

True or False: The term pelvis and pelvic girdle are not synonymous.

True

True/False: Children older than 5 years of age can usually hold their breath after a practice session.

True

True/False: Except for survey exams, individual projections of the elbow, wrist, and shoulder should generally be taken on older children rather than including these regions on a single projection.

True

True/False: For a bone survey of a young child, both limbs are commonly radiographed for comparison

True

True/False: If available, the Pigg-O-Stat should be used rather than relying on prenatal assistance during a pediatric chest examination

True

True/False: It is difficult to distinguish the small bowel from the large bowel on a plain abdomen on an infant.

True

True/False: Malignant bone tumors are rare in young children.

True

True/False: Renal CT scans have largely replaced intravenous urography studies for children.

True

True/False: The chest and abdomen are generally almost equal in circumference in the newborn.

True

True/False: The entire upper limb is commonly included on an infant rather than individual exposures of specific parts of the upper limb.

True

True/False: The parent has the right to refuse the use of immobilization devices

True

True/False: The rectum possesses two anterioposterior curves that have a direct impact on rectal enema tip insertions.

True

True/False: The technologist should always use the shortest exposure time possible during pediatric procedures

True

True/False: The transit time of barium through the small intestine of the pediatric patient is usually less than that required for an adult.

True

True/False: There should be no attempt to straighten out the abnormal alignment of the foot during a clubfoot study

True

True/false: the unilateral frog-leg projection (modified Cleaves method) is intended for nontraumatic hit situations.

True

True/False: It is possible to provide gonadal shielding for both male and female pediatric patient for AP and lateral projections of the hips.

True (if correctly placed)

Type of rib represented by the 5th pair

True Rib

Projections to be performed in addition to a routine rib series if either pneumothorax or hemothorax is suspected as a result of a rib fracture

Upright PA and Lateral Chest

The buildup of nitrogenous waste in the blood

Uremia

The condition that would contraindicate the use of ureteric compression

Ureteric calculi

Constant or frequent involuntary passage of urine

Urinary incontinence

What is the most common clinical indication for a voiding cystourethrogram?

Urinary tract infection (UTI)

Describe or Define: Croup

Viral infection leading to labored breathing and dry cough

Which device should be used for an axiolateral (inferosuperior) projection of the hip to equalize density (brightness) of the hip region?

Wedge compensating filter

Teufel projection

What is another name for a PA axial oblique projection

Inferior aperture

What is another term for the outlet of the true pelvis

It adheres to the bowels while distending it

What is purpose of introducing methylcellulose during an enteroclysis?

Cannot remove polyps during a CTC

What is the chief disadvantage of a CT colonography (CTC)?

Constricted anal canal

What is the last 1 - 1.5 in. of the rectum called?

Sim's position

What is the name of the patient position recommended for insertion of a rectal enema tip?

NPO for at least 8 hours before procedure, no smoking or gum chewing

What is the recommended patient preparation before a small bowel series:

Taeniae coli

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

0.1% barium sulfate suspension is often instilled before the procedure.

What procedure often accompanies a CT enteroclysis?

Duodenojejunal junction

Which aspect of the small intestine is most fixed in position?

Jejeunum

Which division of the small intestine has a feathery or coiled spring appearance during a small bowel series?

1. Gross bleeding 2. Severe diarrhea 3. Obstruction 4. Inflammatory lesions

Which four conditions would prevent the use of a laxative cathartic before a barium enema procedure?

nuclear medicine

Which imaging modality is most sensitive in diagnosing early signs of metastatic carcinoma of the pelvis

AP axial projection

Which of the following projections or methods is used to evaluate the pelvic inlet for possible fx ?

SCFE (slipped capital femoral epiphysis)

Which pathologic indication shows that the epiphyses appear shorter and epiphyseal plate wider

Metastatic carcinoma

Which pathologic indication usually consists of numerous small lytic lesions

Ulcerative colitis

Which pathological conditions may produce a cobblestone radiographic sign during a barium enema?

Volvulus

Which pathological conditions may produce a tapered or corkscrew radiographic sign during a barium enema?

Ileum

Which portion of the small intestine is located primarily in the RLQ?

Jejunum

Which portion of the small intestine is located primarily to the left of the midline?

Prone, it separates loops of intestine

Which position is recommended for small bowel radiographs? Why?

Bilateral Frog*

Which position/s will best demonstrate signs of developmental dysplasia? (WS)*

Double-contrast barium enema

Which procedure is most effective to demonstrate small polyps in the colon?

Situation: A portable AP and lateral hip study is ordered for a patient who is in recovery following hip replacement surgery. The radiograph of teh AP hip shows that the upper portion of the acetabular prosthesis is slightly cut off but is included on the lateral projection. Should the technologist repeat the AP projection? Why or why not?

Yes. Any orthopedic appliance or prosthesis must be seen in its entirety in both projections.

Should a gonadal shield be used for a hip study on a young female?

Yes. Use a shape ovarian shield with top of shield at level of ASIS and bottom at symphysis pubis.

Hypersthenic patient

a high and transverse stomach, duodenal bulb at the vertebral level of T11-T12

what is the standard differences between the standard and hyperstensive IVU

a hyperstensive IVU requires a shorter span of time between projections.

Zenker's diverticulum

a large outpouching of the mid-to-upper esophagus

mass of hair in the stomach, UGI study

a patient comes to the radiology dept with a clinical history of a possible trichobezoar. what is a trichobezoar and which procedure will best diagnose is

800-100mL or appx. 1 quart

amount of bile produced by the average healthy adult liver

the term IVP incorrect in describing a radiographic examination of the kidneys, ureters, and bladder after intravenous injection of contrast media

an IVP is a study of the renal pelvis. IVU is the study of kidneys, ureters, and bladder.

What is another term for laxative?

cathartics

List the two aspects of the large intestine not considered part of the colon.

cecum and rectum

which 2 portions of the vertebral column are classified as secondary or compensatory curves

cervcial and lumbar

concave curve (with respect to posterior)

cervical spine and lumbar spine

secondary curve

cervical spine and lumbar spine

a patient come to the radiology department for a routine cervical spine series. the lateral projection demonstrates only the C1-C6 region. the radiologist want to see C7-T1. which additonal proj

cervicothoracic (swimmers) lateral position

proj. delivers the greatest skin dose to the patient

cervicothoracic lateral position.

BaSO4

chemical symbol for barium sulfate

any disruption in the physiologic functions of the body that may lead to a contrast media reaction is the basis for the

chemotoxic theory

radiographic apperances : bilateral, small kidneys with blunted calyces

chronic bright disease

fx along the metaphysis that results in tearing or avulsion of the metaphysis. appears as crescent shaped osseous density adjacent to the avulsion fragment. caused by forces exerted on the metaphysis such as pulling on extremity, holding a child around the thorax and shaken violently

classic metaphyseal lesion

avulsion fx of the spinous process C7

clay shoveler's fx

the following drugs is often given to the pt as part of the premedication procedure

combination of benadryl and prednisone.

hiatal hernia

condition in which a portion of the stomach herniates through the diaphragmatic opening

urinary pathologic term: urinary incontinence

constant or frequent involuntary passage of urine

the peripheral or outer portion of the kidney is called

cortex

what pathology is commonly seen in AP upper airway as a smooth, tapered narrowing of the upper airway "steeple sign"?

croup

inherited disease in which secretions of heavy mucus cause progressive clogging of the bronchi. s/s not present at birth, appear later on. hyperinflation of lungs results from blocked airways. associated with meconium ileus

cystic fibrosis

radiographic apperances : mucosal changes within the bladder

cystitis

Any change in manual exposure factors? Idiopathic juvenile osteoporosis

decrease (-)

Any change in manual exposure factors? Osteogenesis imperfecta

decrease (-)

Any change in manual exposure factors? Osteomalacia

decrease (-)

The term evacuative proctography is sometimes used for a lower GI tract procedure. This procedure is also commonly called

defecography

bacterial infection of the epiglottis is most common in kids 2-5 years but may also affect adults. is a serious condition that can rapidly become fatal. results from airway blockage due to swelling

epiglottitis

space btwn the metaphysis and epiphysis and is made up of cartilage

epiphyseal plate

parts of bone that increase in size and appearance with growth

epiphysis

conventional radiographic examination for scoliosis

erect AP/PA and lateral spine including bending laterals

when performing a chest xray on a child, what position is most ideal? what are the exceptions?

erect is most ideal. infants in isolette or infants unable to support head are exceptions

A patient with a clinical history of a rectocele comes to the radiology department. Which radiographic procedure will best diagnose this condition?

evacuative proctography

urinary pathologic term: uremia

excess urea and creatinine in the blood

a radiograph of an AP open mouth projection of the cervical spine reveals that the base of the skull is superimposed over the upper odontoid process. which specific positioning error is present

excessive extension of the skull

lateral proj of the cervical spine should be taken during ____ why

expiration for maximum shoulder depression

true/false : the glomerular capsule and proximal and distal convoluted tubules are located in the medulla of the kidney

false. (located in the cortex)

true/false: urticaria is the formal term for excessive vomiting

false. (term for hives)

true/false: a retrograde urogram examines the anatomy and function of the pelvicaliceal system

false. non-functional exam

true/false: if extravasation occurs during the puncture, the tech should slightly retract the needle and then push it forward again

false. the needle should be withdrawn and pressure applied

the longitudinal fissure found along the central medial border of the kidney is called

hilum

femoral head is separated from the acetabulum in newborns. cause is unknown. more common in F, infants born breech

hip dysplasia

congenital condition of the LI, nerves that control rhythmic contractions are missing. results in severe constipation/vomiting. corrected by sx connecting distal portion of normal LI to opening in the abd wall (colostomy)

hirschsprung disease

What breathing instructions should be given to the patient during insertion of the enema tip?

hold breath on expiration

a radiograph of an axial projection of the cervical spine reveals that the intervertebral dsik spaces are not open. the following positioning factors were used: extension of the skull, CR angled 10 degree cephalad, CR centered to the thyroid cartilage, and no rotation or tilt of the spine. which of these factors must be modified to produce a more diagnostic image

increase CR angulation to 15 degree cephalad

two advantages of using higher KV exposure factors (analog imaging) for spine radiography,especially on AP thoracic spine radiograph

increase in exposure latitude (wider range of densities) and decrease patient dose

urinary pathologic term: acute renal failure

indicated by presence of uremia, oliguria, or anuria

disease where developing bones do not harden/calcify, causing skeletal deformities. bowed legs are the most common sign

infantile osteomalacia

the abdomen more prominent and organs are higher in infants or adults?

infants

what age of patients are classified as pediatric?

infants through age 12-14

where is the CR centered for infants in ERECT (and lat/dorsal decub) abd? adolescents?

infants: 1" sup to umbilicus adolescents: 1-2" above crest with top of IR at axilla

what is the typical volume of barium for UGI in infants? adolescents?

infants: 30-75 ml adolescents: 480 ml

which one of the topographic landmarks corresponds to the L2-L3 level?

inferior costal margin

gastritis

inflammation of the lining of the stomach

on a lateral proj of the cervical spine reveals, that C7 is not clearly demonstrated. the following factors were used: erect position, 44 inches SID, arms down by the patient's side, and expsoure made during inspiration. which two of these factors should be changed to produce a more diagnostic image during repeat exposure

initiate exposure during suspended expiration and increase SID to 72 inches

foramina are created by two small notches on the superior and inferior aspects of the pedicle

intervertebral

group of diseases caused most frequently by fibrous adhesions from prior sx in newborns/infants. most often caused by birth defects

intestinal obstruction

Mushroom-shaped dilation with a small amount of barium extending beyond it

intussusception

Telescoping of the bowel into another aspect of it

intussusception

type of intestinal obstruction that is a mechanical obstruction caused by the telescoping of a loop on intestine into another loop. most common in the ileum

intussusception

iodinated contrast media used for urography: non-ionic

is more expensive

impact fx from axial loading of the anterior and posterior arch of C1

jefferson fx

superior margin of this upper section (landmark)

jugular notch (suprasternal)

to ensure that the intervertebral joint spaces are open for lateral thoracic spine proj. it is important to

keeping vertebral column parallel to IR

the following structures is considered to be most posterior

kidneys

inflammation of bone/cartilage in the navicular bone of the foot. more common in M beginning 3-5 years, lasts no more than 2 years

kohler's disease

abnormal or exaggerated convex curvature of the thoracic spine

kyphosis

two bony aspects of the vertebral arch that extend posteriorly from each pedicle to join at the midline

lamina

Where does the reabsorption of inorganic salts occur in the gastrointestinal tract?

large intestine

Zenker's diverticulum

large outpouching of the esophagus just above the upper esophageal sphincter - may be caused by weakening of muscle wall - can be corrected by surgery - common in older women

Compared with the spinous processes of the cervical and thoracic spine, the lumbar process are

larger and more blunt

what are the characteristics of the vertebra in fig. 9-9 that identify it as a lumbar vertebra rather than a thoracic?

larger vertebral bodies, smaller transverse process, bulky spinous process, no facets for ribs

trademark name for diuretic drug is

lasix

which projections are designed to measure mobility of the vertebral column at the site of spinal fusion?

lateral Hyerflexion/Extension

Situation: a patient with a possible compression fracture of L3 enters the emergency room. Which projections of the lumbar spine best demonstrates the extent pf this injury?

lateral L-Spine

conventional radiographic examination for teardrop burst fx

lateral cervical

conventional radiographic examination for unilateral subluxation of cervical spine

lateral cervical spine

what is the term for the same structure, identified in the previous ques. for the C1 vertebra (articular pillar)

lateral mass

conventional radiographic examination for HNP

lateral of affected spine

specific proj must be taken first if trauma to the cervical spine is suspected and the patient is in a supine position on a backboard.

lateral, horizontal beam proj.

what 2 things can be done to reduce high amounts of scatter reaching the IR during the lateral projection of the sacrum and coccyx?

lead mat behind patient, close collimation

what ancillary device should be place behind the patient on the table top for a recumbent lateral proj of the thoracic spine

lead mat or masking

Which colic flexure (right or left) is located 1 to 3 inches (2.5 to 5 cm) higher or more superior in the abdomen?

left colic (splenic) flexure

which foramina are demonstrated with LAO position of the cervical spine

left intervertebral foramina (downside)

The LAO projection best demonstrates the _________ (right or left) colic flexure with the CR and IR centered to the level of ____________.

left; 1 or 2 inches above the iliac crest

disease that leads to abnormal bone growth at the head/neck of the femur. affects kids 5-10 years old. femoral head appears flattened/fragmented. more common in M

legg-calve-perthes disease

two general categories of contrast media reactions

local and systemic

to the right of the midsaggital plane

location of the galbladder on a hypersthenic patient

Near the midsaggital plane

location of the gallbladder on an asthenic patient

anteriorly

location of the gallbladder within the abdomen

to the right of the midsaggital plane

location of the liver within the abdomen

two landmarks must be aligned for an AP "open mouth" proj

lower margin of upper incisors and base of skull

Which aspect of the sternum possesses the jugular notch?

manubrium

upper portion of sternum

manubrium

bile

manufactured by the liver and stored in the gallbladder - emulsifies fats

anterior inferior

marginal location of the gallbladder in the liver

iodinated contrast media used for urography: ionic

may increase the severity of side effects

fetus under stress may pass meconium stools into amniotic fluid, which may be inhaled into the lungs. may result in blockage of airway, causing air sacs to collapse/lung rupture. creating pneumothorax/atelectasis

meconium aspiration syndrome

type of intestinal obstruction that is a mechanical obstruction whereby intestinal contents (meconium) becomed hardened, creating a blockage. found in conjunction with cystic fibrosis

meconium ileus

the spinal cord begins with the ____ of the brain and extends down to the _____ vertebra, where it tapers and ends. this tapered ending is called ____

medulla oblongata, lower border of L1, and conus medullaris

epiglottis

membrane-covered cartilage that moves down to cover the opening of the larynx during swallowing

more common/severe form of spina bifida that involves the protrusion of meninges thru undeveloped opening of vertebrae. appears as CSF filled bulge under the skin

meningocele

which skull positioning line is aligned perpendicular to the IR for PA (judd) projection for the odontoid process

mentomeatal line

body of stomach

middle aspect of the stomach

Where is the central ray centered for an AP projection of the ribs below the diaphragm?

midway between the xiphoid process and lower rib cage

systemic contrast media reaction: light headedness

mild

contrast media reactions: itching

mild systemic

systemic contrast media reaction: angioedema

moderate

systemic contrast media reaction: mild hives

moderate

systemic contrast media reaction: tachycardia (> 100 beats/mins)

moderate

contrast media reactions: angioedema

moderate systemic

contrast media reactions: severe urticaria

moderate systmic

Fundus of stomach

most posterior portion of stomach

radiographic procedure that requires the injection of contrast media into the subarachnoid space

myelography

most severe form of spina bifida. meninges and spinal cord protrude thru the opening. condition is more serious when occurs in the cervical region and caused major physical handicaps, decreased kidney fxn, hydrocephalus

myelomeningocele

falciform ligament

name of the soft tissue structure that divides the liver into left and right lobes

neck

narrowest portion of gallbladder

biliary stenosis

narrowing of the biliary (bile) ducts

inflammation of the inner lining of the intestine caused by injry/inflammation occurs most often in premature newborns and may lead to necrosis of intestine

necrotizing entercolitis

the microscopic functional and structural unit of the kidney is

nephron

which term describes an abnormal drop of the kidneys when the pt is placed erect

nephroptosis

Which of the following structures is (are) found in the costal groove of each rib?

nerve, vein, and artery

childhood cancer, generally in kids under 5. occurs in parts of the nervous system, most frequently in the adrenal glands. 2nd most common cancer type in kids

neuroblastoma

An AP projection of the sacrum reveals that the sacrum is foreshortened and the foramina are not open. What position error led to this?

no angulation on the tube

Situation: A patient comes to radiology with widespread metastases involving the bony thorax. Beyond radiographic studies, what other imaging modality will demonstrate the extent of this condition?

nuclear medicine bone scan

A patient comes to the radiology department with a clinical history of Meckel's diverticulum. Which imaging modality is most often performed for this condition?

nuclear medicine scan

what is the primary role of the RT in child abuse cases?

obtain good quality images and communicate with the radiologist

what is the name of the joint found between the superior articular processes of C1 and the occipital condyles of the skull

occipitoatlantal articulation

what is the purpose of the 15-20 degree angle for AP axial proj of cervical spine.

open the intervertebral disk space

esophagogastric junction

opening between esophagus and stomach

stomach

organ located between the esophagus and small intestine

causes inflammation at the tibial tuberosity. more common in M 5-10 years, usually only affects 1 leg.

osgood-schlatter disease

what is another name for bone development?

ossification

hereditary disorders in which bones grow abnormally, often causing dwarfism/short stature

osteochondrodysplasia

group of diseases that affects epiphyseal plates of long bones, resulting in pain, deformity, abnormal bone growth

osteochondrosis

hereditary disorder in which the bones are abnormally soft/fragile. infants with this condition may be born with many fx, resulting in dwarfism/deformity. sutures of the skull are unusually wide, containing wormian bones

osteogenesis imperfecta

nuclear medicine

other than an esopagogram what other imaging modality is performed to diagnose Barretts esophagus

What does the neck of the Scotty dog represent?

pars interarticularis

urinary pathologic term: polyuria

passage of large volume of urine

For which of the following conditions of the bony thorax are nuclear medicine bone scans not normally performed?

patients with history of multiple myeloma

What does the eye of the Scotty dog represent?

pedicle

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

pelvic brim

what is the specific name for the mass of fat that surrounds each kidney

peri-renal fat or adipose capsule

the following conditions is describe as a rare tumor of the kidney

pheochromocytoma

List the two factors to be considered when determining which specific projections to include in the rib routine as described in the textbook.

place the area of interest closest to IR and rotate the spine away from the area of interest for axillary ribs

What type of movement does the costovertebral joint have? Plane (gliding)-diarthrodial or Immovable- synarthrodial

plane (gliding)- diarthrodial

What type of movement does the eighth interchondral joint have? Plane (gliding)-diarthrodial or Immovable- synarthrodial

plane (gliding)- diarthrodial

What type of movement does the sternoclavicular joint have? Plane (gliding)-diarthrodial or Immovable- synarthrodial

plane (gliding)- diarthrodial

List two chest pathologic conditions that may result from a rib injury and may require a PA and lateral chest projections to be included with the rib routine?

pneumothorax and hemothorax

inherited renal condition many cysts form in the kidney causing enlarged kidneys in infants and children. fatal without dialysis/kidney transplant

polycystic kidney disease

A new growth extending from mucosal wall

polyp

Inward growth from intestinal wall

polyp

Double-contrast barium enemas are most commonly performed on young pediatric patients when _____ are suspected.

polyps

what is double contrast used to dx in lower GI?

polyps

body

portion of the stomach that is anterior/inferior to the fundus

pyloris

portion of the stomach that is posterior/distal to the body

iodinated contrast media used for urography: ionic

poses a greater risk for disrupting homeostasis

6 conditions that could contraindicate the use of ureteric compression

possible ureteric stone, abdominal mass, abdominal aortic aneurysm, recent abdominal surgery, severe abdominal pain, and acute abdominal trauma,

besides rib and healing fx, what other fx may indicate abuse?

posterior fx of scapula and spinous processes and anterior fx of sternum

what is the unique feature of all thoracic vertebrae that distinguishes them from other vertebrae

presence of facets for articulation with ribs

urinary pathologic term: glucosuria

presence of glucose in urine

Which one of the following disorders is best diagnosed during an evacuative proctogram?

prolapse of rectum

the anterior/superior ridge of the upper sacrum is called the

promontory

what is the name of the small gland found just inferior to the male bladder

prostate gland

what structure create a 20 degree angle between the upper and lower pole of the kidney

psoas major muscle

RAO

radiographic projection that would show air in fundus and barium in the body and pyloris

GERD

reason a pt may be asked to swallow a mouthful of water drawn through straw during an esophagogram

a radiograph of an AP projection of the lumbar spine reveals that the SI joints are not equidistant from the spine. The right ala of the sacrum appears wider, and the left SI joint is more open than the left. Which specific position error is evident on this graph?

reduce RPO rotation, rotate a bit back to the left

on a AP "wagging jaw" (ottonello method) proj taken at 75 kv, 20 mAs, and 0.5 second demonstrate that part of the image of the mandible is still visible and obscuring the upper cervical spine. whjich modification needs to be made to proudce a more diagnostic image during repeat

reduce mAs and increase exposure time to produce more bluring of the madible

Situation: a study of the SI joints reveals that the joints are not open and the upper iliac wings are nearly superimposing with the joints. The technologist performed 35 degree RPO and LPO positions with a perpendicular CR. What can be done during the repeat to open the joints?

reduce obliquity to 25-30 degrees

why should the knees and hips need to be flexed for an AP projection of the lumbar spine?

reduces lumbar curvature and brings back closer to IR

three functions of the urinary system

remove nitrogen, regulate water levels, and regulate acid-base balance

radiographic apperances : signs of obstruction of urinary system

renal calculi

radiographic apperances : irregular appearance of renal parenchyma or collecting system

renal cell carcinoma

increased blood pressure to the kidneys due to atherosclerosis

renal hypertension

radiographic apperances : rapid excretion of contrast media

renal hypertension

the term that describes the total functioning portion of the kidney is

renal parenchyma

which structure of the medulla is made up of a collection of tubules that drain into the minor calyx

renal pyramids

Which type of rectal enema tip is ideal for the patient with a relaxed anal sphincter?

retention catheters

the following involves a direct introduction of the contrast media into the structure being studied

retrograde urogram, retrograde cystogram, and retrograde urethrogram.

Which one of the following digestive movements occurs in the small intestine?

rhythmic segmentation

zygapophyseal joints are best demonstrated with an LPO position of the thoracic spine

right

which zygapophyseal joints are demonstrated in a RAO proj of the thoracic spine

right (downside)

which foramina are demonstrated with LPO position of the cervical spine

right intervertebral foramina (upside)

A patient is scheduled for a double-contrast barium enema. During the fluoroscopy phase of the study, the radiologist detects a possible polyp in the lower descending colon. Which specific projection best demonstrates this region of the colon?

right lateral decubitus; it drains excess barium from descending colon, allowing polyps to be visualized.

The RAO projection best demonstrates the __________ (right or left) colic flexure with the CR and IR centered to the level of the ___________.

right; iliac crest

in addition to extending the chin, which additional positioning technique can be performed to ensure that the mandible is not superimposed over the upper cervical vertebrae for oblique proj.

rotate the skull into a near lateral

lack of symmetry of the zygapophyseal joints between C1 and C2 may be caused by injury or may be associated w/

rotation of the skull

mild form of scoliosis and kyphosis developing during adolescence

scheuermann disease

common condition in which bone development changes of vertebrae results in kyphosis. more common in early adolescent M

scheuermann's disease

abnormal latral curvature seen in the thoracolumbar spine is called

scoliosis

a patient comes to the radiology department with a clinical history of scheuermann disease. which procedure is often performed

scoliosis series

conventional radiographic examination for scheuermann disease

scoliosis series

a temporary failure of the renal system is an example of ___ reaction

severe

systemic contrast media reaction: brachycardia (< beats/mins)

severe

systemic contrast media reaction: cardiac arrest

severe

systemic contrast media reaction: hypotension (systolic blood pressure < 80 mm Hg)

severe

systemic contrast media reaction: laryngeal swelling

severe

systemic contrast media reaction: temporary renal failure

severe

contrast media reactions: bradycardia

severe systemic

contrast media reactions: convulsions

severe systemic

contrast media reactions: extravasation

severe systemic

contrast media reactions: respiratory arrest

severe systemic

What are the patient shielding recommendations during a barium enema?

shield all radiosensitive areas outside the region of interest

Bucky slot shield

shielding device best reduces exposure to the lower torso of fluoroscopist

what techniques will minimize burring from patient motion?

short exposure time and high mAs

an expected outcome to the introduction of contrast media is described as a

side effect

contrast media reactions: metallic taste

side effect

contrast media reactions: temporary hot flash

side effect

which set of zygapophyseal joints of the lumbar spine is best demonstrated with an LAO position?

side farthest from IR, upside

small intestine

site where most of the absorption of digestive end products takes place

what is the radiographic imaging order for abuse that assists in determining normal variants vs disease/abuse?

skeletal survey

cardiac antrum

slightly expanded portion of the terminal esophagus

group of disorders where the posterior aspects of the vertebrae fail to develop, exposing parts of the spinal cords. can be discovered before birth by US/amniotic tests

spina bifida

which one of the following conditions is often diagnosed by prenatal ultrasound?

spina bifida

mild form of spina bifida characterized by the defect or splitting of the posterior arch of the L5-S1 vertebrae WITHOUT protrusion of spinal cord and meninges

spina bifida occulta

structures that pass through the intervertebral foramina

spinal nerves and blood vessels

inflammation of the vertebrae

spondylitis

what are the major differences between spondylosis and spondylitis

spondylosis is a condition of the spine characterized by rigidity of a vertebral joint and spondylitis is an inflammatory process of the vertebrae.

___________ is a group of intestinal malabsorption diseases involving the inability to absorb certain proteins and dietary fat.

sprue

what type of renal calculi is often associated with chronic urinary tract infection

stag horn calculi

a large stone that grows and completely fills the renal pelvis

stag horn calculus

What is the name of the palpable junction between the upper and mid portion of the sternum?

sternal angle

Which part of the sternum do the second ribs articulate?

sternal angle

joint between top and center portions (landmark)

sternal angle

the ___ glands are located directly superior to the kidneys

suprarenal (adrenal)

loss of consciousness resulting from reduced cerebral blood flow is termed

syncope

the zygapophyseal joints of the lumbar spine are classified as _______________ joints with _________________ type of movement.

synovial, plane/gliding

congenital deformity of the foot that can be dx prenatally with use of real time US

talipes

comminuted fx of the vertebral body with posterior fragments displaced into the spinal canal

teardrop burst fx

fundus

term for the distal portion of the gallbladder

esophagogastric junction (AKA cardiac orifice)

term for the opening bewteen the esophagus and the stomach

1. pyloric antrum 2. pyloric canal

the 2 divisions of the pyloric portion of the stomach

1. fundus 2. body 3. pyloris

the 3 main divisions of the stomach

mastication

the act of chewing

simple sugars

the end products of digestion of carbohydrates

amino acids

the end products of the digestion of protein

T11

the esophagus extends from C5-C6 to:

posterior inferior

the gallbladder is located in the ____________ margin of the liver

stomach

the greek term gaster or gastro means

duodenojejunal flexure

the junction between the duodenum and jejunum

duodenojejunal flexure

the junction of the duodenum with the jejunum

1. better coating & visibility of the mucosa 2. polyps, diverticula & ulcers are better demonstrated

the major advantages of using a double-contrast media technique for esophagrams & upper GI's

fundus

the most posterior portion of the stomach

duodenal papilla, (Papilla of Vater)

the opening for the common bile and pancreatic ducts into the duodenum

pyloric orifice

the opening, or orifice as it leaves the distal stomach

describe the body build that may require the CR angulation to open the intervertebral joint spaces with a lateral projection of the lumbar spine, even if the patient has waist support?

thicc, wide hips, and thin thorax need 5-8 caudal angle

2 primary or posterior convex curves seen in the vertebral column

thoracic and sacral

convex curve (with respect to posterior)

thoracic spine and sacrum

in addition to the gonads, which other radiosensitive organs are of greatest concern during cervical and thoracic spine

thyroid, parathyroid glands, and breasts

what is the purpose of using an orthostatic (breathing) technique for a lateral proj. of the thoracic spine

to blur out rib and lung markings that obscure detail of thoracic vertebrae

why should a single lateral projection of the sacrum and coccyx be performed rather than separate laterals of the sacrum and coccyx?

to decrease gonadal dose

what is the primary purpose of ureteric compression

to enhance filling of the pelvis-caliceal system with contrast media

what is the purpose of the premedication procedure before an iodinated contrast media procedure

to reduce the severity of a contrast media reaction

fundus

to which aspect of the stomach does barium gravitate to when the pt is in a supine position

a radiograph of an LPO projection of the lumbar spine reveals that the downside of the pedicles are projected toward the posterior aspect of the vertebral bodies. What must be done to correct this?

too obliqued, move patient to 45 degree oblique position

3 features that make the cervical vertebrae unique

transverse foramina, bifid spinous process, and overlapping vertebral bodies

What does the nose of the Scotty dog represent?

transverse process

less CR angle is required for the AP axial proj of the cervical spine if the examination is performed supine rather than erect

true

nuc med is often performed to diagnose bone tumors of the spine

true

only T1,T11, and T12 have full facets for articulation with ribs.

true

the thyroid dose used during a posterior oblique cervical spine proj. is more than 10 times greater than the dose used for an anterior oblique proj of cervical spine

true

to a certain degree, MRI and CT are replacing myelography as the imaging modalities of choice for the diagnosis of a ruptured intervertebral disk

true

true/false: acute renal failure may occur 48 hours after an iodinated contrast media procedure

true

true/false: if unsuccessful during the initial puncture, a new needle should be used during the second attemp.

true

true/false: mild level contrast media reactions do not usually require medication or medical assistance

true

true/false: nuc med is highly effective in demonstrating signs of vesicoureteral reflux

true

true/false: the # of retrograde urography procedure for urethral calculi has been reduced as a result of the increased of CT

true

true/false: the pt dose not require extensive bowel preparation before a CT scan for renal calculi

true

true/false: the pt or legal guardian must sign an informed consent form before a venipuncture procedure is performed on a pediatric pt.

true

true/false: the pt should void before an IVU to prevent possible rupture of the bladder if compression is appled

true

true/false: urinary studies on pediatric pt should be scheduled early in the morning to minimize the risk for dehydration

true

when using digital imaging for spine radiography, it is important to use close collimation,grids, and lead masking

true

The fifth rib is an example of a ____ (true rib or false rib)

true rib

What distinguishes a true rib from a false rib?

true rib attaches directly to the sternum with its own costocartilage.

proper name of the method for performing the cervicothoracic lateral (swimmer's) position

twining method

double contrast

type of contrast that allows visualization of the mucosal folds of the stomach

sliding hiatal hernia

type of hiatal hernia that is caused by weakening of a small muscle located between the terminal esophagus & the diaphragm - the esophageal sphincter weakens and allows a portion of the stomach to herniate through the esophageal hiatus - degree of herniation may vary

Chronic inflammatory condition of the large intestine

ulcerative colitis

bezoar

undigested material trapped in the stomach

produces the "bow tie" sign

unilateral subluxation

common hepatic duct

union of the left and right hepatic ducts form which duct

a build-up of nitrogenous waste in the blood is called

uremia

what is the name of the junction found between the distal ureters and urinary bladder

ureterovesical junction

the following structures is located most anterior as compared with the others

urinary bladder

an eruption of wheals (hives) often caused by a hypersensitivity to food or drugs is a condition termed

urticaria

CR centering for a lateral L5-S1 projection of the lumbar spine

1 1/2" inferior to the iliac crest and 2" posterior to ASIS

Skin dose from a lateral sacrum/coccyx projection on an average Pt

1000-1500 mrad

Angle to the coronal plane at which the sacroiliac joints lie

30° Oblique

How many segments make up the sacrum in neonate?

Ideal kV range for ribs above the diaphragm

65kVp - 70kVp

Average breast dose range for a posterior oblique rib projection

66 mrad

Amount of breats dose decrease for an anterior oblique rib projection verus a posterior oblique rib projection

About 5%

Classification for rib joints that have diarthrodial movement

Synovial

number on bones sacrum

specific aspect of the kidney is visualized during IVU

collecting system of the kidney

Hepatopancreatic ampulla

Common passageway between common bile duct and pancreatic duct (ampulla of Vater)

Amount of patient dose for either the thyroid or the breast on a correctly collimated PA SC projection

1-5 mrad

List three factors that reduce the number of repeat exposures with pediatric patients:

1. Improper immobilization 2. Short exposure times 3. Accurate manual technique charts

What are five of the six specific classifications of child abuse?

1. Neglect 2. Physical Abuse 3. Sexual Abuse 4. Psychological Maltreatment 5. Medical Neglect

List three factors that reduce the number of repeat exposures with pediatric patients:

1. Proper immobilization 2. Short exposure times 3. Accurate manual technique charts

Rotation of the thorax required for an anterior oblique SC projection

10°-15°

3 contricted points along the length of the ureters where a kidney stone is most likely to lodge

1. Ureteropelvic junction (UPJ) 2. Near brim of pelvis 3.Ureterovesical junction (UVJ)

what are the methods of decreasing pt dose for CT exams?

1. perform only necessary exams 2. adjust parameters based on: child size, region scanned, organ system scanned 3. scan resolution

what are the 4 main examples of commercial immobilization devices?

1. tam-em board 2. posi-tot 3. pigg-o-stat 4. papoose board

Three projections required for a Pt with trauma to sternum and left SC region

1.15°-20° RAO sternum with breathing technique 2.Lateral Sternum on inspiration 3.10°-15° LAO of SC joint on inspiration

Two (2) joints that are Synarthrodial or immovable

1.1st Sternocostal 2.3rd Costochondral

The amount of urine normally produced by the kidneys in 24 hours

1.5 liters

Two (2) projections to be included in a rib routine when either pneumothorax or hemothorax is suspected

1.PA Chest 2.Lateral Chest

Two (2) most important considerations for Rib Routines

1.Place the area of interest (injury) closest to IR 2.Rotate the spine away from the area of interest for axillary ribs

Three (3) conditions for which bony thorax nuclear medicine bone scans are normally performed

1.Possible Fractures 2.Osteoporosis 3.Osteomyelitis (NOT Hx of multiple myeloma)

Three (3) joints which are Diarthrodial or plane (gliding) in the bony thorax

1.Sternoclavicular 2.Costovertebral 3.8th Interchondral

Descending portion

2nd portion of the duodenum which is the longest segment & contains the duodenal papilla

1. carbohydrates 2. proteins 3. lipids (fats)

3 classes of substances that are ingested & need to be chemically digested

number on bones cervical

the zygapophyseal joints for the second through seventh cervical vertebrae are at a ____ angle to the midsagittal plane; the thoracic vertebrae are at a ____ to the midsagittal plane.

90 degree and 70-75 degree

diverticula

A blind outpouching of the mucosal wall of the stomach

Gonion

What gender type appears wide and contains ischial spines protruding less into pelvic inlet on a pelvic radiograph?

Female

Which gender receives a greater gonadal dose with an AP pelvis projection when gonadal shielding is not used?

Females. Because of the location of the CR and reproductive organs.

What is the largest and strongest bone of the body?

Femur

Correction to be made on an x-ray of the upper ribs if the diaphragm is superimposed over the 8th ribs, which is in the area of interest

Have the Pt suspend respiration during inspiration enough to move the diaphragm below the 8th ribs

Which of the following is NOT the name of a known commercially available immobilization device?

Hold-em Tiger

third portion of duodenum

Horizontal portion of duodenum

Projections which should be taken to evaluate flexibility following spinal fusion surgery

Hyperextension and hyperflexion projections

Best series for a Pt with a lumbar fusion with orders to assess mobility

Hyperflexion and hyperextension lateral positions

Follow up study after spinal fusion of lower C-spine C5-C6. Surgeon wants to check AP mobility of a fused spine. Additional projections?

Hyperflexion and hyperextension lateral projections

Female pelvis

Iliac Wings flared. Larger/More rounded inlet. Obtuse pubic arch.

What part of the hip bone articulates with the sacrum to form the sacroiliac (SI) joints?

Ilium

What part of the hip bone contains the Ala?

Ilium

Enteritis

Inflammation of the intestine

Describe or Define: Cystic fibrosis

Inherited disease leading to clogging of bronchi

What are the three aspects of the lesser pelvis and what is the birth route during the delivery process?

Inlet (Superior Aperture), Cavity, and Outlet (Inferior Aperture)

What might the only recourse be if a pediatric patient refuses to drink barium for an upper GI series?

Insert a nasogastric tube into the stomach

Positioning error shown when downside pedicles and zygapophyseal joints are projected over the anterior portion of the vertebral bodies (LPO lumbar spine)

Insufficient rotation of the spine - should be to midvertebral bodies)

The superior and inferior vertebral notches create which foramina?

Intravertebral foramina

Which pathologies is best demonstrated with a radiographic abdomen procedure?

Intussusception and Meconium ileus

Which position or projection of the cervical spine best demonstrates the zygapophyseal joints? (Between C3 & C7)

Lateral position

Which specific joint spaces are visualized with a LAO projection of the thoracic spine?

Left zygapophyseal joints (downside)

Which landmark is not a palpable bony landmark? (Greater trochanter, lesser trochanter, ischial tuberosity, ASIS)

Lesser trochanter

What structures on an AP pelvis or hip radiograph indicate whether the proximal head and the neck are in position for a true AP projection?

Lesser trochanter should not be visible or barely showing for a radiograph.

Location of CR centering for a PA projection of the sternoclavicular joints

Level of T2-T3

Possible perforated hollow viscus Large bowel obstruction

List the two conditions that may prevent the use of barium sulfate during a small bowel series.

Extravasation is classified as this type of reaction

Local

jejunum

Makes up 40% of the small intestine

Unable to process certain nutrients

Malabsorption syndrome

Acute pubis arch (less than 90°)

Male

Heart-shaped (oval) inlet

Male

Iliac wings that are less flared

Male

Outpouchings located in distal ileum

Meckel's diverticulum

Nuclear medicine

Meckel's diverticulum is best diagnosed with which imaging modality?

Is the lesser trochanter located on the medial or lateral aspect of the proximal femur?

Medial

What is formed by the fusion of the sacral spinous processes?

Median Sacral Crest

What kind of mechanical digestion takes place in the stomach?

Mixing (chyme) Peristalsis

Tachycardia (> 100 beats/min) is a symptom of this type of reaction

Moderate reaction

The area in which bone growth in length occurs is termed the _________.

Metaphysis

Should a grid be used for a 2-year-old lateral chest?

What is the bowel prep for a pediatric voiding cystourethrogram (VCUG)?

No bowel prep is required

pyloric orifice

Opening leaving the stomach

What is the second method for locating the femoral head?

Palpate ASIS and go 1 to 2 inches medial at the level of the symphysis pubis or greater trochanter which is 3 to 4 inches distal to the original palpation point.

The condition that is considered high risk for an iodinated contrast media procedure

Pheochromocytoma

The most suitable immobilization device for erect chests and/or the abdomen is the:

Pigg-O-Stat

Situation: A patient comes to the radiology department for an IVU following abdominal surgery the day before. The IVU protocol requires the ureteric compression be used. What else can be done to achieve the same goal without using compression?

Place patient in 15 deg Trendelenburg position during the first part of procedure

Name of the anterior and superior aspect of the sacrum that forms the posterior wall of the pelvic inlet

Promontory

Name of the anterior ridge of the upper sacrum

Promotory

Ideal general body position to demonstrate an injury to the ribs found below the diaphragm

Recumbent

Positions to be performed for a unilateral rib study (ER Pt with left lower posterior rib injury)

Recumbent AP and LPO positions

Reason for flexing the knees and hips for an AP lumbar spine projection

Reduces lumbar curvature which opens the intervertebral disk space

The procedure that may require a Brodney clamp

Retrograde ureterogram on a male patient

The kidneys are ____________________ structures

Retroperitoneal

AP axial (Taylor method) demonstrates anterior pelvic bones of female patient foreshortened. Central ray angle 30° caudad and 1 to 2 inches distal to symphysis pubis. Modifications?

Reverse central ray angle

Projections to be performed for ER Pt with multiple rib Fx - MD suspects flail chest and Pt can stand and move

Rib series - PA and lateral chest study

Specific set of zygapophyseal joints that are demonstrated with an LAO position

Right (upside)

What are the two bones that make up the pelvic girdle?

Right and left hip bones

What are the four bones that make up the pelvis?

Right and left hip bones, sacrum, and coccyx.

Joint which is demonstrated by the RPO position

Right zygapophyseal joints

Which joints are synovial joints but with amphiarthrodial mobility? (Union of acetabula, hip joints, sacroiliac, symphysis pubis)

Sacroiliac joints

Abnormal lateral curvature of the vertebral column

Scoliosis

An abnormal or exaggerated lateral spinal curvature is called

Scoliosis

Scheuermann disease is a form of

Scoliosis and/or kyphosis

What rib attaches to the sternal angle?

Second rib

Classification and movement type of the lumbar zygapophyseal joints

Synovial and plane (gliding)

Classification, mobility, and movement type for lumbar zygapophyseal joints

Synovial, Diarthrodial, Plane (gliding)

Ulcerative colitis

Sever form of colitis

Laryngeal swellingis is classified as type of reaction

Severe Level reaction

A greater central ray angle is required. Female patients require a central angle of 30º to 45º.

Situation: a radiograph of an AP axial projection for anterior pelvic bones reveals that the pubic and ischial bones are not elongated sufficiently. The following factors were used for this study: 86kV, 7mAs, bucky, 20º to 30º central ray cephalad angle, and 40 inches (100cm) SID. The emale patient was placed in a supine position on the table. What must be changed to improve the quality of the image during the repeat exposure?

Which modality is used to assess joint stability during movement of the lower limbs on infants?

Sonography

Part of the sternum that articulates with the 2nd rib

Sternal Angle

Name of the palpable junction between the upper and midpoint of sternum

Sternal angle

What is the lower end of the manubrium called?

Sternal angle

Name of the anterior end of the rib

Sternal end

Name of the most anterior end of the rib

Sternal end

cholecystectomy

Surgical removal of the gallbladder

T/F: consent from the parent is needed before using an immobilization device

True

Which ligament holds the dens against the anterior arch of C1?

Transverse atlantal ligament

to break down or emulsify fats

The primary function of bile

Gonadal shielding should be used for all patients of reproductive age unless when?

Unless it covers anatomic structures of primary interest.

Ideal body position for projections of ribs above the diaphragm

Upright if possible

A type I Salter-Harris fracture involves the:

epiphyseal plate.

cholecystitis

inflammation of the gall bladder

A radiograph of an RAO positions of the sternum reveals that the width of the sternum is foreshortened and the sternum is shifted away from the spine and out of the heart shadow. The patient has a large "barrel" chest. The technologist performed the RAO with 20 to 25 degrees of rotation and used a breathing technique. Which positioning error led to this radiographic outcome?

Overrotation of the sternum. A large-chested patient only requires approximately 15 degrees of rotation. Overrotation will lead to foreshortening along the width of the sternum and will shift the sternum away excessively from the spine.

Situation: A patient comes to the ER with a right upper, anterior rib injury. A unilateral rib study is ordered. What are the basic projections taken for this patient?

PA and LAO positions taken erect if possible

Positioning and breathing routines for an ER Pt with injury to the left upper anterior ribs who cannot stand but can lay prone

PA and RAO performed recumbent on inspiration

Situation: A patient with an injury to the left upper anterior ribs comes to the ER. His unable to stand but can lie on his abdomen. List the position routine that would be used for this patient. Include breathing instructions.

PA and RAO performed recumbent. Expose upon inspiration.

Situation: A patient comes to the ER with multiple rib fractures. The ER physician suspects a flail chest. The patient is able to stand and move. Beyond a rib series what projections should be taken for this patient?

PA and lateral chest study

Projection or method used to demonstrate the degree of scoliotic deformity between the primary and compensatory curves as part of a scoliosis study

PA(AP), Ferguson method (with and without block under convex side of curve

Situation: A technologist notices that his AP pelvis projections often demonstrate a moderate degree of rotation. What positioning technique can the technologist perform to eliminate (or at least minimize) rotation on his AP pelvis projections?

Palpate both ASIS and ensure both are equal distance from tabletop. Ensure iliac wings are symmetric.

A portion of the lamina located between the superior and inferior articular processes

Pars Interarticularis

1. Oral cavity (mouth) 2. Pharynx 3. Esophagus 4. Stomach 5. Duodenum & small intestine

Parts of the alimentary canal studied in Upper GI

Situation: A radiograph of an AP pelvis shows that the right iliac wing is foreshortened as compared with the left side. Which specific positioning error was made?

Patient is rotated toward the left (left posterior oblique).

Malabsorption syndrome

Patient with lactose or sucrose sensitivities

Name for the "eye" of the "scottie dog" which should be near the center of the vertebral body on a correctly obliqued lumbar spine

Pedicle

Part of the body which must remain stationary during right and left bending positions of the lumbar spine (AP or PA)

Pelvis

Situation: A patient with a possible pelvic ring fracture from a trauma enters the emergency room. The AP pelvis projection, which was taken to determine whether the right acetabulum was fractured, is inconclusive. Which other radiographic projection can be taken to better visualize the acetabulum? What other imaging modality can be used to determine the presence of a pelvic ring fracture?

Posterior oblique (Judet method). CT is often judged superior in detecting pelvic ring fractures.

Patient with possible pelvic ring fracture. AP pelvis projection is inconclusive. Other additional pelvic projections to demonstrate possible pelvic fractures?

Posterior oblique projection (Judet method) will demonstrate possible pelvic ring and acetabular fracture's and AP axial "outlet" and AP axial "inlet" the ischium and pubis

Which special projection of the hip demonstrates the anterior and posterior rims of the acetabulum and the ilioischial and iliopubic columns? (include the projection name and the method name).

Posterior oblique projections of acetabulum (Judet method)

The end of the rib that is most superior

Posterior vertebral end

Does the lesser trochanter project anteriorly or posteriorly from the junction between the neck and shaft?

Posteriorly

The ureters enter the ________________ aspect of the bladder

Posterolateral

Describe or Define: Craniostenosis

Prematurely closed cranial sutures

Primary or Assisting technologist? Instructs the parents

Primary technologist

Primary or Assisting technologist? Positions the patient

Primary technologist

Describe or Define: Meningocele

Protrusion of meninges through opening

What part of the hip bone forms the anterior, inferior aspect of the lower pelvic girdle?

Pubis

The major calyces of the kidney unite to form this structure

Renal pelvis

The 8 to 18 conical masses found within the renal medulla

Renal pyramids

Situation: A radiograph of a unilateral frog-leg (modified Cleaves) projection produces distortion of the femoral neck. Based on the AP hip projection, the radiologist suspects a nondisplaced fracture of the femoral neck. What can the technologist do to define the region better?

Repeat the exposure and only abduct femur 20 to 30 degrees from vertical.

Set of zygapophyseal joints of the lumbar spine best demonstrated with an LAO position

Right or upside joints

Joint which is demonstrated by the LAO position

Right zygapophyseal joints

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

Rotate the lower legs 15 to 20 degrees internally to put the proximal femurs in a true AP position.

Rotate the lower limbs 15º to 20º internally to place the proximal femurs in a true AP position. (With general chronic pain, the lower limbs can usually be rotated safely.)

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

If possible, elevate the patient at lease 2 inches (5 cm) by placing sheets or blankets beneath the pelvis.

Situation: A radiograph of an axiolateral (inferosuperior) projection reveals that the posterior aspect of the acetabulum and femoral head were cut off of the bottom of the image. The emergency room physician requests that the position be repeated. What can be done to avoid this problem on the repeat exposure?

Reduce CR angle to 12º cephalad

Situation: A radiograph of the Teufel method (PA axial oblique) demonstrates distortion of the acetabulum. During positioning, the patient was rotated 35º to 40º toward the affected side and CR was angle 20º cephalad. What modifications are needed during the repeat exposure?

angle CR 30º cephalad

Situation: A radiograph produced using the Taylor method demonstrates that the anterior pelvic bones of a femur patient are foreshortened. The following postioning factors were used: supine position 40-inches (100cm) SID and central ray angled 30º caudad and centrered 1 to 2 inches (3-5cm) distal to symphysis pubis. Which one of the following modifications should be made during the repeat exposure?

Palpate both ASIS and ensure they are equal distance from tabletop.

Situation: A technologist notices that his AP pelvis projections often demonstrate a moderate degree of rotation. What prositioning technique can the technologist perform to eliminate (or at least minimize) rotation of his AP pelvis projections?

Only abduct the femurs 20º to 30º from the veritcal rather than 45º to minimize distortion of the femoral neck.

Situation: A unilateral frog-leg (modified Cleaves) demonstrates foreshortening of the femoral necks. The physician is unsure if ther is a defect withing the anatomical neck. What can be done to minimize destortion of the neck during a repeat expsoure?

AP pelvis and bilateral "frog-leg" (modified Cleaves) projections.

Situation: A very young child comes to the radiology department with a clinical history of DDH. What is the most common positioning routine for this condition?

AP pelvis projection and possibly posterior oblique (Judet method) projection to provide another perspective of the ASIS region (Note: Perform projections on 14 x 17 inch (35 x 43cm) IR to demonstrate entire pelvis). Decrease kV to 65 to 70 (from standard 80 to 90kV)

Situation: A young patient comes to the radiology department with a chronic pain near the ASIS. She is an active athlete who injured her pelvis while running hurdles. Her physician suspects an avulsion fracture. Which position(s) may best diagnose this condition? Must the technologist increase or decrease kV for this projection to demonstrate the fracture?

AP pelvis and bilateral "frog-leg"

Situation: A young patient with a clinical history of SCFE comes to the radiology department. Which projections are most often taken for this condition?

The AP axial outlet projection (Taylor method will elongate the pubis and ischium and define this region more complete.

Situation: An initial AP pelvis radiograph reveals possible fractures involving the lower anterior pelvis. The emergency room physician asks for another projection to better demonstrate this area of the pelvis. The patient is traumatized and must remain in a supine position. Which projection should be taken?

Posterior oblique -Judet method

Situation: a patient with a possible pelvic ring fracture from a trauma enters the emergency room. The AP pelvis projection, which was taken to determine whether the right acetabulum is fractured, is inconclusive. Which other radiographic projection can be taken to better visualize the acetabulum?

Axiolateral inferosuperior projection of a hip demonstrates a soft tissue density that is visible across the infected hip and acetabulum. Artifact obscuring image of proximal femur. Cause of artifact?

Soft tissue from the unaffected thigh (unaffected leg not lifted high enough). The leg must be flexed and elevated enough to keep it from superimposing the affected hip.

Visible rotation in the vertebral column during AP lumbar spine

Spinous process should be midline to the vertebral column

Forward displacement of one vertebra onto another vertebra

Spondylolisthesis

Forward movement of one vertebra in relation to another

Spondylolisthesis

Dissolution and separation of the pars interarticularis

Spondylolysis

Lack of development of vertebral arch and separation of pars interarticularis

Spondylolysis

Name of the joint that is the only connection of the bony thorax to the upper limbs

Sternoclavicular Joint

1. vitamins 2. minerals 3. water

Substances ingested but NOT disgested - these substances are used in the form in which the body ingests them

1. carbohydrates 2. proteins 3. lipids (fats)

Substances ingested, digested, and absorbed during chemical digestion

Procedure which will open the L5-S1 joint space for a lateral projection of the L5-S1

Support (sponge or pillow) beneath the middle aspect of the spine, and CR angle to 5°-8° caudal

Ideal breathing instructions to demonstrate an injury to the ribs found below the diaphragm

Suspend on Expiration

Breathing instructions for projections of ribs above the diaphragm

Suspend on Inspiration

Breathing instructions for any SC joint projections

Suspend respiration on expiration

Breathing instructions for a PA projection of the sternoclavicular joints

Suspend respiration on inspiration

a radiograph of an AP proj thoracic spine reveals that the upper thoracic spine is greatly overexposed but the lower vertebrae are well visualized. the head of the patient was placed at the anode end of the table. what can be modified during the repeat exposure to produce a more diagnostic image

use a compensating wedge filter with thicker part of filter placed over the upper thoracic spine to equalize the density along the thoracic spine

lateral thoracic spine reveals that lung markingsand ribs make it difficult to visualize the verteral bodies. the following factors were used: recumbent position, 40 inch SID, short exposure time, and exposure made during full expiration. which one of these factors must be modified to produce a more diagnostic image

use of an orthostatic (breathing) technique to blur lung markings and ribs more effectively

iodinated contrast media used for urography: ionic

uses a parent compound of a benzoic acid

iodinated contrast media used for urography: non-ionic

uses a parent compound of an amide or glucose group

Esophageal varices

varicose veins in the esophagus - a tortuous dilation caused by hypertension in portal vein which causes back-up - can be caused by cirrhosis of the liver

which type of reaction is caused by the stimulation of the vagus nerve by introduction of contrast medium, which causes heart rate and blood pressure to fall

vasovagal reaction

What is the correct term for the appendix?

vermiform appendix

artificial opening between the urinary bladder and aspects of the large intestine

vesicorectal fistula

radiographic apperances : signs of abnormal fluid collections

vesicorectal fistula

backwards flow of urine from the bladder to the ureters/kidneys. increased chance of spreading infection

vesicoureteral reflux

A tapered or corkscrew appearance seen during a barium enema

volvulus

A twisting of the intestine on its own mesentery

volvulus

type of intestinal obstruction caused by the twisting of the intestine upon itself

volvulus

Peristalsis

wavelike involuntary contractions that help propel food down the esophagus

A patient comes to the radiology department with a clinical history of giardiasis. She is scheduled for a barium enema procedure. Which of the following precautions must be followed during the procedure?

wear gloves

antral muscle thickness exceeding 4 mm

what criterion is used with ultrasound in determining whether the pt has HPS

Illium

what is the largest bone in the pelvic girdle?

mumps

what is the name of the condition that results from the viral infection of the parotid

hip fractures (bilateral) or limited hip movement lateral/proximal hip trauma*

what situation is the Clements-Nakayama method utilized for?*

None. CR is perpendicular.

what type of CR angle is required for the Judet Method

a radiograph of a right posterior oblique (RPO) cervical spine projection reveals that the lower intervertebral foramina are not open. the upper intervertebral foramina are well visualized . what positioning error most likely led to this

when the lower intervertebral foramina are narrowed while the upper foramina are well demonstrated the positioning error most often is under rotation of the upper body. the upper body must be rotated 45 degree.

Right lateral

which UGI position best demonstrates a possible gastric diverticulum in the posterior wall of the fundus of the stomach

Fundus

which aspect of the stomach fills with air when the patient is prone during a double contrast UGI

common bile duct (CBD)

which duct carries bile form the cystic duct to the duodenum

Cholecystokinin (CCK)

which hormone leads to the contraction of the gallbladder to release bile

angular notch (incisura angularis)

which of the following aspects of the stomach is defined as an indentation between the body and pylorus

Dehydration

which of the following conditions may prevent the use of water soluble contrast agents for a geriatric patient

sacroiliac joint

which of the following joints are synovial jts but with amphiarthrodial mobility?

lesser trochanter

which of the following landmarks are not a palpable bony landmark

trachea

which of the following structures does not pass through the diaphragm

ischial spines

which of the following structures is considered as the MOST posterior?

hydrolysis

which process leads to a concentration of bile within the gallbladder

RUQ

which quadrant is the liver located in a sthenic patient

rotated to the left (LPO)*

which specific positioning error cause an AP pelvis to demo. that the right obturator foramen is more open or elongated compared to the left?*

rotated to the right (RPO)*

which specific positioning error caused an AP image of the pelvis to demo. that the left iliac wing is foreshortened as compared to the right wing?*

Epiglottis

which structure in the pharynx prevents aspiration of food and fluid into the larynx

chyme

which term describes food after it enters the stomach and is mixed with gastric secretions

Chapter 7 Femur and Pelvic Girdle ****, Pediatric Positioning Chapter 16 self test, Bontrager Chapter 16, Ch 14: Urinary System & Venipuncture self test only, bontrager ch. 14, Chapter 13 Lower Gastrointestinal System: Self Test, Lower GI System - Ch...

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