Pelvis (and some random too)

LOOK AT XRAY COMPONENTS (SIMPLE TOO)

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All the following are palpable bony landmarks used in radiography of the pelvis except A the femoral neck B the pubic symphysis C the greater trochanter D the iliac crest

The Correct Answer is: A Femoral necks are nonpalpable bony landmarks. The ASIS, pubic symphysis, and greater trochanter are palpable bony landmarks that may be used, according to policy of the facility, in radiography of the pelvis and for localization of the femoral necks. (Frank, Long, and Smith, 11th ed., vol. 1, p. 341)

What lies immediately under the phosphor layer of a PSP storage plate? A Reflective layer B Base C Antistatic layer D Lead foil

The Correct Answer is: A The PSP storage plate within the IP has a layer of europium-activated barium fluorohalide (BaFX: Eu 2 +; X = halogen) mixed with a binder substance. This layer serves as the image receptor when exposed. The barium fluorohalide is usually granular or turbid phosphors. Other examples of turbid phosphors are gadolinium oxysulfide and rubidium chloride. "Needle"-shaped, or columnar phosphors (usually cesium iodide), have the advantage of better x-ray absorption and less light diffusion. Just under the barium fluorohalide layer is a reflective layer that helps direct emitted light up toward the CR reader. Below the reflective layer is the base, behind that is an antistatic layer, and then the lead foil to absorb backscatter. Over the top of the barium fluorohalide is a protective layer.

Which of the following statements regarding the male pelvis is (are) true? 1. The angle formed by the pubic arch is less than that of the female. 2. The pelvic outlet is wider than that of the female. 3. The ischial tuberosities are further apart. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: A The architectural features of the female pelvis are designed to accommodate childbearing. The female pelvis as a whole is broader and more shallow than its male counterpart, having a wider and more circular pelvic outlet. The ischial tuberosities and acetabula are further apart. The sacrum is wider and extends more sharply posteriorly. The pubic arch of the man is significantly narrower than that of the woman. (Saia, pp 106-108)

What structure can be located midway between the anterosuperior iliac spine (ASIS) and pubic symphysis? A Dome of the acetabulum B Femoral neck C Greater trochanter D Iliac crest

The Correct Answer is: A The dome of the acetabulum lies midway between the ASIS and the symphysis pubis. On an adult of average size, a line perpendicular to this point will parallel the plane of the femoral neck. In an AP projection of the hip, the CR should be directed to a point approximately 2 inches down that perpendicular line so as to enter the distal portion of the femoral head. (Frank, Long, and Smith, 11th ed., vol. 1, p. 341)

The most commonly used method of low-flow oxygen delivery is the A oxygen mask. B nasal cannula. C respirator. D oxyhood.

The Correct Answer is: B The most commonly used method of low-flow oxygen delivery is the nasal cannula. It can be used to deliver oxygen at rates from 1 to 4 L/min at concentrations of 24% to 36%. The nasal cannula also provides increased patient freedom to eat and talk, which a mask does not. Masks are used for higher-flow concentrations of oxygen, over 5 L/min; depending on the type of mask, they can deliver anywhere from 35% to 60% oxygen. Respirators and ventilators are high-flow delivery mechanisms that are used for patients who are in severe respiratory distress or are unable to breathe on their own. Oxyhoods or tents generally are used for pediatric patients who may not tolerate a mask or cannula. The amount of oxygen delivered is somewhat unpredictable, especially if the opening is accessed frequently. Oxygen delivery may be between 20% and 100%. (Adler and Carlton, 4th ed., p. 204)

The lateral aspect of the obturator foramen is formed by the A ilium. B ischium. C pubis. D sacrum.

The Correct Answer is: B The obturator foramen is the largest foramen in the human skeleton. Blood vessels and nerves pass through this large pelvic foramen. Whereas the ilium, ischium, and pubis make up the pelvis—only two of those bones, the ischium and pubis, make up the obturator foramen. The lateral aspect of the foramen is comprised of the ischium and its rami, while its medial aspect is formed by the pubis and its rami. (Tortora, 11th ed, p 242)

The right posterior oblique position (Judet method) of the right acetabulum will demonstrate the anterior rim of the right acetabulum right iliac wing right anterior iliopubic column A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: B The posterior oblique projection of the acetabulum (Judet method) requires a 45-degree obliquity of the entire MSP. In the RPO position, the down side (the right side in this case) will demonstrate the anterior rim of the right acetabulum, the right posterior ilioischial column, and the right iliac wing. When centered to the up side (left in this case), the structures demonstrated are the posterior rim of the left acetabulum, left anterior iliopubic column, and the left obturator foramen. (Bontrager and Lampignano, 7th ed., p. 279)

If the entrance dose for a particular exam is 1200 mGy, the radiation exposure at 1 m from the patient will be approximately A 120 mGy B 12.0 mGy C 1.20 mGy D 0.12 mGy

The Correct Answer is: C During radiography and fluoroscopy, radiation scatters from the patient in all directions. In fact, the patient is the single most important scattering object in both radiographic and fluoroscopic procedures. The approximate intensity (quantity) of scattered radiation at 1 m from the patient is 0.1% of the entrance dose. Therefore, if the entrance dose for this image is 1200 mGy, the intensity of radiation at 1 m from the patient is 0.1% of that, or 1.20 mGy (0.001 × 1200 = 1.20). (Bushong, 8th ed., p. 572)

Which of the following personnel monitoring devices is commonly used in diagnostic radiography and considered to be most sensitive and accurate? A TLD B Film badge C OSL dosimeter D Pocket dosimeter

The Correct Answer is: C Ionization is the fundamental principle of operation of both the film badge and the pocket dosimeter. In the film badge, the film's silver halide emulsion is ionized by x-ray photons. The pocket dosimeter contains an ionization chamber, and the number of ionizations taking place may be equated to exposure dose; it is accurate, but it is used only to detect larger amounts of radiation exposure. Is not commonly used in diagnostic radiography. The TLD can measure exposures as low as 5 mrem, whereas film badges will measure a minimum exposure only as low as 10 mrem. TLDs contain lithium fluoride crystals that undergo characteristic changes on irradiation. When the crystals are subsequently heated, they emit a quantity of visible (thermo) luminescence/light in proportion to the amount of radiation absorbed. The relatively new OSL dosimeters contain aluminum oxide crystals that also undergo characteristic changes on irradiation. When the Al 2 O 3 crystals are stimulated by a laser, they emit (optically stimulated) luminescence/light in proportion to the amount of radiation absorbed. OSL dosimeters can measure exposures as low as 1 mrem. (Thompson et al., p. 461)

Which of the following will reduce patient dose during fluoroscopy? 1. Decreasing the source-skin distance (SSD) 2. Using 2.5 mm Al filtration 3. Restricting tabletop intensity to less than 21 mGya/min A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: C Patient dose during fluoroscopy can be considerable because the x-ray tube is in close proximity to the patient. We can therefore decrease patient dose by increasing the SSD as much as possible. The law states that the SSD must be at least 38 cm (15 inches) with fixed fluoroscopic equipment and at least 30 cm (12 inches) with mobile fluoroscopic equipment. The use of 2.5 mm Al equivalent filtration in equipment operated above 70 kVp is also required by law to reduce patient skin dose. Another requirement of fluoroscopic equipment is that the tabletop intensity not exceed 21 mGya/min. Using high level control fluoroscopy, the tabletop intensity must not exceed 200 mGya/min. (Bushong, 11th ed., p. 552, 554)

Chemical substances that are used to kill pathogenic bacteria, especially on hard surfaces, are called 1. antiseptics. 2. germicides. 3. disinfectants. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: C Some chemical agents used in health-care facilities function to kill pathogenic microorganisms, while others function to inhibit the growth/spread of pathogenic microorganisms. Germicides and disinfectants are used to kill pathogenic microorganisms, especially on hard surfaces. Antiseptics (like alcohol) are used to stop the growth/spread of pathogenic microorganisms, especially on living tissue. Sterilization is another associated term; it refers to the killing of all microorganisms and their spores. (Ballinger & Frank, vol 1, p 15)

The axiolateral, or horizontal beam, projection of the hip requires the IR to be placed parallel to the central ray (CR) parallel to the long axis of the femoral neck in contact with the lateral surface of the body A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: C The cassette for a cross-table (axiolateral or horizontal beam) lateral projection of the hip is placed in a vertical position. The top edge of the cassette should be placed directly above the iliac crest and adjacent to the lateral surface of the affected hip. The cassette is positioned parallel to the femoral neck; the CR is perpendicular to the femoral neck and cassette. (Frank, Long, and Smith, 11th ed., vol. 1, p. 358)

A diabetic patient who has taken taken insulin while preparing for a fasting radiologic examination is susceptible to a hypoglycemic reaction. This is characterized by fatigue cyanosis restlessness A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3

The Correct Answer is: C The diabetic patient who has taken their insulin, but not eaten food, can develop hypoglycemia/low blood sugar. Hypoglycemic reactions can be very severe and should be treated with an immediate dose of sugar in the form of juice or candy. Symptoms of hypoglycemia include fatigue, restlessness, irritability, and weakness. Diabetic patients who have taken their insulin prior to a fasting examination should be given priority, and their examinations should be expedited as quickly as possible. (Torres et al., 6th ed., pp. 169-170)

The femoral neck can be located A parallel to the femoral shaft. B perpendicular to the femoral shaft. C perpendicular to a line drawn from the ASIS to the pubic symphysis. D perpendicular to a line from the iliac crest to the pubic symphysis.

The Correct Answer is: C The landmarks that can be used in radiography of the bony pelvis are the iliac crest, the ASIS, the pubic symphysis, the greater trochanter, the ishchial tuberosity, and the tip of the coccyx. With the patient in the anatomic position, the femoral neck is located 2½ in. distal on a line drawn perpendicular to the midpoint of a line drawn between the ASIS and the pubic symphysis. It is recommended to rotate the legs inward about 15 degrees, whenever possible, to place the femoral neck parallel to the IR. (Frank, Long, and Smith, 11th ed., vol. 1, p. 354)

Which of the following bones participate(s) in the formation of the obturator foramen? Ilium Ischium Pubis A 1 and 2 only B 1 and 3 only C 2 and 3 only D 1, 2, and 3

The Correct Answer is: C The obturator foramen is a large oval foramen below each acetabulum and is formed by the ischium and pubis. The acetabulum is the bony socket that receives the head of the femur to form the hip joint. The upper two-fifths of the acetabulum is formed by the ilium, the lower anterior one-fifth is formed by the pubis, and the lower posterior two-fifths is formed by the ischium. Thus, the acetabulum is formed by all three of the bones that form the pelvis—the ilium, the ischium, and the pubis. (Frank, Long, and Smith, 11th ed., vol. 1, p. 335)

Which of the following may be used as landmark(s) for an AP projection of the hip? 2 inches medial to the ASIS Prominence of the greater trochanter Midway between the iliac crest and the pubic symphysis A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3

The correct answer is: (B) For an AP projection of the hip, two bony landmarks are used. The CR is directed perpendicular to a point located 2 inches medial to the ASIS at the level of the greater trochanter. A point midway between the iliac crest and the pubic symphysis is too superior and medial to coincide with the hip articulation. (Frank, Long, and Smith, 11th ed., vol. 1, p. 354)