Bontrager ch.10 Bony Thorax, 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 - Chapter 13 Bo...
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
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 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)
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
Classification of the 11th and 12th ribs
False and floating
Formed primarily by the ala of the ilium
False pelvis
Greater pelvis
False pelvis
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.
T/F A breathing technique is recommended for studies of the sternoclavicular joints.
False. Exposure is made with suspended respiration upon expiration.
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
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
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.
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).
LPO
Position that produces a radiograph showing the fundus filled with barium, but duodenal bulb filled with air in profile
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.
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
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
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
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
Three (3) joints which are Diarthrodial or plane (gliding) in the bony thorax
1.Sternoclavicular 2.Costovertebral 3.8th Interchondral
Three (3) Structures that make up the bony thorax
1.Sternum 2.Thoracic Vertebra 3.12 pairs of ribs
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
Skin dose from a lateral sacrum/coccyx projection on an average Pt
1000-1500 mrad
Rotation of the thorax required for an anterior oblique SC projection
10°-15°
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
Amount of rotation of the thorax recommended for an anterior oblique of the sternoclavicular joints
10°-15° from PA
Which ribs do not have costotransverse joints?
11th and 12th
Numbered pairs of ribs that are classified as floating
11th through 12th ribs
number on bones thoracic
12
What type of CR angle is required for the PA axial oblique (Teufel method) for acetabulum?
12° cephalad
What size of analog image receptor should be used for an adult bilateral frog-leg projection?
14 x 17 landscape
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)
number on bones cervical
7
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
normal B.U.N levels for an adult should range between
8-25 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
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
Patient position angle which best demonstrates the intervertebral foramina
90° Lateral
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.
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
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 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
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
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 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 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
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
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)
Modification of the lumbar spine series for a Pt with a clinical Hx of severe kyphosis
Basic lumbar spine projections should be performed erect
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
RAO
Best position to visualize the esophagus in a radiograph
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
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
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
mastoid tip
C1
Gonion
C3
gonion
C3
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
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
CT
Best imaging modality for compression fractures of the lumbar spine
CT
Which modality is recommended for a teardrop burst fracture?
CT
modality: demos slight differences in tissue density. head scans for: blood clots, edema, neoplastic processes. high resolution for chest pathology (parenchymal edema)
CT
re abuse: visualizes visceral damage (abd/head/skeletal fx), useful for dx brain injury from abuse and symptoms of SBS
CT
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
Describe or Define: Wilms' tumor
Cancer of the kidney of embryonic origin
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
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
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 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
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
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
US
re abuse: beneficial for visceral damage (hemorrhage) with the added benefit of no radiation
US
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
Gonadal shielding should be used for all patients of reproductive age unless when?
Unless it covers anatomic structures of primary interest.
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
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
Ideal body position for projections of ribs above the diaphragm
Upright if possible
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)
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
A type I Salter-Harris fracture involves the:
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
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
middle aspect of gallbladder
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
contrast media reactions: vomiting
mild systemic
systemic contrast media reaction: angioedema
moderate
systemic contrast media reaction: mild hives
moderate
systemic contrast media reaction: tachycardia (> 100 beats/mins)
moderate
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
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.
contrast media reactions: angioedema
moderate systemic
contrast media reactions: severe urticaria
moderate systmic
Does an asthenic patient require a little more or a little less obliquity than a hypersthenic patient in the RAO position of the sternum?
more
barium sulfate
most common radiopaque contrast medium used in the GI system
Fundus of stomach
most posterior portion of stomach
spiral valve
mucosal folds in the cystic duct
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
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
cholecystitis
inflammation of the gall bladder
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
for the lateral L5-S1 projection, the CR is parallel to the _______________ plane.
interiliac plane
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
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
bile
liquid substance that aids in digestion and is manufactured in the liver and stored in the gallbladder
contrast media reactions: pulmonary edema
local
two general categories of contrast media reactions
local and systemic
lesser curvature
location of the angular notch of the stomach
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
abnormal, or exaggerated, "sway back" lumbar curvature is called
lordosis
two landmarks must be aligned for an AP "open mouth" proj
lower margin of upper incisors and base of skull
radiographic apperances : abnormal rotation of kidney
malrotation
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
inherited renal condition many cysts form in the kidney causing enlarged kidneys in infants and children. fatal without dialysis/kidney transplant
polycystic kidney disease
multiple cysts in one or both kidney
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: pneumouria
presence of gas in urine
urinary pathologic term: glucosuria
presence of glucose in urine
emulsification of fats
primary function of bile
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
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
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 lateral curvature of the spine
scoliosis
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
spiral valve
series of mucosal folds in cystic duct
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
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
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
inferior
which of the following is not a recognized lobe of the liver
trachea
which of the following structures does not pass through the diaphragm
hydrolysis
which process leads to a concentration of bile within the gallbladder
RUQ
which quadrant is the liver located in a sthenic patient
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
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
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
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
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
Stove-pipe appearance of colon
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
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
alternative names for C7
vertebra prominens
the opening, or passageway, for the spinal cord is
vertebral (spinal) canal
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
"Angio"
vessel
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
mumps
what is the name of the condition that results from the viral infection of the parotid
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
What range of kV should be used for ribs above the diaphragm?
65 to 70 kV
Ideal kV range for ribs above the diaphragm
65kVp - 70kVp
the angle of the mid-lumbar spine zygapophyseal joints in relation to the midsagittal plane is
30-50 degrees; upper=50, lower = 30
Average breast dose range for a posterior oblique rib projection
66 mrad
Amount of rotation required to properly visualize the zygapophyseal joints at the L5-S1 level
30°
Degree of obliquity required for an oblique projection of the L5-S1 level of the spine
30°
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
A patient has a clinical history of regional enteritis. Which of the following procedures is most often performed for this condition?
enteroclysis
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
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)
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
what degree of rotation from supine is required to place the kidneys parallel to the IR
30 degree
The amount of time the venipuncture site should be cleaned with an alcohol wipe before the needle insertion
30 seconds
Angle to the coronal plane at which the sacroiliac joints lie
30° Oblique
Patient position angle to best demonstrate the lower zygapophyseal joints
30° Oblique
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
simple sugars
the end products of digestion of carbohydrates
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
Where is the CR centered for a KUB on a 3 month old infant?
1 inch above umbilicus
Volvulus
"Beak Sign"
what is the recommended SID for a lateral proj. of the cervical spine
60-72 inches
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
Two (2) chest pathologic conditions that may result from a rib injury
1.Pneumothorax 2.Hemothorax
Change in manual exposure factor? Idiopathic juvenile osteoporosis
(-)
Change in manual exposure factor? Osteogenesis imperfecta
(-)
Change in manual exposure factor? Osteomalacia
(-)
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.
1
number on bones coccyx
1
number on bones sacrum
1
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
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
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
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 factors that reduce the number of repeat exposures with pediatric patients:
1. Proper immobilization 2. Short exposure times 3. Accurate manual technique charts
List three safeguards to help reduce repeat exposures during pediatric procedures
1. Proper immobilization 2. Short exposure times 3. Accurate manual technique charts
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
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
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) projections to be included in a rib routine when either pneumothorax or hemothorax is suspected
1.PA Chest 2.Lateral Chest
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
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
AP axial projection of cervical spine
15° to 20° cephalad
Average degree of rotation for RAO sternum
15°-20°
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"
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 AP sacrum projection
2" superior to symphysis pubis
CR centering for an AP coccyx
2" superior to the symphysis pubis
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
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
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
for the small bowel follow thru, what is the time interval that the abdomen images are taken at?
20-30 mins
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
26
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
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
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)
Average breast dose range for an anterior oblique rib projection
3 mrad
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
The height that the tourniquet should be placed above the puncture site
3 to 4 inches (8 to 10 cm)
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
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
each sacroiliac joint opens obliquely ______________ degrees posteriorly
30
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
How much is the pelvis and/or thorax rotated for a PA axial oblique ( Teufel method) for acetabulum?
35° to 40° toward affected side
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
Age at which the most distal aspect of the sternum ossifies
40
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.
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°
Angle of the midlumbar spine zygapophyseal joints in relation to the MSP
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
48
The amount of time a patient must be withheld from taking metformin following an iodinated contrast media procedure
48 hours
How many segments make up the sacrum in neonate?
5
number on bones lumbar
5
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°
diverticula
A blind outpouching of the mucosal wall of the stomach
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
rhythmic segmentation
A churning or mixing activity present in the small intestine
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
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
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
hiatal hernia
A portion of the stomach protruding through the diaphragmatic opening
Therapeutic intubation
A procedure to alleviate postoperative distention of a small intestine obstruction is called ___________
duodenal papilla
A protrusion into the duodenum
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
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
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)
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
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
What is the classification, mobility, and movement type of the hip joint?
Synovial; Diarthrodial; Ball and Socket
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)
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
When is the urinary reflux most likely to occur during a VCUG?
When the bladder is full and when voiding
amino acids
the end products of the digestion of protein
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
T11
the esophagus extends from C5-C6 to:
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
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)
Complete cessation of urinary secretion by the kidneys
Anuria
posterior inferior
the gallbladder is located in the ____________ margin of the liver
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 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.
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
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.
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)
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)
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
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
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 Intussusception?
Abdomen
Which exam is associated with Meconium ileus?
Abdomen
Which exam is associated with NEC?
Abdomen
RUQ
Abdominal quadrant containing the gallbladder
Describe or Define: Osteogenesis imperfecta
Abnormally soft bones
Amount of thyroid dose decrease for an anterior oblique rib projection verus a posterior oblique rib projection
About 1/3 or 33% less
Amount of breats dose decrease for an anterior oblique rib projection verus a posterior oblique rib projection
About 5%
Type of radiographic technique required for an injury to the region of the 8th or 9th rib (above or below diaphragm)
Above the diaphragm
What type of contrast media is recommended for reducing an intussusception?
Air for the pneumatic reduction of intussusception
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
stomach
the greek term gaster or gastro means
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
Virtual colonoscopy
Another term for CT colonography (CTC) is ____________
The kidneys lie on the ___________ surface of each psoas major muscle
Anterior
The end of the rib that is most inferior
Anterior sternal end
Adenocarcinoma
Apple core sign
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
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
duodenojejunal flexure
the junction between the duodenum and jejunum
CR at the level of which structure/landmark: AP supine abdomen (older children)
At level of iliac crest
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
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
The veins that are not normally selected for venipuncture during an IVU
Axillary
Most lateral portion of a rib where it essentially curves the most
Axillary portion (angle of rib)
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
duodenojejunal flexure
the junction of the duodenum with the jejunum
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
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
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
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
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
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
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 conditions contraindicates the use of laxatives before a contrast media procedure? A. Gastritis B. Blood in stool C. Appendicitis D. Diverticulosis
C. Appendicitis
Which of the following clinical indicators applies to a pediatric skull series? A. Osteomyelitis B. CHD C. Craniostenosis D. Hyaline membrane disease
C. Craniostenosis
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
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 pathologies is best demonstrated with a radiographic chest procedure?
Cystic fibrosis and Hyaline membrane disease
Chest or Upper/lower limb radiographic procedure: Atelectasis
Chest
Chest or Upper/lower limb radiographic procedure: Cystic fibrosis
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
Routine that is always performed if a pulmonary injury is suspected
Chest Study
Ileus
Circular staircase or herringbone sign
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
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
Two common terms for the classic metaphysical lesion (CML), which may indicate child abuse, are:
Corner fx and bucket-handle fx
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
Another name for the sacral horns
Cornu
Medially facing surface of the rib containing arteries, veins and nerves
Costal groove
Name of the section of cartilage that connects the anterior end of the rib to the sternum
Costocartilage
Describe or Define: Hemoptysis
Coughing up blood
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
Hepatopancreatic ampulla
Common passageway between common bile duct and pancreatic duct (ampulla of Vater)
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)
Chronic inflammatory condition of small intestine
Crohn's disease
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
cholesterol
Concentrated levels of this may lead to gallstones
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
Enlarged thyroid at birth
Congenital goiter
A common condition in children between the ages of 1 to 3, caused by a viral infection
Croup
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
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
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
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
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 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
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)
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
True/False: Parents should never be in the radiographic room with their child
False (may be permissible with proper lead shielding if not pregnant)
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
Primary centers of bone formation (ossification) involving the midshafts of long bones are called _________.
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
when using digital imaging for spine radiography, it is important to use close collimation,grids, and lead masking
true
True/False: Bony landmarks in infants are easy to palpate and locate.
False (most bony landmarks are non-existent in infants)
The fifth rib is an example of a ____ (true rib or false rib)
true rib
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
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
What distinguishes a true rib from a false rib?
true rib attaches directly to the sternum with its own costocartilage.
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
Secondary centers of ossification of the long bones are called __________.
Epiphyses
Epiphysis, Diaphysis, or Epiphyseal plate? Secondary centers
Epiphysis
Epiphysis, Diaphysis, or Epiphyseal plate? Continues to change from birth to maturity
Epiphysis & Epiphyseal plate
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
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
Positioning error committed if the pedicles are projected too far posterior with a 45° oblique position of the lumbar spine
Excessive rotation
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: 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)
True/False: The radiographic contrast on a pediatric abdominal radiograph is high compared with that of an adult abdominal radiograph.
False (contrast is low)
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 A pediatric patient should not have solid food 8 hours before an IVU.
False
T/F Female caregivers of childbearing age should never be allowed to stay in the room to assist with the procedure.
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 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: Battered child syndrome (BCS) is the current term for child abuse
False (correct term is 'nonaccidental trauma' or NAT)
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 wide and contains ischial spines protruding less into pelvic inlet on a pelvic radiograph?
Female
What gender type appears with the pubic arch angle of 110 degrees 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
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
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.
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
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
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
Ascending colon
Found between the cecum and transverse colon
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.
What is the small depression located in the center of the femoral head called?
Fovea Capitis
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
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 is the alternative term for the greater and lesser pelvis?
Greater Pelvis: False pelvis; Lesser Pelvis: True Pelvis
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 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
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
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)
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
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?
Projections designed to measure anteroposterior movement at the site of a spinal fusion
Hyperextension and hyperflexion lateral projections
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
What does the front of the Scotty dog represent?
IAP
Which landmark is not a palpable bony landmark? (Greater trochanter, lesser trochanter, ischial tuberosity, ASIS)
Lesser trochanter
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 articulates with the sacrum to form the sacroiliac (SI) joints?
Ilium
What part of the hip bone contains the Ala?
Ilium
What part of the hip bone contains the Anterior superior iliac spine (ASIS)?
Ilium
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 _______.
LUQ & LLQ
In which two abdominal quadrants would the majority of the jejunum be found?
proper name of the method for performing the cervicothoracic lateral (swimmer's) position
twining method
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
Change in SID which is advantageous for AP and lateral projections of the lumbar spine
Increasing from 40" to 44" or 46"
angular notch
Indentation found along lesser curvature
Which sign indicates that the proximal femur's are in position for a true AP projection?
Limited visibility of the lesser trochanter in profile
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
Enteritis
Inflammation of the intestine
appendicitis
Inflammation of the vermiform appendix is called_____.
Colitis
Inflammatory condition of the large intestine
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
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)
Specific foramina which is demonstrated by the Lateral position
Intervertebral Foramina
What is formed where the superior and inferior vertebral notches joined
Intervertebral Foramina
Lateral
Into which position is the patient placed for imaging during the evacuative procedure
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
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
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 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 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 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)
What is the names for the upper most border of the manubrium?
Jugular notch Suprasternal notch Manubrial notch
Specific lumbar joint which is demonstrated with the LPO position
Left zygapophyseal Joints
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
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
Which projection of C-spine demonstrates the left intravertebral foramen?
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
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
Position or projection of the lumbar spine which best demonstrates a possible compression fracture
Lateral
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
Which position of the thoracic spine best demonstrates the intravertebral foramina?
Lateral position
Which position or projection of the cervical spine best demonstrates the zygapophyseal joints? (Between C3 & C7)
Lateral position
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
Specific lumbar joint which is demonstrated with the RAO position
Left zygapophyseal joints
Which specific joint spaces are visualized with a LAO projection of the thoracic spine?
Left zygapophyseal joints (downside)
SI joint which is visualized in the RPO position
Left
List the four bones of the pelvis
Left hip bone (ossa coxae innomate bone) Right hip bone (ossa coxae innomate bone) Sacrum Coccyx
Location of CR centering for a PA projection of the sternoclavicular joints
Level of T2-T3
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
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)
Possible perforated hollow viscus Large bowel obstruction
List the two conditions that may prevent the use of barium sulfate during a small bowel series.
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.
Extravasation is classified as this type of reaction
Local
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
Describe or Define: Meconium aspiration
May develop during stressful births
Describe or Define: Pyloric stenosis
May result in repeated, forceful vomiting
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
What gender type appears as a heart-shaped pelvic inlet on a pelvic radiograph?
Male
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
Aspect of the sternum containing the jugular notch
Manubrium
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)
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
The area in which bone growth in length occurs is termed the _________.
Metaphysis
Usually consist of numerous small lytic lesions
Metastatic carcinoma
Where is the central ray placed for an AP unilateral frog-leg projection?
Midfemoral neck
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
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 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
What is the other name for AP bilateral or unilateral frog-leg?
Modified Cleaves method
What is proximal hip fracture?
Most common fracture in old patients because of high incidence of osteoporosis or avascular necrosis.
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)
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
Lower rectum
Name the Infraperitoneal structures of the lower abdomen.
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
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
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
Should a grid be used for a 2-year-old lateral chest?
No
What is the bowel prep for a pediatric voiding cystourethrogram (VCUG)?
No bowel prep is required
Recommended NPO fasting before the pediatric contrast media procedure: Infant lower GI
No prep required
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
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
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
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
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
Describe or Define: Ileus
Obstruction caused by lack of contractile movement of the intestinal wall
Ileus
Obstruction of the small intestine
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
1. Oral cavity (mouth) 2. Pharynx 3. Esophagus 4. Stomach 5. Duodenum & small intestine
Parts of the alimentary canal studied in Upper GI
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
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.
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
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
pyloric orifice
Opening leaving the stomach
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
Inherited condition that produces very fragile bones
Osteogenesis imperfecta
AKA Rickets
Osteomalacia
Condition which can develop as a postoperative complication following open heart surgery
Osteomyelitis
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
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.
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
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
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
Part of the body which must remain stationary during right and left bending positions of the lumbar spine (AP or PA)
Pelvis
Which exam is associated with CHD?
Pelvis & Hips
Which exam is associated with Legg-Calve-Perthes disease?
Pelvis & Hips
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
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
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
AP
Position that produces a radiograph showing the fundus filled with barium
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
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
The drug that can be given as part of the premedication protocol before an iodinated contrast media procedure
Prednisone
Describe or Define: Craniostenosis
Prematurely closed cranial sutures
What is the one feature of all thoracic vertebrae that make them different from all other vertebrae?
Presence of facets for articulation with ribs
True or False: Any orthopedic device or appliance of the hip should be seen in its entirety on an AP hip radiograph.
True.
Primary or Assisting technologist? Instructs the parents
Primary technologist
Primary or Assisting technologist? Positions the patient
Primary technologist
Primary or Assisting technologist? Positions the tube and collimates
Primary technologist
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
Describe or Define: Meningocele
Protrusion of meninges through opening
The procedure that may require a Brodney clamp
Retrograde ureterogram on a male patient
The kidneys are ____________________ structures
Retroperitoneal
What part of the hip bone forms the anterior, inferior aspect of the lower pelvic girdle?
Pubis
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
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
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
What kind of mechanical digestion takes place in the small intestine?
Rhythmic segmentation (churning) Peristalsis
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
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
Reason for flexing the knees and hips for an AP lumbar spine projection
Reduces lumbar curvature which opens the intervertebral disk space
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
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
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.
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.
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
Joint which is demonstrated by the RPO 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.
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 spinous processes are not midline to the vertebral column and distortion of the vertebral bodies is present (AP lumbar spine)
Rotation of the spine
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.
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
Vertebral level of the ASIS
S1-S2
What does the ear of the Scotty dog represent?
SAP
Epiphyses appear shorter and epiphyseal plate wider
SCFE
Visible rotation in the SI joints during AP lumbar spine projection
SI joints are equidistant from the spine
Which joints are synovial joints but with amphiarthrodial mobility? (Union of acetabula, hip joints, sacroiliac, symphysis pubis)
Sacroiliac joints
Fracture involving the epiphyseal plate
Salter-Harris fracture
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
Ulcerative colitis
Sever form of colitis
Laryngeal swellingis is classified as type of reaction
Severe Level reaction
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
Which exam is associated with Premature closure of fontanelles?
Skull
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.
Which modality is used to assess joint stability during movement of the lower limbs on infants?
Sonography
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
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
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
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
cholecystectomy
Surgical removal of the gallbladder
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
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
Classification for rib joints that have diarthrodial movement
Synovial
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)
What is the classification, mobility, and movement type of the Sacroiliac?
Synovial; Amphiarthrodial; Limited
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
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
specific thoracic vertebrae are classified as typical thoracic vertebrae
T5-T8
3" to 4" below jugular notch
T7
3-4 inches (8-10 cm) below jugular notch
T7
At what vertebral level is the xiphoid process found?
T9 - T10
Vertebral level of the xiphoid process
T9-T10
xiphoid process (tip)
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
Pyloris of stomach and C-loop
The aspect of the GI tract that is best demonstrated with an RAO position during an upper GI
Body & pyloris of stomach + duodenal bulb
The aspect of the upper GI tract that will be filled with barium in the PA (prone) position
What is the other name for an AP axial for pelvic "outlet" bones?
Taylor
100-125 kV
The average kV range fro an esophagram & upper GI when using barium sulfate (single contrast study)
5ft (1.5m)
The average length of the large intestine is ______.
C5-6 to T11
The esophagus extends from:
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. 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
1. salivary glands 2. pancreas 3. liver 4. gallbladder
The 4 accessory organs of digestion
Ascending portion
The 4th and final segment of the duodenum
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
35-40 degrees cephalad
The CR angle required for the PA axial projection for a hypersthenic patient during an upper GI
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.
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
With what injury do we use the Modified axiolateral (Clements-Nakayama method)?
Trauma
4 sections, 2 flexures
The colon is divided into ____sections and has _____ flexures.
cholelithiasis
The condition of having gallstones
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
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
Duodenal bulb or cap
The first part of the superior portion of the duodenum
True/False: There should be no attempt to straighten out the abnormal alignment of the foot during a clubfoot study
True
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
True/false: the lumbar possesses a concave posterior spinal curvature.
True
True/false: the unilateral frog-leg projection (modified Cleaves method) is intended for nontraumatic hit situations.
True
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
to break down or emulsify fats
The primary function of bile
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
90-100 kV
The recommended kV range for a double-contrast upper GI projection
falciform ligament
The soft-tissue structure that separates the right and left lobes of the liver
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
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)
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
Type of rib represented by the 5th pair
True Rib
Cavity
True pelvis
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
Forms the actual birth canal
True pelvis
Found below the pelvic brim
True pelvis
Lesser pelvis
True pelvis
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
Which ligament holds the dens against the anterior arch of C1?
Transverse atlantal ligament
With what injury do we use Axiolateral/inferosuperior (Danelius-Miller) projection?
Trauma
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 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
T/F For a bone survey of a young child, both limbs are commonly radiographed for comparison
True
T/F Psychologic maltreatment is one of the six categories of child abuse.
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: consent from the parent is needed before using an immobilization device
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 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: 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
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
Describe or Define: Croup
Viral infection leading to labored breathing and dry cough
When gonadal shielding should not be used during studies of the lumbar spine, sacrum, and coccyx
When shielding could obscure essential anatomy
Which device should be used for an axiolateral (inferosuperior) projection of the hip to equalize density (brightness) of the hip region?
Wedge compensating filter
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?
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?
It adheres to the bowels while distending it
What is purpose of introducing methylcellulose during an enteroclysis?
S3 and is about 4.5 in. long.
What is the anatomical landmark where the rectum is found?
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?
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?
Sim's position
What is the name of the patient position recommended for insertion of a rectal enema tip?
Plicae circulares
What is the older term for the mucousal folds found within the jejunum?
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?
Annular carcinoma
What it the most common form of carcinoma found in the large intestine?
0.1% barium sulfate suspension is often instilled before the procedure.
What procedure often accompanies a CT enteroclysis?
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?
When the contrast medium passes through the ileocecal valve
When is a small bowel series deemed completed?
15 to 30 minutes after ingesting contrast medium
When is the first radiograph generally taken during a small bowel series?
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)
To the posteromedial surface of the cecum
Where is the vermiform appendix usually attached?
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?
Duodenojejunal junction
Which aspect of the small intestine is most fixed in position?
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?
Jejeunum
Which division of the small intestine has a feathery or coiled spring appearance during a small bowel series?
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?
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?
Suspensory muscle of the duodenum (ligament of Treitz)
Which muscular band marks the junction between the duodenum and jejunum?
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?
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 has the smoothest internal lining and does not present a feathery appearance when barium filled?
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?
Double-contrast barium enema
Which procedure is most effective to demonstrate small polyps in the colon?
Evacuative proctography
Which procedure uses the thickest mixture of barium sulfate?
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?
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.
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 male patient?
Yes. Top of shield should be placed at the inferior margin of symphysis pubis.
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.
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
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
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
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
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
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
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
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.
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
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
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
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
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
when do most primary centers of bone formation appear?
before birth
enlargement of prostate gland
benign prostatic hperplasia
where is the pars interarticularis found?
between superior and inferior articular processes
"Chole"
bile
waste
bile after it passes the cystic duct
"Cysto"
bladder
hematemesis
blood in vomit
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
two most common types of needles used for bolus injection of contrast media
butterfly and over-the-needle-catheter
what age of patients are classified as pediatric?
infants through age 12-14
What type of movement does the sternoclavicular joint have? Plane (gliding)-diarthrodial or Immovable- synarthrodial
plane (gliding)- diarthrodial
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
common bile duct
carries bile from the cystic duct to the duodenum
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
develops as child learn to hold head erect
cervical spine
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
hepatopancreatic sphincter
circular muscle fibers adjacent to duodenal papilla
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
specific aspect of the kidney is visualized during IVU
collecting system of the kidney
the following drugs is often given to the pt as part of the premedication procedure
combination of benadryl and prednisone.
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
hiatal hernia
condition in which a portion of the stomach herniates through the diaphragmatic opening
cholelithiasis
condition of gallstones
urinary pathologic term: urinary incontinence
constant or frequent involuntary passage of urine
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
the peripheral or outer portion of the kidney is called
cortex
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
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
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
Inflammation of the small intestine
enteritis
double contrast
type of contrast that allows visualization of the mucosal folds of the stomach
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
the modified body of C2 is
dens or odontoid process
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
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 bevel of the needle needs to be facing downward during the actual puncture into a vein
false. (facing upward)
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
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
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
fracture through the pedicles and anterior arch of C2 with forward displacement upon C3
hangman's fx
presence of multiple fx in the healing stage
healing fx
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
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)
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
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
projections is considered a "functional study" of the cervical spine
hyperextension and hyperflexion lateral position
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 is considered the longest?
ileum
Which aspect of the small intestine possesses the small diameter?
ileum
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
What type of movement does the third costochondral union 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: ionic
incorporates sodium or meglumine to increase solubility of the contrast media
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
iodinated contrast media used for urography: non-ionic
is a near-isotonic solution
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
The part of of the intestine with a "feathery" and "coiled spring" appearance when filled with barium is the:
jejunum
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
Apple-core lesion
neoplasm
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
neoplasm
new tumor growth that can be benign or malignant
The neonate is defined as a child:
newly born.
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
imaging modality is ideal for dectecting early signs of osteomyelitis
nuc med
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
vitamins
nutrient not digested
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
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
esophageal reflux
older term for GERD
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
which two processes move urine through the ureters to the bladder
peristalsis and gravity
the following conditions is describe as a rare tumor of the kidney
pheochromocytoma
trapped vegetable fiber in the stomach
phytobezoar
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
iodinated contrast media used for urography: non-ionic
produces less severe reactions
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
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
RAO
radiographic projection that would show air in fundus and barium in the body and pyloris
upper GI
radiographic study of the distal esophagus, stomach, and duodenum
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
String sign
regional enteritis
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
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 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.
the kidneys and ureters are located in the ____ space
retroperitoneal
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)
1. fundus 2. body 3. pyloris
the 3 main divisions of the stomach
mastication
the act of chewing
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
"Gastro"
stomach
the ___ glands are located directly superior to the kidneys
suprarenal (adrenal)
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
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
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
1. pyloric antrum 2. pyloric canal
the 2 divisions of the pyloric portion of the 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
primary curve
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
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
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
Which one of the following structures is intraperitoneal?
transverse colon
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
many geriatric patients have a fear of falling off the radiographic table
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