A&P 120: Ch 3-4 Exam 2

six organs of the digestive system

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

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

-Pneumoperitoneum

Exposure factors for KUB Analog/Digital kVp

70-80

Liver

8

Inferior Costal Rib Margin

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

Type of fracture is best demonstrated with a modified Robert method

Bennett Fracture

The process that the Coronoid fossa accommodates

Coronoid process of ulna when flexed

anterior superior iliac spine

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

kind of joint the wrist is

Ellipsoid

Type of joint that the radiocarpal joint is

Ellipsoidal

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

Epigastric, Umbilical, and Pubic (hypogastric)

Symphysis pubis:

F -the fibrocartilaginous union of the anterior pubic bones

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

False

guidelines that should be followed with digital imaging of the abdomen

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

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

Level of the axils

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

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

double-walled membrane lining the abdominal cavity

Peritoneum

Proximal Radioulnar articulation location

Radial notch of ulna and head of radius

Proximal radioulnar location

Radial notch on ulna and head of radius

three fossa's of distal humerus

Radial, coronoid, and olecranon

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

Radius (thumb side)

Bones that separate with supination and cross with hand rotation

Radius and ulna

articulates directly with scaphoid and lunate only

Radius directly

Most commonly fractured carpal bone

Scaphoid

xiphoid process corresponds with this vertebral level

T9-T10

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

The umbilicus ("belly button")

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

Wrist

Osteomyelitis

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

Radiographic Appearance of Intussusception and exposure factor

air filled coiled spring appearance - decrease (-)

capitulum of humerus

articulates with head of radius (lateral)

Infraperitoneal Organs

bladder, male reproductive organs, lower rectum

Middle Phalanx 2nd digit

bone or joint of the right hand: H

PIP of digit 2

bone or joint of the right hand: I

Separates abdominal cavity from thoracic cavity

diaphragm

medical prefix for stomach

gastro

The most important muscles in abdominal radiography

hemidiaphragm and psoa's

Kind of joint that the finger is

hinge

The 3 articulations of the elbow joint

humeroulnar, humeroradial, proximal radioulnar

junction of the small and large intestine

ileocecal valve

longest part of the small intestine

ileum

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

ileus

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

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

Elbow Fat Pads and Stripes

indicates a radial head fracture; seen on lateral view

structures that connects the small intestine to the posterior abdominal wall

mesentery

Radoiocarpal Joint

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

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

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

The 5th CMC joint

-A

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

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

Proximal Phalanx of 2nd Digit

-B

Head of the 5th metatacarpal

-C

Iliac Crest (lateral)

-C -Level of L4-L5, Vertebral Interspace

4th metacarpophalangeal joint

-D

ASIS (lateral)

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

Head of proximal phalanx of fifth digit

-E

greater trochanter (lateral)

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

Important factors to consider for geriatric abdomen

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

Base of middle phalanx of digit 4

-F

symphysis pubis (lateral)

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

DIP of 4th digit

-G

ischial tuberosity (lateral)

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

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

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

Oral Cavity

1

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

1-2 inches

Grids are used if the body part measures greater than:

10 cm

Number of phalanges

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

Number of phalanges in both hands

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

small intestine length

15-18 ft

Pharynx

2

Thumb has this number of phalanges

2

Number of bones in hand and wrist

27

Esophagus

3

Number of fossa in the Distal Humerus

3

Stomach

4

Number of metacarpals in palm

5

Small Intestine

5

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

5 minutes

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

5-10 minutes

Large Intestine

6

best set of exposure factors for upper limb radiography

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

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

Wrist and forearm

Acute Abdominal Series

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

Topographical landmarks of abdomen

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

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

Approximately 2 inches above level of iliac crest

Inferior Costal Margin (Lateral)

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

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

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

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

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

Iliac Crest

C -level of L4-L5 Verterbra interspace

used to evaluate patients with acute appendicitis

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

Largest of the carpal bones

Capitate

Located on distal humerus

Capitulum

CMC is located between these two structures

Carpal and metacarpal

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

Carpal canal position (Gaynor-Hart method)

The base of phalanges articulates with this

Carpals

Steve Left The Party

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

Exams that the diaphragm must be motionless during exposure of

Chest or abdomen

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

Close collimation

collimation margin for an adult abdomen

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

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

Coyle Method

This is located between distal and Middle phalanx

DIP

Joints in fingers from distal to proximal

DIP, PIP, MCP, and CMC

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

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

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

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

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

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

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

False

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

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

Has three joints

Fingers

PIP joint for

Fingers

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

LLD: left lateral decubitus

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

Large Intestine

Mesentary

Large folds formed by peritoneum that bind abdominal organs

Peritoneum

Large serous double wallets sac like membrane

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

Lateral Decubitus (Ap Projection)

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

Lateral Decubitus replaces erect

Two Way KUB Decubitus Positions

Lateral Decubitus, Dorsal Decubitus

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

Left Hypochondriac, Left Lateral, and Left Inguinal

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

Left lateral decubitus

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

Left lateral decubitus

Accessory Organs of Abdominal Cavity

Liver, Gallbladder, pancreas, spleen

Intraperitoneal Organs

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

Metacarpals

Makes up the palm

MCP is located between which two structures

Metacarpal and proximal phalanx

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

Modified Robert's method

Number of abdominal regions

Nine

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

Norgaard method - ball catcher's position

Alternative name for the mesentery

Omentum

Distal radioulnar location

On the ulnar notch on radius and head of ulna

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

PA chest

Modified Stecher Method

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

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

Pronated (palm down)

How the diaphragm remains motionless during exams

Proper breathing instructions on inspiration or expiration

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

Proximal Ulna Correlation

name of abdominal region that contains the rectum

Pubic (Hypogastric)

abdominal quadrants

RUQ, LUQ, RLQ, LLQ

Accommodates radial head when flexed

Radial Fossa

Proximal portion of duodenum

duodenal bulb or cap

First portion of the small intestine

duodenum

the three parts of the small intestine

duodenum, jejunum, ileum

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

erect images of PA chest or erect AP Abdomen

this is located in the mediastinum of the thoracic cavity

esophagus

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

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

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

females

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

iliac crest

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

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

Bariatric patient second projection location

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

Bariatric patient first projection location

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

Bursitis

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

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

iodinated contrast media

Radiographic Appearance of ileus and exposure factor

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

Radiographic Appearance of volvulus and exposure factor adjustment

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

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

lateral

this is located near the first intercostal space

left hemi-diaphragm

Region of the abdomen that contains the spleen

left hypochondriac

Lesser Omentum

lesser curvature of stomach to liver

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

long scale

Automatic exposure control (AEC) systems are designed to optimize

mAs

structure that helps stabilize and support the small intestine

mesentery

Location of olecranon process

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

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

nuclear medicine

time when gonadal shielding should not be used during abdomen radiography

obscures essential anatomy

The two beak-like processes on the proximal ulna

olecranon and coronoid process

What is a fat pad?

pad of fat located around joints for protection and cushion

Three accessory organs

pancreas, liver, gallbladder

abdominal structures not visible on a properly exposed KUB

pancrease

Placement of long axis of the anatomic part being imaged

parallel to the long axis of the IR

Another term describing a nonmechanical bowel obstruction is:

paralytic ileus

The double-walled membrane that lines the abdominopelvic cavity

parietal peritoneum

KUB Clinical Indications: AP Supine Abdomen

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

the primary cause for involuntary motion in the abdomen

perisaltic action of the bowel

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

peritoneum

Mesocolon

peritoneum that attaches the colon to the posterior abdominal wall

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

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

Type of structure pancreas is classified as

Retroperitoneal

terms for organ relationship

Retroperitoneal, Infraperitoneal, Intraperitoneal

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

Right Hypochondriac, Right Lateral, Right Inguinal

Retroperitoneal Organs

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

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

Rotate upper limb medially

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

Rotation toward the right

To Take Carolyn Home

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

Thumb joint

Saddle

Arthrography is a radiographic study of:

Soft-tissue structures within certain synovial joints

Skier's Thumb

Sprain or tear of the ulnar collateral ligament

Retroperitoneal

Structures closely attach to posterior abdomen, behind peritoneum

Infrapertioneal

Structures located under or beneath the peritoneum

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

Supinated (palm up)

Forearm rotational movements

Supination of hand and pronation of hand

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

Synovial fluid

Triquetrum

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

Number of phalanges one digits 2 through 5

Three

First MCP for

Thumb

First Metacarpal

Thumb

CMC joint

carpometacarpal joint

saclike portion of the large intestine below the ileocecal valve

cecum

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

conditions or diseases related to bowel obstruction or perforation

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

contrast medium

Parietal Peritoneum

covers the walls of the abdominal cavity

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

decrease obliquity of the hand

Forms the first Carpometacarpal joint

Trapezium & first metacarpal (thumb)

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

Trauma axial lateral projection - Coyle method for coronoid process

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

Ulna (little finger side)

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

Umbilical

ileocecal valve

Valve at the junction of the small and large intestines

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

Volvulus

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

diaphragm

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

diaphragm

Radiographic Appearance of fibrous adhesions

distended loops of air filled small intestine

Radiographic Appearance of Crohn's Disease

distended loops of air filled small intestine (cobblestone appearance)

Shape of Diaphragm

dome shaped/umbrella

Omentum

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

Free air or gas in the peritoneal cavity is:

pneumoperitoneum

Cecum

portion of the large intestine below the ileocecal valve

location of pancreas to the stomach

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

Digits 2-5 have 3 phalanges

proximal, middle, distal

muscles that are located laterally to the lumbar vertebrae

psoas major muscles

Osteoporosis

reduction in the quantity of bone or atrophy of skeletal tissue

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

retroperitoneal

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

sonography

preferred imaging modality for examining the gallbladder quickly

sonography/ultrasound

Peritoneal Cavity

space between visceral and parietal peritoneum

abdominal organ not associated with digestive system

spleen

organs of the lymphatic system

spleen, thymus, tonsils

expandable reservoir for swallowed food and fluids

stomach

three digestive organs within the abdominal cavity

stomach, small intestine, and large intestine

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

superior border of the symphysis

Visceral Peritoneum

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

Radiographic Appearance of Pneumoperitoneum

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

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

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

Greater Omentum

transverse colon to greater curvature of stomach

Image receptor alignment for an abdomen study on an obese patient

two exposures of the abdomen with a landscape alignment

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

two psoas major and minor muscles faintly visible

endocrine glands that are superomedial to each kidney

two suprarenal (adrenal) glands

A chronic disease involving inflammation of the large intestine is:

ulcerative colitis

Most abdominal projections are taken:

upon expiration

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

ureters

Intraperitoneal

within the peritoneal/abdominal cavity

principal exposure factors for abdominal images

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

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

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

KUB must include this to ensure the bladder is seen

KUB must include the symphysis pubis

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

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

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

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

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

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

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

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

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

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

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

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

Three accessory organs of digestion located in the abdominal cavity

-pancreas -liver -gallbladder

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

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

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

68-70kVp

Pancrease

7

Number of Carpal Bones

8

Number of carpals in wrist

8

Spleen

9

Xiphoid Process

A

Xiphoid process of sternum (lateral)

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

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

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

Exam that demonstrates borders of psoas major muscles

AP Abdomen (KUB)

markers seen

AP KUB Description of possible error of Anatomic side markers:

Most common exam of abdomen

AP Supine

Three way KUB: acute abdomen series

AP Supine Abdomen, AP Erect Abdomen, PA erect Chest

symphysis pubis is cut off from image

AP Supine KUB Description of possible error of Anatomy demonstrated:

indicate psoas muscles

AP abdomen (KUB)

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

AP and lateral forearm projections to include the wrist

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

AP erect abdomen

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

AP erect abdomen

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

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

Location of digestive tract

Abdominal cavity

Joint Effusion

Accumulated fluid in the joint cavity

Clinical indications that require a decrease in manual exposure factors

Advanced Osteoperosis

CR location for a PA projection of digit 2

Affected PIP joint

free intraperitoneal air

Air outside the digestive tract

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

All of the above

3 muscles visualized during abdomen x ray

Diaphgram, right PSOAS muscle, and left PSOAS muscle

3 important muscles of abdominal cavity

Diaphragm and the two PSOAS muscles

Fingers and thumbs are called

Digits

Called numeral condyle

Distal Humerus

Finger Joints names

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

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

Dorsal Decubitus (Rt or Lt Lateral)

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

Dorsal decubitus

Intestine that is the shortest and widest

Duodenum

first portion of the small intestine

Duodenum

greater trochanter

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

appearance of this indicates non visible fracture and joint effusion

Elbow fat pad

term for the radiographic study of the entire urinary system

Excretory or Intravenous Urogram

Ulnar Deviation or Ulnar Flexion

Flexion toward ulna

Radial deviation or radial flexion

Flexion towards radius

Bennett Fracture

Fracture at base of first metacarpal

ischial tuberosity (lateral)

G -receives the weight of the body when sitting

structure that stores and releases bile

Gallbladder

Kind of joints the IP joints are

Ginglymus

Hooklike process extending anteriorly from the hamate

Hamulus (hamular process)

Distal radius crosses over the ulna when this is pronated

Hand

Bones of upper limb are divided into 4 groups

Hand and wrist, forearm, arm, shoulder girdle

All phalanx have 3 parts

Head, body, and base

iliac crest of ilium

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

thoracic vertebrae (12)

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

PSOAS left

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

cocyx

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

pubic symphysis

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

ischial tuberosity of ischium

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

topographic landmark found at L4-L5 vertebral interspace

Iliac Crest

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

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

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

Inferior costal (rib) margin

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

Insufficient medial rotation

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

Intussusception

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

PA stress (Folio method) projection

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

PA, erect chest for free air under diaphragm

This is located between prox and middle phalanx

PIP

Posterior wall of abdomen is formed by these muscles

PSOAS

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

PSOAs

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

PSOAs major and minor

Abdomen Radiography Image should demonstrate optimal density and include:

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

Carpal Tunnel Synrdrom

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

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

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

3 parts of metacarpals are similar to this

Phalanges

2 or more fingers are named

Phalanges (pleural)

A digit consists of separate bones that are called this

Phalanx

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

Place humerus/forearm in same horizontal plane.

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

Tangential projection - carpal bridge projection

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

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

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

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

Smith Fracture

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

CR location placed for a PA projection of hand

Third MCP joint

Large concave depression that articulates with the trochlea of humerus

Trochlear Notch

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

Trochoidal (pivot

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

True

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

Two AP projections with acute flexion and a lateral projection

Number of exposures a hypersthenic patient may require

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

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

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

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

about 0.4 to 1.5 inches (1 to 4 cm)

Positions that best demonstrate patient with a history of ascites

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

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

ascites

conditions that is demonstrated radiographically as general abdominal haziness

ascites

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

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

Distal Phalanx of 1st digit

bone or joint of the right hand: J

IP of 1st digit

bone or joint of the right hand: K

1st MCP joint

bone or joint of the right hand: L

Two causes of voluntary motion

breathing and movement

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

broad hypersthenic patient

Carpal Canal

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

Radiographic Appearance of Ascites

general abdomen haziness

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

greater omenteum

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

greater trochanter

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

head of ulna

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

right hemi-diaphragm

quadrant that the large intestine begins in

right lower quadrant

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

rotate wrist laterally 5-10 degrees

elongation of iliac wing indication

rotation in that direction

Carpal Bones Names

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

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

short exposure time

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

short exposure time best controls peristalsis

best mechanism to control involuntary motion

shortest exposure time possible

trapped air is easier to penetrate than

soft tissue with x-rays

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

symphysis pubis

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

tall hyposthenic or asthenic

Intussusception

telescoping of the intestines