RAD 110 - Ch 15 Trauma, Mobile, & Surgical Radiography - Key Terms

Members of the Surgical Team

1. Surgeon

2. Certified surgical technologist (CST)

3. Radiologic technologist

4. Scrub (CST or RN)

Scrub

- Prepares and maintains sterile surgical field and instruments

- Gowns members of surgical team

Radiation Protection with C-Arm

- Place x-ray tube under table to reduce head and neck exposure to operator

- Minimize use of boost exposures

- Minimize distance between anatomy and image intensifier

- Provide lead aprons for those remaining in area not behind lead shields

3 Methods of Protecting the Sterile Environment

1. Draping C-arm

2. Draping patient

3. Shower curtain

Technologist's Surgical Attire

- Scrubs

- Shoe covers

- Nonsterile gloves

- Protective apron

- Head cover

- Surgical mask

C-Arm Orientation - Vertical PA

- Least exposure to operator

- X-ray tube below

- I.I. above patient

C-Arm Orientation - 30º C-Arm Tilt

- Increased exposure to face and neck by a factor of four

C-Arm Orientation - Horizontal

- Increased exposure at x-ray tube end

C-Arm Orientation - Vertical AP

- Must be avoided, increased exposure to head and neck

Three Cardinal Principles of Radiation Protection

1. Distance

2. Time

3. Shielding

Internal Fixator Devices

Ilizarov tibial external fixator

Pelvic external fixator

Intramedullary rods and nails

Femoral Neck Fracture

Comminuted subtrochantric fracture

Intertrochanteric Fracture

Sprain

Forced wrenching or twisting of a joint, resulting in partial rupture or tearing of supporting ligaments

Fracture

A break in the bone

Contusion

A "bruise" type injury without a fracture or break in the skin

Apposition

relationship of the long axes of fracture fragments

Types of apposition

1. Anatomic apposition

2. Lack of apposition

3. Bayonet apposition

Anatomic apposition

Anatomic alignment of ends of fractured bone fragments, wherein the ends of the fragments make end-to-end contact

Lack of apposition

the ends of fragments are aligned but pulled apart and are not making contact with each other

Bayonet apposition

A fracture wherein the fragments overlap and the shafts make contact, but not at the fracture ends

Angulation

loss of alignment

Apex angulation

Describes the direction or angle of the apex of the fracture, such as medial or lateral apex, wherein the point or apex of the fracture points medially or laterally

Types of Apex Angulation

1. Varus angulation

2. Valgus angulation

varus angulation

deviating toward midline

valgus angulation

deviating away from midline

Simple fracture

Bone does not break through skin (closed fracture)

Compound fracture

Bone protrudes through skin (an open fracture)

Incomplete fracture

Fracture does not traverse through entire bone

Examples:

- Torus fracture

- Greenstick fracture (imaged)

- Plastic fracture

Complete fracture

Fracture traverses through entire bone

Examples:

- Transverse fracture

- Oblique fracture

- Spiral fracture (imaged)

Comminuted fracture

Two or more fragments

Examples:

- Segmental fracture (double-type fracture)

- Butterfly fracture (two fragments)

- Splintered fracture (thin, sharp fragments)

impacted fracture

One fragment driven into another (ends of bones)

Colles' fracture

Posterior displacement of distal radius

Reverse Colles' (Smith) fracture

anterior displacement of distal radius

Monteggia's fracture

Proximal ulna along with dislocation of radial head

Pott's fracture

Ankle fracture of distal fibula with frequent fracture of medial malleolus

Baseball (mallet) fracture

fracture of distal phalanx

Barton fracture

intra-articular fracture posterior lip of the distal radius

Bennett's fracture

involves the first metacarpal & carpometacarpal joint

Boxer's fracture

fracture of the 5th metacarpal

Hangman's fracture

Bilateral fracture of pedicles of C2 due to hyperextension

- Unstable

Hutchinson's (chauffeur's) fracture

Fracture of the radial styloid process

Nursemaid's elbow

- jerked elbow

- not a fracture

Compression fracture

Vertebral body collapses or is crushed

Stellate fracture

Fracture lines radiate from a center point of injury

Tuft fracture

Comminuted fracture of distal phalanx