Radr 1411 - Exam 1 Review

Skull: Cranium (8), Facial bones (14)

Hyoid (1)

Auditory ossicles (6, 3 in each ear)

Vertebral column: Cervical (7), Thoracic (12), Lumbar (5), Sacral (1), Coccyx (1)

Thorax: Sternum (1), Ribs (24)

Total of 80

What bones make up the Axial skeleton?

Shoulder: Clavicles (2), Scapula (2)

Upper limbs: Humerus (2), Ulna (2), Radius (2), Carpals (16), Metacarpals(10), Phalanges (28)

Pelvic girdle: hip bones (2)

Lower limbs: Femur (2), Tibia (2), Fibula (2), Patella (2), Tarsals (14), Metatarsals (10), Phalanges (28)

Total of: 126

What bones make up the Appendicular skeleton?

Diaphysis (shaft)- and becomes body of bone

What is the primary center for bone ossification?

Sagittal (midsagittal)

Coronal (midcoronal)

Oblique

Horizontal (axial or transverse)

List 4 body planes

sagittal plane - divides the body into right & left parts

coronal plane - plane that divides the body into anterior & posterior parts

horizontal plane (axial, transverse plane) - divides body into superior and inferior parts (into top of "T")

oblique plane - at an angle or slant

Epiphysis - and appears near ends of long bones

What is the secondary center for bone ossification?

C. Distal radioulnar

Which of the following joints is classified as trochoidal?

A. Wrist joint

B. Metacarpophalangeal

C. Distal radioulnar

D. Shoulder

B. Interphalangeal

Which of the following joints is classified as ellipsoidal?

A. Wrist

B. Interphalangeal

C. Ankle

D. Hip

D. Knee

Which of the following joints is classified as bicondylar?

A. Metacarpophalangeal

B. First carpometacarpal joint

C. Proximal radioulnar joint

D. Knee

midsagittal plane

MSP

midcoronal plane

MCP

refers to the back half of the patient, or the part of the body seen when the person is viewed from the back

posterior or dorsal

refers to front half of the patient, or the part seen when viewed from the front; includes the tops of the feet and the fronts or palms of the hands in the anatomic position.

anterior or ventral

refers to the sole or posterior surface of the foot.

plantar

refers to the top or anterior surface of the foot (dorsum pedis).

dorsal (foot)

Dorsal also refers to the back or posterior aspect of the hand (dorsum manus)

dorsal (hand)

refers to the palm of the hand; in the anatomic position, the same as the anterior or ventral surface of the hand.

palmar

Describes the direction of travel of the CR, which enters at an anterior surface and exits at a posterior surface

anteriorposterior (AP) projection

Describes the direction of travel of the CR, which enters at an posterior surface and exits at a anterior surface

posteroanterior

A projection of a body part that is rotated, shot anterior to posterior (should also contain a qualifying "medial" or "lateral" term)

AP oblique projection

A projection of a body part that is rotated, shot posterior to anterior (should also contain a qualifying "medial" or "lateral" term)

PA oblique projection

CR enters one side of the body, passing transversely along the coronal plane

lateral projection

The primary radiation enters the medial side of the body or part and exits the lateral side

mediolateral projection

The primary radiation enters the lateral side of the body or part and exits the medial side

lateromedial projection

the person lies on one side or the other; side-lying position. Specific lateral positions described by the part closest to the IR or the body part from which the CR exits.

lateral position

right side of the body closest to the image receptor (IR) in the erect position

right lateral position

left side of the body closest to the image receptor (IR) in the erect position

left lateral position

refers to an angled position in which neither the sagittal nor the coronal body plane is perpendicular or at a right angle to the IR.

oblique position

Lying on the left posterior surface, the right posterior surface is elevated.

left posterior oblique (LPO)

Lying on the right posterior surface, the left posterior surface is elevated.

right posterior oblique (RPO)

Lying on the left anterior surface, the right anterior surface is elevated.

left anterior oblique (LAO)

Lying on the right anterior surface, the left anterior surface is elevated.

right anterior oblique (RAO)

Recumbent (lying down) position with a horizontal CR.

Named according to the body surface on which the patient is lying.

decubitus position

The patient is lying on his or her right side and the CR is horizontal

Right lateral decubitus

The patient is lying on his or her left side and the CR is horizontal

Left lateral decubitus

the patient is lying on the dorsal (posterior) surface with the x-ray beam directed horizontally, exiting from the side closest to the IR (left or right)

Dorsal decubitus position (left or right lateral)

the patient is lying on the ventral (anterior) surface with the x-ray beam directed horizontally, exiting from the side closest to the IR (left or right)

Ventral decubitus position (left or right)

•Anatomic structures superimposed (some conditions may not be visible from one projection only)

•Localization of lesions or foreign bodies (helps determine location)

•Determination of alignment of fractures

Three reasons for this general rule of a minimum of two projections

taken at 90° or as near right angles from each other as possible

How are the two projections (general rule)taken?

When joints are in prime interest area. AP or PA, lateral, oblique projections. Needed bc more information is needed than can be provided on only two projections.

When are 3 projections required?

Postreduction upper and lower limbs generally require only two projections for checking fracture alignment.

A pelvis study requires only single AP projection unless hip injury is suspected.

Exceptions to 3 projection rule?

•Vertebral prominens (PA Chest)

- Locate at C7, is a bony prominence located at the base of the neck (use thumb and 5th digit to locate t7)

•Jugular notch (AP Chest)

- located at T2-3 level (manubrial or suprasternal notch). Is a large, visible dip located between the clavicles. (T7 is located 3 to 4 inches from

This landmark)

Identify the topographical landmarks of the chest and their vertebral levels.

sthenic, hyposthenic, asthenic, and hypersthenic

4 body habitus

Approximately 50% of the population falls into this category. For the purpose of radiographic positioning, styles are considered average in shape and internal organ location.

sthenic body habitus

A thin body style, which is more slender than the sthenic body habitus. Approximately 35% of the population.

hyposthenic body habitus

A massive body style, which has a large and broad frame as compared to the sthenic body habitus. Approximately 5% of the population.

hypersthenic body habitus

Approximately 10% of the population is very thin or slender with a long and narrow body build. More slight in stature than even the hyposthenic patient.

asthenic body habitus

The medial portion of the thoracic cavity between the lungs

mediastnum

◦Trachea

◦Esophagus

◦Thymus gland

◦Heart and great vessels

structures located in the mediastinum

The patient should be asked to hold the second full inspiration rather than the first. More air can be inhaled w/o too much strain on the second breath compared with the first.

What are the proper respiration instructions for a routine chest radiograph?

Any chest or lung movement that occurs during the exposure results in "blurring" of the radiographic image.

Why are clear breathing instructions for a routine chest radiograph important?

when the radiograph shows 10 ribs above diaphragm

How can you confirm the respiration was adequate on the produced radiograph?

Allows diaphragm to move farther down

Demonstrates air-fluid levels

Prevents engorgement of pulmonary vessels

What are reasons a chest radiograph should be taken erect whenever possible?

a PA at 72" is recommended to reduce heart shadow

What SID is recommended for routine chest radiography? Why?

T7

Where is the CR entrance on a PA chest? Lateral chest? AP chest?

1(1/2) to 2 inches or 5 cm above the shoulders.

Where should the top of the LW image receptor be placed on an average pt for PA chest?

Shoulders rotated forward against IR to allow scapulae to move

laterally clear of lung fields; shoulders depressed downward to move clavicles below the apices

How do you position arms for PA chest? Why?

Arms raised above head to prevent superimposition on the upper chest field.

How do you position arms for lateral chest? Why?

By examination of both sternal ends of the clavicles or a symmetric appearance in relationship to the spine.

How do you determine rotation on PA chest?

lack of superimposition of posterior ribs, amount of separation of the right and left posterior ribs and separation of the two costophrenic angles.

How do you determine rotation on lateral chest?

for visualization of calcifications, cavitations, and masses of the apices and upper lobes. (beneath the clavicles)

What area is of interest on a lordotic chest? What pathology is associated with this projection?

Small pleural effusions are demonstrated by air fluid levels in pleural space

Small amounts of air in pleural cavity may demonstrate a possible pneumothorax

Is also often performed if the patient cannot assume erect position.

Why would decubitus chest projections be performed?

down

Suspected side _________ for possible fluid in pleural cavity (pleural effusion)

up

Suspected side ________ for possible air in pleural cavity (pneumothorax)

to investigate pathology involving the lung fields, trachea, and mediastinal structures.

Rotated 45° (left or right)

Why would an oblique chest projection be performed? How much is the patient rotated?

60° LAO

______ ______ best visualizes the heart outline, great vessels, and trachea

left lung

When performing a LPO chest, which lung is best visualized and elongated?

right lung

When performing a RPO chest, which lung is best visualized and elongated?

right lung

When performing a LAO chest, which lung is best visualized and elongated?

left lung

When performing a RAO chest, which lung is best visualized and elongated?

Lateral

AP

What are routine projections for upper airway exams?

72"

SID Lateral Upper Airway

40"

SID AP Upper Airway

right and left hemi-diaphragms and the right and left psoas major.

What are important muscles of the abdomen?

Stomach

Small intestines

Large intestines

Liver

Gallbladder

Spleen

Pancreas

Kidneys

abdominal cavity

Rectum

Sigmoid

Urinary bladder

Reproductive organs

pelvic cavity

liver,

gallbladder,

right colic (hepatic) fixure,

duodenum (c-loop),

head of pancreas,

right kidney and adrenal,

right suprarenal gland

RUQ (abdomen quadrants)

stomach,

left colic (splenic) flexure, tail of pancreas,

left kidney,

spleen,

left suprarenal gland

LUQ organs

ascending colon, appendix, cecum 2/3 of ileum, ileocecal valve

RLQ

descending colon

sigmoid colon

2/3 of jejunum

LLQ

oral cavity (mouth),

pharynx,

esophagus,

stomach,

small intestine,

large intestine

What are the primary organs of digestion?

liver, gallbladder, pancreas

Accessory organs of the digestive system

Two kidneys

Two ureters

One urinary bladder

One urethra

What are the organs of urinary system?

Double-walled membranous sac that encloses the cavity.

Inner layer - visceral peritoneum

Outer layer - parietal peritoneum

peritoneum

space behind peritoneum

retroperitoneum

Located under or beneath the peritoneum in the true pelvis

infraperitoneal organs

Liver

Gallbladder

Spleen

Stomach

Jejunum

Ileum

Cecum

Transverse colon

Sigmoid colon

Intraperitoneal organs

Kidneys

Ureters

Adrenal glands

Pancreas

C-loop of duodenum

Ascending and descending colon

Upper rectum

Major abdominal blood vessels (aorta and inferior vena cava)

Retroperitoneal organs

Lower rectum

Urinary bladder

Reproductive organs

Male—closed sac

Female—open sac (female uterus, tubes, and ovaries, extending into the peritoneal cavity)

Infraperitoneal (pelvic) organs

A specific of type of double fold peritoneum that loosely connects the small intestine to the posterior abdominal wall

What is mesentery?

A specific type of double fold peritoneum that extends from the stomach to another organ

What is omentum?

"fatty apron" because of its location and the amount of fat contained there in

What is the omentum commonly referred to as?

1.Xiphoid process (T9-T10)

2.Inferior costal margin (L2-L3)

3.Iliac crest (L4-L5)

4.ASIS (anterior superior iliac spine)

5.Greater Trochanter

6.Symphysis Pubis

7.Ischial Tuberosity

Identify the topographical landmarks for abdomen positioning and their vertebral levels.

1.Xiphoid process (T9-T10)

2.Inferior costal margin (L2-L3)

3.Iliac crest (L4-L5)

4.ASIS (anterior superior iliac spine)

5.Greater Trochanter

6.Symphysis Pubis

7.Ischial Tuberosity

"take in a deep breath—let it all out and hold it—do not breathe." Abdominal radiographs are exposed on expiration, w/the diaphragm in a superior position or better visualization of abdominal structures.

What are the breathing/respiration instructions for abdominal radiography?

70 to 80 kVp range

80 to 85 kVp range for lateral abdomen

Identify proper exposure factors for abdominal radiography. (kv range)

Left Lateral Decubitus Position

Dorsal Decubitus Position - Right Lateral

Identify alterations in positioning for erect radiographs if pt can't stand.