CH 5 mosby procedures

Which body habitus is considered a slender build?

Asthenic

Which body habitus is considered a massive build?

Hypersthenic

In which body habitus is the stomach and gallbladder low, vertical, and near the midline?

Asthenic

Which body habitus is considered an average build, present in about 35% of the population?

Sthenic

Which is the most common body habitus, present in about 50% of the population?

Hyposthenic

In which body habitus is the stomach and gallbladder high and horizontal?

Hypersthenic

Which body habitus has a narrow and shallow thorax?

Asthenic

Which body habitus has a broad and deep thorax?

Hypersthenic

Key points in performing pediatric radiography are:

Work quickly, communicate clearly with the child and parents, and report suspected child abuse

The most important point to remember when performing trauma radiography is:

Do no additional harm to the patient.

When you are performing trauma radiography:

Remove cervical collars only under the direction of an emergency department physician or radiologist.

Which plane passes transversely across the body?

Transverse

Which plane passes vertically through the midline of the body from front to back?

Median sagittal

Which plane divides the body into superior and inferior portions?

Transverse

Which plane passes vertically through the midaxillary region of the body and through the coronal suture of the cranium at right angles to the midsagittal plane?

Midcoronal

Which describes any plane parallel to the midsagittal plane?

Sagittal

What type of joint is the hip?

Ball-and-socket

What type of joint has a rounded head of one bone that moves in a cup-like cavity?

Ball-and-socket

What type of joint permits motion in one plane only?

Hinge

What type of joint has opposing surfaces that are convex-concave, allowing great freedom of motion?

Saddle

What type of joint permits rotary movement in which a ring rotates around a central axis?

Pivot

The minimum two projections needed for every radiographic exam are:

Two at right angles to one another

Patient respiration when imaging the lower ribs is:

Suspended at the end of expiration

Which of the following statements are true regarding contrast arthrography? * Asepsis is required. * The exam may be performed on the knee, shoulder, TMJ, hip, and wrist. * Indications include trauma, capsular damage, meniscal tears, rupture of ligaments, and arthritis. * The joint is manipulated by hand to distribute contrast medium.

1, 2, 3, and 4

Which of the following statements are true concerning myelography? (Select 2)

• Injection is always performed at the L3 to L4 interspace.

• Oily, iodinated contrast agent is the medium of choice.

• Indications include herniated intervertebral disks, space-occupying lesions, and degenerative diseases of the CNS.

• Contrast medium is distributed by manual manipulation of the subarachnoid space.

• The head must be kept hyperflexed so that the contrast medium does not enter the cerebral ventricles.

• Spinal fluid may be withdrawn for laboratory analysis.

3 and 6

Intravenous urography is being replaced by which imaging modality?

CT

The proper centering point for a PA projection of the hand is the:

Third metacarpophalangeal joint

For a lateral projection of the wrist:

The radius and ulna should be superimposed.

For a lateral projection of the forearm, (Select 2)

• The ulnar surface must be in contact with the image receptor.

• The thumb should be in a relaxed position.

• The humerus and forearm should be in contact with the table.

• The elbow should be flexed 45 degrees.

• The central ray is directed toward the injured joint.

1 and 3

For an AP projection of the elbow, (Select 3)

• The forearm and humerus should be at right angles.

• The central ray is directed perpendicular to the joint.

• The forearm and humerus should be parallel to the table.

• The hand must be pronated.

• The patient may have to lean laterally to ensure AP alignment.

2, 3, and 5

For a lateral projection of the humerus, (Select 3)

• The hand should be pronated.

• The patient may be upright or supine.

• The humeral epicondyles are placed perpendicular to the image receptor.

• The arm should be slightly adducted.

• The central ray is directed perpendicular to the midshaft.

1, 2, and 5

For a scapular Y projection (PA oblique) of the shoulder, (Select 2)

• The central ray is directed to the shoulder at a 10-degree cephalad angle.

• The anterior surface of the affected shoulder is centered to the image receptor.

• The patient is rotated so that the midcoronal plane forms a 45- to 60-degree angle with the image receptor.

• The patient continues shallow breathing during exposure

3 and 4

For an AP projection of the AC joints:

To show AC separation properly, joints both with and without weights should be shown on one image receptor if possible

When the clavicle is being radiographed, (Select 4)

• PA projection must always be used.

• A central ray angle of 25 to 30 degrees cephalad is used for the PA axial projection.

• The patient’s head should be turned away from the affected side.

• AP projection may be used for patient comfort.

• An erect position may be used for patient comfort.

• A central ray angle of 25 to 30 degrees caudad is used for the PA axial projection.

2, 3, 4, and 5

For the lateral projection of the scapula, which statements are true? (Select 3)

• The patient should be upright to reduce pain.

• The patient is positioned obliquely with the unaffected scapula centered to the image receptor.

• The body is adjusted by palpating the axillary and vertebral borders of the scapula so that the scapula is lateral.

• The scapula must be projected free of the rib cage.

1, 3, and 4

What is the name of a fracture of the medial and lateral malleoli of the ankle with ankle joint dislocation?

Pott fracture

What condition involves the posterior portion of the tibia and the medial and lateral malleoli?

Trimalleolar fracture

What condition is more commonly seen in elderly patients?

Osteoarthritis

What is a tumor that arises on bone with a large bubble-like appearance and may be benign or malignant?

Giant cell myeloma

What condition is characterized by the degeneration of one or several joints?

Osteoarthritis

For AP radiography of the foot, (Select 2)

• A wedge-compensating filter may be used.

• The dorsal surface rests on the image receptor.

• The central ray is directed 10 degrees toward the heel.

• The central ray is directed at the head of the third metatarsal.

1 and 3

When an AP axial projection is performed for the os calcis, (Select 3)

• The leg should be fully extended.

• The plantar surface of the foot should be parallel to the image receptor.

• The central ray is directed 40 degrees cephalad to the long axis of the foot.

• The central ray enters the foot at the head of the fifth metatarsal.

• A cylinder cone may be used for this projection.

1, 3, and 5

For a medial oblique position of the ankle, (Select 2)

• The leg and foot are rotated medially.

• The ankle is adjusted to a 90-degree angle.

• The medial rotation is adjusted to 45 degrees to show the mortise joint.

• The medial rotation is adjusted to 15 to 20 degrees to show the bony structure.

• The central ray is directed vertically midway between the malleoli.

4 and 5

For a lateral lower leg projection,

• The leg is centered to the image receptor.

• The exam may be performed with the patient on the tabletop or Bucky.

• Roll the patient away from the affected side.

• The patella should be perpendicular to the image receptor.

• Include both joints.

• The tibia and fibula should be superimposed.

• The central ray is directed to the midpoint of the leg.

1, 2, 4, 5, and 7

When a lateral knee projection is performed,

• The patient turns onto the affected side.

• The knee is flexed 20 to 30 degrees.

• The patella must be parallel to the image receptor.

• The central ray is directed 5 to 7 degrees caudad.

• The central ray enters the knee joint inferior to the medial epicondyle.

1, 2, and 4

For a tangential projection of the patella, which statements are true?

• The patient is prone.

• The affected knee is flexed so that the tibia and fibula form a 50- to 60-degree angle with the table.

• The central ray is directed 45 degrees cephalad through the patellofemoral joint.

• The tangential patella projection may also be performed with the patient supine.

2, 3, and 4

For an AP projection of the femur:

The lower leg is rotated medially 15 degrees.

The central ray for an AP projection of the hip is:

Directed 2.5 inches distal on a line drawn perpendicular to the midpoint of a line between the symphysis pubis and the ASIS.

Which condition is commonly caused by motor vehicle accidents?

Hangman fracture

Which condition is caused by acute hyperextension of the head on the neck and a fracture of the arch of C2?

Hangman fracture

Which of these is a defect of the posterior aspect of the spinal canal caused by failure of the vertebral arch to form properly?

Spina bifida

Which of these is a defect in the pars articularis?

Spondylolysis

Which of these is a comminuted fracture of the atlas that involves both anterior and posterior arches and causes displacement of the fragments?

Jefferson fracture

For a lateral projection of the cervical spine, (Select 3)

• The patient may be upright, seated, or supine, depending on their condition.

• SID of 72 inches should be used because of increased object-to-image receptor distance.

• The shoulders should lie in the same plane.

• The cervical collar should be removed so that it does not obstruct pertinent anatomy.

• The chin should be in contact with the chest

1, 2, and 3

For a lateral projection of the thoracic spine, which statements are true? (Select 3)

• The head and spine should be in the same plane.

• The central ray is directed to T7, at a cephalad angle of 10 degrees.

• The patient should continue shallow breathing during exposure.

• The exam should not be performed in a room with a falling load generator, if possible.

1, 3, and 4

For a lateral projection of L5 to S1, (Select 4) * The patient is in a lateral position. * The hips and knees are extended. * The image receptor is centered to the central ray. * A cylinder cone may be used to greatly reduce the production of scatter radiation. * The central ray is centered on a coronal plane 2 inches posterior to the ASIS and 1½ inches inferior to the iliac crest.

1, 3, 4, and 5

For RPO and LPO positions for sacroiliac joints:

Image the joint farthest from the image receptor.

For an AP projection of the coccyx:

The central ray should be directed 10 degrees caudad, entering 2 inches superior to the symphysis pubis.

Which of these pathologic conditions is easy to penetrate?

Emphysema

Which of these conditions is a collapse of lung tissue and is harder to penetrate?

Atelectasis

Which of these conditions is characterized by air trapped in the alveoli, making the condition very easy to penetrate?

Emphysema

Which of these conditions should not be imaged using AEC?

Emphysema

Which of these conditions is lung cancer arising from bronchial mucosa?

Bronchogenic carcinoma

Which progressive condition is marked by diminished capabilities of inspiration and expiration?

COPD

For an AP projection of the ribs above the diaphragm, (Select 2) * The top of the image receptor is placed 1 to 2 inches above the shoulders. * The shoulders are relaxed, and the scapulae are flat against the table. * The central ray is directed to T7. * Exposure is performed on full expiration to depress the diaphragm.

2 and 3

For an RAO position of the sternum:

Breathing should be shallow during exposure; a falling load generator should not be used, if possible

Which of these statements is true regarding lateral radiography of the sternum?

The patient should breathe during exposure, and the top of the image receptor should be positioned 1 to 2 inches above the jugular notch

Which of these conditions is characterized by soft bones resulting from deficiency of vitamin D and sunlight?

Rickets

Which of these conditions is a bone disease that causes bone destruction and unorganized bone repair and is generally difficult to penetrate?

Paget disease

Which of these conditions is an abnormal demineralization of bone, seen more often in females?

Osteoporosis

Which of these conditions is marked by abnormal accumulation of cerebrospinal fluid in the brain?

Hydrocephalus

Which of these conditions is most often seen in elderly patients?

Paget disease

For a direct PA projection of the skull, the central ray is directed:

Perpendicular to the image receptor, exiting the nasion when the OML is perpendicular to the IR.

When the skull is radiographed in the lateral position:

The MSP and IOML are parallel to the IR, and the IPL is perpendicular to the IR

Most radiographic imaging of the skull has been replaced by what imaging modality?

Computed tomography (CT)

When a parietoacanthial (Waters) projection is performed for the facial bones:

The MSP is perpendicular to the IR, the head rests on the chin, and the OML forms a 37-degree angle with the plane of the IR

For the axiolateral oblique projection of the mandible:

Adjust the broad surface of the ramus perpendicular to the image receptor.

When the mandibular body is radiographed with the patient in the SMV position:

The IOML is parallel with the plane of the image receptor, the head is resting on the vertex, and the MSP is perpendicular to the IR

Which of these projections provides the best survey study of the paranasal sinuses?

. Parietoacanthial (Waters)

Which of these is a condition in which a portion of the stomach protrudes through the diaphragm?

Hiatal hernia

Which of these conditions involves an intestinal obstruction?

. Ileus

Which of these conditions involves chronic inflammation of portions of the bowel?

Crohn disease

Which of these conditions may be adynamic or mechanical?

Ileus

Which of these conditions appears in an “apple-core” pattern on a barium enema exam?

Annular carcinoma

Which of these conditions is visualized by performing an upper GI series?

Pyloric stenosis

Which of these conditions describes a bowel obstruction caused by immobility of the bowel?

Adynamic ileus

Which of these conditions is characterized by pouch-like herniations of the colonic wall?

Diverticula

Which of these conditions causes a narrowing of the sphincter at the distal end of the stomach?

Pyloric stenosis

Which of these conditions is a severe inflammation of the colon and rectum with loss of mucosal lining?

Ulcerative colitis

For an RAO position of the esophagus:

The right side is elevated 35 to 40 degrees, with the esophagus centered at T5 or T6

For a PA projection of the stomach:

Center midway between the xiphoid process and umbilicus and halfway between the midline and lateral border of the abdominal cavity.

For the LPO or RPO positions for the colon:

The patient is supine, rotated 35 to 45 degrees from AP, with the central ray at the level of the iliac crest

For a lateral decubitus position of the colon:

The patient lies on one side, with the image receptor and horizontal central ray centered at the iliac crest.

A procedure used to evaluate biliary and pancreatic pathologic conditions with an endoscope is:

ERCP — Endoscopic retrograde cholangiopancreatography

Which of these conditions is characterized by fluid-filled masses in the kidney?

Renal cysts

Which of these conditions is a malignant cancer of the kidney?

Wilms tumor

Which of these conditions includes enlarged kidneys containing numerous cysts?

Polycystic kidney disease

Which of these conditions is seen primarily in children?

Wilms tumor

Which of the following describes a kidney stone?

Renal calculus

For the RPO and LPO positions of the kidneys:

The patient is supine, rotated obliquely 30 degrees, with the kidney nearer the IR imaged in profile and the kidney farther from the IR imaged in its entirety