Radiology Procedures and Anatomy Review

Flashcards covering key anatomical terms, radiographic positioning, and procedural details for various X-ray examinations, with a focus on the upper limb and chest.

Glucagon

A medication used for a spasmodic colon, often given during a barium enema to relax the colon and reduce patient pain.

Water (as contrast)

Considered a negative or neutral contrast agent in radiology; it does not absorb radiation like barium or iodine and appears dark rather than white on X-rays or CAT scans.

AP Chest X-ray Centering

The central ray is positioned at $T7$, a few inches below the jugular notch.

SID for Chest X-ray

The standard Source-to-Image Receptor Distance (SID) for a chest X-ray is $72$ inches.

Standard Chest X-ray Views

Typically include a PA (Posteroanterior) and a lateral view, with a $90$-degree difference between them.

Optimal KVP and mAs for PA Chest X-ray

A kilovoltage peak (KVP) typically around $110$ to $125$ and a milliampere-second (mAs) around $4$ (or small) are good starting points, adjusted for body habitus.

PA Chest X-ray (Advantages)

Preferred when possible because the patient's chest is closer to the image receptor (IR), which helps reduce magnification and potentially exposure time.

Desired Ribs in Chest X-ray

A good chest X-ray should ideally demonstrate at least $10$ ribs.

Indication of Rotated Chest X-ray

Rotation can be identified by looking at the SC (sternoclavicular) joints, specifically the inner part of the trabeculae close to the sternum.

Alternative Chest X-ray Views

Include the lordotic view and oblique views (e.g., RAO, LAO) for specific anatomical visualization.

Pathology Modality Report

A two-page, double-spaced report due next Wednesday, requiring students to pick a thoracic cavity pathology, describe its effects on the lungs (e.g., shortness of breath, coughing, density changes) and other necessary radiology modalities (e.g., CT scan, ultrasound).

October 7 Test

An upcoming exam focused on the anatomy and positioning for the hand, finger, thumb, and wrist.

Upper Limb X-ray Components

Includes separate X-rays for the hand, finger, wrist, forearm, elbow, humerus, and shoulder girdle (which encompasses AC joint, clavicle, sternum, and scapula views).

Distal Interphalangeal (DIP) Joint

A joint found in fingers two through five, located furthest from the palm.

Proximal Interphalangeal (PIP) Joint

A joint found in fingers two through five, located closer to the palm than the DIP joint.

Metacarpal Phalangeal (MCP) Joint

A joint where the metacarpal bones meet the phalanges in fingers two through five.

Interphalangeal (IP) Joint (Thumb)

The single joint found in the thumb's phalange, unique compared to the multiple IP joints in other fingers.

Radius Location

The radius bone in the forearm is consistently located on the thumb side of the wrist.

Wrist Bone Mnemonic

A mnemonic 'Steve Left The Party To Take Farrell Home' is used to help remember the names of the eight carpal bones in the wrist.

Carpal Canal/Tunnel View

A specific X-ray view performed for patients experiencing carpal tunnel pain.

Radial Deviation (Wrist)

The movement of the wrist, literally deviating it towards the radius bone.

Ulnar Deviation (Wrist)

The movement of the wrist deviating it towards the ulna bone; commonly performed for scaphoid fractures.

Good Lateral Wrist X-ray Quality

Indicated when the radius and ulna bones are superimposed on one another.

Carpal Metacarpal (CMC) Joint

The joint where the carpal bones articulate with the metacarpal bones.

Pronation (Hand AP position)

When the hand is pronated in an AP position, the radius and ulna bones in the forearm cross over each other.

Collimation for Extremities

It is crucial to tightly collimate side to side and top to bottom to optimize image quality and reduce patient exposure.

Long Axis on IR

Positioning the long axis of the body part (e.g., hand, forearm) parallel to the image receptor (IR) is essential for best image quality, minimizing distortion and magnification.

General X-ray Views

Typically consist of an AP or PA view, an oblique view, and a lateral view.

Two-View X-ray

Generally refers to an AP or PA view combined with a lateral view.

Routine Views (Wrist, Hand, Finger)

Typically include a PA (or AP), an oblique, and a lateral view; most are PA projections.

Central Ray (CR) for Finger X-ray

For a finger X-ray, the central ray is directed to the PIP (Proximal Interphalangeal) joint.

Collimation for Finger X-ray

The light field should extend to about midcarpal or mid-metacarpal, ensuring the entire phalanx and the top part of the metacarpal are included.

Oblique Finger (Index Finger)

For the index finger, an AP medial oblique projection is sometimes preferred to achieve less OID (Object-to-Image Receptor Distance).

Oblique Angle (Hand, Wrist, Finger)

All oblique projections for the hand, wrist, and finger generally require a $45$-degree rotation.

Unrotated X-ray (Appearance)

A good unrotated X-ray shows no elongation of bones, symmetrical appearance, and the body part is parallel to the image receptor (IR).

AP Projection of the Thumb

The thumb is unique as it can be positioned for both AP and PA projections, depending on patient tolerance and desired view.

Central Ray (CR) for Thumb X-ray

The central ray is directed all the way down to the CMC (Carpal Metacarpal) joint to include the entire thumb articulation.

Thumb in Flat Position (Table)

When the hand is laid flat on the table, the thumb is technically in an oblique position for imaging.

Modified Robert Method

An AP projection of the thumb with a $15$-degree proximal angle to the first CMC joint (achieved via tube angle or hand tilt), used to open up the joint space for better visualization of potential fractures.

Central Ray (CR) for PA Hand

The central ray is positioned at the MCP (Metacarpal Phalangeal) joint.

Marker Placement (PA Hand)

The marker is typically placed on the lateral side of the hand.

Good PA Hand X-ray Quality

A good image includes the entire hand, carpals, top of the radius and ulna, all fingers without clipping soft tissue, with no rotation and symmetrical appearance.

Oblique Hand (Technique)

Requires keeping the fingers straight and parallel to the IR while rotating the hand $45$ degrees to ensure open joint spaces.

Indicator of Good Oblique Hand

Partial superimposition of the third, fourth, and fifth metacarpals, along with open joint spaces in the fingers.

Fan Lateral Hand

Achieved by having the patient make an 'okay' sign, slightly separating fingers, and ensuring the wrist is true lateral, which helps to separate the metacarpals and phalanges.

Wrist X-ray (PA Position)

Best performed with the patient making a small fist, which helps to flatten the wrist on the image receptor, resulting in a truer PA projection.

SID for Wrist X-ray

The standard Source-to-Image Receptor Distance (SID) for a wrist X-ray is $40$ inches.

Scaphoid Projection

A specialized PA view with ulnar deviation, often combined with a $10$ to $20$-degree (or up to $30$-degree) angle (via sponge or tube) toward the elbow, used to better visualize the scaphoid bone due to its common fracture rate.

Navicular (common misuse)

Often incorrectly used interchangeably with 'scaphoid' in the context of the wrist, but 'navicular' properly refers to a bone in the foot.

Superimposition (without)

Refers to a view where no other bones are overlapping on top of the bone of interest, allowing for clear visualization.

Modified Stetcher Method

A PA axial scaphoid technique utilizing an elevated hand with or without ulnar deviation (using a sponge) to achieve a similar radiographic view as an angled tube, useful for patients who cannot tolerate a tube angle or if avoiding movement is critical.

Gainer Hart Method (Carpal Canal)

A special view for the carpal tunnel, involving a $25$- to $30$-degree central ray angle toward the palm/head, with the hand rotated toward the radius.

Carpal Bridge View

Another specialized wrist view, where the central ray is angled $45$ degrees towards the forearm, used to demonstate specific carpal anatomy.

Total Body Positioning

The ideal radiographic positioning where the forearm and entire limb are at the same level, with a $90$-degree angle in the elbow, to ensure optimal image quality and prevent distortion.