Quiz 2 rads 350

Alternatives to pa and lateral chest

AP trauma chest or AP decubitus

Pt prep for an abdomen series:

Jewelry and metal removed from the waist up

Hair removed from light field

For KUB pull pants half way down

Positing for erect abdomen:

Back against IR, MSP centered to IR, CR 2" above iliac crest, gonadal shielding not required

Positions for KUB:

Pt supine on table, MSP centered to midline, arms at sides, CR to level of iliac crest, gonadal shelling not required

Chest positioning for a lateral

Erect with left side touching IR to minimize distortion, CR at t-7, gonadal shielding at waist

Evaluation for a lateral chest:

No rotation, superimposition of posterior ribs, lungs visible, costophrenic angles and apices included, helium in center of radiograph

Alternatives to lateral chest:

Ventral or dorsal decubitus

Positioning for a PA chest:

Pt erect and facing Bucky, arms wrapped around, shoulders rolled forward to remove scapula from lung field, Cr at T-7, chin elevated

What is the SID for a KUB

40"

Evaluation for PA chest:

Entire lungs from apices to costophrenic angles, no rotation, 10 posterior ribs visible, air filled trachea in middle of radiograph

Where does the central ray enter for chest exams

T-7

Where does the central ray enter for a Pa hand

3rd MCP joint

Where does the central ray enter for an oblique hand

3rd MCP jt

Where does the central ray enter for a lateral hand

2nd MCP joint

What are the routine chest exams

PA and lateral

What is the SID used for a Pa and Lateral chest

72"

Does chest use a grid

Yes

What are the routine hand exams

Pa, oblique, lateral

What anatomy should be included on hand x-rays

All phalanges, carpals, metacarpals, distal ends of radius and ulna must

Pa hand evaluation criteria

Entire hand included open IP and MCP joints with no rotation, 1" around soft tissue, and evidence of Collimation

Oblique hand evaluation criteria

-Evidence of proper collimation

- anatomy from fingertips to distal radius and ulna

- digits separated slightly with no overlap of their soft tissues

- 45 degrees of rotation of anatomy

• minimal overlap of the third, fourth, and fifth metacarpal bodies

• slight overlap of the metacarpal bases and heads

• separation of the second and third metacarpals

-open IP and MCP joint

- soft tissue and bony trabecular detail

Lateral fan evaluation criteria

Entire hand and carpals demonstrated

Center of field at second MCP joint

Fingers equally separated

Exposure factors

thumb and pointer finger do not touch

Thumb free of motion and superimposition

Extended digits

Hand in true lateral position

Superimposed metacarpals

Superimposed distal and radius and ulna

Anatomy that must be on a chest x-ray

Entire lung field from apices to costophrenic angles, 10 ribs on right side, thoracic vertebrae, right and left hemidiaphragm, cardiac shadow, clavicles, sternum, scapulae, ac joints, acrimon process

KVP range for hand x-rays

50-65

What is the kVp for chest

Non grid 70-90 grid 110-125

Alternative projections to a pa chest:

AP supine chest, stretcher/wheelchair chest, decubitus chest

Chest anatomy

Entire lung field from apices to costophrenic angles, 10 ribs on right side, thoracic vertebrae, right and left hemidiaphragm, cardiac shadow, clavicles, sternum, scapulae, ac joints, acrimon process

Osteoarthritis

cartilage shock absorbers between bones wears away. bones rub together

volar angulation

Bends towards the palm, Directed towards palm of the hand

Abdomen anatomy

Iliac crest, symphysis pubis, femoral heads, Asis, lumbar spine, diaphragm, bowel gas, costophrenic angles, liver, spinous process, transverse process

Avulsion injury

tendon separates from bone, removes bone material

Where should the marker be placed on a hand

On the medial side or anterior side for a lateral

Routine shoulder projections

external & internal rotation (scaly y or grassy can be routine

Shoulder anatomy

sternum, clavicle, scapula, humerus

Ap neutral shoulder evaluation criteria

Greater tubercle partially overlapping the head of humerus, general head in partial profile, overlap of numeral head and glenoid cavity

Finger evaluation criteria

must include the entire digit (fingertip to the adjoining metacarpal head) with clear soft-tissue and bony trabecular details.

Oblique finger evaluation criteria

a visible 45° rotation, open interphalangeal (IP) and metacarpophalangeal (MCP) joint spaces

Lateral finger evaluation criteria

the finger must be in a true lateral position parallel to the image receptor with the PIP joint centered. The fingernail should be in profile, joint spaces must be open, and adjacent digits must be retracted to prevent bony or soft-tissue superimposition.

Evaluation for an erect abdomen

clear visualization of the diaphragm to check for free gas, inclusion of the lateral abdominal walls, and no patient rotation.

Evaluation criteria for KUB

zero patient rotation, accurate exposure factors to visualize soft tissues and pubic symphysis, correct anatomical marker placement, and inclusion of both kidneys and the lower liver margin

Grashey evaluation criteria

Glenoid cavity profiled; scapulohumeral joint centered; optimal exposure.

Scapular Y evaluation criteria

Humeral head and glenoid cavity superimposed

Humeral shaft and scapular body superimposed

No superimposition of the scapular body over the bony thorax

Acromion projected laterally and free of superimposition

Scapula in lateral profile with lateral and vertebral borders superimposed.

Scapular y positioning

pt obliqued 45-60 degrees

hands at side

Grashey position

Alternative patient position to the internal rotation shoulder when trauma has occurred