Rad Tech III Exam Review

What positioning line is perpendicular to the IR for a parietoacanthial ( Waters) projection?

MML

For an axiolateral projection of the mandible, what head position will best demonstrate the mentum?

45° rotation

For a submentovertex (SMV) projection, how is the MSP positioned?

Perpendicular to the IR

On a PA Axial (Caldwell) projection of the skull, the distance between the left lateral orbit and the lateral cranial cortex is greater than on the right. What does this indicate?

Face was rotated to the right

For an AP Axial ( Caldwell) on a trauma patient, how is the CR directed to project the petrous ridges in the lower third of the orbits?

15° caudad to OML

How is the CR directed for a parietoacanthial (Waters) projection of the facial bones?

Exiting the acanthion

For an AP axial (Towne) for mandible, how is the CR directed?

35° caudad

Where is the CR centered for a lateral of the nasal bones?

1.25 cm inferior to nasion

On an oblique axiolateral projection of the mandible, what region of the mandible is best demonstrated when the patient's head is in a lateral position?

Ramus

For what projection is the IOML parallel to the IR?

Submentovertex (SMV)

For a lateral skull projection, what body plane is parallel to the IR?

Midsagittal

How is the head positioned for an oblique axiolateral ( tangential) projection of the LEFT zygomatic arch?

Head rotated to the left; chin tilted to the left

On a parietoacanthial projection ( Waters) of the sinuses, the patient's front teeth are demonstrated within the maxillary sinuses. What positioning error has occurred?

Patient's neck is overextended

For an AP Axial ( Towne) projection, how is the appearance of the image affected by insufficient neck flexion?

Dorsum sellae is projected superior to the foramen magnum

When performing an AP Axial ( Towne) for zygomatic arches, where is the CR centered?

2.5 cm superior to nasion

To which bone is the CR centered for a lateral projection of the facial bones?

Zygoma

For which projection of the facial bones is the interpupillary line perpendicular to the IR?

Lateral

What projection/position of the skull will demonstrate the sella turcica and clivus in profile?

Lateral

For a lateral position of the sinuses, what radiographic criteria is used to confirm appropriate exposure of the image?

Visible sphenoid sinuses without overexposing maxillary sinuses

How is the CR directed for an oblique axiolateral (tangential) projection of the zygomatic arch?

Perpendicular to the IOML

When performing a sinus exam on a five year old patient, what projection/position might be the only one requested?

Parietoacanthial (Waters)

For a PA projection of the mandible, what positioning line is perpendicular to the IR?

OML

When the MML is positioned perpendicular to the IR, where are the petrous ridges demonstrated on the resulting radiograph?

Below the maxillary sinuses

How is the IOML positioned for a lateral projection of the skull?

Perpendicular to the front edge of the IR

When performing an oblique axiolateral projection of the TMJ, how is the MSP positioned when the CR is angled 15 ° caudad?

Rotated 15 ° toward the IR

A patient arrives in the ER via ambulance. She is brought to the X-ray department for cervical spine, skull and facial bones. The patient is immobilized in a cervical collar with her neck slightly extended and her OML 5° from perpendicular. What CR angle will the technologist use to obtain the AP axial ( Towne)?

35° caudad

What Kv range is recommended for cranium imaging?

80-90

A patient arrives in the DI department for orbit imaging. His neck is slightly flexed and cannot be corrected. His OML is 10° from perpendicular. What CR angle will the technologist use to obtain the PA axial ( Caldwell for Orbits)?

40° caudad

On a PA axial ( Caldwell) for skull, what positioning line is positioned perpendicular to the IR?

MSP

On a PA Axial (Caldwell) of the sinuses, the petrous ridges are projected into the superior aspect of the orbits. What action will the technologist take when repeating this exam?

Decrease patient's neck flexion

On an axiolateral oblique mandible image, the ramus is superimposed over the cervical spine. What positioning error has occurred?

Insufficient neck extension

The TEA corresponds to what other anatomical structure?

Petrous ridges

What projection/position of the skull will best demonstrate the frontal bone and the greater & lesser wings of the sphenoid?

PA Axial ( Caldwell)

Why is a horizontal CR recommended when imaging the paranasal sinuses?

Better demonstration of fluid levels

For which exam is the lateral position performed without a grid?

Nasal bones

For an oblique axiolateral projection of the mandible, how is the head positioned when the body of the mandible is the area of interest?

Rotated 30° toward the IR

Why is it important to obtain an x-table lateral as part of a trauma skull series?

For demonstration of a basal skull fracture

What projection of the zygomatic arches works best for patients with depressed fractures?

Oblique Inferosuperior ( tangential)

Where is the centering point for a lateral projection of the paranasal sinuses?

Halfway between EAM & outer canthus

For a parietoacanthial (Waters) projection of the sinuses, what is the relationship between the OML and the plane of the IR?

37°

What projection/position will best demonstrate tripod and Le Fort fractures?

Parietoacanthial (Waters)

On a submentovertex (SMV) projection of the zygomatic arches, how is the symphysis of the mandible demonstrated?

Superimposed over the frontal bone

T or F: Pain and anxiety associated with the injection of contrast media can cause a vasovagal reaction in patients.

True

Which is a common "disadvantage" of lower osmolality contrast media: Shorter shelf life, Lower iodine concentration, Cannot be injected intra-arterially, Increased viscosity

Increased viscosity

What is the purpose of administering Buscopan or Glucoagon to patients during imaging of the digestive system?

Reduces bowel spasm

Which statement regarding iodinated contrast media is correct? Primarily eliminated by the liver, Cannot cause any reaction if less than 1 ml given, Cannot be given to a pregnant women, Does not cross a normal blood-brain barrier

Does not cross a normal blood-brain barrier

What is the term for injection into the subarachnoid space?

Intrathecal

What medication may be administered to a patient experiencing uriticaria following a contrast media injection?

Antihistamine

While performing an injection of contrast media, the patient complains of pain at the injection site and the technologist observes swelling. How will the technologist proceed?

Stop injection; remove needle; notify Radiologist

Which patient symptom would be classified as a mild reaction? Rhinorrhea, Bronchospasm, Arrhythmia, Bradycardia

Rhinorrhea

What characteristic of barium sulfate results in its contraindication in patients with a possible perforation?

That it is not water soluble

When would a patient require a water-soluble contrast enema rather than a barium enema?

Suspected perforation of bowel

Why is contrast media warmed prior to injection?

Decreased viscosity of contrast

T or F: A patient is unlikely to experience an anaphylactic-type reaction to contrast if the amount used is less than 25 ml.

False

If a child weighs 20 kg, what volume of iodinated contrast media would be recommended?

20-40 ml

Which iodinated contrast media has the lowest osmolality?

Visapaque® ( iodixanol)

How does the procedure for a single-contrast barium enema differ from a double-contrast?

Higher Kv used for single-contrast

Nephrogenic Systemic Fibrosis is potential side effect of what type of contrast media?

Gadolinium

What type of medication may increase the risk of contrast media reactions?

NSAIDS

T or F: Vasovagal reactions are mild and never require treatment.

False

Which is considered a risk factor for anaphylactic-type reaction to contrast media? Heart disease, Diabetes, Sickle cell anemia, Previous reaction

Previous reaction

Which condition is considered a contraindication to barium enema? Diverticulosis, Toxic megacolon, Volvulus, Intussusception

Toxic megacolon

Most contrast media reactions will occur within \_____________ after injection.

20-30 minutes

What creatinine level is within the normal range for a female patient? 80 µmol/L, 140 µmol/L, 32 µmol/L, 48 µmol/L

80 µmol/L

What serum creatinine level would be within normal range for a male patient? 80 µmol/L, 200 µmol/L, 50 µmol/L, 150 µmol/L

80 µmol/L

Which symptoms are consistent with a moderate contrast media reaction? Bronchospasm, Rhinorrhea, Seizures, Ventricular tachycardia

Bronchospasm

For which type of exam are Volumen® and PEG® used?

CT of the small bowel

What is the atomic number of barium?

56

What is the primary difference between Optiray® 280 and Optiray® 320?

Iodine concentration

Which body habitus is most common?

Sthenic

Which is a potential side effect of the iodine-based oral contrast media administered to CT patients? Hypertension, Diarrhea, Nephrogenic Systemic Fibrosis, Constipation

Diarrhea

Which is a risk factor for CI-AKI? Asthma-hayfever, Latex allergy, Pregnancy, Intra-arterial injection

Intra-arterial injection

T or F: It is possible to determine if someone is allergic to iodinated contrast media by performing blood work.

False

What criteria is used to determine if a a patient has experienced a contrast-induced acute kidney injury?

Increased serum creatinine by at least 44 µmol/L

What is urticaria?

Hives

Why should patients be kept well hydrated both before and after most interventional radiology procedures?

Decreases complications of contrast media

What is the osmolality of blood plasma?

290 mOsm/kg

T or F: A patient can experience an anaphylactic-type reaction to contrast media the first time they are receive it.

True

A patient experiences diaphoresis, nausea and bradycardia with syncope while receiving an IV injection of contrast media. What type of reaction is this patient most likely experiencing?

Vasovagal

In which situation would an item be considered "sterile"?It is used for an invasive procedure, Sterility indicator is valid, It had brief contact with a non-sterile item, It was become slightly wet

Sterility indicator is valid

What post-procedure care is required after a femoral artery puncture? Patient remains supine for 12-24 hours, Extremity is immobilized, Extremity is monitored for warmth and colour, Patient maintains bedrest for 48 hours

Extremity is monitored for warmth and colour

What technique should two sterile staff members use if they must pass by each other?

Both staff members turn so their backs face one another as they pass

Where is the sterile corridor located in the OR?

From the sterile drape on the OR table to the instrument table

Which renal artery is the longest?

Right

Of what interventional procedure is endoleak a complication? EVAR, PTC, ERCP, TIPS

EVAR

What procedure treats aortic valve stenosis in patients that cannot undergo an open repair?

TAVI

What is a risk factor for coronary angiography? Acute MI in previous month, Low INR, Depressed creatinine levels, Moribund patient

Moribund patient

What is the most common diameter for guidewires used in vascular interventional procedures?

0.035 cm

What post procedural care is required for most angiography procedures? No solid foods for 24 hours, Increased fluid intake, Bed rest for 48-72 hours, Limit fluid intake for 12 hours

Increased fluid intake

When prepping a patient's skin for a sterile procedure, how should the technologist proceed?

Prep center area first and work outward in a circular pattern

What artery is best demonstrated by a 15° RAO centered @ L3? Celiac, Splenic, SMA, IMA

IMA

What is the most commonly performed vascular interventional procedure?

Angioplasty

What is the benefit of a sheath when performing vascular procedures?

Allows easier exchange of catheters

Which aspect of the sterile tray should a "non-scrubbed" technologist open first?

The correct answer is: Front flap; opening tray away from themselves

What is the best treatment option for a STEMI?

PCI

During an angiography of the abdominal aorta, the radiologist injects the contrast media using the power injector at a rate of 20 ml/ sec. The injection lasts for 5 secs. How much contrast media did this patient receive?

100 ml

Where is the CR centered to demonstrate the entire abdominal aorta?

L2

What patient condition can be treated by embolization? AVM, Refractory ascites, STEMI, Limb ischemia

AVM

Where is the ideal site for a femoral artery puncture?

Below inguinal ligament

T or F: Medical asepsis should be employed for all medical procedures.

True