Studied by 2 peopleWhat 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
Note
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