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58 Cards in this Set
- Front
- Back
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What are other names for x-ray?
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radiograph
roentgenogram plain film |
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What does CT (CAT) stand for?
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computed tomography
(computed axial tomagraphy) |
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What does MRI stand for?
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magnetic resonance imaging
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List types of imaging modalities?
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radiography
CT scan MRI US = sonography fluoroscopy nuclear medicine scans = scintography |
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What is fluoroscopy?
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real-time radiographs
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What are the indications for fluoroscopy?
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radiographic guided procedures
-esophogram -angiography -myelography -GI studies -interventional procedures -surgical guidance |
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How are axial CT and MRI images viewed?
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as if standing at the patient's feet
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What views are available for CT scans?
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axial (transverse)
sagittal coronal |
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Which of the following use ionizing radiation - radiography, CT, MRI?
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radiography
CT |
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MRI images can be viewed in any plane (not limited to anatomical planes), true or false?
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true
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Which provides the most detail, radiography, CT, or MRI?
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MRI > CT > radiography
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Which is most expensive, radiography, CT, or MRI?
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MRI > CT > radiography
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What are the cons of MRI?
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extremely expensive
very small space → claustrophobia loud contraindicated if metal in body |
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What are the pros of MRI?
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non-ionizing radiation
imaging in any plane detailed |
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What is MRI used for?
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tissue imaging for brain, spine, joints, soft tissues
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What is radiography dependent on?
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densities and thickness
can distinguish structures when different densities |
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To localize things on radiographs, what do you need?
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orthogonal (perpendicular) views
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List the following structures from least dense to most dense: muscle, air, bone, water/tissue, fat, metal?
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air (black) < fat < muscle < water/tissue < bone < metal (white)
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Define myelography.
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imaging procedure using contrast medium (injection of dye into spinal cord) to detect spinal cord pathologies
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Define angiography.
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imaging prodecure using contrast medium (injection of dye into blood vessels or organs) to detect pathologies
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Define barium enema.
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radiographic examination of large intestine via insertion of barium (contrast) into rectum
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silhouette sign
loss of RT heart border indicates RML affected loss of RT hemi-diaphram border indicates RLL affected RML/RLL pneumonia |
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What does PA stand for?
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posteroanterior
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What does AP stand for?
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anteroposterior
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Describe a PA view.
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film place against anterior (chest) of patient; x-ray beam shot from posterior (back) of patient to anterior (chest) of patient
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Describe an AP view.
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film placed against back of patient; x-ray beam shot from anterior (chest) of patient to posterior (back) of patient
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What is a portable CXR?
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AP CXR
film placed against back and x-ray beam shot from anterior to posterior |
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What are the limitations of a portable CXR?
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since shot anterior to posterior, film further away from anterior structures (i.e. heart, great vessels)
the further away film is from structures, the more magnified and blurry they become thus heart is misleadingly magnified and heart borders are blurry |
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What is string sign?
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1. radiographic sign seen on contrast GI studies
2. indicates narrowing of bowel loop (potentially dispensible or permanently narrowed) 3. usually seen in terminal ileum in Crohn's disease where bowel loop irritability → severe spasm → may lead to fibrosis and permanent narrowing 4. may also be caused by carcinoid, hypertrophic pyloric sphincter |
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string sign
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What is an apple core lesion?
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1. radiographic sign seen on barium enema
2. usually occur in sigmoid colon, sometimes esophagus 3. appears when mass encircles and narrows a tubular structure of the body 4. often caused by adenocarcinoma or lymphoma |
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apple core lesion
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subdiaphragmatic free air
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What is subdiaphragmatic free air?
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1. radiograph sign seen on abdominal x-ray
2. air beneath diaphragm 3. indicates pneumoperitoneum 4. caused by perforation → most often peptic ulcer perforation |
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What is a sentinal loop?
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1. radiographic sign seen on abdominal x-ray
2. isolated distended loop of bowel near site of inflammation/injury 3. body attempts to localize inflammation → distension caused by local paralysis and accumulation of gas |
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How do you determine if there is appropriate inflation on a CXR?
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lungs should span 9 ribs
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colon cut-off sign
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string of pearls sign (small bowel obstruction)
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"Bat wing" appearance on CXR indicates?
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pulmonary edema
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What radiographic views should be ordered for suspected airway obstruction/foreign body?
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PA view
lateral view |
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What radiographic views should be ordered for suspected apical lung tumors?
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PA view
lordotic view |
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What is the silhouette sign?
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chest imaging sign
characterized by loss of border between structures in thoracic cavity → density of structures is abnormally equal helps to localize disease → lung, lobe, segment |
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What is the interpretation of silhouette sign?
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loss of LT heart border → LUL affected
loss of LT hemi-diaphragm border → LLL affected loss of RT heart border → RML affected loss of RT hemi-diaphragm border → RLL affected |
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What are the indications for a portable CXR?
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patient incapable of standing or sitting for PA view
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What is the most common cause of string sign?
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Crohn's disease
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What is the air bronchogram sign?
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normally bronchi are not visible because they are filled with air and surrounded by air
if surrounding alveoli become filled with fluid, bronchi become visible as dark branching markings surrounded by abnormal white lung may indicate pneumonia, pulmonary edema, or hemorrhage lesion must be in lung! |
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Which is better, AP view or PA view, and why?
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1. PA view
2. heart and great vessels are situated more anteriorly 3. the closer the film is to structures, the less magnified and blurry those structures are |
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What are orthogonal views?
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two images that are perpendicular to each other
necessary for localization |
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What is a Jones fracture?
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fx of 5th metatarsal
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Describe a lateral view.
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film place against left side of patient
x-ray shot from right side to left side so right side is magnified commonly ordered with PA view to localize lesions possibly hidden behind heart or diaphragm |
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Describe the approach to reading a CXR.
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1. identify patient
2. verify correct placement of film on light box 3. assess quality of film a. inspiration – 9-rib lung span indicates adequate inspiration to properly assess lungs b. rotation – equal space between medial ends of clavicles and interspersed spinous processes indicates no rotation c. exposure i. underexposure 1. if underexposed, film is whiter, and borders between more dense structures (metal, bone, fluid) may be lost 2. underexposure indicated if vertebral column not visible ii. overexposure 1. if overexposed, film is darker, and borders between less dense structures (gas, fat) may be lost 2. overexposure indicated if vessels of lungs not visible 4. get mental image of patient a. gender b. age c. size, shape d. position of patient e. lines, tubes, foreign bodies 5. assess chest wall a. clavicles, scapulae, ribs, vertebrae b. soft tissue 6. assess pleural cavities a. RT pleural cavity b. LT pleural cavity c. compare bilaterally 7. assess mediastinum 8. assess diaphragm 9. assess upper adbdomen if possible, compare new radiograph to old radiographs |
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Large breasts may appear as diffuse white areas over lungs on a CXR, true or false?
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true!
do not mistake for disease state! |
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normal CXR
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normal lateral CXR
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Lung fissures are only visible when parallel to x-ray beam, true or false?
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true
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On what view are major/oblique fissures visible?
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lateral
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On what view are minor/horizontal fissures visible?
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frontal and lateral
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