Rad Tech 2Nd Semester Test 1

Front 1

What are the technical considerations in taking an abdominal x-ray (4)?

Back 1

1. No artifacts

2. Rule out pregnancy

3. Take exposure at end of expiration

4. Gonadal shielding for males

Front 2

Why is it important to expose at the end of expiration?

Back 2

It is easier for the patients to hold

There is less compression of abdominal structures

Front 3

What will structures will a well exposed image of the abdomen demonstrate (3)?

Back 3

1. Outline of the kidneys

2. Lateral borders of the psoas muscles

3. Transverse processes of the lumbar vertebrae

Front 4

What views are required for an abdominal series?

Back 4

AP supine abdomen, AP upright abdomen, and chest.

Front 5

If patient is unable to sit or stand, what images are taken?

Back 5

AP supine abdomen, left lateral decubitus, and chest.

Front 6

What are the other names for AP supine abdomen?

Back 6

KUB, Flat Plate, or Abdomen.

Front 7

Where is the IR centred to for AP supine abdomen?

Back 7

Iliac crest.

Front 8

What anatomy should be included in an image of AP supine abdomen?

Back 8

1. Symphysis pubis

2. Kidneys

3. Lower liver margin

Front 9

Why is it important to take an image of an AP upright abdomen?

Back 9

It shows air fluid levels and or intraperitonial air (free air).

Front 10

How long should a patient be erect prior to exposure?

Back 10

Minimum 5 minutes, 10-20 is even better. This is why the erect image should be acquired first.

Front 11

Where is the IR centred to for an AP erect abdomen?

Back 11

2" above the iliac crests.

Front 12

What needs to be included in the AP erect abdomen image?

Back 12

Diaphragm

Front 13

Why might a PA prone abdomen be done?

Back 13

For a small bowl followthrough.

Front 14

Why is left lateral decubitus the preferred decubitus position for abdomen?

Back 14

Free air can be easier to see under the right hemidiaphragm. The liver provides good soft tissue contrast, and the gastric air bubble will not be in the way.

Front 15

State the patient position for a left lateral decubitus abdomen?

Back 15

Patient lying on side for a minimum of 5 minutes, usually done PA at QEH but no preference, arms raised. Filter should be used.

Front 16

Where should the CR be centred for a left lateral decubitus?

Back 16

2" above the iliac crests.

Front 17

What should be demonstrated for a left lateral decubitus abdomen image?

Back 17

The diaphragm

Both sides of body included if possible

- if free air, upside hemidiaphragm included

- if fluid, demonstrate the side down

Front 18

When is a right/left dorsal decubitus abdomen preformed? What will it show?

Back 18

When patient is too ill to be on their side. Will show an abdominal aneurysm, foreign body, and some air fluid levels.

Front 19

When can a PA chest be excluded in an abdominal series?

Back 19

If patient had a chest radiograph in the past 7 days. However if a chest was requested specifically, the chest is done regardless of previous imaging.

Front 20

What will a PA chest best demonstrate for an abdomen?

Back 20

Free air under the diaphragm.

Front 21

What is the part position for an AP Humerus (3)?

Back 21

1. Humerus slightly abducted

2. Hand is supinated

3. Humeral epicondyles parallel to IR

Front 22

Where should the CR be centred and where should you collimate to?

Back 22

CR is perpendicular to mid-humerus. Collimation includes glenohumeral joint and elbow.

Front 23

State the image critique for an AP humerus (4).

Back 23

1. Greater tubercle in profile

2. Lesser tuberosity is between head & greater tuberosity

3. Humeral head is in profile medially

4. Medial and lateral epicondyles are in profile (elbow is in true AP)

Front 24

What will happen if the hand is not supinated for an AP humerus?

Back 24

The greater tubercle will not be in profile.

Front 25

What is the part position for a lateral humerus (4)?

Back 25

1. Humerus is slightly abducted

2. Elbow may be slightly flexed

3. Humeral epicondyles are perpendicular to IR

4. Hand is internally rotated and may be placed on hip

Front 26

State the image critique for a lateral humerus (3).

Back 26

1. Lesser tubercle in profile

2. Greater tubercle is superimposed over humeral head

3. Epicondyles are superimposed

Front 27

When doing an AP projection of the shoulder, what bony landmarks are in profile if the arm is externally rotated (anatomical position)?

Back 27

The greater tuberosity is in profile laterally and the humeral head is in profile medially.

Front 28

When doing an AP projection of the shoulder, what bony landmarks are in profile if the arm is in a neutral position?

Back 28

The greater tuberosity is on the anterior humerus (superimposed).

Front 29

When doing an AP projection of the shoulder, what bony landmarks are in profile if the arm is internally rotated?

Back 29

The greater tuberosity is on the medial humerus and the lesser tuberosity is in profile.

Front 30

How do the epicondyles of the elbow align with the bony landmarks of the humerus?

Back 30

The lateral epicondyle and the greater tuberosity are aligned. The medial epicondyle and the humeral head are aligned.

Front 31

For a standard AP of the shoulder, where is the CR centred?

Back 31

1" inferior to coracoid

Front 32

What anatomy should be included for an AP shoulder (4)?

Back 32

1. Proximal humerus

2. Glenohumeral joint

3. Upper aspect of scapula

4. Distal 3rd of the clavicle

Front 33

Why is it important to have good soft tissue detail in a shoulder x-ray?

Back 33

To demonstrate calcium deposits.

Front 34

State the patient position for an AP Glenoid (Grashey Method) x-ray.

Back 34

1. Posterior aspect of patient against the IR

2. Rotate patient 35-40 degrees toward side of interest - scapula parallel to IR, coracoid and acromion are aligned and perpendicular to IR

Front 35

Where should the CR be centered for an AP Glenoid x-ray?

Back 35

Centered to glenohumeral joint - 2" inferior and medial from superolateral border of humerus.

Front 36

State the criteria for an AP Glenoid projection (3).

Back 36

1. Glenoid fossa is in profile

2. Joint space is well seen

3. Coracoid superimposes about 0.25" of humeral head

Front 37

How can you tell if there is too much or too little rotation in a Glenoid projection?

Back 37

If the coracoid is superimposed too much then there is too much rotation, and vice versa.

Front 38

State the patient/part position for an inferosuperior axillary projection (4).

Back 38

1. Patient is supine

2. Arm is abducted 90 degrees from body

3. Head is rotated away from side of interest

4. IR is placed along superior border of shoulder as close to neck as possible

Front 39

How is the CR directed for an inferosuperior axillary projection?

Back 39

CR is horizontally directed to the axilla. Will need to angle tube 25-30 degrees medially.

Front 40

What is done to the angle if the patient cannot abduct arm the full 90 degrees for an axillary shoulder?

Back 40

The CR angle must be lowered.

Front 41

State the patient/part position for a superoinferior axillary projection of the shoulder (3).

Back 41

1. Patient is sitting

2. Arm is abducted 90 degrees, elbow is flexed 90 degrees

3. Patient leans over IR.

Front 42

Where is the CR centered to and how is it angled for a superoinferior axillary projection of the shoulder?

Back 42

The CR is centered to the glenohumeral joint, and is angled 5-15 degrees toward the elbow. Less abduction = less angle.

Front 43

State the criteria for an axillary projection of the shoulder (6).

Back 43

1. Acromion partially superimposed over humeral head

2. AC joint

3. Coracoid free of superimposition

4. Glenoid fossa is in profile

5. Lesser tuberosity is shown superiorly

6. Greater tuberosity is shown inferiorly

Front 44

What is the axillary projection best used for?

Back 44

Demonstrating anterior or posterior dislocation of the shoulder

Front 45

State the part position for a PA Scapular Y view (4).

Back 45

1. If possible arm is placed across chest. Trauma patients arm remains as is.

2. Scapula is perpendicular to IR

3. Patient faces IR, rotated 30 degrees from the lateral position (towards IR - 60 degrees from IR)

4. Alignment of coracoid/acromion should be parallel to IR.

Front 46

State the part position for an AP Scapular Y view (4).

Back 46

1. If possible arm is placed across chest. Trauma patients arm remains as is.

2. Scapula is perpendicular to IR

3. Patient's back is against IR, side of interest rotated 60 degrees away from IR

4. Alignment of coracoid/acromion should be parallel to IR.

Front 47

State the criteria for a Scapular Y projection of the shoulder (7).

Back 47

1. Body of scapula superimposed on end

2. Acromion and coracoid processes in profile

3. Humeral head and glenoid cavity are superimposed

4. Optimal exposure factors

5. Scapula is in true lateral

6. Scapula is not superimposed over ribs

7. Glenohumeral joint is demonstrated

Front 48

What is Stewart Campbell's Shoulder Outlet projection?

Back 48

A PA Transcapular lateral with CR angled 5-10 degrees caudad.

Front 49

What does the shoulder supraspinatus outlet projection demonstrate?

Back 49

The supraspinatus outlet is open and in profile. Demonstrates coracoacromial arch.

Front 50

How is the arm positioned for an AP Scapula projection?

Back 50

Arm is abducted 90 degrees, elbow is bent 90 degrees, hand is supinated

Front 51

What does the arm position of an AP scapula projection do to the anatomy?

Back 51

Moves scapula laterally to decrease superimposition on thorax.

Front 52

Where should the CR be centred for an AP scapula projection?

Back 52

2" below coracoid process.

Front 53

What is the breathing technique used for an AP scapula projection?

Back 53

Longer exposure time (not possible with DR), patient breathes quietly during exposure. This blurs the lungs and demonstrates the scapula nicely.

Front 54

State the image critique for an AP scapula (2).

Back 54

1. Entire scapula demonstrated

2. Lateral border should not be superimposed over ribs

Front 55

State the two positions for lateral scapula.

Back 55

1. Effected arm is positioned across the chest grasping opposite shoulder (demonstrates body of scapula) Patient rotated 30-45 degrees from lateral - less rotation needed with this one

OR

2. Effected arm is flexed and back of hand is placed against lower back (demonstrates arcromion and coracoid process) Patient rotated 30-45 degrees from lateral

Front 56

State the evaluation criteria for a lateral scapula (3).

Back 56

1. Vertebral and lateral borders are superimposed

2. Body of scapula is not superimposed by ribs

3. Humeral head should superimpose as little of the scapula as possible

Front 57

What is the evaluation criteria for an AP clavicle (4)?

Back 57

1. Entire clavicle demonstrated

2. No rotation

3. Optimal exposure factors

4. Both SC and AC joints demonstrated

Front 58

How is the CR angled for an AP Axial Clavicle?

Back 58

15-30 degrees. Thinner patients require more angle to project clavicle away from thorax.

Front 59

State the evaluation criteria for AP Axial clavicle.

Back 59

Same as AP clavicle but more clavicle is seen above ribs. Only medial end of clavicle is superimposed over ribs.

Front 60

What two projections are performed for AC joints?

Back 60

One image without patient holding weights, and one with patient holding weights. Demonstrates AC separation.