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262 Cards in this Set
- Front
- Back
Which view is taken at 84" FFD?
|
Full spine x-ray
|
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Why do we take the chest on full inspiration?
|
To see the ribs - if you do not see at least 9-10 posterior ribs the x-ray is NO GOOD
|
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T/F Chest X-rays are taken at very small mas and large kv
|
True, to limit motion and increase detail
Example: AP thoracic=32 mas/80 kv PA Chest=5mas/120kv |
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Which films are taken at 72" FFD?
|
-Cervical spine:
Lateral Cervical Flexion/Extension RPO/RAO Cervicals - PA Chest - Lat Chest |
|
Why do we place the patients left side to the grid cabinet for the lateral chest film?
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To see the heart and minimize magnification
|
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Which views are taken at 40" FFD?
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All but:
-Cervical spine: Lateral Cervical Flexion/Extension RPO/RAO Cervicals - PA Chest - Lat Chest Full spine x-ray |
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Why do we take lumbar films on expiration?
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To elevate the diaphragm
And give more room for the abdominal organs - so we can get a better view of the lumbar spine |
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Where do you put the marker on the Lateral lumbar view?
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Lower Left for Lateral Lumbar
LL for LL |
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Which views of the cervical spine have tube tilt?
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Cervical Spine:
RPO/LPO RAO/LAO APLC APOM Pillar/PA Cervical |
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Which Cervical spine films have 15‚cephalad tube tilt?
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RPO/LPO
APLC |
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Which cervical spine film is taken with 15‚caudal tube tilt?
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RAO/LAO
But this is difficult to do b/c the tube would need to be too high so we normally don't even do these |
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Which cervical spine film is taken with 5‚cephalad tube tilt?
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APOM
|
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Which cervical spine film is taken with 35‚cephalad tube tilt?
|
Pillar/PA cervical view
|
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Which lumbar spine views are taken with tube tilt?
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Sacral base tilt up
-AP coccyx And if you can't see L5 w/o tube tilt try again on: -RPO/LPO -RAO/LAO |
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What is the tube tilt for the Sacral Base tilt up? AP and PA?
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AP=25-30‚cephalad
PA=25-30‚caudal |
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On the A-P lumbar, where is the gonadal shield placed?
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Males: @ bottom of the PS
Females: @ top of PS |
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T/F You have to shield the gonads 100% of the time in each and every patient
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False - you only have to shield if gonads are 5 cm (2") from the field of view or less - by law
|
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What is the tube tilt for the AP coccyx?
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10‚caudal
|
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Is there tube tilt on the AC joint view?
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Yes, 5‚ cephalad
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Which views are taken on full inspiration?
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Cervical:
Obliques APLC Swimmer's view Thoracic: AP Thoroacic Lateral thoracic PA chest Lateral chest Shoulder: AP int/ext rotation AC jt weighted/unweighted |
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Which views are taken on full expiration?
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Cervical:
Lat cervical Flexion/extension Lumbar: Lateral lumbar AP Lumbar Lumbar obliques Elbow: AP elbow Lat elbow (these can be expiration or suspended) |
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Which views are taken with suspended breath?
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apom
PA/Pillar Cervical Sacral base tilt up Lateral spot shot AP coccyx Lateral coccyx AP hip Frog leg |
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What do you tell your patient to prepare them for the x-ray?
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-tell them what you are going to x-ray
-ask them if they are under any radiation therapy? -is there any chance that you might be pregnant? If they are procreative age they must sign a form -please remove all metal from the region to be x-rayed only -pt must wear a gown |
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Measurements are recorded in
A mm B cm C inches D any of the above |
B cm
|
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You need the correct measurements for which of the following factors:
A time B kv C ma D all of the above |
C ma
|
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What are the 3 sizes of cassettes
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8x10
10x12 14x17 |
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What is the definition of focal film distance (FFD)?
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Distance from the tube to the film
Film=image receptor) |
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What is the usual FFD?
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40"
|
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What are the 6 exceptions to the 40" FFD rule?
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Full spine (84")
Lat cervical Flexion/Extension Cervical obliques PA Chest Lat Chest |
|
Depending on the anatomy, tube tilt is generally
A caudal B cephalic C through the plane line of the disc D all of the above |
C through the plane line of the disc
|
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Where do you measure for the lateral cervical?
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Laterally @ the widest area @ C6
|
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Where is the central ray placed in the lateral cervical?
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C4 w/top of light between the EAM top of ear
|
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Why do you ask the patient to exhale all the way out on the lateral cervical? (this is an A/F on mids)
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To bring the shoulders down out of the way
|
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What is another option for bringing the shoulders down on the lateral cervical?
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Use sand bags - but you need to mark them as weighted
|
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Why do we take the cervical flexion extension views?
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To look for ligament instability at C1-C2
|
|
What is normal ADI?
|
3mm
3mm =potentially unstable or hypermobility |
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C4 w/ top of light between EAM and top of the ear is the location of the CR for which films?
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Lat Cervical
Flexion/Extension Cervical obliques |
|
What precautions do you need to take when doing the Cervical Extension view?
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Make sure the patient is stable - this view may create dizziness - place a chair nearby for them to stabilize themselves with
|
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Where does the marker go on a Right Posterior Oblique?
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in front of the patient
@ the vertebral body |
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Why are cervical posterior obliques preferred over the anterior obliques
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They are impossible to do in the health center
There is supposed to be 15‚caudal tube tilt This would mean that the tube would need to be extremely high |
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Which views are measured AP @ C4?
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APLC
APOM PA Cervical/Pillar |
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Which views are measured laterally at the widest part of C6?
|
lat cervical
Cervical flexion/extension Cervical obliques Swimmer's view |
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Why do we take the APLC on full inspiration?
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To see the lung apices
|
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Why do we need to check the lung apices in the APLC?
|
These patients often present with TOS
Or pancoast tumor |
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Where is the central ray placed in the APLC?
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@ C4 over the thyroid cartilage with the top of the light between the upper lips and bottom of the nose
|
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What is the pt position for the APLC?
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Pt back against the grid cabinet with head in slight extension
|
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What is the law regarding collimation?
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@must have evidence of collimation on @ least 3 sides of the film
|
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In general where is the id lead blocker usually placed?
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Upper right corner with exceptions in the thoracic region
|
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Which view is the ONLY view where we collimate smaller than the film size in order to avoid radiating the eyes?
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APOM
|
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What are 3 reasons we take the APOM?
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-to see the overhang of lateral masses
-to check the integrity of the dens -to check the integrity of the transverse ligament |
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What is the normal overhang of the lateral masses in a child?
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10 mm is ok
|
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What is the normal distance of the transverse ligament on each side of the dens?
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3 mm on each side
7 mm all together |
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What is the collimation on the APOM using an 8x10 film?
|
8x5(top#)
|
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Why do we take the swimmer's view?
|
to see the lower cervicals when we can't see them on the APLC
|
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Where is the central ray on the swimmer's view?
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With the cross hairs @ the sternoclavicular jxn closest to tube to view C6-T3
|
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What is the patient position on the swimmer's view?
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Film side hand on top of head, other hand in back pocket; adjust shoulders to make them lateral, NOT oblique
|
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What are we looking for on the PA cervical/pillar view?
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Equal size pillars bilaterally
|
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Where does the central ray go on the PA cervical/Pillar view?
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ALWAYS @ C5 1" lateral to the midline on the side of interest
|
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What is the pt position in the PA cervical/pillar view?
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Facing grid cabinet, rotate head 45-50‚ AWAY from the side of interest
|
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What is the common sense rule on PA cervical/pillar films?
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Always do both sides and compare
|
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What is the tube tilt on the PA cervical/pillar views?
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35‚cephalad
|
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What is the general rule about tube tilt past 15‚?
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For every 5‚of tube tilt past 15‚you should approximate the tube to the image receptor by 1"
|
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Given the tube tilt rule, what is the FFD for the PA cervical/pillar views?
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40"-4"=36"
|
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What film size should you use for the PA cervical/pillar view?
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Either an 8x10 or a 10x12 and collimate down since the field of view will be distorted
|
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Which views do we place the ID lead blocker in the lower left instead of the upper right?
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LAP thoracic
Lat thoracic PA chest Lat chest (?) Lat lumbar (if poor posture) |
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Where do you measure for the AP thoracic?
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AP center over top @ sternum ~ T6
On full inspiration |
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Where is the central ray on the AP thoracic?
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set top of light 2-3 fingers above the superior trap the vertical ray through the jugular notch
|
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How do we compensate for the differences in densities in structures of the AP thoracic?
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Use a compensating filter on the upper half of the thorax because it has a decreased density due to lung tissue being filled with air
|
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What is the thoracic compensating filter made of?
|
Aluminum
|
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What landmark do we use on the film in the AP thoracic?
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The costophrenic angle should be at T12
|
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Where do we measure for the lateral thoracic?
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Lateral at the axilla
Where the lats meet the torso Under the arm NOTE: SAME FOR PA thoracic |
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What is the patient position in the lateral thoracic?
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Pt arms crossed holding the grid cabinet w/ one hand or holding a cane
|
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Where is the central ray in the lateral thoracic?
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Use the same set up for the lateral thoracic (2 fingers above superior trap) then turn the patient to face the wall
|
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How do we compensate for different densities in the lateral thoracic?
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Use the compensating filter on the bottom 1/3 since there is less density there (more density above b/c the shoulder girdle)
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Which view do you set the cassette to the patient and then set the central ray to the cassette?
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PA chest
|
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Where is the central ray for the PA chest?
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Superior border of the cassette 2" above the shoulders and match the CR to the cassette
|
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How do you know if the PA chest is a good or bad x-ray?
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If you don't see at least 9-10 posterior ribs the film is not good
|
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How do you make sure you see 9-10 ribs on the PA chest?
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Take the film on full inspiration
|
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How do the factors differ from usual for the PA chest? Give examples and state why
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Chest x-rays are taken @ very small mas and large kv
Example: AP thoracic 32 mas/80kv PA chest 5 mas/120kv This limits motion and increases detail - we have motion from heart which needs to be compensated for to get greatest detail |
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Where do we place the central ray on the lateral chest?
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Same as the PA chest then have the pt turn facing you
(cassette=2" above the shoulders/match the CR to the cassette) |
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What is pt position in the lateral chest?
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With their left side touching the grid cabinet and arms up over head
|
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Why do we place the pts left side against the grid cabinet in the lat chest?
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To see the heart and to minimize its magnification
This decreased the object-film distance which decreases magnification and increases detail |
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Where do you measure for the lateral lumbar?
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Lateral @ widest part
|
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Where is the central ray in the lateral lumbar?
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@ the iliac crest, 1/2 way between ASIS PSIS - vertically palpate greater trochanter
|
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What is the patient position in the Lat Lumbar?
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Arms crossed holding grid w/one hand or holding a cane
|
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When would you use a filter for the lateral lumbar? Where do you put it when you do use it?
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Use the compensating filter as needed, when you have a pt with a wasp waist
It goes from the top down to the iliac crest |
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Where would you put the ID lead blocker in the AP lumbar?
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Upper right hand corner
|
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Where do you measure for the AP lumbar?
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A-P @~L5 or widest part L3-L5
|
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Where is the central ray for the AP lumbar?
|
1" below the iliac crest centered @ the belly button
The bottom of the light should be just above the shield on a male pt and just below the shield on the female pt |
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What is the patient placement for the AP lumbar?
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Back to grid cabinet w/ hands holding sides of grid cabinet, internally rotate feet 15-20‚to see the femoral necks
|
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Why do we take the AP lumbar on full inspiration?
|
To get the diaphragm out of the way and to spread out the contents of the abdomen so we can get a clearer view of the spine in this region
|
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Where is the proper placement of the gonadal shield on a male patient?
|
@ bottom of the PS
|
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What is the male gonaldal shield made of?
|
Lead
|
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What is the proper placement of the gonadal shield on a female patient?
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@ top of PS
|
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T/F you should always shield your patient for a film taken in the area of the reproductive organs
|
False - only in patients in the procreative age
|
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T/F you must have your patients remove their bras for a lateral lumbar view
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True
|
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What is the law about when you are required to use the gonadal shield?
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You only have to shield if the gonads are within 5cm (2") or less from the field of view
|
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What factors do we use for the lumbar obliques?
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The same factors as the lateral lumbar
|
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Where do you measure for the lumbar obliques?
|
As for the lateral - measure hip to hip
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Where does the central ray go for the lumbar obliques?
|
1" above the iliac crest, line up umbilicus @ midline and rotate 25-45‚(or fist behind) @ L3
|
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Do you need to shield the patient for the lumbar oblique? Why or why not?
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No, b/c the gonads will not be within 5 cm of the field of view
|
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What do you do with the patients arms for the lumbar obliques?
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Have them hold the grid cabinet to get the arm out of the way
|
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What soft tissue structure must you look for on the lumbar obliques?
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Gallstones or Kidney stones
|
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Gall stones would be located lateral or medial?
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Lateral
|
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Kidney stones would be located lateral or medial? Why?
|
Medial - closer to the spine because they are retroperitoneal
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50% of the darkening of the film is due to
|
Scatter
|
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When you cut the size of the field of view, what happens to the scatter?
|
It is reduced
|
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What do you need to do to compensate for less scatter due to a smaller field of view?
|
-increase mas 50%or the film will be too light
|
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Where is the id lead blocker on the sacral base tilt up?
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Upper right
|
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Where is the marker on the sacral base tilt up?
|
Upper left
|
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Why do we take the sacral base tilt up?
|
To see L5-S1 and/or the SI joints
|
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What size film do we use for the sacral base tilt up?
|
28x10 or 10x12 depending on the size of the patient
|
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How do we measure for the sacral base tilt up?
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We set the central ray and measure A-P through the central ray
|
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Where is the central ray on the sacral base tilt up?
|
1/2 way between umbilicus pubic symphysis
Or 2" above the pubic symphysis at L5/S1 disc when taken P-A |
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Which sacral base view, AP or PA, is preferred in the female patient? Why?
|
P-A to protect the gonads
|
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Is there tube tilt on the sacral base tilt up?
|
Yes
25-30‚cephalad when taken A-P 25-30‚caudal when taken P-A |
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What is the FFD for the sacral base tilt up?
|
40" approximated due to tube tilt = 37-38"
|
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Why do we take a lateral L/S spot shot?
|
To get a better view of L5-S1
|
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Where is the central ray on the lateral L/S spot shot?
|
Bisect the ASIS PSIS vertically
1" below the iliac crests horizontally |
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Where do you measure for the Lateral L/S spot shot?
|
Through the central ray
|
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What do you do with the patients hands in the lateral L/S spot shot?
|
Have them hold a cane
|
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Where do you put the marker on the lateral L/S spot shot?
|
At the apex of the L5 lordosis
Just above the horizontal CR @ the edge of the film |
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What are the factors for the lateral L/S spot shot?
|
Use the lateral lumbar factors but increase mas by 50% because you have a decreased field of view/decreased scatter and must compensate
|
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What is the best patient position for the AP coccyx? Why?
|
Recumbant
It's easier for the patient and Spreads out the contents of the abdomen better so you can view the joint plane line |
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What film size do you use for the AP coccyx?
|
8x10
|
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What is the collimation for the AP coccyx?
|
5x5
|
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Where is the central ray for the AP coccyx?
|
2 1/2" above the PS \
|
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Where do we measure for the AP coccyx?
|
At the central ray
|
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Where do we put the marker on the AP coccyx?
|
In the corner of the film
|
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How is the marker exposed if it's not in the field of view?
|
By compton scatter
|
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Which end of the tube (cathode or anode) is closer to the thicker part of the coccyx?
|
The cathode (-)
|
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What factors do we use for the AP coccyx?
|
Double the mas from the AP lumbar factors
Because you are decreasing film size, field of view and scatter |
|
What is the tube tilt for the AP coccyx?
|
10‚caudal
|
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What size film and collimation do we use on the lateral coccyx?
|
"8x10 film size and 8x8 collimation
|
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What factors do we use for the lateral coccyx?
|
The lateral lumbar factors and increase the mas by 50%
|
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Where is the central ray on the lateral coccyx?
|
Palpate the sacrococcygeal junction,
And go 2" anterior to the posterior body surface |
|
Where do we measure for the lateral coccyx?
|
At the central ray
|
|
What is this?
Young adult Night pain relieved by salicylates Nidus viewed at femoral head w/ surrounding sclerosis |
Osteoid osteoma
Nidus is pathognomonic |
|
Where is the central ray for the AP hip?
|
Bisect the ASIS PS
Then go 2" lateral in about the inguinal ligament |
|
Where do we measure for the AP hip?
|
A-P through the central ray but don't go too far;
You want the hip, not the belly |
|
What is the patient position for the AP hip?
|
Back against grid cabinet with internal rotation of legs 15‚(pigeon toed)
|
|
Do we use a gonadal shield for the AP hip view? Why or why not?
|
Use a gonadal shield on the male pt
But not the female Use only if the shield is not in the field of view |
|
What views would you take if you needed bilateral hip views?
|
1 AP pelvis
2 Bilateral frog leg views (3 views total) |
|
What is the crescent sign?
|
A finding in avascular necrosis
|
|
If you see the crescent sign, it means your patient may be predisposed to what?
|
-legg calve perthes - if child
-Chandelier's - if adult -alcohol, steroid or pregnancy |
|
Where is the central ray on the frog leg view?
|
Same as the AP hip:
Bisect the ASIS PS, then go 2" lateral in about the inguinal ligament |
|
What is the patient position in the frog leg?
|
Back against the grid cabinet, with leg abducted, external rotation extension, figure 4 w/ foot on stool
|
|
Which shoulder view do you see the "ice cream cone"? What is this?
|
The AP shoulder - internal rotation
You cannot see the greater trochanter on this view so the humeral head appears more rounded |
|
Where is the central ray on the AP shoulder - internal rotation view?
|
At the corocoid process
|
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How do you find the corocoid process?
|
1" medial and 1" up from the axilla
|
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Where do you measure for the AP shoulder?
|
At the corocoid/central ray
|
|
What is the patient position for the internal rotation - AP shoulder?
|
Back against the grid cabinet
DOCTOR rotates pt's arm by grabbing the arm ABOVE the elbow and rotating it internally |
|
What is the hatchet deformity? What view would you see it?
|
A compaction fracture on the posterior lateral aspect of the humerus
Can be seen on either the Internal or External AP shoulder view |
|
What is HADD and on what view would you look for it?
|
Calcification of the supraspinatus tendon
It is best seen on the external rotation AP shoulder, especially if it's subtle We can see the "critical zone" of the tendon on this view and this is where it begins to calcify |
|
Which AP shoulder view do you see the greater tubercle?
|
External rotation
|
|
How does the external rotation AP shoulder differ from the internal rotation
|
Exactly the same but the arm is externally rotated by the doctor
Don't forget to grab the arm above the elbow |
|
You will get 2 points take off the lab practical if you do not do this on the shoulder film
|
Use the internal/external markers
|
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What are the 2 views for the AC joint?
|
Weighted and unweighted
|
|
What is the collimation for the AC jt view?
|
10x6 looks "prettier"
|
|
Where do you measure for the AC joint view?
|
@ the AC joint
|
|
Where is the central ray for the AC joint view?
|
Through the AC joint
|
|
Is there tube tilt?
|
Yes, 5‚cephalad
|
|
What is the patient position for the ac joint?
|
Back against the grid cabinet with AC joint centered to grid cabinet - externally rotate patients arms
|
|
What wieghts do we use for the weighted AC view?
|
10-15 lb weights - tell the patient the weighted view may be painful
|
|
What is the non-grid technique?
|
When the cassette is placed directly on the table and the body part is placed directly on the cassette
|
|
When is the non-grid technique used?
|
For extremities
Elbows and distal Knees and distal |
|
What cassette speed is used for plain film spinal xrays?
|
400 speed cassette
|
|
T/F slower speed cassette produces a more detailed image
|
True
|
|
What speed cassette is used for extremeties?
|
Slower for greater detail, ideally 100 speed cassette
|
|
What position is the position in to have a gonad dose ratio of 003 millirads
|
Collimate and have pt looking away
|
|
How much does the lead apron weigh?
|
About 9 pounds
|
|
Why don't you fold the lead apron?
|
Because it ruins it radiation will be able to get through- hang it instead
|
|
What is the collimation on the AP elbow?
|
Collimate to the arm
|
|
Where is the central ray on the AP elbow?
|
Cubital fossa joint space
1" below the epicondyles |
|
Where do you measure for the AP elbow?
|
A-P through the elbow @ the epicondyles
|
|
What is the pt position for the AP elbow?
|
Seated with the arm fully extended over the cassette
Hand supinated (palm up) Pt looking away form the light |
|
What factors do we use for the AP elbow? Why?
|
Double the mas that is in the book because the cassette speed is @ 400 instead of the optimal 100 for extremities
|
|
When will you see the posterior fat pad in the elbow?
|
Never, unless there is a problem
|
|
Where is the central ray in the lateral elbow?
|
Mid-elbow - just anterior to the lateral epicondyle
|
|
What is the pt position for the lateral elbow?
|
shoulder, elbow wrist all in the same plane, bend elbow 90‚
Thumb up toward tube Hand in knife edge position |
|
If you use a slower speed film/cassette combination in room 1 what do you need to do to the mas?
|
Double it
|
|
When using the extremity cassette, what do you need to do to the factors in the binder? Why?
|
You need to double the mas because the film speed is 400 and the factors are for ??? Spped film?? It must be 200 speed?? Check this - if it were 100 speed wouldn't you increase mas by 4??
|
|
What 4 views are standard views of the wrist?
|
PA
Lateral Ulnar deviation Oblique (teacup) |
|
Is there tube tilt on the PA wrist?
|
No
|
|
What is the collimation for the PA wrist?
|
1/4 of the cassette
(10x12 film) |
|
Where is the central ray for the PA wrist?
|
At the lunate or the proximal carpal region
|
|
What is the patient position for the PA wrist?
|
Hand flat, fingers curled
|
|
Why do you curl the fingers for the PA wrist?
|
To allow the carpals to spread out so you can see the joint space
|
|
Which view is best for a subtle fracture of the scaphoid?
|
Ulnar deviation of the wrist
|
|
What is the patient position for the ulnar deviation wrist view?
|
Fingers curled with ulnar deviation - sandbag at the thumb to stabilize and keep the ulnar deviation in place
|
|
What is the advantage of using a slower speed film?
|
Greater detail
|
|
The factors in the book are for 400 speed film and are:
29 mas/50 kv You want to use 200 speed film, what factors should you use? |
58 mas (round to 60mas)
50 kv |
|
If you have 400 speed film and your factors are 29mas/50kv but you want to use 100 speed film what factors should you use?
|
4x29 mas=12 mas
50 kv |
|
If you are using the extremity factors on the last page of the binder - what do you need to do?
|
Double the mas -
Why? I'm not sure on this one?? Or is it because of the speed of the extremity cassette? Must be? |
|
What is the pt position on the oblique wrist?
|
Thumb index fingers together rest on cassette
|
|
What is the aka for the oblique wrist view?
|
Teacup
|
|
Why would you want to take the oblique wrist?
|
to get another aspect of the scaphoid
|
|
Give 3 reason's for taking a lateral wrist?
|
Lunate dislocation
Colle's fx Triquetrum fx |
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Which views do you measure at the mid-carpals P-A?
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PA
Ulnar deviation Oblique wrists |
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Where do you measure for the lateral wrist?
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Lateral between the styloid processes
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Where is the central ray on the lateral wrist?
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Scaphoid
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What is the patient position for the lateral wrist?
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Thumb in neutral position, knife edge, pinky down, rest thumb on foam
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Why would you want to take a PA hand?
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For DIP articulations
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What is the most common benign tumor of the hand?
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Enchondroma
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What % enchondromas will undergo malignant transformation?
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1%
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What is enchondromatosis
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When more than 1 bone is affected by an enchondroma
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What is an aka for enchondromatosis?
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Ollier's disease
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Where is the central ray for the PA hand?
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3rd metacarpal head or middle
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What other view has the central ray at the 3rd metacarpal?
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Oblique hand
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What is Maffucci's syndrome?
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Enchondromatosis plus
Soft tissue hemangiomas |
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What percentage of Maffucci syndromes under go malignant degeneration?
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20%
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Where is the central ray and measurement for the lateral hand?
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2nd metacarpal head
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What is the patient position for the lateral hand?
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Spread fingers, pinky side down, wedge to rest hand on
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What is the aka for the ball catcher's view?
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Norgaard's projection
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What would you use the ball catcher's view for?
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If you suspect Rheumatoid arthritis
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Why is the ballcatcher's view good for rheumatoid arthritis?
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Because this view shows the MCP joints and you can see subtle erosions
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What is the only x-ray that you can put both extremities on one cassette?
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Ball catchers/
Norgaard view |
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Where do you put the central ray on the Norgaard view?
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Between the 5th metacarpals
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What is the patient position for the Norgaard view?
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Hands palm up
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Where is the most common place for osteoarthiritis?
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Knee
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What are signs of osteoarthritis?
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Alignment
Jt space Bone-osteophytes |
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If you see a metaphyseal cortical destructive lesion in a young kid it is most likely to be?
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Osteosarcoma
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If you see an diaphyseal cortical destructive lesion in a young kid it is most likey to be
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Ewings sarcoma
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Is there tube tilt on an AP knee?
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Yes 5 degrees cephalad
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Why is the tube tilt important in the knee?
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It is important to see the joint space
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Where is the central ray for the AP knee?
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1 cm inferior to the apex of the patella
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What is the patient position for the AP knee?
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Supine - lying or sitting
Knee internally rotated leg slightly so knee is in true AP position Sandbag ankle to stabilize |
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Is there tube tilt on the lateral knee?
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@5 degrees cephalad or none
Can't do tube tilt if pt is standing |
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Where is the central ray on the lateral knee?
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1 cm distal to the medial epicondyle
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What is the pt position on the lateral knee?
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Pt lying on side with involved leg down
Flex lower leg no more than 45 degrees Cross opposite leg over involved leg avoiding pelvic rotation |
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Why do you not flex the leg more than 45 degrees for the lateral knee?
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You will get too much superimposition if you flex more than 45 degrees
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What is the most common location for osteitis condritis dessicans of the knee?
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The lateral portion of the medial femoral condyle - you will see a semicircular detachment
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What is the aka for the tunnel view?
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Intercondylar view
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Is there tube tilt for the tunnel view?
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45 degrees caudal
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What is the FFD for the tunnel view
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36" because you must remember to approximate the tube because of the 45 degree tube tile
For every 5 degrees greater than 15 approximate 1 inch |
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What do you take the tunnel view for?
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To get a good look at the tibial emminences
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What is the view that you would take to see the patellofemoral joint space?
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Sunrise view
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What is the aka's for the sunrise view?
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Tangential
Jones view |
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What is the tube tilt for the sunrise view?
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10 degrees cephalad
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What is the patient position for the sunrise view?
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Pt prone
With knee in middle of cassette Hyperflexed knee held with a belt |
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What is the collimation for the AP ankle
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6x10
Or half the film |
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What is the tube tilt for the ap ankle?
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None
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Which 2 views are measured AP at the mortise of the ankle?
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AP and oblique ankle
Expect about 9-10 cm |
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Which 2 views have the central ray between the malleoli - aim for the middle of the joint?
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AP ankle and
Oblique ankle |
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What is the patient position for the AP ankle view?
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Seated
Knee extended Foot no more than 90 degrees dorsiflexed Toes up |
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What are the 2 most common benign lesions of the calcaneous?
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Simple bone cysts - lucent
Interosseous lipoma - mixed blastic |
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These lesions may cause weakening which may result in what?
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Pathological fractures
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What else might you see on a lateral ankle view?
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Calcaneal spurs
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The ankle and feet are the only place you can take a view that sees what?
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It is the only place you can take 1 film to see both areas because the central rays are so close there won't be much compromise
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Due to the anode heel effect which end of the tube do you have pointing at the toes?
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Anode
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Which end of the tube is pointing to the heel?
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Cathode
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Is there tube tilt for the AP ankle?
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10 degrees cephalad or less depending on the patient's arch
If they have flat feet, you may not use tube tilt @ all - stay perpendicular |
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How many views are you allowed to take if you need to look at both the ankle and foot regions?
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5
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The oblique foot is set up the same as which other view?
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AP
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What is the patient position in the oblique foot?
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Patient seated
Bent knee Foot flat on the cassette Internally rotate knee so little toe comes up 15-30 degrees wedge foam underneath 15-30 degrees internal rotation |
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How is the patient positioned for the lateral foot?
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Foot diagonal on film
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What is the ffd for the full spine film
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84"
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What is the collimation for the full spine film?
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To the patient
Collimate from bottom of nose to bottom of ischial tubes Match the film to the central ray or top of film @ bottom of nose Bottom of film @ ischial tubes |
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How do we measure for the full spine film?
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Same as the AP lumbar
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What are the breathing instructions for the AP full spine?
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Full inspiration
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Ffd can never be less than? For the full spine film?
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Never less than 72"
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What is the cut off for the AP full spine patient size?
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26 cm
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