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Eval Test 4
all spine, ribs, pelvis, sacrum/coccyx, sternum, SC joints, SI joints,
| Question | Answer |
|---|---|
| What is the CR placement for an AP pelvis? | midway between level of ASIS & symphysis pubis (2" inferior to ASIS) |
| Which structures on the AP pelvis should be demonstrated medially? | lesser trochanters |
| Why is a RAO better than a LAO on a sternum? | RAO projects the sternum into the heart's shadow ensuring a more homogenous density. |
| How is the patient positioned on a lateral sternum? | erect with the arms drawn back with chest puffed out forward. |
| What is the centering for PA SC joints? | perpendicular to T2/T3; 3" distal to vertebra prominence. |
| When are SC joints sometimes ordered? | when a medial clavicle fracture is suspected. |
| On oblique SC joints which side is visualized? | side down; side closest to the IR. |
| What is the tube angulation on AP sacrum? | 15 degrees cephalic |
| What is the CR placement for AP sacrum? | 2" below ASIS; midsagittal |
| T/F: On an AP sacrum the pubic bone should overlap the sacrum. | False; should NOT overlap/superimpose |
| What is the CR placement for AP coccyx? | 10 degrees caudal; 2" inferior to ASIS @ midsagittal |
| What is the tube angulation for females on AP SI joints? | 35 degrees cephalic |
| What does SI stand for? | sacroiliac |
| How much obliquity is for the SC joints? | 25-30 degrees |
| What side is visualized and should be marked on SI joints? | the upside; side furthest away from the IR. |
| What is the centering for just AP sacrum? | 3-4" posterior to ASIS; level of ASIS |
| Which obliques are used for posterior rib pain? | posterior obliques (RPO or LPO) |
| What is the centering for above the diaphragm ribs? | T7; midway between the outer margin & MSP. |
| Which ribs should be included on the above the diaphragm? | 1-9 |
| AP c-spine: lift chin till line from________ & __________ are perpendicular to the IR. | occlusal plane & base of skull |
| Which vertebra are seen on the AP axial c-spine? | C3-T1 |
| Which projection of the cervical spine demonstrates the zygapophyseal joints? | lateral |
| Hyperflexion c-spine opens up what? | spinous processes |
| Why does someone expirate on an AP T-spine? | to decrease air volume in the thorax; more uniform density |
| How do you check for rotation with AP T-spine? | *spinous processes in midline *SC joints should be equal distance from the spine |
| Which position of the T-spine demonstrates the zygapophyseal joints? | 70 degree obliques; visualize the upside |
| On a RPO T-spine oblique which zygapophyseal joint is of interest? | left (upside) |
| AP lumbar what is the CR? | *clinicals: 2" above the crest *texts: level of crest (L4-L5) |
| How is rotation detected on an AP lumbar? | *spinous processes *sacrum & coccyx |
| What is used to detect rotation on an oblique lumbar? | the pedicle (eye) |
| What happens when the spine is not parallel to the table on AP and laterals? | disk spaces will be closed |
| If a pelvis is rotated LPO which obturator foramen is more open? | right(the upside) |
| If a pelvis is rotated RPO which iliiac wing will be foreshortened? | left |
| If a pelvis is rotated RPO which obturator foramen is more closed? | right |
| If a pelvis is rotated LPO; the sacrum/coccyx will be off in which direction? | right (moves in the upside direction) |
| What is the respiration for a RAO sternum? | breathing technique |
| RAO sternum: how much do you oblique a hypersthenic patient? | 15 degrees |
| RAO sternum: how much do you oblique an asthenic patient? | 20 degrees |
| T/F: RAO sternum: the sternum should be free of superimposition of the heart shadow. | false; should be in the heart shadow and free of superimposition of the spine |
| What is the respiration of a lateral sternum? | inspiration |
| How do you check for rotation on a lateral sternum? | heart shadow also if it looks like the ribs wrap around instead of come up to meet at the lateral sternum. |
| How much obliquity is used for oblique SC joints? | 15 |
| What is the joint between the body & manubrium of the sternum? | sternal angle |
| If a RAO SC joints is done, what joint is visualized? | right |
| If a LAO SC joints is done, what joint is visualized? | left |
| Are SC joints done AP or PA? | PA |
| For oblique SC joints, where should the joint of interest be to the spine? | directly in front of the spine |
| A pelvis is rotated RPO, which ischial spine is foreshortened? | left |
| A pelvis is rotated RPO, which obturator foramen is more open? | left |
| A pelvis is rotated LPO, which iliac wing is more in profile? | left |
| How can you tell if AP (below the diaphragm) lower ribs are done on inspiration instead of expiration? | if there are 9 ribs above the diaphragm = inspiration |
| How much patient obliquity is for oblique ribs? | 45 degrees |
| When positioning for AP upper oblique ribs and what to demonstrate the right ribs, where do you center? | T7; between outer margin and spine |
| When positioning for AP upper oblique ribs doing an LPO and want to demonstrate the right ribs where do you center? | T7; between the outer margin and the sternum on the right side. |
| On oblique ribs, which portion should be demonstrated free of superimposition? | axillary |
| Some protocols order a PA & lateral CXR with ribs series, why might they order that? | to rule out possible pneumothorax or other pathology |
| If anterior oblique ribs are done, which side is in profile? | side up; affected side should be away from the bucky. RAO = left side in profile |
| What is the centering for AP below diaphragm ribs? | T7; midway between outer margin & MSP; also midway between lower margin of ribs & xiphoid tip |
| What level of vertebra is the xiphoid tip at? | T10 |
| What does it mean if the sacrum overlaps the pubis? | too much tube angulation |
| Why would the sacrum become foreshortened? | not enough tube angulation |
| What is the centering when including both the lateral sacrum and coccyx? | 3-4" posterior to ASIS; 1" distal to ASIS |
| On the lateral sacrum/coccyx, what anatomy is included? | lateral view of sacrum, L5-S1 joint & coccyx |
| How is rotation detected on the lateral sacrum and coccyx? | *femur overlap (acetabulum & femoral heads) *posterior margins of ischium (greater sciatic notches) |
| For oblique SI joints, what is the patients obliquity? | 25-30 degrees |
| What is the centering for the oblique SI joint? | perpendicular to the ASIS; 1" medial to upside ASIS. |
| What is the centering for males AP SI joints? | 30 degrees cephalic & 2" below level of ASIS. |
| What is the patient's obliquity for RAO & LAO SC joints? | 15 degrees |
| For AP T-spine, which vertebral bodies should be included? | C7-L1 |
| What happens on an AP T-spine if the patient is supine and the knee are not bent? | the intervertebral disk spaces are normally closed. |
| What is the respiration for lateral T-spine? | breathing technique recommended or expiration |
| What is the centering for AP axial C-spine? | 15 degrees to C4 (lower margin of thyroid cartilage) |
| What vertebral bodies should be included on a lateral T-spine? | T4-L1 |
| What is recommended to be placed behind the patient for a lateral T-spine? | lead blocker |
| Which projection of the T-spine demonstrates the intervertebral foramina? | lateral |
| About how much tube angulation is used on a swimmer's view? | 3-5 degrees caudal to separate the shoulders |
| T/F: On a swimmer's, it is recommended to angle the tube. | false; its optional |
| What vertebral bodies are demonstrated on the swimmer's view? | C4-T3 |
| What needs to be fixed if on an oblique c-spine the intervertebral disk spaces are closed? | angle the tube more |
| What is the positioning for an AP Open Mouth? | adjust head so line from lower margin of the base of skull to the upper incisors is perpendicular to the IR. |
| How is rotation detected on an AP axial c-spine? | *mandibular angles @ equal distance *spinous processes in midline *transverse processes symmetrical *air-filled trachea |
| What anatomy should be included in the AP open mouth? | dens (odontoid process), vertebral body of C2, lateral mass of C1, zygapophyseal joints |
| On AP lumbar, if the spinous processes roll to the left what is the rotation? | RPO |
| On AP lumbar, if the spinous processes roll to the right what is the rotation? | LPO |
| If the coccyx is rolled to the left on an AP lumbar what is the rotation? | RPO |
| What is the centering for the oblique lumbar? | 2" medial to the upside ASIS & *texts: level @ crest (L4 & L5) *clinicals: 2" above crest |
| What is the patient's obliquity for oblique lumbar? | 45 degrees |
| What is visualized on the oblique lumbar views? | "scotty" dogs |
| What part of the scotty dog is formed from the pedicle? | eye |
| What part of the scotty dog is formed from the transverse process? | nose |
| What part of the lumbar vertebral body form the scotty dog's neck? | lamina OR pars interarticularis |
| How is over and under rotation detected on oblique lumbar views? | the location of the pedicle "eye" |
| Where is the pedicle if the oblique lumbar is under rotated? | "eye" (pedicle) is too anterior to the mid-vertebral body |
| Where is the pedicle if the oblique lumbar is over rotated? | "eye" (pedicle) is too posterior from the middle of the vertebral body. |
| Which projection of the lumbar spine demonstrates the zygapophyseal joints? | 45 degree oblique (demonstrates the downside joint) |
| For an RPO oblique lumbar which zygapophyseal joint is demonstrated? | right |
| Which projection of the lumbar spine demonstrates the interverbral foramina? | lateral |
| What is the centering for L5-S1 lateral? | 1 1/2" inferior to iliac crests & 2" posterior to ASIS. |
| How do you know whether to angle on the lateral L5-S1? | CR should be parallel to the inter-iliac plane. |
| On the lateral lumbar, if the iliac crests are superimposed and the L5-S1 joint space is open should you still angle for the spot 5-8 degrees caudad? | no |
| Which projection of the cervical spine demonstrates the intervertebral foramina? | 45 degree obliques; demonstrates the upside |
| For an LPO of the c-spine, which intervertebral foramina are being demonstrated? | the right side |
| For cervical hyperextension what anatomy opens up? | anterior vertebral disk spaces |
| If the pedicles and intervertebral foramina are seen on an oblique c-spine, what does that indicate? | correct patient obliquity |
| If the superior intervertebral disk spaces are closed compared to the inferior disk spaces, what does this indicate? | the patient's head is leaning on the IR. sometimes shown on the mandible also (tilting) |
| On oblique ribs, if there is not twice as much distance between the spine and the outer border of the affected side as compared to the unaffected side what does this mean? | the patients obliquity is too shallow |
| AP sacrum: If the sacrum is superimposed by the pubic bone, what does that mean about the tube angulation? | too much tube angulation |
Created by:
mokapis
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