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Radiology Midterm
Tri 2
| Question | Answer |
|---|---|
| X rays discovered by and when? | Roentgen in 1895 |
| what was first x ray? | wifes hand nov 8 1895 |
| 1st Nobel prize in physics | Roentgen in 1901 |
| Pupin | Intensifying screen |
| Edison | first flourescope |
| Potter and Bucky | 1921, moving grid |
| Full AP Spine radiograph | 1935, Sausser |
| Cardinal rule | always take at least two views taken at right angles |
| C1 ATLAS | (blank) |
| C1 general | no body, ring shaped, three ossification centers..2 in lateral masses, and 1 in anterior arch. |
| Posterior arch | smiles..and i slarger and anterior |
| Anterior arch | frowns..and has a larger tubercle |
| Superior facet | face up and in to form atlantoccipital joint space |
| Inferior facet | face down, slight medial and backward to form atlantoaxial joint space. |
| basion | anterior margin of foramen magnum |
| opistion | posterior margin of foramen magnum |
| C2 Axis | (blank) |
| (blank) | strongest cervical vertebrae |
| Five primary ossification centers | body, 2 in neural arches, 2 in lateral part of dens |
| secondary ossification centers | at apex of dens, inferion aspect of VB |
| dens | height approx same as C2 bidy |
| Subdental synchondrosis!! | area of fusion between base of dens and the C2 body, a slightly radiolucent line on plain film |
| other | large pedicles & lamina, small angled inferiorly tvps, large irregular bifircated SP, lower lip like projection |
| Lower cervicals | (blank) |
| general | increase in size down, triangle shaped, IVD larger anteriorly creating curve, uncinate processes, (flat at newborn and full by 10 yrs), short bifid SPs. |
| Pedicles | postereolateral about 45 degrees from body, |
| Articular pillar | junction of pedicle and lamina |
| TVPs | anterolateral inferior position about 60 degrees with 15 degree caudal angulation |
| IVFs | anterolateral 45-60degrees 15 degrees caudally. C2/3 largest |
| Discovertebral Joints | IVD w body above and below |
| Uncovertebral Joint | Joint of Luschka |
| Z-joints | facet joints |
| Radiography of Cervical Spine | 3 routine views, 5 extended views, 7 Davis Series |
| Routine Views | LCN, APLC, APOM |
| Extended series | LCN, APLC, APOM, R & L Obliques |
| Davis Series | LCN, APLC, APOM. R & L Obloques, Flexion and extension |
| normal flex/ext displacement | 1-2 mm AP. can cause re bleeding of hematoma with increased prevertebral space, usually resolves within 3 weeks |
| LCN X ray | (blank) |
| general | upright, use 'Cross Table Lateral' for acute situations, all 7 must be seen..if not a SWIM LATERAL must be done for lower, R & L superimposed, sella tursica should be seen, look at sinuses, check 4 main lines |
| ADI | Atlantodental Interspace, between C1 anterior tubercle and anterior dens. no greater than 3mm in adults and 5 in children. |
| Soft tissues of Anterior neck | Prevertebral fat stripe ( paralleling ALL), Retropharyngeal soft tissue space (NO more than 7mm @ C2) Retrotracheal soft tissue space (No more than 22mm @ C6 adult and 14mm children) |
| Hyoid bone | C3 |
| Throid cartilage | C4-C6 |
| Densities | order of least tissue density to most....air/gas, fat, water/soft tissue, bone, metal |
| Film ID | clinic name/doctors name, name and location of which film was taken, Pt name, Pt DOB, Gender, Date, ID number, R or L |
| Mitchell Markers | uses mercury or small metallic balls in center |
| Radiographic ID | mitchell markers, Stenmark, Oblique markers, Clips |
| APOM | (blank) |
| markers | according to which side is closer to folm and behind the Pt . |
| primary view | to view craniocervical junction in AP orintation |
| arches | posterrior arch smiles, anterior arch frowns |
| Vertical radioleucency | appears to slit odontoid in half..due to front incisors |
| Mach Effect | linear line crossing base od dens |
| Paradontois space | distance between lateral odntoid and the medal lateral mass. Should be equal on both sides. NO greater than 2mm difference. |
| APLC | (blank) |
| (blank) | you cannot see segments above C3 or C4 due to superimposition of mandible. Best view to see the uncinate processes |
| Lines to assess | Center line connecting SP, Parallel lines connecting pedicles |
| calcification of thyroid is visible laterally to C4-C6 | Hyoid seen at C3 |
| Lung Apexes | seen |
| Oblique Cervicals | (blank) |
| Pt at 45 degree angle, mark film behind spine to indicate an anterior, infront spine to indicate posterior | (blank) |
| (blank) | best to see IVF |
| Anterior Cervical Obliques | same side structures |
| Posterior cervical Obliques | opposite structures |
| Cervical Anomoliies | (blank) |
| Occipitalization | Atlas fused to Occiput. NO normal motion on flexion/extension |
| Paracondylar process | extra bony process extending downward from jugular process of occiput to TVP of C1. Can form an articulation |
| Epitransverse Process | extra bony form TVP pf C1 extending upward |
| Third Condyle | small bony ossicle near anterior margin of foramen magnum |
| Agenisis of Posterior arch of C1 | partial or caomplete absence. May associate with other syndromes. often C2 has a megaspinous, |
| Absence of Transverse Ligament | seen in up to 20% of Down Syndrome Pt |
| Agenisis of anterior arch | rare |
| Hypoplasia | thinning posterior arch |
| Posterior ponticle | also called posticus posticus, calcification forming a foramen where the vertebral artery passes. In 15% of population |
| Os Odontoid | only top of Dens forms, |
| SBO | Spina Bifida Occulta-midline defect, cleft in posterior neural arch, most often inmales at L5-S1, tuft of hair, |
| Sponyloschisis | SBO at C1 |
| Stylohyoid ligament calcification | long styloid processes, eagle symdrome, |
| Congenital Block Vertebrae | failure of two segments to seperate, wasp waist, most often at C5/6 or C2/3 T12/L1 L4/5 |
| Klippel Feil | 2 or more blocked vertebrae in cervicals or upper thoracic. Clinical Triad--low hairline, webbed neck, low ROM |
| Omovertebral Bone | extra bone |
| Sprengel's deformity | high scapula, more in females, with klippel feil, |
| Cervical Ribs | C7 usually, more in females, bilaterall, may result in thoracic outlet syndrome, |
| Nuchal Bone | ossificationof nuchal ligament |
| Enlarged EOP | can fracture with trauma |
| Cervical Lines of Mesuration | (blank) |
| Sella tursica size | LCN view, 16mm max horizantal, 12mm max vertical. Enlargement caused by pituitary neoplasm |
| Martin's Basialar Angle | from nasion to center of sella tursica, and then to foramen magnum. no larger than 152 degrees, no smaller than 123 degrees |
| Mcgregors line | hard palate to most inferior surface of accipital bone. Dens should not extend past 8mm above line |
| Chamberlains Line | posterior hard palate to posterior foramen magnum, dens should not extend past 5 mm above. |
| McRae's line | basion to opisthion, |
| Digastric Line | two lines joining digastric grooves medial to mastoid processes. |
| Atlantodental Interspace | adult no more than 5mm. child no more than 3mm |
| Georges line | down spine at mid vertebral body. |
| Spinolaminar junction line | (blank) |
| Atlanto axial alignment | (blank) |
| Angle of cervical curvature | atlas to C7 at 90 degrees/angle should be 30-45 degrees. less than 30 is hypolordoses. more than 45 is hyperlordosis. |
| Ruth Jackson's Cervial Stress Lines | flexion extension lines intersecting |
| Retropharyngeal soft tissue space | no more than 7mm |
| Retrotracheal soft tissue space | no more than 22mm adults, 14mm child |
| MRI | (blank) |
| physics review | H atom used to make image, , at a fixed location the H atom vector will be there or wont creating a change in osillations. FOURIER TRANSFORMATION.(when a coil antennae recieves the oscllations from the H)The stronger the magnetization, the more current. |
| Bright Areas | tissue with a lot of magnetization, high signal intensity |
| time | 20-60 min |
| Signal | the amount of information on an image |
| Noisy | signal poor |
| Field of View | formed by pixels, determined by matrix size. The smaller the matrix, the larger the pixel. |
| Voxel | small 3D cube of tissue |
| NEX | number of excitations, signal averages, |
| High signal strength | high FOV, high slice thickness, low matrix size, high NEX |
| Image resolution | voxel size inversley proportionate. Smaller voxel=high resolution/ |
| High resolution | low FOV, low slice thickness, high matrix size |
| Contrast | ability to differentiate diff. tissue om their signal intensities. Known as weighting the image. |
| Relaxation | time protons need to realign themselves |
| TE (echo time) | time elapsed b/tw 90 degree RF pulse and the echo. Long TE=low signal (water bright. fat dark), Short Te water dark, fat bright |
| TR (repetition time) | amount o ttime elapsed b/tw successive 90 degree pulse sequence applied to the same slice. |
| Flip angle | FA=amount of rotation |
| TI (INVERSION TIME | TIME B/TW INVERSIONAL pulse |
| T1 weighted image | great anatomical detail, high signal for fat, poor detection of edemas, fluid pathology. TR<1000 TE<30 FA=30 |
| T2 WEIGHTED IMAGE | great fluid detection, tumor, infection, long image time. TR>2000 TE>60 FA=90 |
| proton density spin echo | TR>1000 TE<30 FA=90 |
| Inversion recovery (STIR) | TR>2000 TE>60 FA=180-90 TI=120-150, water signal increased, fat removed, sensitive to soft tissue pathology, cannot be used with contrast |
| T2 GRASS | TR variable, TE<30 FA=5-20 noisy. |
| Thoracic spine | (blank) |
| 12 segments, kyphotic curve, heart shaped, typical=2-8 | demifacets are articulations with rib head. T9 may or may not have inferior facets. , Long SPs inferiorly pointed, IVFs are lateral, Articular processes at 60 degrees, Superior facets Back , up and lateral. |
| Thoracic Stnd Series | AP thoracic, Lateral Thoracic |
| AP thoracic | all 12 must be visible, see blockhead(eyes=pedicles, nose=SP, ears=TVP), right pedicle clearer than left, lung field seen in medial 1/3, |
| Lateral Thoracic | must identify normal kyphosis. swim lateral may be needed, count be locating lowest rib, hemidiaphram crosses at 11 IVD, scapula over T7 |
| Big rib sign | Rib cage furthest from film will be magnified |
| Angle of thoracic kyphosis | lines at sup. endplate of T1 and inferior endplate of T2. Should not exceed 55 degrees |
| Chest Projection | P-A to decrease heart shdow. FFD of 6-10 ft at full inspiration. |
| lateral chest projection | with left closest to film, arms held up |
| Diaphrams | right side higher than left about 4 cm. usually at 9-10th posterior rib on PA projection |
| costophrenic sulci | cardiophrenic sulci |
| cardiovascular borders | (blank) |
| right atrium | RIGHT BORDER of heart, not visible on lateral |
| left atrim | upper third left heart borderon PA |
| Right Ventricle | not visible on PAb/c it is on front |
| Left Ventricle | lower 2/3 leaft heart border on PA |
| Descending thoracoc aorta | overlies eft of spine, , should not ovelor on lateral |
| trachea | lies on midline, bifurcates at T5/6. Right stwm bronchusis more vertical. SUBCARINAL ANGLE formed by inferior margins of main stem bronchi 70-90 degrees |
| Normal heart size | less than or equl to 50% of greatest maximal internal diameter of chest. 1;2 |
| Left lung | sup amd inf lobes by oblique fissure. lingula, |
| RIGHT LUNG | sup,inf, middle by oblique and horizontla fissure, |
| Azygous lobe | on the right lung, |
| inferior accessory fissure | 35% |
Created by:
hwhite
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