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Review of important concepts for final exam

C-arm position that will give the operator/surgeon the lowest dose PA - tube under table, II on top
C-arm position that will give the operator/srugeon the greatest dose AP - tube on top, II under table
What is the minimum that an operator should stand from the x-ray tube during exposure with a c-arm or portable unit? 6 feet
how far apart should the minimum two views be obtained from each other for trauma radiography? 90 degrees
T/F: when imaging a trauma extremity, the intial view should have both joints included True
T/F: when imaging a trauma extremity, a follow up film (i.e. post reduction) would only need one joint visualized on the image True
If it is impossible to get both joints on an image for a trauma extremity, which joint should be included? joint nearest injury
to avoid grid cutoff when performing trauma views, what should a radiographer do? orientate grid lines parallel with angled beam path
when a bone is displaced from a joint dislocation
a partial dislocation subluxation
"bruise" type injury contusion
a forced wrenching or twisting of a joint that results in a partial rupture or tearing of suppporting ligaments without dislocation sprain
a break in a bone fracture
describes the manner in which fragmented ends of bone make contact with each other apposition
anatomic alignment of ends of fractured bone fragments wherein the ends of the fragments make end-to-end contact anatomic apposition
ends of fragments are aligned but pulled apart and are not making contact with each other lack of apposition
a fracture wherein the fragments overlap and the shafts make contact but not at the fracture ends bayonet apposition
describes the direction or angle of the apex of the fx apex angulation
distal part of the distal fragments angled toward the midline varus
distal part of the distal fragments are angled away from midline valgus
a fx that does not break through the skin simple (closed)
a fx in which a portion of the bone breaks through the skin compound (open)
a frx that does not traverse through the entire bone incomplete (partial)
buckle of the cortex, no complete break in the cortex torus fx
fx on one side of the bone only greenstick
fx is transverse or near right angle to long axis of bone transverse
fx passes through bone at an oblique angle oblique fx
fx where bone has been twisted apart spiral
fx resulting in bone that is splintered or crushed at the site of impact; two or more fragments comminuted
type of double fx where two fx lines isolate a distinct segment of bone resulting in 3 pieces of bone segmental fx
fx with two fragments on each side of a main wedge shaped separate fx butterfly fx
bone is spintered into thin sharp fragments splintered fx
fx where one fragment end is driven into the other fragment end impacted
interatricular fx of the posterior lip of the distal radius barton's
fx of the distal phalanx caused by ball striking the end of an extended finger baseball
longitudinal fx which occurs at the base of the first metacarpal extending into CMC bennett's
fx most commonly involves distal fifth metacarpal boxer's
fx of the wrist displaced posteriorly colles'
fx of the wrist with anterior displacement smith's (reverse colles')
fx occurs through the pedicles of the axis with or without displacement of C2 on C3 hangman's
interarticular fx of radial styloid process hutchinson's (chauffeur's)
fx of the proximal half of the ulna and dislocation of radial head from being struck with forearm raised monteggia's
fx of distal fibula with frequent fx of distal tibia or medial malleolus pott's
fragment of bone is spearated or pulled away by attached tendon or ligament avulsion
fx from direct blow to the orbit blowout (tripod)
fx that involves isolated bone fragment chip
vertebral fx caused by compression type injury with a decreased anterior vertebral body vertical dimension compression
fragment depressed; sometimes called ping-pong fx; appears in the skull depressed fx
fx through the epiphyseal plate epiphyseal fx
classification system for epiphyseal fx salter-harris classification
fx due to disease process within the bone pathologic
fracture with lines radiating from a central point stellate
fx from a nontraumatic origin stress (fatigue)
fx of the ankle joint that involves the medial, lateral, and posterior malleoli of distal tibia trimalleolar
comminuted fx of the distal phalanx tuft (burst)
stands for open reduction, internal fixation; refers to surgical procedure to realign a fx ORIF
what view would demonstrate a AAA dorsal decub
what view would demonstrate free intraperitoneal air? LLD
what must be included on a LLD of the abdomen? diaphragm of side up
how many monitors are normally found on a c-arm workstation cart? two
what are the three cardinal rules for radiation protection? time, distance, shielding
of the three cardinal rules, which is the most effective? distance
what should the beam be aligned with for a portable chest? perpendicular to the sternum
what should the CR be aligned with for an AP abdomen? iliac crests (perpendicular)
what degree of angulation and direction should the CR be directed for a AP oblique sternum? 15-20 degrees mediolaterally (right to left) for LPO position
what SID should you have for a lateral sternum as much as possible or minimum of 40
what breathing instructions are used for the LPO sternum shallow breaths
what breathing instructions are used for the lateral sternum full inspiration
when imaging ribs above diaphragm, what breathing instructions should you use? full inspiration
when imaging ribs below the diaphragm, what breathing instructions should you use? full expiration
in the immobile trauma patient, what CR angle would you use for oblique ribs 30-40 degrees
when using a mobile fluoroscopy unit in a vertival position in the O.R., if the II is tilted 30 degrees away from surgeon, the dose to the face and neck region will increase by a factor of? four
If performing an imaging procedure for pneumothorax, what position do you place the patient in? With side of possible pneumothorax up
If performing an imaging procedure for a patient with a suspected pleural effusion, what position do you place the patient in? with possible affected side down
T/F: you can remove immobilization devices that may cause an artifact on a patient's resulting radiographs prior to imaging False - this is not within a technologist's scope of practice
If a patient's hand is in the flexed position and patient is unable to flatten out the hand, how should you proceed with imaging the fingers? attempt to get parts of interest parallel to IR
A patient presents for elbow series but is unable to supinate arm. How do you proceed with obtaining an AP type view? Find the epicondylar plane and align IR parallel then direct CR perpendicular to this plane
If you need a lateral humerus on a patient with a suspected humeral fx, what alternative method could you use? transthoracic lateral with separate distal humerus view
Your patient arrives to ER on backboard for a clavicle x-ray. The patient is skinny. What CR angle will you use for your AP axial? 30 degrees
What angle would you use for the AP axial clavicle on a football line man (big guys on the front row)? 15 degrees
how do you determine the degree of angulation for a lateral scapula on a trauma patient? palpate medial and lateral borders then come in parallel to this plane
If needing to demonstrate a shoulder dislocation, what view would be best on a trauma patient? transthoracic
What degree of angulation should be implemented for an oblique foot when the patient cannot rotate foot or lower leg? 30 to 40 degrees
How do you determine CR angulation for a trauma ankle? Align angle to be parallel with long axis of foot
What degree of obliquity is required for a mortise view? 15 degrees
How do you determine CR angulation for a trauma lower leg? Align angle to be parallel with the long axis of foot
How much do you angle on an AP knee for ASIS to tabletop measurement of 25 degrees? 3-5 degrees cephalic
Why would a doctor need a lateromedial oblique knee on a trauma patient? Provides an unobstructed view of the fibular head and neck
What degree of angulation should be used for a lateromedial oblique knee on a trauma patient? 45 degrees from AP
What are three methods for obtaining a lateral hip image on a trauma patient? danelius-miller, sanderson, clements-nakayama
what must be determined for proper CR alignment for the danelius-miller method? position of the femoral neck; CR perpendicular to femoral neck
what must be determined for proper CR alignment and angulation on the sanderson method? rotation of foot
why would we use the clements-nakayama method? if patient has bilateral hip fx or is unable to raise unaffected leg
when is a grid indicated? if part is greater than 10 cm thick
what breathing technique would be used on a transthoracic shoulder or humerus? breathing to blur out lung markings
For a patient with a pelvic fx, where would the CR be directed? to the center of the IR when the IR is placed with top of IR 1" above iliac crest
why might a "low pelvis" be ordered? following hip surgery for view of hardware placement
where would CR be directed for a "low pelvis" pubic symphysis
kV range for lateral hip 70-80
kV range for a pelvis 75-80
kV range for a distal femur 70-75
kV range for a knee 65-70
kV range for a lower leg 60-70
kV range for an ankle 60-70
kV range for a foot 60-65
kV range for a shoulder, scapula, or clavicle 75-80
kV range for a transthoracic humerus 75-80
kV range for an AP humerus 65-70
kV range for a elbow 60-70
kV range for a forearm 65-70
kV range for a hand, wrist, or fingers 50-60
kV range for an abdomen 70-80
kV range for ribs 65-70 above diaphragm; 75-80 below diaphragm
kV range for sternum 60-70
kV range for a chest 90-125
What is meant by arthroplasty? total joint replacement
Define laminectomy removal of bone (lamina) from the vertebra to stop impingement on a nerve
alternate name for baseball fracture mallet fracture
alternate name for hutchinson's fx chauffeur's fx
alternate name for reverse colle's fx smith fx
alternate name for simple fx closed fx
alternate name for blowout fx tripod fx
alternate name for greenstick fx hickory stick or willow stick fx
alternate name for stress or fatigue fx march fx
who is responsible for the radiation protection for all personnel in a trauma room? technologist
how should CR be directed for trauma lateral cervical spine horizontal and perpendicular
what is the recommended SID for trauma lateral cervical spine 60-72"
how much angle is required for an AP Trauma c-spine 15-20 degrees
where is the CR directed for an AP Trauma c-spine? lower thyroid cartilage (C4)
what should the CR be directed parallel to for an AP C1-2 on a trauma patient parallel to lower margin of upper incisors to base of skull line
what's an alternative to the AP C1-2 open mouth projection for a patient who cannot open his/her mouth? angle CR cephalad 35-40 degrees
where should CR be directed for alternate AP Axial C1-C2? just below mentum
where is the CR centered for a trauma swimmer's lateral? C7-T1
what is meant by a compound angle? CR angle with both a mediolateral/lateromedial angle and cephalad/caudal angle (2 angles)
what type of angle is used on a AP Axial Trauma Oblique c-spine? 45 degree lateromedial angle with 15 degree cephalad angle (compound angle)
how is CR centered for an AP Trauma Thoracic? T7
how is CR centered for a Trauma Lateral thoracic horizontal beam to T7 centered in the posterior half of thorax
how is CR centered for an AP trauma Lumbar? midline to L3-L4
how is CR centered for a trauma lateral lumbar? horizontal beam perpendicular to IR at the level of L3-L4
how is the CR directed for a lateral elbow in the supine patient CR projects parallel to the interepicondylar plane
how much elbow flexion is required for the Coyle method for radial head? 90 degrees
how much elbow flexion is required for the Coyle method for coronoid process? 80 degrees
what is the CR angle for the coyle method for radial head? 45 degrees toward shoulder
what is the CR angle for the coyle method for coronoid process? 45 degrees away from shoulder (caudal)
If the CR is directed mediolaterally from right to left, which ribs would be demonstrated on a supine trauma patient? left
CR for a PA thumb 1st MCP
what do you use for cr alignment for AP humerus CR should be perpendicular to the epicondyles/epicondylar plane
how do you align CR for lateral humerus CR should be parallel to the epicondylar plane
for a lateral scapula on a trauma patient, how do you direct the CR? CR should be parallel to the scapular body (have patient reach across if possible to pull scapula out a little bit)
when using an angled CR, what should you do with your grid to avoid grid cutoff? turn grid crosswise so that the grid lines run parallel with the direction of beam travel
how do you determine CR angulation for an AP foot in patient who cannot bend knee to place foot flat on table/stretcher? align IR with the plane of the foot, align CR to be perpendicular to IR then angle posteriorly 10 degrees
if patient cannot rotate foot, how would you achieve an oblique foot? angle lateromedially 30-40 degrees in relation to the plantar surface of the foot
what is CR aligned to for an AP ankle? CR should be parallel to the long axis of the foot midway between the malleoli
how would you align the CR for an AP Mortise if the leg can't be rolled? align for an AP then add 15-20 lateromedial angle
how do you align CR for AP lower leg align to be parallel with the long axis of the foot
how many IRs are required for a lateral lower leg? generally 2 unless you are able to turn and support the IR in a diagonal position
do you still angle on an AP trauma knee? yes if it is warranted - 3-5 degree cephalad ASIS to TT measurement of 24cm+; 3-5 degrees caudal for less than 19cm
what do you use for knee positioning in a trauma situation for alignment of the CR? femoral condyles
what does the CR come in perpendicular to for an AP Trauma Femur? condylar plane
how do you place an IR for an AP pelvis top of IR 1" above iliac crest
how do you place an IR for a "low pelvis"? centered to pubic symphysis
how can you locate the hip joint on a trauma patient? 1-2" medial to ASIS and 3-4" inferior to ASIS
true/false: it is possible to shield all patients for a pelvis image true
if lesser trochanters of the femurs are projected medially on an AP pelvis, what do you need to do? internally rotate patient's femora approximately 15 degrees if no hip fx suspected
if you are unable to place anatomy into the center of the grid for a Danelius-Miller method, what should you do? turn grid so that grid lines are vertical to prevent grid cutoff
what can you use to provide uniform density on a inferosuperior axial hip? compensating filter
what do you align the IR with for a Sanderson method? IR should be parallel to long axis of the foot
what two methods can be employed for a trauma lateral hip if the unaffected side cannot be elevated? Sanderson and Clements-Nakayama method
How much CR angle is needed for a Clements-Nakayama method? CR angled posteriorly 15 degrees and perpendicular to femoral neck
What is another name for subluxation of the elbow joint? Nursemaid's elbow
When performing follow-up studies on a known fracture of a long bone, how many joints must be included on the film? one
If an LPO of the sternum is done with a 15-20 degree angle from right to left, how much angle would you do on an asthenic patient? 20 - takes more angle to get the sternum off the spine
What's a drawback to a trauma PA thumb vs. an AP thumb? Increase in OID, decrease in Recorded Detail, Increased magnification
technique conversion for small-medium dry plaster cast Increase mAs 50%-60% or +5-7 kV
technique conversion for large plaster or wet cast Increase mAs 100% or increase 8-10 kV
technique conversion for fiberglass cast Increase mAs 25%-30% or +3-4 kV
If patient is unable to flex the knee due to trauma for a "sunrise" view of the patella, what other position could be utilized (besides AP and Lat) to demonstrate the patella oblique (usually medial rotation)
Greenstick fractures occur in what patient population? Pediatrics
Which gender has more trauma occur? Male
What age group is more likely to have trauma occur? 18-24 yo
According to the NTDB 2012 report, what is the least common source of trauma injury? firearm
Radiographer's role in trauma includes what duties? Perform quality diagnostic imaging procedures Practice ethical radiation protection Provide patient care
Which trauma patient status would warrant immediate reporting to a physician Loss of consciousness (unresponsive to voice or touch) Pale or bluish skin pallor (cyanosis) Bluish nail beds Seizures Increasing abdominal distention and firmness to palpitation
What are qualities of a trauma radiographer? Speed Accuracy Quality Positioning Practice standard precautions Immobilization Anticipation Attention to detail Attention to ED protocol and scope of practice Professionalism
what are radiopaque arrow markers used for in penetrating trauma injuries? identifying entrance and exit wounds
Created by: hschmuck1