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Chest Abdomen Upper Limb Radiography
Final Exam for Clinical
143
Medical
04/11/2011

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Term
HYPERSTHENIC
Definition
What body habitus generally requires the IR to be placed crosswise or transverse in the upright wall stand for a chest exam?
Term
DOWNWARD
Definition
Which direction does the diaphragm move on inspiration?
Term
MAKING THE EXPOSURE ON DEEP INSPIRATION ALLOWS THE DIAPHRAGM TO MOVE TO THE LOWEST POINT AND BETTER VISUALIZATION OF THE THORACIC CAVITY
Definition
Why is it important to do a chest x-ray with inspiration?
Term
EXPOSE ON PATIENT'S SECOND FULL INSPIRATION
Definition
What are the proper breathing instructions for chest radiography?
Term
MAKE SURE TO REMOVE ALL RADIOPAQUE OBJECTS FROM THE CHEST REGION (ALSO ADJUST THE POSITION OF OXYGEN TUBING, HEART MONITOR LEADS, TO BE REMOVED FROM THE LUNG FIELD)
Definition
Before positioning a patient for a chest exam, what is something the technologist must do?
Term
SMALL PNEUMOTHORAX, FIXATION OR ABNORMAL MOVEMENT OF DIAPHRAGM, PRESENCE OF FOREIGN BODY, OR TO DISTINGUISH THE DIFFERENCE IN A DENSITY LOCATED AROUND A RIB OR IN THE LUNG (FOREIGN BODY)
Definition
Please list a reason why a chest exam might be performed on expiration as well as inspiration.
Term
SHOULD BE ABLE TO COUNT A MINIMUM OF 10 PAIRS OF POSTERIOR RIBS ABOVE THE DIAPHRAGM
Definition
When evaluating a chest radiograph, how can you determine if the patient successfully followed your breathing instructions?
Term
ALLOWS DIAPHRAGM TO MOVE TO THE LOWEST POSITION, UTILIZES A HORIZONTAL BEAM WHICH DEMONSTRATES AIR/FLUID LEVELS, PREVENTS ENGORGEMENT OF PULMONARY VESSELS
Definition
Why should all chest exams be performed upright when possible?
Term
LESS MAGNIFICATION OF THE HEART BECAUSE OF LESS BEAM DIVERGENCE
Definition
Why should chest exams be performed at a SID of 72"?
Term
PLACES THE HEART AND GREAT VESSELS CLOSER TO THE IR (BECAUSE THEY ARE LOCATED IN THE ANTERIOR PORTION OF THE THORAX) THEREBY REDUCING MAGNIFICATION
Definition
Why should chest exams be performed PA rather than AP?
Term
THE SC JOINTS SHOULD BE SYMMETRICAL OR EQUAL DISTANCES TO THE MIDLINE OF THE SPINE TO ENSURE NO ROTATION
Definition
How do you evaluate a PA chest radiograph for rotation?
Term
THE PATIENT WAS ROTATED TOWARD THEIR RIGHT SIDE (RAO)
Definition
If the SC joints are not symmetrical and the right one is closer to the spine, what positioning error has occurred?
Term
SO THE CHIN/MANDIBLE WILL NOT BE SUPERIMPOSED OVER THE APICES OF THE LUNGS
Definition
Why do you ask patients to elevate their chin before taking a PA chest radiograph?
Term
TO REMOVE THE SCAPULAE FROM THE LUNG FIELD AS MUCH AS POSSIBLE
Definition
Why do you ask patients to roll their shoulders forward before exposing a PA chest radiograph?
Term
VERIFY THAT THE POSTERIOR RIB MARGINS AND COSTOPHRENIC ANGLES ARE SUPERIMPOSED.  THE RIGHT COSTOPHRENIC ANGLE WILL BE HIGHER THAN THE LEFT, DUE TO THE PRESENCE OF THE LIVER
Definition
How do you evaluate a lateral chest radiograph for rotation?
Term
IF THE DISTANCE BETWEEN THE POSTERIOR RIB MARGINS MEASURES MORE THAN 1 CM
Definition
When should you repeat a lateral chest film for rotation?
Term
TO PREVENT THE UPPER ARMS FROM SUPERIMPOSING UPPER AREAS OF THE CHEST
Definition
Why should the patient raise their arms above their heads before taking a lateral chest exam?
Term
T7
Definition
What is the CR location for either a PA or AP chest exam?
Term
USE THE FINGER SPREAD METHOD; 7" BELOW VERTEBRA PROMINENS FOR FEMALES, 8" FOR MALES
Definition
How should you locate T7 for an PA chest radiograph?
Term
LOCATE THE JUGULAR NOTCH AND CENTER 3" INFERIOR (3-4 FINGER WIDTHS)
Definition
How should you locate T7 for an AP chest radiograph?
Term
TO PLACE THE CR PERPENDICULAR TO THE STERNUM OF THE PATIENT SO THAT THE CLAVICLES WILL NOT OBSCURE THE APICES
Definition
When performing a chest exam portable, the patient is usually positioned as close to upright as possible by raising the bed.  What is the goal of angling the CR for this portable AP chest projection?
Term
EITHER A RIGHT OR LEFT LATERAL DECUBITUS
Definition
If a patient is unable to sit or stand for a PA upright chest radiograph, what specific position will also demonstrate air/fluid levels in the chest?
Term
RIGHT LATERAL DECUB
Definition
If you need to evaluate a pneumothorax in a patient's left lung, which decub position would be best?
Term
LEFT LATERAL DECUB
Definition
If you need to evaluate pleural effusion in a patient's left lung, which decub position would be best?
Term
AP OR APICAL LORDOTIC DECUB
Definition
What projection of the chest will demonstrate the apices with the clavicles demonstrated above?
Term
LAO (IF THE PATIENT IS IN THE ANTERIOR OBLIQUE POSITION, IT WILL BEST DEMONSTRATE THE LUNG FARTHEST AWAY FROM THE IR; OPPOSITE IF THE PATIENT IS PLACED IN A POSTERIOR OBLIQUE POSITION)
Definition
If an order was written to perform an anterior oblique chest exam to demonstrate the right lung, what specific position would you place your patient?
Term
LIES AT THE LEVEL OF T1
Definition
Where does the vertbra prominens, the spinous process of C7 lie?
Term
LIES AT THE LEVEL OF T2-3
Definition
Where does the jugular notch (manubrial, suprasternal) lie?
Term
LIES AT THE LEVEL OF T9-T10
Definition
Where does the xiphoid tip or process lie?
Term
PHARYNX
Definition
What is the common passageway for food, fluid, and air?
Term
ANTERIOR
Definition
Is the trachea anterior or posterior to the esophagus?
Term
AT THE CARINA (T5)
Definition
Where does the trachea bifurcate into the right and left bronchi?
Term
THE RIGHT BRONCHUS BECAUSE IT IS WIDER IN DIAMETER AND MORE VERTICAL
Definition
Which bronchus would objects that are aspirated are more likely to travel down?
Term
ALVEOLI
Definition
What are the smallest structures called where oxygen and carbon dioxide are exchanged in the lungs called?
Term
RIGHT LUNG: 3  LEFT LUNG: 2
Definition
How many lobes does the right and left lung have?
Term
TRACHEA, ESOPHAGUS, HEART/GREAT VESSELS, AND THYMUS GLAND
Definition
What does the mediastinum, the area of the thoracic cavity, located between the lungs consist of?
Term
AT PUBERTY AND THEN BEGINS TO DECREASE AND IS ALMOST UNIDENTIFIABLE IN AN ADULT
Definition
When does the thymus gland reach its largest size?
Term
DIAPHRAGM
Definition
What is the name of the muscle that divides the thoracic and abdominal cavities?
Term
PSOAS MAJOR MUSCLES
Definition
What are the names of the muscles located on either side of the lumbar spine which will be seen on a properly exposed abdomen radiograph?
Term
KIDNEYS, URETERS, AND BLADDER
Definition
Another name for the AP supine abdomen radiograph is the KUB.  What does KUB stand for?
Term
BOWEL OBSTRUCTION, PERFORATIONS THAT INVOLVE FREE-AIR, EXCESSIVE FLUID (ASCITES), OR POSSIBLE MASS
Definition
What conditions would exist in which an acute abdominal series would be performed instead of only an AP supine abdominal radiograph?
Term
LIVER, GALLBLADDER, PANCREAS
Definition
What are the accessory organs to digestion?
Term
STOMACH, SMALL INTESTINE, LARGE INTESTINE
Definition
What are the organs of digestion that lie within the abdominopelvic cavity?
Term
DUODENUM, JEJUNUM, ILEUM
Definition
What are the three portions of the small intestine?
Term
ILEOCECAL VALVE, CECUM, ASCENDING COLON, RIGHT COLIC (HEPATIC) FLEXURE, TRANSVERSE COLON, LEFT COLIC (SPLENIC) FLEXURE, DESCENDING COLON, SIGMOID COLON, RECTUM, ANUS
Definition
Name the portions of the large intestine in anagrade fashion (direction of normal flow)
Term
SPLEEN
Definition
What organ is classified as part of the lymphatic system that is located in the left upper quadrant of the abdomen?
Term
PRIMARILY RIGHT UPPER
Definition
Which quadrant of the abdomen houses the liver?
Term
RIGHT LOWER
Definition
Which quadrant is the cecum located?
Term
KIDNEYS, URETERS, BLADDER, URETHRA
Definition
What are the structures of the urinary system located within the abdominopelvic cavity?
Term
ENDOCRINE
Definition
The adrenal or suprarenal glands are part of what body system?
Term
UPPER POLES OF EACH KIDNEY
Definition
Where are the adrenal glands located?
Term
KIDNEYS, MOST OF THE URETERS, PANCREAS, DUODENUM
Definition
What major structures of the abdomen are considered retroperitoneal?
Term
VERTEBRAL LEVEL OF L2-L3
Definition
Where is the inferior rib margin located at?
Term
VERTEBRAL LEVEL OF L4-L5
Definition
Where is the iliac crest located at?
Term
THE SYMPHYSIS PUBIS
Definition
This is considered to represent the lowest level or the inferior margin of the abdominal cavity.
Term
TO ALLOW THE DIAPHRAGM TO RISE TO ITS HIGHEST POINT AND DEMONSTRATE THE ABDOMINAL CAVITY BETTER
Definition
Why do you make abdominal exposures on expiration?
Term
BY PLACING THE SUPERIOR MARGIN OF THE SHIELD AT THE INFERIOR MARGIN OF THE SYMPHYSIS
Definition
When using a contact gonadal shield for male abdomen procedures, where is the shield placed?
Term
LEVEL OF THE ILIAC CREST AND TO THE MIDSAGITTAL PLANE
Definition
Where is the CR location for an AP supine abdomen (KUB) radiograph?
Term
14 x 17 LENGTHWISE UNLESS THE PATIENT'S BODY HABITUS REQUIRES 2 IRs USED CROSSWISE TO DEMONSTRATE THE DIAPHRAGM AND SYMPHYSIS
Definition
What size of IR should be used for most adult abdomen radiographs?
Term
PLACE THUMBS ON EACH ASIS TO MAKE SURE THEY ARE EQUAL DISTANCES TO THE TABLETOP
Definition
When positioning for a KUB, what can the technologist do to ensure the patient is not rotated?
Term
BY LOOKING AT THE SIZE AND SHAPE OF THE ILIAC WINGS.  IF A WING IS ELONGATED OR WIDENED, THE PATIENT WAS ROTATED IN THAT DIRECTION; IF A WING IS FORESHORTENED, THAT SIDE OF THE PATIENT WAS FARTHER FRO THE TABLETOP
Definition
How do you verify by analyzing the image on a KUB whether or not the positioning was achieved?
Term

TWO WAY: AP SUPINE AND AP UPRIGHT ABDOMEN RADIOGRAPHS

 

THREE WAY: SAME AS TWO-WAY BUT ALSO INCLUDE AN UPRIGHT PA CHEST PROJECTION

Definition
If an acute abdominal series is ordered, what projections are most routinely performed?
Term
DIAPHRAGM
Definition
What specific anatomy must be demonstrated on upright abdominal radiographs and decubs?
Term
LEFT LATERAL DECUB
Definition
What projection should be performed if a patient is unable to be positioned for an upright abdominal radiograph?
Term
THE LEFT LATERAL DECUB POSITION PLACES THE PATIENT'S RIGHT SIDE UP AND ALLOWS FREE AIR (IF PRESENT) TO RISE AND BE BETTER VISUALIZED IN THE SHADOW OF THE LIVER INSTEAD OF COMPETING WITH THE AIR IN THE FUNDUS OF THE STOMACH IF THE PATIENT WERE PLACED IN A RIGHT LATERAL DECUB POSITION
Definition
Why should the left lateral decub projection be performed in the left lateral decub position?
Term
2" ABOVE THE ILIAC CREST
Definition
When positioning for the upright abdomen or left lateral decub abdomen projections, where is the CR location?
Term
TO ALLOW ABNORMAL AIR TO RISE AND FLUID TO SETTLE
Definition
Why should the patient be positioned a minimum of 5 minutes erect before any upright abdominal radiographs are performed?
Term
TO DEMONSTRATE ANEURYSMS, CALCIFICATION OF AORTA, OR UMBILICAL HERNIAS
Definition
Why would a cross-table lateral or dorsal decub position be performed on an abdomen?
Term
14 PHALANGES, 5 METATARSALS, 8 CARPALS;  27 TOTAL
Definition
How many and what specific bones comprise a hand and wrist?
Term
HEAD
Definition
Which portion of the metacarpal is more distal?
Term
SCAPHOID
Definition
Which carpal bone is most commonly fractured?
Term
CAPITATE OR OS MAGNUM
Definition
Which carpal bone is the largest?
Term
PISIFORM
Definition
Which carpal bone has only one name?
Term
TRAPEZIUM OR GREATER MULTANGULAR
Definition
Which carpal bone articulates with the 1st metacarpal?
Term
RADIUS
Definition
Which bone of the forearm is located laterally?
Term
PROXIMAL
Definition
Where is the radial head located?
Term
DISTAL
Definition
Where is the ulnar head located?
Term
CORANOID
Definition
What is the name of the beak-like process that projects anteriorly on the ulna at its proximal end?
Term
OLECRANON
Definition
What is the name of the large process located on the proximal, posterior aspect of the ulna?
Term
SYLOID
Definition
What is the name of the two processes located on both the distal radius and ulna?
Term
TROCHLEA
Definition
Which specific condyle of the distal humerus is located medially?
Term
CAPITULUM
Definition
Which specific condyle of the distal humerus is located laterally?
Term
LATERAL SIDE OF THE ANTERIOR, DISTAL HUMERUS
Definition
The radial fossa is located where?
Term
OLECRANON FOSSA
Definition
Name the deep depression located on the distal, posterior surface of the humerus.
Term
SUPINATION TO PRONATION
Definition
The radius pivots or rotates around the ulna during what motion?
Term
MUST BE KEPT PARALLEL TO THE IR; SOMETIMES THERE WILL BE AN INCREASE IN OID, BUT THIS IS ACCEPTABLE WHEN KEEPING THE PART PARALLEL
Definition
In order to display open joint spaces in the fingers, hands, and wrists, how must the parts be kept to the IR?
Term
LATERALLY OR EXTERNALLY FROM A PRONATED POSITION
Definition
Which direction should the hand and wrist be rotated when performing a routine oblique procedure?
Term
AP AND LATERAL
Definition
What are the two basic projections for a forearm exam?
Term
THE AP PROJECTION ALLOWS THE RADIUS AND ULNA TO BE POSITIONED BESIDE ONE ANOTHER WITH MINIMAL SUPERIMPOSITION
Definition
Why should a forearm be performed AP instead of PA?
Term
ELBOW SHOULD BE FLEXED 90 DEGREES, HAND AND WRIST POSITIONED IN A TRUE LATERAL, AND THE HUMERUS SHOULD BE IN THE SAME PLANE AS THE FOREARM
Definition
When performing a lateral forearm and/or elbow exam, what 3 things must be achieved?
Term
PRONATED
Definition
How will the hand be positioned for an oblique projection of the thumb?
Term
AP
Definition
What is the best way to provide a frontal image of the thumb?
Term
EXTENSION LATERAL
Definition
When performing a lateral radiograph of the hand and looking for foreign bodies, which type of lateral positioning is best?
Term
THE JOINT SPACES WILL NOT BE OPEN ON THE RADIOGRAPH DUE TO THE PART NOT BEING KEPT PARALLEL TO THE IR
Definition
Why should an oblique hand not be positioned with the fingers in contact with the IR when looking at injuries to the digits?
Term
TAKE TWO AP PROJECTIONS; ONE WITH THE FOREARM PARALLEL TO IR AND THE OTHER WITH THE HUMERUS PARALLEL TO THE IR
Definition
What should be done if an AP elbow is ordered and the patient cannot straighten or extend their arm?
Term
3rd METACARPOPHALANGEAL JOINT
Definition
Where is the CR location for a PA hand projection?
Term
MEDIAL OBLIQUE
Definition
Which projection of the elbow will best demonstrate the coronoid process of the ulna?
Term
LATERAL ELBOW
Definition
Which projection will best demonstrate the olecranon process?
Term
LATERAL OBLIQUE
Definition
Which projection will best demonstrate the radial neck, head, and tuberosity with minimal superimposition of other structures?
Term
GREATER
Definition
Which tubercle of the humerus is profiled laterally in anatomical position?
Term
SURGICAL NECK
Definition
What is the most common site for fractures of the proximal humerus?
Term
GLENOID FOSSA
Definition
Name the area of the scapula where the humeral head articulates to form the shoulder joint.
Term

HAND SUPINATED UNTIL HUMERAL EPICONDYLES ARE PARALLEL WITH IR

 

CONSIDERED AN AP EXTERNAL ROTATION PROJECTION

 

GREATER TUBERCLE WILL BE PROFILED LATERALLY ON RADIOGRAPH AND LESSER WILL BE SEEN ANTERIOR

Definition
To provide an AP view of the proximal humerus:
Term

HAND PRONATED UNTIL HUMERAL EPICONDYLES ARE PERPENDICULAR TO IR

 

CONSIDERED AN AP INTERNAL ROTATION PROJECTION

 

LESSER TUBERCLE WILL BE PROFILED MEDIALLY AND GREATER IS SEEN ANTERIOR

Definition
To provide a lateral view of the proximal humerus:
Term
AP WITH NEUTRAL ROTATION, AND EITHER A TRANSTHORACIC LATERAL OR SCAPULAR Y VIEW
Definition
What routine shoulder projections should be performed if a patient is suspected of having a fracture or dislocation?
Term
LEVEL OF SURGICAL NECK
Definition
Where is the CR location for a transthoracic lateral projection?
Term
INFEROSUPERIOR AXIAL OR TRANSAXILLARY LATERAL
Definition
What is the name of the projection that may be performed on a non-trauma shoulder that has the patient's arm abducted 90 degrees from the body?
Term
BREATHING TECHNIQUE TO BLUR THE RIBS/LUNGS SO AREA OF INTEREST REMAINS IN FOCUS AND BETTER VISUALIZED
Definition
What specific breathing instructions can be given to the patient when performing a transthoracic lateral and AP scapula exams?
Term
45 TO 60 DEGREE OBLIQUE
Definition
In order to perform a lateral scapula or scapular Y view projection, how will the patient's body be positioned in relation to the IR?
Term
AP AND AP WITH 15-30 DEGREE CEPHALIC ANGLE
Definition
Name the two routine projections for a clavicle exam.
Term
72"
Definition
What SID should be utilized for AC joints?
Term
YES, BOTH SIDES EXAMINED FOR COMPARISON
Definition
Are AC joints considered a bilateral study?
Term
RIGHT IN BOTH SCENARIOS
Definition
When performing lateral scapula projections, if the patient is placed in an RAO position, which scapula will best be demonstrated?  In an LPO?
Term
AP WITH WEIGHTS AND AP W/O WEIGHTS
Definition
What are the routine projections for AC joints?
Term
FOREIGN OBJECTS ARE SWALLOWED OR ASPIRATED INTO THE AIR PASSAGES
Definition
What is aspiration?
Term
COLLAPSE OF ALL OR PORTION OF LUNG
Definition
What is atelectasis?
Term
MOST COMMON FORM IS EMPHYSEMA.  FORM OF PERSISTANT OBSTRUCTION OF THE AIRWAYS THAT USUALLY CAUSES DIFFICULTY IN EMPTYING THE LUNGS OF AIR.
Definition
What is COPD?
Term
SHORTNESS OF BREATH;  DIFFICULTY IN BREATHING
Definition
What is dyspnea?
Term
Definition
Term
ACCUMULATION OF AIR IN PLEURAL CAVITY
Definition
What is pneumothorax?
Term
WHEN BLOOD  IS ACCUMULATED IN THE PLEURAL CAVITY
Definition
What is hemothorax?
Term
ABNORMAL ACCUMULATION OF FLUID IN THE PLEURAL CAVITY
Definition
What is pleural effusion?
Term
THE DELICATE, DOUBLE-WALLED SAC OR MEMBRANE CONTAINING THE LUNGS
Definition
What is pleura?
Term
THE INNER LAYER ADHERING TO THE SURFACE OF THE LUNGS
Definition
What is visceral pleura?
Term
THE OUTER LAYER OF THE PLEURAL CAVITY ADHERING TO THE INNER SURFACE OF THE CHEST WALL AND DIAPHRAGM
Definition
What is the parietal pleura?
Term
THE POTENTIAL SPACE BETWEEN THE PARIETAL PLEURA AND THE VISCERAL PLEURA
Definition
What is the pleural cavity/space?
Term
APICES
Definition
What is the upper, rounded portion above the level of the clavicles of the lungs called?
Term
BASE
Definition
What is the lower, concave portion of the lungs called?
Term
COSTOPHRENIC ANGLES
Definition
What is the extreme, outermost lower corner of the lungs called?
Term
HILUM
Definition
What is the central area in which bronchi and blood vessels enter the lungs called?
Term
PERITONEUM
Definition
What is the double-walled membrance lining the abdominopelvic cavity called?
Term
MESENTARY
Definition
What is the double folds that holds the small intestine in place in the abdominal cavity called?
Term
OMENTUM
Definition
What is the double fold peritoneum that extends from the stomach to another organ in the abdominal cavity called?
Term
MESOCOLON
Definition
What is the peritoneum that attaches the colon to the posterior abdominal wall called?
Term
MECHANICAL BOWEL OBSTRUCTION
Definition
What is the complete blockage of the flow of intestinal contents called?
Term
ADYNAMIC ILEUS
Definition
What is paralysis of the ileus called?
Term
INTUSSUSCEPTION
Definition
What is the telescoping of a section of bowel into another loop of bowel called?
Term
VOLVULUS
Definition
What is a twisting of a loop of bowel that creates an obstruction called?
Term
LATERAL, SUPERIOR, AND INFERIOR
Definition
What are the 3 angles of the scapula called?
Term
MEDIAL (VERTEBRAL) BORDER AND LATERAL (AXILLARY) BORDER
Definition
What are the 2 borders of the scapula called?
Term
CORACOID PROCESS (ANTERIOR) AND ACROMION PROCESS (POSTERIOR)
Definition
What are the 2 processes of the scapula called?
Term
GLENOID CAVITY (FOSSA)
Definition
What is the fossa called on the scapula that articulates with the head of the humerus?
Term
VENTRAL (COSTAL) SURFACE AND DORSAL (POSTERIOR) SURFACE
Definition
What are the 2 surfaces of the scapula called?