PCM X-ray Flashcards.txt
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What are the four radiodensities of the body
When taking a radiograph in �en face� how does the beam travel through the patient?
Anterior to posterior
When taking a radiograph �in profile� how does the beam travel through the patient?
Soft tissue such as muscle is most similar to what density (air, fat, water or bone)
True or False it is important to get more than one view or possition
Name the ABCS Search pattern
- B-bone density
- C- cartilage spaces
- S- soft tissue
Name the 3 parts to looking for proper alignment on an X-ray
- Gross normal size and number
- Alignment of adjacent bones
3 things to look for when assessing gross size and number on an X-ray
- supernumerary (too many bones)
- Absent bones (too few bones)
- Congenital/developmental deformities
What are three qualities of the contours that you should assess when looking at an X-ray
- Avulsions, impaction fractures
- Post surgical changes
What are three things you should look for when assessing the alignment of adjacent bones?
- Subluxation- incomplete or partial dislocation
3 parts to looking at bone density on an X-ray
- General bone density- general loss of contrast bone compared to tissue
- Texture abnormalities- trabecular changes thin, lacy, fluffy
- Subchondral Bone-
- sclerosis in the DJD
- Erosions of RA or gout
- Epiphyseal plate thickness
Erosion due to gout look like _________ while erosions due to RA are _____.
Ratbites with overhanging margins, clean
4 things to consider when looking at soft tissue structures on X-ray
- Muscles- wasting or swelling
- Fat pads/lines- displacement of joint effusion, or elevation or blurring of fat planes
- Joint capsules- distention with effusion or hemorrhage
- Periosteum- reactions- solid onionskin, spiculated, sunburst, codman's triangle
- (Other soft tissue findings include foreign bodies, calcifications, and gass bubbles)
When a bone has a lesion (such as a tumor) that grows in spurts the periosteum has time to lay down a new layer while the tumor is not growing as fast before it has another spurt this causes a radiologic pattern of layers that grow out from the bone called a ___________
the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone
When there is a rapidly growing bone lesion the periosteum does not have time to lay down communicating layers so it makes fibers that penitrate through the tumor and connect it to the bone these fibers show up on radiology as lines radiating out from the bone and are called a __ or __ pattern
Sunburst or Hair on end
A fracture that does not go all the way through the bone
A fracture that goes all the way through the bone
a fracture that is incomplete with both bones oriented in their original place
A fracture with the distal portion moved inward toward the midline
medial displaced complete fracture
A fracture with the distal portion moved outward away from the midline
lateral displaced complete fracture
A fracture that is complete but the top and bottom portions remain in their original orientation to one another
A fracture where the lower portion moves back up and overlaps a portion of the superior portion
Fracture orientation when the fracture is straight across the shaft of a bone
Fracture orientation when the fracture is at a diagonal angle
Fracture orientation when the fracture is helical down the shaft
A fracture in which bone fragments are separate completely
A fracture in which the bone fragments are still partially joined. In such cases there is a crack in the osseus tissue that does not completely transverse the width of the bone
A fracture that is parallel to the bone's logn axis
A fracture that is at a right angle to the bone's long axis
A fracture that is at a diagonal to the bone's long axis
A fracture where at least one part of the bone has been twisted
A fracture in which the bone has broken into a number of pieces
A fracture caused when bone fragments are driven into eachother
Fracture that occurs in children within their developing years when there is a mechanical failure on the side to which there has been significant tension. This causes the bone to bow.
Greenstick fracture; Torus fracture
What should you worry about with pelvic or femoral fractures
What should you worry about with a crush injury or multiple fractures
What should you worry about with an elbow fracture?
Brachial artery injury
what should you worry about with a proximal humeral fracture?
Axillary artery/nerve injury
What should you worry about with a shoulder dislocation?
Axillary artery tear; brachial plexus injury, axillary nerver injury
What should you worry about with an elbow dislocation?
Brachial artery injury, radial/ulnar nerve injury
What should you worry about with hip dislocation?
Femoral artery/nerve injury, fracture, artery to the head of the femur (femur head necrosis)
What should you worry about with knee dislocation?
Popliteal artery/nerve injury
A boxer's fracture is a fracture of what bone?
The fifth metacarpal
what is the most common mechanism for getting a boxer fracture?
- Impact (punch) the metacarpal head taking head on force with a clenched fist
- (palmar displacement of the metacarpal head)
What other wound should you look for with a boxers fracture?
�fight bite� wound from teeth or a rotational deformity
How would you manage a boxer's fracture?
Ulnar gutter splint, 2nd and 3rd metacarpal neck fixation
Which fracture has a �dinner fork� deformity?
Where is a colles fracture located?
Lower end of the radius with posterior displacement of the distal fragment
What is the most common method of getting a colles fractuer
fall on outstretched hand with wrist in extension
What X- rays should you order for a colles fracture?
Wrist AP/Lateral and oblique
What are the complications of a colles fracture?
- Median nerve compression
- EPL tendon rupture
How would you splint a Colles fracture?
Double sugar tong or volar splint wrist
Most common mechanism for a monteggia fracture
fall on outstretched hand/direct blow
Where is a monteggia fracture?
Proximal 1/3 ulnar fractue with radial head dislocation
How should you manage a Monteggia fracture?
Check neurovascular status
How would you X-ray a monteggia fracture?
AP and lateral forearm wrist and elbow
What are some complications of a Monteggia fracture?
Radial nerve injury, decreased ROM, compartment syndrome
What is a Galeazzi fracture
radial shaft fracture usually the mid to distal 1/3 of the radius with dislocation of the ulnar joint
Most common mechanism of Galeazzi fracture
Fall on outstretched hand
How would you X-ray a Galeazzi fracture
AP/Lateral forearm wrist and elbow
What is Gamekeepers thumb?
- Rupture of the ulnar collateral ligament, causing ligament laxity at the mcp joint
- also called skiers thumb
Gamekeepers thumb causes ligament laxity at what joint?
How would you image a gamekeepers thumb
stress x rays
how do you fix a gamekeepers thumb
partial- cast immobilization or full surgical repair
What are the common ways to have a midshaft humoral fracture?
Motorvehicle accident, gunshot wound, direct blows or falls, fall onto elbow
What are some signs and symptoms of a humoral fracture
pain swelling deformity, crepitation, foreshortenting
What should you be sure to assess when dealing with a humoral fracture?
- Neurovascular function especially the radial nerve
- look for weak/absent wrist dorsiflexion and �wrist drop� along with decreased sensation in the dorsal hand
What is a Nursemaids elbow?
Radial head dislocation from the annular ligament
A nondisplaced radial head fracture is a mason classification class ___
A single displaced fragment with a radial head fracture is a Mason classification class __
A comminuted radial head fracture is a mason classification type ___
a fracture with elbow dislocation is a mason classification class ___
Most common area of the radial head to be fracture is the ----
What motions will a person with a radial head fracture find difficult/painful
pronation and supination
Most common way to get a radial head fracture
�Fat Pad Sign�
Radial head fracture
Most common way to get a scaphoid fracture
fall on outstretched hand
�pain in the anatomical snuffbox�
What X-rays should you order for a scapoid fracture?
PA/Lat and oblique of the hand as well as a scaphoid view and then order again in a week if negative for the first set the patient may still have a fracture that is not visible on x ray
how do you splint a scaphoid fracture?
What are the complications of a scaphoid fracture
- A vascular necrosis of the scaphoid and nonunion
- the blood supply is retrograde so hard to heal
Will a patient with a knee dislocation be able to bear weight?
How do you get a knee dislocation
high energy trauma to the knee
True or false a dislocated knee is an orthopedic emergency
what diagnostic studies would you run for a dislocated knee?
AP lateral x-ray consider arteriogram and MRI
What are some complications of a knee dislocation
popliteal artery injury, pperoneal nerve injury, chronic instability
A proximal fracture of the fibula with external rotation/disrupted syndesmosis of the interosseus membrane
What is the treatment for a Maisonneuve fracture
long leg cast and frequent follow up
Knee pain in adolescents with edema of the tibial tubricle secondary to traction (inflammation of the tibial tuberosity caused by alotta jumping)
Osgood schlatter disease
True or False Osgood schlatter disease is self limiting
true it resolves with the cessation of the exacerbating activity
Prepatellar bursitis is more commonly called ____
What are some risks for housmaid's knee
occupations requiring kneeling (housemaids, plumbers, professional blowjobists)
What are the signs and symptoms of Housmaid's knee
- swelling tenderness in the prepatellar area
- decreased flexion
What is the treatment for housmaid's knee
aspiration/injection or I/D
By the Alter Harris classification a bone with the entire epiphysis broken off is a Class __
Class II Salter Harris
the entire epiphysis along with a portion of the metaphysis
Class III Salter Harris
A portion of the epiphysis
Class IV Salter Harris
a portion of the epiphysis along with a portion of the metaphysis
Class V Salter Harris
- Compression injury of the epiphyseal plate nothing is broken off
- 3 factors that lead to a technically compromised film on a chest X-ray
- insufficient inhalation
- incorrect angle
Name some of the criteria to look for when evaluating to see if a CXR is adequate or not
- trachea visible from midline
- no rotation the ends of the clavicals are equidistant from the central line
- entire lung fields from apices to costophrenic angles should clearly be visible
- faint shadow of the ribs and thoracic vertebrae visible through the heart shadow
- lung markings are visible from the hilum to the periphery of the lung
- sharp outline of the heart and diaphragm
- ten posteior ribs visible above the diaphragm
A mediastinal shift with no pleural markings on one side and a pleural line on X ray indicate
An enlarged heart that takes up the majority of the mediastinum and crosses the sternum on x ray
A lobular opacity that takes up the entire right upper lobe
Which view is best for seeing layering associated with pleural effusion?
Lateral decubitius film
Diffuse patchy infiltrates on CXR indicate what type of pneumonia
pneumocystis in HIV and immunosuppressed
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