PCM X-ray Flashcards.txt

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BostonPhysicianAssist
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PCM X-ray Flashcards.txt
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2011-12-09 16:13:26
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  1. What are the four radiodensities of the body
    • 1.air/gas
    • 2.water
    • 3.fat
    • 4.bone
  2. When taking a radiograph in �en face� how does the beam travel through the patient?
    Anterior to posterior
  3. When taking a radiograph �in profile� how does the beam travel through the patient?
    Laterally
  4. Soft tissue such as muscle is most similar to what density (air, fat, water or bone)
    water
  5. True or False it is important to get more than one view or possition
    true
  6. Name the ABCS Search pattern
    • A-alignment
    • B-bone density
    • C- cartilage spaces
    • S- soft tissue
  7. Name the 3 parts to looking for proper alignment on an X-ray
    • Gross normal size and number
    • Contours
    • Alignment of adjacent bones
  8. 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
  9. What are three qualities of the contours that you should assess when looking at an X-ray
    • Avulsions, impaction fractures
    • Spurs
    • Post surgical changes
  10. What are three things you should look for when assessing the alignment of adjacent bones?
    • Fracture
    • Subluxation- incomplete or partial dislocation
    • Dislocation
  11. 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
  12. Erosion due to gout look like _________ while erosions due to RA are _____.
    Ratbites with overhanging margins, clean
  13. 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)
  14. 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 ___________
    �Onion skin�
  15. the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone
    Codman's Triangle
  16. 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
  17. A fracture that does not go all the way through the bone
    incomplete fracture
  18. A fracture that goes all the way through the bone
    complete fracture
  19. a fracture that is incomplete with both bones oriented in their original place
    Nondisplaced fracture
  20. A fracture with the distal portion moved inward toward the midline
    medial displaced complete fracture
  21. A fracture with the distal portion moved outward away from the midline
    lateral displaced complete fracture
  22. A fracture that is complete but the top and bottom portions remain in their original orientation to one another
    Distraction
  23. A fracture where the lower portion moves back up and overlaps a portion of the superior portion
    Overriding fracture
  24. Fracture orientation when the fracture is straight across the shaft of a bone
    Transverse
  25. Fracture orientation when the fracture is at a diagonal angle
    Oblique
  26. Fracture orientation when the fracture is helical down the shaft
    Spiral
  27. A fracture in which bone fragments are separate completely
    Complete fracture
  28. 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
    Incomplete fracture
  29. A fracture that is parallel to the bone's logn axis
    Linear fracture
  30. A fracture that is at a right angle to the bone's long axis
    Transverse fracture
  31. A fracture that is at a diagonal to the bone's long axis
    Oblique fracture
  32. A fracture where at least one part of the bone has been twisted
    Spiral fracture
  33. A fracture in which the bone has broken into a number of pieces
    Comminuted fracture
  34. A fracture caused when bone fragments are driven into eachother
    impacted fracture
  35. 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
  36. What should you worry about with pelvic or femoral fractures
    hemorrhage
  37. What should you worry about with a crush injury or multiple fractures
    fat embolism
  38. What should you worry about with an elbow fracture?
    Brachial artery injury
  39. what should you worry about with a proximal humeral fracture?
    Axillary artery/nerve injury
  40. What should you worry about with a shoulder dislocation?
    Axillary artery tear; brachial plexus injury, axillary nerver injury
  41. What should you worry about with an elbow dislocation?
    Brachial artery injury, radial/ulnar nerve injury
  42. What should you worry about with hip dislocation?
    Femoral artery/nerve injury, fracture, artery to the head of the femur (femur head necrosis)
  43. What should you worry about with knee dislocation?
    Popliteal artery/nerve injury
  44. A boxer's fracture is a fracture of what bone?
    The fifth metacarpal
  45. 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)
  46. What other wound should you look for with a boxers fracture?
    �fight bite� wound from teeth or a rotational deformity
  47. How would you manage a boxer's fracture?
    Ulnar gutter splint, 2nd and 3rd metacarpal neck fixation
  48. Which fracture has a �dinner fork� deformity?
    Colles fracture
  49. Where is a colles fracture located?
    Lower end of the radius with posterior displacement of the distal fragment
  50. What is the most common method of getting a colles fractuer
    fall on outstretched hand with wrist in extension
  51. What X- rays should you order for a colles fracture?
    Wrist AP/Lateral and oblique
  52. What are the complications of a colles fracture?
    • Median nerve compression
    • EPL tendon rupture
  53. How would you splint a Colles fracture?
    Double sugar tong or volar splint wrist
  54. Most common mechanism for a monteggia fracture
    fall on outstretched hand/direct blow
  55. Where is a monteggia fracture?
    Proximal 1/3 ulnar fractue with radial head dislocation
  56. How should you manage a Monteggia fracture?
    Check neurovascular status
  57. How would you X-ray a monteggia fracture?
    AP and lateral forearm wrist and elbow
  58. What are some complications of a Monteggia fracture?
    Radial nerve injury, decreased ROM, compartment syndrome
  59. What is a Galeazzi fracture
    radial shaft fracture usually the mid to distal 1/3 of the radius with dislocation of the ulnar joint
  60. Most common mechanism of Galeazzi fracture
    Fall on outstretched hand
  61. How would you X-ray a Galeazzi fracture
    AP/Lateral forearm wrist and elbow
  62. What is Gamekeepers thumb?
    • Rupture of the ulnar collateral ligament, causing ligament laxity at the mcp joint
    • also called skiers thumb
  63. Gamekeepers thumb causes ligament laxity at what joint?
    MCP
  64. How would you image a gamekeepers thumb
    stress x rays
  65. how do you fix a gamekeepers thumb
    partial- cast immobilization or full surgical repair
  66. What are the common ways to have a midshaft humoral fracture?
    Motorvehicle accident, gunshot wound, direct blows or falls, fall onto elbow
  67. What are some signs and symptoms of a humoral fracture
    pain swelling deformity, crepitation, foreshortenting
  68. 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
  69. What is a Nursemaids elbow?
    Radial head dislocation from the annular ligament
  70. A nondisplaced radial head fracture is a mason classification class ___
    I
  71. A single displaced fragment with a radial head fracture is a Mason classification class __
    II
  72. A comminuted radial head fracture is a mason classification type ___
    III
  73. a fracture with elbow dislocation is a mason classification class ___
    IV
  74. Most common area of the radial head to be fracture is the ----
    anteriolateral
  75. What motions will a person with a radial head fracture find difficult/painful
    pronation and supination
  76. Most common way to get a radial head fracture
    FOOSH
  77. �Fat Pad Sign�
    Radial head fracture
  78. Most common way to get a scaphoid fracture
    fall on outstretched hand
  79. �pain in the anatomical snuffbox�
    Scaphoid fracture
  80. 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
  81. how do you splint a scaphoid fracture?
    Thumb spica
  82. 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
  83. Will a patient with a knee dislocation be able to bear weight?
    No
  84. How do you get a knee dislocation
    high energy trauma to the knee
  85. True or false a dislocated knee is an orthopedic emergency
    true
  86. what diagnostic studies would you run for a dislocated knee?
    AP lateral x-ray consider arteriogram and MRI
  87. What are some complications of a knee dislocation
    popliteal artery injury, pperoneal nerve injury, chronic instability
  88. A proximal fracture of the fibula with external rotation/disrupted syndesmosis of the interosseus membrane
    Maisonneuve
  89. What is the treatment for a Maisonneuve fracture
    long leg cast and frequent follow up
  90. 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
  91. True or False Osgood schlatter disease is self limiting
    true it resolves with the cessation of the exacerbating activity
  92. Prepatellar bursitis is more commonly called ____
    housemaids knee
  93. What are some risks for housmaid's knee
    occupations requiring kneeling (housemaids, plumbers, professional blowjobists)
  94. What are the signs and symptoms of Housmaid's knee
    • swelling tenderness in the prepatellar area
    • erythema
    • decreased flexion
  95. What is the treatment for housmaid's knee
    aspiration/injection or I/D
  96. By the Alter Harris classification a bone with the entire epiphysis broken off is a Class __
    I
  97. Class II Salter Harris
    the entire epiphysis along with a portion of the metaphysis
  98. Class III Salter Harris
    A portion of the epiphysis
  99. Class IV Salter Harris
    a portion of the epiphysis along with a portion of the metaphysis
  100. 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
    • rotation
    • insufficient inhalation
    • incorrect angle
  101. 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
  102. A mediastinal shift with no pleural markings on one side and a pleural line on X ray indicate
    pneumothorax
  103. An enlarged heart that takes up the majority of the mediastinum and crosses the sternum on x ray
    cardiomegally
  104. A lobular opacity that takes up the entire right upper lobe
    lobular pneumonia
  105. Which view is best for seeing layering associated with pleural effusion?
    Lateral decubitius film
  106. Diffuse patchy infiltrates on CXR indicate what type of pneumonia
    pneumocystis in HIV and immunosuppressed

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