Spine midterm study guide-1.txt

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wahlquist1981
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91177
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Spine midterm study guide-1.txt
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2011-06-18 21:12:28
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revised midterm study guide
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  1. When taking an AP Cervical Open Mouth x-ray, what is the ideal position for the patient?
    Supine; Although we comp with the patient standing
  2. When taking an AP Oblique x-ray of the cervical spine the body is at ____*, the tube is at ____*, and the central ray is through _____.
    45,15-20, C4
  3. When taking an x-ray of the cervical spine in the lateral position what are the tube angulation and the SID?
    Perpendicular to C4, 72"
  4. Where is the central ray for the AP Cervical Open Mouth projection?
    Centered to the open mouth
  5. What is the proper tube angulation for an AP projection of the coccyx?
    10* caudal
  6. What is the name of the most anterior portion of the thoracic vertebrae?
    Body
  7. The brain and spinal cord make up what part of the nervous system?
    Central
  8. How many cervical vertebrae are there?
    7
  9. How many thoracic vertebrae are there?
    12
  10. How many lumbar vertebrae are there?
    5
  11. The natural curve of the lumbar spine is classified as what type? (Convex or Concave?)
    Convex anteriorly, concave posteriorly
  12. Which vertebrae have demifacets for articulation with the ribs?
    Thoracic
  13. What is another name for C1?
    Atlas
  14. What position/projection is necessary to demonstrate the intervertebral foramina of the cervical spine?
    45* Oblique
  15. How much should the body be rotated for the oblique position of the sacroiliac joints?
    25-30*
  16. Long exposure time (Shallow breathing technique) is useful in what projection?
    Lateral thoracic spine
  17. What are the functions of the vertebral column?
    Encloses and protects the spinal cord; supports the trunk and skull superiorly; provides for attachment of ribs and muscles.
  18. How many bones make up the vertebral column?
    33
  19. Which vertebrae are true and how many are there?
    The upper 24 vertebrae are true. The pelvic region is false.
  20. Where does the vertebral column articulate with the hips?
    SI Joints
  21. At what angle do the intervertebral foramina lie on the cervical vertebrae?
    45* anteriorly and 15* inferiorly to MSP
  22. The Z-Joints of the Thoracic Spine form what angle with the MSP?
    70-75*
  23. How much should you rotate the patient from MCP when you are shooting an AP Oblique Projection of the thoracic vertebrae?
    15-20*
  24. The Z-Joints of the Lumbar Spine form what angle with the MSP?
    30-60*
  25. Dorsal Decubitus Lateral is also known as what projection?
    Cross Table C-Spine
  26. When using the anode heel effect you should place the cathode side at which end of the body?
    Feet
  27. What should you place behind the patient when shooting a lateral projection?
    Lead rubber
  28. On the lateral L-spine how should you position the knees?
    Flexed and superimposed over each other
  29. What classification of bones are the vertebrae?
    Irregular
  30. How many sacral bones occupy the vertebral column?
    5
  31. How many coccygeal bones occupy the vertebral column?
    3-5
  32. The cervical and lumbar vertebrae are ____ anteriorly and are called ____ curves.
    Convex; lordotic
  33. The thoracic and pelvic curves are _____ anteriorly and are called _____ curves.
    Concave; kyphotic
  34. Which spinal curves are considered primary curves?
    Thoracic and Pelvic
  35. At what age does the cervical spine begin to develop? Lumbar spine?
    3-4 months when child is able to hold the head up; 1-1.5 when child begins to walk
  36. The lumbar and pelvic curves are more pronounced in ______ (men or women)?
    Women
  37. Any abnormal increase in the thoracic curvature is called what?
    Kyphosis
  38. Any abnormal increase in the lumbar curvature is called what?
    Lordosis
  39. Any abnormal increase in the lateral curvature of the spine is called what?
    Scoliosis
  40. What are the 2 main parts of the typical vertebrae?
    Vertebral body and vertebral arch
  41. The vertebral arch and body enclose a space called the _____?
    Vertebral foramina
  42. The vertebral bodies are separated by what?
    Intervertebral disks
  43. What makes up 1/4 of the length of the vertebral column?
    Intervertebral disks
  44. Each disk has a central mass called the ____, which is surrounded by the ____.
    Nucleus pulposis; annulus fibrosis
  45. This condition occurs when the nucleus ruptures or protrudes into the vertebral canal.
    Herniated nucleus pulposis or more commonly called a slipped disk
  46. ______ allow for transmission of spinal nerves and blood vessels.
    intervertebral foramina
  47. The transverse processes are made up of ___ and ____.
    Lamina and pedicles
  48. These join at the midline to form the spinous processes.
    Laminae
  49. A congenital defect of the vertebral column in which the laminae fail to unite posteriorly.
    Spina bifida
  50. What 2 parts of the vertebrae form the Z-Joint?
    Superior and Inferior articulation processes
  51. What makes C1 (atlas) unique?
    Contains lateral masses but has no body.
  52. What is the strong conical process that arises from C2?
    The Odontoid process (dens)
  53. C7 is also called _____, what makes it unique?
    Vertebral prominens; the spinous process is easy palpable as it is almost horizontal
  54. Name 2 anatomical features that make the cervical spine unique.
    They have transverse foramina and they have a bifid spinous process
  55. These are for the transmission of the vertebral artery and veins.
    Transverse foramina
  56. In order to see the z- joints on the cervical vertebrae what position/projection is necessary?
    Lateral (see table below)
  57. How many thoracic vertebrae articulate with the tubercle of the rib?
    10
  58. How many thoracic vertebrae articulate with the head of the rib?
    12
  59. How much should you rotate the patient from the lateral position to demonstrate the z- joints of the thoracic vertebrae?
    15-20*
  60. Which vertebrae have mamillary processes?
    Lumbar
  61. The part of the lamina between the superior and inferior processes is called the _____ on the lumbar vertebra.
    Pars interarticularis
  62. At what angle do the z-joints of the lumbar spine lie?
    30-60* posteriorly from MSP
  63. This condition is characterized by the anterior displacement of one vertebra over another caused by a bony defect in the pars interarticularis. This condition almost exclusively involves the lumbar spine.
    Spondylolisthesis
  64. What projection would you use to demonstrate Spondylolisthesis?
    Oblique b/c that is where the "neck" of the "Scottie dog" is seen.
  65. Where is the base located on the sacrum/coccyx? The apex?
    Superiorly; inferiorly - the base of the coccyx articulates w/ the apex of the sacrum
  66. Whose sacrum (males or female?) is more acutely curved?
    Female
  67. At the superior ridge of the sacrum there is a prominent ridge, what is it called?
    Sacral promontory
  68. On each side of the sacral base is a large, wing like lateral mass called the ___?
    Ala
  69. The pelvis and the sacrum articulate at the ____, more specifically the _____ surfaces.
    SI Joints; auricular surface
  70. What type of joint is the atlanto-occipital joint?
    Ellipsoidal
  71. What type of joint is the atlantoaxial joint?
    Gliding at the lateral aspect; pivot at the medial aspect (dens)
  72. This is an avulsion fracture of the spinous process in the lower cervical and upper thoracic region.
    Clay Shoveler's
  73. This is a fracture of the anterior arch of C2 due to hyperextension
    Hangman's Fracture
  74. What is a Jefferson fracture?
    Comminuted fracture of the ring of C1
  75. When would you use the Fuch's method?
    When the dens has not been clearly demonstrated in the open-mouth position.
  76. What is the correct patient position for the Fuch's method?
    Supine with chin extended until tip of the chin and tip of mastoid process are vertical.
  77. Where do you center the IR for the Fuch's method?
    Center to level of mastoid tips
  78. What is the respiration phase for the Fuch's method?
    Suspended.
  79. Where is the central ray directed for the Fuch's method?
    Perpendicular to MSP just distal to the tip of the chin
  80. Where should you view the dens?
    Within the foramen magnum
  81. What is the recommended SID for the open-mouth projection?
    30"
  82. What is the recommended patient position for the open-mouth projection?
    Supine
  83. What anatomical landmarks should you use when positioning for the open-mouth projection?
    Upper incisors and the mastoid tips
  84. What is the respiration phase for the open-mouth projection?
    Phonate "ah"
  85. Where is the IR centered for the open-mouth projection?
    C2
  86. Why should you have the patient say "ah"?
    To depress the tongue out of the way of the dens and will prevent movement of the mandible
  87. Where is the central ray directed for the open-mouth projection?
    Entering midpoint of open mouth
  88. Which 2 patient positions could you use on an AP Axial projection of the c-spine?
    Upright or supine
  89. Why do you have the patient extend the chin in an AP Axial projection of the c-spine?
    To prevent superimposition of the mandible and midcervical vertebrae
  90. What is the respiration phase for the AP Axial projection of the c-spine?
    Suspend
  91. Where/how is the central ray directed for the AP Axial projection of the c-spine?
    15-20* cephalad entering at the level of C4
  92. How many vertebrae should you see on the AP Axial projection of the c-spine?
    You should see the lower 5 cervical vertebrae and the first 2 thoracic (C3- T2)
  93. The lateral projection of the cervical spine is also called what?
    The Grandy method
  94. What is the recommended SID for the Grandy method? Why?
    60-72" because of the increase OID created by the shoulder, the larger SID demonstrates C7 better.
  95. Where should the top of the IR be for the Grandy method?
    1" above EAM (about the top of the ear)
  96. How should you position the patient's shoulders for the Grandy method?
    If the patient has round shoulders rotate them anteriorly otherwise rotate them posteriorly, also make sure they are on the same plane and depress them as much as possible.
  97. What is the respiration phase for the Grandy method? Why?
    Suspend at the end of full expiration, this will help depress the shoulders
  98. Where is the central ray directed for the lateral projection of the cervical spine?
    Perp to C4
  99. What should be seen on the lateral projection of the cervical spine?
    C1- 1/3 of T1
  100. What projection should you use if C7-T1 is not clearly seen?
    Swimmers
  101. What is the recommended SID for the AP Axial Oblique projection of the c-spine?
    60-72"
  102. What much should you rotate the patient for the AP Axial Oblique projection?
    45* and the head should be lateral
  103. The AP Axial Oblique projection should have a central ray angle of how many degrees? Where is it directed?
    15-20* cephalad entering C4
  104. What is being demonstrated on the oblique projection of the cervical spine?
    Intervertebral foramina
  105. What is the respiration phase for the oblique projection of the c-spine?
    Suspended
  106. True or False: You should be able to clearly view the intervertebral foramina on C1 and C2 on the oblique projection?
    False
  107. What is another name for the AP projection of the c-spine?
    Ottonello
  108. What technique do you use on the AP projection to blur and sometimes obliterate the mandibluar shadow?
    An even chewing method during the exposure.
  109. The swimmers technique has 2 methods, what are they?
    Recumbent (Powlow) and Upright (Twining)
  110. If the patient cannot depress the shoulder how should you angle to tube for the swimmers technique?
    3-5* caudal
  111. Monda recommended angling the tube _____ on the Swimmers position to better demonstrate the disk spaces.
    5-15* cephalad
  112. What is the respiration phase for the Swimmers Technique?
    Suspended; or if the patient can be immobilized you can use slow shallow breathing.
  113. All of the joints in the vertebrae are synovial, freely moveable except which one?
    Intervertebral Joints
  114. The intervertebral joint is what kind of joint?
    Cartilaginous, Symphysis Slightly Moveable
  115. L1-L3 have an average angle range of what?
    0-30*
  116. L3-L4 have an average angle range of what?
    15-45*
  117. L4-S1 have an average angle range of what?
    45-60*
  118. On which projections can you use a compensating filter on?
    AP T-Spine, Swimmers
  119. Which 2 positions are acceptable for the AP T-Spine?
    Upright and Supine (Supine is recommended)
  120. How should the legs be positioned for the AP T-Spine?
    Hip and legs flexed
  121. Where should the superior border of the IR be placed for the AP T-spine?
    1 1/2-2" above the shoulders (The same is true for the lateral t-spine)
  122. What is the respiration phase for the AP and lateral T-spine?
    Shallow breathing or suspend on expiration
  123. What 2 bony landmarks can you use to help center for the AP T-Spine?
    Xiphoid Process and Jugular Notch
  124. Approximately where should the CR enter for the AP T-Spine?
    T7
  125. True or False: You can place the patient in a lateral recumbent position or an upright position for the lateral T-spine projection?
    True
  126. Why do you place the patient in a left lateral position rather than a right (for lat t-spine)?
    To reduce magnification of the heart
  127. What should you place under the patients head to ensure that the long axis of the spine is horizontal (for lat t-spine)?
    A firm pillow
  128. Which half of the thorax should be placed at the midline of the grid (for lat t-spine)?
    Posterior half
  129. How should you position the patients' knees (for lat t-spine)?
    Flexed and superimposed
  130. How are the patients arms positioned (for lat t-spine)?
    Positioned at a right angle to the body
  131. Although using a sponge to put the long axis of the t-spine horizontal is the preferred method, what else could you do if the long axis of the t-spine isn't horizontal for lateral t-spine?
    You can angle to tube 10-15* cephalad. (10* for women 15* for men b/c of the broad shoulders)
  132. True or False: The c-spine "Swimmers lateral" is the same projection as the t-spine "swimmers lateral"?
    True
  133. True or False: On the lateral t-spine T1-T3 will not be well visualized?
    True
  134. Which joints are demonstrated on the oblique projection of the t-spine?
    Z-joints
  135. On an AP oblique t-spine, which Z Joints CLOSEST OR FARTHEST are demonstrated?
    Farthest
  136. How much do you rotate the patient (from the AP position) for an oblique t-spine projection?
    70*
  137. With reference to the patient where you place the top of the light on the oblique proj. of the t-spine?
    1 1/2 - 2" above shoulder (center at T7)
  138. What is the respiration phase for the oblique t-spine?
    Suspend on expiration
  139. If possible what should be cleared from the intestinal tract for the AP Lumbar projection?
    Gas and fecal matter
  140. What effect does flexing the knees have on the curve of the lumbar spine (for the AP lumbar proj)?
    It reduces lordosis
  141. What is the recommended SID for all lumbar projections?
    48"
  142. Where should you place the patient's arms for the AP Lumbar projection?
    Flex elbow and place hands on the chest
  143. Why should you place a sponge under the patient's lower back?
    To prevent rotation
  144. When using a 14x17" film where should you center the IR? 11x14"? (This is for AP and Lateral proj)
    L4 for 14x17; L3 for 11x14"
  145. What is the respiration phase for AP l-spine?
    Suspend on expiration
  146. Where do you direct the CR for a lumbosacral projection? Lumbar? (This is for AP and Lateral proj)
    L4 for l.s. and L3 for lumbar
  147. Why do some Doctors request that you leave the collimation wide open on an AP l-spine?
    Trauma, visualization of the liver, kidney, spleen, psoas muscles margins, and air or gas patterns
  148. What is the respiration phase for the AP and lateral L-spine?
    Suspend on expiration
  149. If the spine cannot be moved into a horizontal position by using a ___, then you should place an angulation of __ to __ degrees.
    Sponge; 5-8* caudal
  150. Which vertebrae should be visualized on this image? (lateral l-spine)
    Lower thoracic to sacrum (or to coccyx when using the bigger film)
  151. Is the L5 intervertebral foramina visualized on the lateral projection of the L-spine?
    No because of its obliquity you see them better on the oblique projection.
  152. Which AEC chambers should you use for the lateral l-spine?
    Center pod
  153. What position is the patient in for the L5-S1 lateral projection?
    Lateral recumbent
  154. What is another name for the L5-S1 lateral projection?
    The spot
  155. If possible, how should the legs be positioned for the spot projection?
    Extended the legs and superimpose the knees
  156. Where should you place a sponge for the spot projection to try and get the spine into a horizontal position?
    Under the lower thorax
  157. What is the respiration phase for the spot projection?
    Suspend
  158. Where is the central ray angled for the spot projection?
    2" posterior to ASIS and 1 1/2" inferior to crest
  159. If using a sponge does not help with getting the spine horizontal, what other technique could be used?
    Angle the tube 5-8* caudal
  160. Francis identified another method to demonstrate the L5-S1 joint space, what is it?
    Draw an imaginary line between the two crests (iteriliac plane) and adjust the central ray angulation to be parallel with it.
  161. The AP Oblique projections should demonstrate which joints?
    Z joints
  162. With the patient in the RAO position, which Z Joints are being demonstrated on an oblique l-spine?
    Left side (farthest)
  163. True or false: the patient may be in either an upright or supine position for the AP oblique l-spine?
    True
  164. How much should you rotate the patient on an oblique l-spine?
    45*
  165. On which plane does the spine lie for the oblique projection of the l-spine?
    2" medial to ASIS
  166. How much should you rotate the patient to demonstrate the Z joint of L5-S1 in an oblique projection (not lateral!)?
    As much as 60*
  167. What is the respiration phase for the AP Oblique projection of the l-spine?
    Suspend on expiration
  168. Where is the central ray directed for the oblique l-spine?
    2" medial to ASIS and 1 1/2" above crest
  169. Where should you direct the central ray for the oblique l-spine of the 5th Z joint?
    2" medial to ASIS and up to a point midway between ASIS and Crest
  170. What does the ear of the "Scottie Dog" represent?
    Superior articular process
  171. What does the nose of the "Scottie Dog" represent?
    Transverse process
  172. What does the eye of the "Scottie Dog" represent?
    pedicle
  173. What does the collar of the "Scottie Dog" represent?
    Pars interarticularis
  174. What does the body of the "Scottie Dog" represent?
    lamina
  175. What does the leg of the "Scottie Dog" represent?
    Inferior articular process
  176. What is another name for the AP or PA axial projection of the lumbosacral junction and SI joints?
    Ferguson method
  177. How should the lower limbs be positioned for the Ferguson method?
    Extended or you can abduct the thighs
  178. What is the respiration for the Ferguson method?
    Suspend
  179. Ferguson originally recommended a ____ degree angle but it has been modified and now we use __-__ degrees ______ for the AP projection.
    45*; 30* for males-35* for women cephalad
  180. Where do you direct the central ray?
    1 1/2" above pubic symphysis
  181. If the patient is in the prone position how would you direct the central ray?
    35* caudal entering the spinous process of L4
  182. For the AP Oblique projection of the SI joints which side, CLOSEST OR FARTHEST, is being demonstrated?
    Farthest
  183. How much do you rotate the patient for the AP Oblique projection of the SI joints?
    25-30*
  184. Align the body so that a sagittal plane passing ___" medial to the ASIS of the ______ side of the patient is centered to the midline of the grid. (AP Oblique projection of the SI joints)
    1"; elevated
  185. Where should you center the IR for AP Oblique projection of the SI joints?
    At level of ASIS
  186. What is the respiration phase for the AP Oblique projection of the SI joints?
    Suspend
  187. Where should you direct the central ray?
    Perpendicular entering 1" medial to elevated ASIS
  188. If you were to use an axial angle for an AP Oblique of the SI joints how much and in which direction would you use? Where would you center the central ray?
    20-25* cephalad entering 1" medial and 1 1/2" distal to ASIS
  189. For the AP or PA axial projections of the sacrum and coccyx where should you place the hands?
    Flex elbows and place the hands on the chest.
  190. Can women be shielded for the axial projections of the sacrum/coccyx?
    No
  191. What is the respiration phase for the axial projections of the sacrum/coccyx?
    Suspended
  192. When the patient is in the supine position where do you direct the central ray for the axial projection of the sacrum?
    15* cephalad entering 2" superior to pubic symphysis
  193. With the patient in the prone position where do you direct the central ray for the axial projection of the sacrum?
    15* caudal entering at the clearly visible sacral curve
  194. When the patient is in the supine position where do you direct the central ray for the axial projection of the coccyx?
    10* caudal entering 2" superior to pubic symphysis
  195. With the patient in the prone position where do you direct the central ray for the axial projection of the coccyx?
    10* cephalad entering the coccyx
  196. Why do you use an angle for the sacrum and coccyx?
    To purposely elongate them.
  197. Which side should you have the patient laying on for the lateral sacrum/coccyx?
    The indicated side (affected side?)
  198. How are the legs positioned for the lateral sacrum/coccyx?
    Flex hips and superimpose the knees
  199. What is the respiration phase for lateral sacrum/coccyx?
    Suspend
  200. Where is the central ray directed for the lateral sacrum?
    Perpendicular 3 1/2" posterior to ASIS
  201. Where is the central ray directed for the lateral coccyx?
    Perpendicular 3 1/2" posterior and 2" inferior to ASIS
  202. What scale of contrast should be seen with all sacrum/coccyx views?
    Short scale
  203. The PA projection of the thoracolumbar region (which is a scoliosis projection) is also called what?
    Ferguson
  204. What is the bony thorax formed by?
    12 ribs, 12 thoracic vertebrae, and the sternum
  205. What is the purpose of the bony thorax?
    The enclose and protect the heart and lungs
  206. Which end, top or bottom, of the thorax is narrower?
    Top
  207. The sternum is also called the _____?
    Breastbone
  208. What type of bone is the sternum?
    Flat
  209. How long is the sternum?
    6 inches
  210. How many parts of the sternum are there? Name them?
    3; Manubrium, body, xiphoid process
  211. What does the sternum support at the superior manubrial angles?
    Clavicles
  212. How many ribs attach directly to the sternum?
    7
  213. What is the widest portion of the sternum?
    Manubrium
  214. What is the depression on the superior border of the Manubrium called?
    Jugular notch
  215. What is the longest part of the sternum? How long is it?
    The body, it is 4 inches long
  216. The Manubrium joins the sternal body at what articulation?
    Sternal angle
  217. The sternal angle lies at what vertebral level?
    T4-T5 interspace
  218. This process is cartilaginous in the early stages of life but ossifies later in life. It is also the smallest portion of the sternum.
    Xiphoid process
  219. This portion of the sternum deviates slightly from the midline of the body.
    Xiphoid process
  220. At what level does the xiphoid process lie?
    T10 (remember that X is the roman numeral for 10)
  221. The xiphoid process is a useful landmark in locating what organs?
    Superior border of the liver and the inferior border of the heart.
  222. How many ribs are there in a normal body?
    12
  223. True or False:: The ribs are numbered according to what vertebrae they are attached to.
    True
  224. What type of bone are the ribs?
    Flat
  225. Ribs attach to the sternum by a piece of _______ cartilage.
    Hyaline
  226. Which ribs attach directly to the sternum?
    1-7
  227. How do ribs 8-10 attach anteriorly?
    Through the costal cartilage of the 7th rib
  228. What are the first seven ribs called?
    True ribs
  229. Which ribs are false?
    8-12
  230. Which ribs are floating?
    11-12
  231. Why are the last 2 ribs considered floating?
    Because they do not articulate anteriorly
  232. The ribs are situation on an oblique plane so that their anterior ends sit ____ inches below the level of their vertebral ends.
    3-5"
  233. What are the spaces b/w ribs called?
    Intercostal space
  234. Where do cervical ribs attach?
    C7
  235. Lumbar ribs are often confused as what?
    Fractured transverse process of the L1 vertebrae
  236. True or False:: The first rib is the shortest and narrowest.
    False; the first rib is the shortest and widest
  237. Which rib would be the longest?
    7th
  238. Which rib would be the narrowest?
    12th
  239. A typical rib consists of what?
    Head, neck, tubercle, and body
  240. Ribs have facets on their heads for articulation with the ________.
    Vertebral body.
  241. What is the articulation between the vertebral body and the head of the rib called?
    Costovertebral joint
  242. The tubercle of the rib has a facet for articulation with the _________.
    Transverse process
  243. What is the articulation between the tubercle of the rib and the transverse process of the rib called?
    Costotransverse joints
  244. Which vertebrae do not have a tubercular facets or neck?
    11 and 12
  245. Each rib has a costal groove located on the _____ _____ border. It contains _____, ____, and _____.
    Inferior, internal border. It contains arteries, veins, and nerves.
  246. How many joints are there in the bony thorax?
    8
  247. Which joints are the only point of articulation between the upper limbs and the trunk?
    SC Joints
  248. The sternocostal and costochondral joints are classifies as what?
    Cartilaginous, synchondroses immovable joints.
  249. Which ribs only articulate with 1 vertebral body?
    1, 10, 11, 12
  250. On deep inspiration the anterior ends of the ribs are carried __________, while the necks are rotated _____.
    Anterior ends are carried anteriorly, superiorly, and laterally. The necks are rotated inferiorly.
  251. On deep expiration the anterior ends of the ribs are carried __________, while the necks are rotated _____.
    Anterior ends are carried inferiorly, posteriorly, and medially. The necks are rotated superiorly.
  252. In which body habitus does the diaphragm sit at a higher level?
    Hypersthenic
  253. For sthenic patients the diaphragm sits at what level?
    Posteriorly at 6th or 7th costal cartilage to the level of 9th or 10th thoracic spine when in upright pos.
  254. Which side of the diaphragm sits at a lower level?
    Left
  255. The diaphragm reaches its highest level when the patient is in what position?
    Supine-( lowest when they are upright)
  256. Rib injuries are painful, even minor ones; therefore you should exam the patient in which position?
    The position in which they come in.
  257. Why is it important to have women with large breasts tape them back for the lateral sternum?
    b/c the breast tissue will interfere with the inferior portion of the sternum (xiphoid process)
  258. When doing the PA oblique projection of the sternum which patient position should you use and why?
    RAO- to use the heart shadow for contrast
  259. What is the recommended SID for the RAO sternum?
    30"- to blur posterior ribs
  260. What is the average rotation of the patient in the RAO position?
    15-20*
  261. What should be centered to the grid for the RAO sternum?
    The sternum
  262. Where should the top of the IR be placed for the RAO sternum?
    1 1/2" above jugular notch
  263. What is the respiration phase for the RAO sternum?
    Slow shallow breathing or suspend on expiration
  264. In a trauma situation the patient is brought in on a back board, and the doctor orders an oblique sternum. Which patient position would be suitable in this scenario?
    LPO or AP and angle the tube medially
  265. Where is the CR directed for the RAO sternum?
    Entering the elevated side @ T7 approx 1" lateral to midsagittal plane
  266. What is the SID for the lateral sternum?
    72"
  267. True or False:: The patient may be sitting or standing for the lateral sternum?
    true
  268. Describe how you should position the patient's arms for the lateral sternum?
    Have the patient lock their hands behind their back; or above the head for recumbent positions
  269. Where should the top of the IR be placed for the lateral sternum?
    1 1/2" above jugular notch
  270. For a lateral projection of just the SC joints where should you center the IR?
    At the level of jugular notch (use an 8x10 portrait)
  271. What is the respiration phase for the lateral sternum?
    Suspend on deep inspiration
  272. Where should the CR enter the patient for the lateral sternum?
    The lateral border of the sternum
  273. True or False:: The SC joints should be superimposed on the lateral sternum projection
    True
  274. What is the difference between the upright and recumbent lateral sternum?
    You should have the patient put their hands above their head instead of behind their back for the recumbent position.
  275. Can you use a cross table projection to obtain a lateral sternum?
    Yes
  276. What is the recommended patient position for the PA projection of the SC joints?
    Prone
  277. Where should you center the IR for the PA projection of the SC joints?
    At the level of the spinous processes of T3
  278. How should you place the arms for this projection for the PA proj of SC joints?
    At the patients sides
  279. For a bilateral projection of the SC joints how should you position the patients head?
    Rest the head on the chin
  280. For a unilateral proj. of the SC joints how should you position the patients head?
    Turn the head to face the affected side and rest the cheek on the table.
  281. What is the benefit of turning the head towards the affected side?
    Turning the head toward the affected side turns the spine slightly away from the side being examined thus allowing better visualization.
  282. What is the respiration phase for the SC joints?
    Suspend on expiration
  283. Where is the CR for the SC joints?
    Midsag @ T3
  284. What should be demonstrated on the SC joints?
    SC joints and medial portion of the clavicles
  285. What patient position should you use for the PA oblique projection of the SC joints?
    RAO and LAO
  286. The PA oblique projection of the SC joints is also called what?
    Body rotation
  287. What size IR should you use for all sternum projections?
    8x10
  288. Which side should be closest to the IR for the oblique proj of the SC joints?
    Affected side
  289. How much should you rotate the patient for the oblique SC joints?
    10-15*
  290. True or false:: The shoulders should be on the same plane for the oblique proj?
    True
  291. What is the respiration phase for the oblique proj of SC joints?
    Suspend on expiration.
  292. Where is the CR directed for the oblique proj of the SC joints?
    Perp to the SC joint closest to the IR. CR enters T2-T3 & 1-2" lateral from MSP.
  293. If the CR enters the right side, which SC joint is being demonstrated?
    Left; and vice versa
  294. Instead of using the body rotation method how else could you get an oblique projection of the SC joints?
    Place patient in prone position and angle tube 15* toward MSP
  295. What size IR should you use for most projections of the ribs?
    14x17
  296. True or false:: patients can be upright or recumbent for projections of the ribs.
    True
  297. If the patient is complaining of pain on anterior ribs which patient position should you use? Posterior ribs?
    PA; AP
  298. The axillary portion of the ribs is best demonstrated on which projection?
    Obliques
  299. Why would you need to use a lateral projection of the ribs?
    To demonstrate air/fluid levels
  300. Which positions would the ribs be free from superimposition of the heart?
    LAO or RPA
  301. What scale of contrast would you want for the ribs?
    Short scale
  302. What IR orientation should be used for the upper ribs?
    Portrait
  303. What IR orientation should be used for the lower ribs?
    Transverse
  304. Where should the top of the light be placed for the upper ribs?
    1 1/2" above the shoulders
  305. When taking unilateral projections of the ribs what size IR should you use?
    11x14 or 30x35 cm
  306. What is the respiration phase for the upper ribs?
    Suspend on inspiration
  307. Where is the CR directed for the upper ribs?
    Enters @ T7
  308. What is a useful technique for demonstrating 7-9 ribs?
    Angle tube 10-15* caudal
  309. Which projection would best demonstrate the anterior ribs above the diaphragm?
    PA(pg 489 the posterior ribs will be seen but the anterior ribs are seen in better detail b/c they are closer to the IR)
  310. The AP proj of the ribs will better demonstrate which ribs?
    Posterior ribs
  311. When the patients position permits how should you position the patient for images of ribs above the diaphragm? Below the diaphragm? (this is true for both PA/AP proj and obliques)
    Upright; recumbent
  312. What is the respiration phase for the lower ribs?
    Suspend on expiration
  313. Where should the lower edge of the IR be placed for images of the lower ribs?
    At crest
  314. How much do you rotate the patient for the axillary proj of the ribs?
    45*
  315. True or false: It doesn't matter where the patient's arms are positioned for proj of the ribs?
    False; they need to be out of the way
  316. The digestive system consists of the ____ and certain _____?
    Alimentary tract and certain accessory organs.
  317. How many and what are the accessory organs?
    The teeth, salivary glands, and the liver and pancreas.
  318. What is the largest gland in the body?
    The liver.
  319. What divides the liver into right and left lobes?
    The falciform ligament
  320. Two minor lobes are located on the _____ side of the right lobe, and what are they called?
    Medial side, which are called the caudate and quadrate lobe.
  321. What is the hylum of the liver called, and where is it located?
    The porta hepatis is located transversely between the two minor lobes.
  322. The _____ and the _____, which convey blood to the liver, enter the porta hepatis and branch out through the liver substance.
    The portal vein and the hepatic artery.
  323. The portal vein ends in the _____, and the hepatic artery ends in the _____ that communicate with _____.
    Sinusoids, capillaries, that communicate with sinusoids.
  324. The liver also receives blood from the _____.
    The portal system.
  325. The portal system consists of veins arising from _____.
    The walls of the stomach, the greater part of the gi tract, the gallbladder, pancreas, and spleen.
  326. What carries blood from the liver to the inferior vena cava?
    The hepatic veins through the liver sinusoids.
  327. How much bile does the liver create each day?
    1-3 pints.
  328. What is bile responsible for?
    The digestion of lipids. (fats)
  329. The two hepatic ducts emerge from the _____.
    Porta hepatis.
  330. Hepatic and cystic ducts are approximately how long?
    1 1/2"
  331. The hepatopancreatic ampulla opens on an elevation known as the _____.
    The major duodenal papilla.
  332. The gallbladder functions to concentrate the bile by absorbing the _____.
    The water content.
  333. The muscle contraction of the gallbladder is controlled by _____.
    Cholecystokinin.
  334. The broad lower aspect of the gallbladder is termed the _____.
    The fundus.
  335. The gallbladder sits in a depression on the posterior aspect of the liver called the _____.
    The gallbladder fossa.
  336. What body habitus would the gallbladder be low and near the spine?
    Asthenic
  337. What are the four parts of the pancreas?
    The head, neck, body, and the tail.
  338. Which end is proximal to the hepatopancreatic duct?
    The head of the pancreas
  339. What vertebral level does the head of the pancreas lie?
    L2 or L3
  340. The pancreas is both a _____ and _____ type of gland.
    Exocrine gland and endocrine gland.
  341. What is produced by the exocrine portion?
    Pancreatic juices.
  342. What is produced by the endocrine function?
    Insulin and glucagon.
  343. The endocrine portion of the gland consists of _____ cells.
    Islet cells, otherwise known as islets of langerhans.
  344. The islet cells releases its glucagon and insulin secretions through _____ and not through the _____.
    Capillaries, not through the pancreatic duct.
  345. What body system is the spleen part of?
    The lymphatic system.
  346. AAA stands for what?
    Abdominal aortic aneurysm.
  347. ERCP stands for what?
    Endoscopic retrograde cholangiopancreatography.
  348. NPO means what?
    Nothing by mouth, or nil per os
  349. PTC stands for what?
    Percutaneous transhepatic cholangiography
  350. RUQ stands for what?
    Right upper quadrant
  351. Why would you perform a left lateral decubitus instead of a right lateral decub? (abdominal)
    The stomach lies on the left side, and would obscure any peritoneal free air.
  352. Where does the abdominal cavity extend from?
    The diaphragm to the superior aspect of the bony pelvis
  353. What organs does the abdominal cavity contain?
    Stomach, small and large intestine, liver, gallbladder, spleen, pancreas and kidneys
  354. What organs does the pelvic cavity contain?
    Rectum, sigmoid of the large intestine, urinary bladder, and the reproductive organs.
  355. The abdominopelvic cavity is enclosed in a double-walled seromembranous sac called what?
    Peritoneum
  356. What is the outer portion of this sac called?
    Parietal peritoneum
  357. What is the inner portion of the sac called?
    Visceral peritoneum
  358. The peritoneum forms folds called what?
    Mesentery and omenta
  359. What is the space called between the two layers of the peritoneum?
    Peritoneal cavity
  360. What is the retroperitoneum?
    The cavity behind the peritoneum
  361. What is the largest gland in the body?
    Liver
  362. The liver is divided into two lobes at what?
    Falciform ligament
  363. What portions convey blood to the liver?
    The portal vein and the hepatic artery
  364. What does the liver produce?
    Bile
  365. What does the biliary system of the liver consist of?
    The bile ducts and gallbladder
  366. What do the two main hepatic ducts emerge to form?
    Common hepatic duct
  367. What forms the common bile duct?
    Common hepatic duct and cystic duct
  368. What do the common bile duct and pancreatic duct enter into?
    Hepatopancreatic ampulla or ampulla of vater
  369. What is the hepatopancreatic ampulla controlled by?
    Sphincter of the hepatopancreatic ampulla or sphincter of oddi
  370. The muscle contraction of the gallbladder is activated by what hormone?
    Cholecystokinin
  371. Where is the gallbladder located?
    Lodged in a fossa on the inferior surface of the right lobe of liver
  372. What are the parts of the pancreas?
    Head, neck, body, and tail
  373. What do the exocrine cells of the pancreas produce?
    Pancreatic juice
  374. What does the endocrine portion of gland consist of?
    Islet cells
  375. What do the islet cells produce?
    Insulin and glucagon
  376. What is the function of the spleen?
    Produce lymphocytes and store and remove dead or dying RBC
  377. Where is the spleen located?
    Left upper quadrant, below diaphragm and behind the stomach
  378. The cystic duct enables bile from the liver to be stored where?
    Gallbladder
  379. What organ lies in the duodenal loop?
    Pancreas
  380. What is the name of the main bile duct that leads directly from the liver?
    Hepatic ducts
  381. What is the name of the duct that transports bile from the gallbladder?
    Cystic duct
  382. The digestive system consists of what two parts?
    The accessory glands and the alimentary canal.
  383. What are the four accessory glands?
    Salivary glands, liver, gallbladder, and pancreas.
  384. These glands secrete digestive enzymes where?
    The alimentary canal.
  385. The alimentary canal extends from where to where?
    The mouth to the anus.
  386. The esophagus is approximately how long and how wide?
    10 inches long, 3/4 inches in diameter.
  387. The esophagus and the rest of the alimentary canal has how many layers?
    Four.
  388. What are the layers, from the outside in?
    Fibrous (serous) layer, muscular layer, submucosal layer, mucosal layer.
  389. The esophagus lies in which body plane?
    The midsagittal plane.
  390. The esophagus originates where?
    C6
  391. The esophagus is posterior to the?
    Trachea and heart
  392. The esophagus passes inferiorly through the diaphragm at?
    T10
  393. Inferiorly the esophagus curves sharply in which direction?
    Left.
  394. The esophagus joins the stomach at what junction, and what level is it at?
    Esophogastric junction at T11 or the siphons tip.
  395. The expanded portion of the terminal esophagus is termed the what?
    Cardiac antrum.
  396. The stomach has how many parts?
    Four
  397. What are the 4 parts of the stomach?
    Cardia, fundus, body, pyloric portion.
  398. What part of the stomach is termed the gas bubble when the pt is upright?
    The fundus
  399. What part of the stomach descends from the fundus, starting at the cardiac antrum?
    The body
  400. The gastric folds of the stomach are termed what?
    Rugae.
  401. When the stomach is full, the rugae are?
    Smooth.
  402. The body of the stomach ends at a vertical plane passing through the what?
    Angular notch
  403. Distal to the plane of the angular notch is what portion of the stomach?
    The pyloric portion.
  404. Directly to the right of the angular notch where the bolus passes is the what?
    Pyloric canal and pyloric sphincter.
  405. The stomach has what two surfaces?
    Anterior and posterior surfaces.
  406. The right border of the stomach is called what?
    The lesser curvature.
  407. The left border is called what?
    The greater curvature.
  408. The greater curvature starts at what part of the stomach?
    The cardiac notch.
  409. The greater curvature is how many times longer than the lesser curvature?
    4 to 5 times longer.
  410. The entrance and exit to the stomach are controlled by what?
    A sphincter.
  411. The connection between the stomach and the small intestine is termed what?
    The pyloric orifice.
  412. What muscle controls the pyloric orifice?
    The pyloric sphincter.
  413. The stomach is horizontal and high in what body habitus?
    Hypersthenic.
  414. The stomach is vertical and low in what body habitus?
    Asthenic
  415. sthenic and hyposthenic habitus' accounts for what percentage of the population?
    85%
  416. The small intestine extends from the _____ to the _____.
    The pyloric sphincter to the ileocecal valve.
  417. What is the average length of the adult small intestine?
    22 feet.
  418. The proximal diameter of the small intestine is _____. The distal diameter is _____.
    1 1/2"; 1"
  419. The wall of the small intestine contains _____ layers?
    4
  420. The mucosa of the small intestine contains a series of projections called _____?
    Villi
  421. The small intestine is divided into what three portions?
    The duodenum, the jejunum, and the ileum.
  422. The duodenum is _____ to _____ inches in length?
    8 to 10
  423. What is the widest portion of the small intestine?
    Duodenum
  424. How many regions of the duodenum are there?
    4
  425. What is the name of the first duodenal region?
    Duodenal bulb
  426. In what region in the duodenum is the hepatopancreatic ampulla?
    The second
  427. The common bile duct and the pancreatic duct unite to form the _____.
    Hepatopancreatic ampulla.
  428. The fourth region of the duodenum joins the jejunum at the _____.
    Duodenaljejunal flexure
  429. The upper two fifths of the small bowel is called the _____.
    Jejunum
  430. The lower three fifths of the small bowel is called the _____.
    Ileum
  431. The most fixed part of the small intestine is the _____.
    The duodenum
  432. The jejunum and the ileum are gathered into freely movable loops called _____.
    Gyri
  433. The small bowel is attached to the posterior wall of the abdomen by the _____.
    Mesentery
  434. The large intestine begins in what abdominal region?
    Inguinal
  435. The large intestine has how many main parts?
    4
  436. The 4 main parts of the large intestine are the _____, _____, _____, and _____.
    Cecum, colon, rectum, anal canal.
  437. The large intestine is _____ long.
    5 feet
  438. The external band of muscle on the large intestine is the _____.
    Taeniae Coli
  439. How many bands of taeniae coli are there?
    One anteriorly and two posteriorly.
  440. Taenia Coli form a series of pouches called the _____.
    Haustra
  441. The large intestine is responsible for the elimination of waste and for _____.
    Absorption of fluids.
  442. The proximal pouch like portion of the large intestine is the _____.
    Cecum
  443. The _____ is attached to the posteromedial side of the cecum.
    Appendix
  444. The junction of the cecum and the ileum is the _____.
    Ileocecal valve
  445. The cavity within a tube is termed the _____.
    Lumen
  446. The colon is divided into what four portions?
    Ascending, transverse, descending, sigmoid.
  447. The ascending colon is between _____ and _____.
    The cecum and the hepatic flexure
  448. The transverse colon is between the _____ and _____.
    The hepatic flexure and the splenic flexure.
  449. The descending colon is between _____ and _____.
    The splenic flexure and the sigmoid colon.
  450. The sigmoid colon ends in the _____.
    Rectum
  451. The rectum extends from the sigmoid colon to the _____.
    Anal canal
  452. Just above the anal canal is a dilation called the _____.
    Rectal ampulla
  453. The anal canal terminates at the _____.
    Anus
  454. The rectum and anal canal have _____ AP curves.
    Two
  455. _____ is contraction waves of the digestive tube.
    Peristalsis
  456. How many waves occur in the stomach per minute.
    3 to 4
  457. The average emptying time of a normal stomach is _____.
    2 to 3 hours
  458. Contractions in the duodenum and jejunum occur at intervals of _____ during digestion.
    3 to 4 seconds.
  459. A barium meal normally reaches the ileocecal valve in _____.
    2 to 3 hours
  460. _____ radiography makes it possible to observe the alimentary canal in motion.
    Fluoroscopic
  461. The contrast medium universally used in examinations of the alimentary canal is _____.
    Barium Sulfate.
  462. Barium sulfate is available as _____ and _____.
    Dry powder and liquid.
  463. In addition to barium sulfate, _____ is also used.
    Water soluble iodinated contrast media.
  464. If water-soluble contrast escapes into the peritoneum what ill effects result.
    No ill effects
  465. A disadvantage of iodinated preparations is their _____.
    Strongly bitter taste
  466. A common compression device is a _____.
    Compression paddle
  467. One of the most important considerations in gastrointestinal radiography is the elimination of _____.
    Motion.
  468. The highest degree of motor activity is normally found in _____ and _____.
    Stomach and proximal small intestine.
  469. Narcotics, respiration, body position and pathologic changes can affect _____.
    Peristaltic speed
  470. The esophagus may be examined by performing a _____ study.
    Single/double contrast.
  471. When using fluoroscopy to view the esophagus using a double contrast study, _____ and _____ are the 2 contrast agents.
    High-density barium and CO2 crystals.
  472. What weight to volume suspension should be used for the single contrast technique of the esophagus?
    30-50%
  473. How many steps are in the single contrast esophagus?
    3
  474. For single contrast exams of the esophagus what position does the patient start out in.
    upright.
  475. For single contrast exams of the esophagus what is the second position is _____.
    Horizontal or Trendelenburg
  476. For the single contrast exam of the esophagus what is the 3rd position is _____.
    Upright drinking barium.
  477. Foreign bodies lodges in the _____ and _____ can normally be demonstrated without contrast media.
    Pharynx and upper part the esophagus
  478. What are the projections for the esophagus?
    AP/PA, obliques and lateral
  479. What are the projections for the stomach and duodenum?
    PA/AP, PA axial, PA/AP oblique, lateral
  480. What are the projections for small intestine?
    PA/AP
  481. What are the projections for large intestine?
    PA/AP, PA/AP Axial, obliques, lower lateral, AP/PA decub
  482. What size IR is used for esophageal studies?
    14x17 portrait
  483. Where is the IR centered for all esophageal studies?
    T5-T6
  484. What is the patient position for the oblique esophagus?
    RAO or LPO
  485. The body forms and angle of _____ degrees from MSP, when performing oblique esophageal studies.
    35-40*
  486. For the RAO position of the esophagus, how should you position the patient's arms?
    The right arms should be down at the patient's side the left arm should be resting on the pillow (For the LPO position the left arm will be down and right up)
  487. For the oblique study of the esophagus, center the elevated size black inches lateral to MSP.
    2"
  488. Why is the recumbent position preferred over the upright position for the esophageal exams?
    The contrast will flow against gravity making the images have better contrast.
  489. The contrast filled esophagus should be demonstrated from _____ to _____.
    Lower part of neck to esophogastric junction.
  490. What should the esophagus be superimposed over in the AP/PA projection?
    The t-spine
  491. The lesser curvature starts at the esophogastric junction and ends at the what?
    Pylorus

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