RDSC 233 Mid-term Review
The following slides highlight the information covered through the unit on
the colon.
1.
2.
3.
4.
5.
Terminology from the units
Review questions with answers
Index of pathology from each unit
Technique factors from each unit
Images
Abdomen:
distention
flatulence
flank stripes
mass
arteriosclerosis
free air
air fluid levels
anomaly
fecal stasis
peritonitis
adhesions
volvulus
intussusception
aerophagia
eructation
vena cava filter
pulmonary embolism
Chest:
nasogastric (NG) tube
endotracheal (ET) tube
SOB
dyspnea
angina
sputum
hemoptysis
fibrile/afibrile
aspiration
chronic/acute
heart mummer
hyaline membrane disease
empyema
thoracocentesis
pneumonectomy
rales
interstitium
pulmonary edema
subcutaneous emphysema
Kerely B lines
cardiomegaly
neoplasm
benign
malignant
crepitant
situs inversus
tracheostomy
UGI:
non per os (NPO)
contraindication
fistula
collodial suspension
MI
N/V
hematemesis
retrogastric space
motility series
enteroclysis
intubation
valsalva maneuver
reflux
trendelenburg position
asymptomatic
Menkel’s diverticulum
Single contrast colon:
cathartic
purgative
proctology
proctoscopy
Air contrast colon:
colonoscopy
stenosed (stenosis)
Sims position
adenoma
guaiac test
sessile
occult blood
villous
familial
pedunculated
sepsis
carcinoma
septacemia
cytologic
differentiated
metastasis
enteritis
inflammatory bowel disease
colitis
Quiz Questions
Name the 9 regions
of the abdomen
and pelvis
1
4
7
2
5
8
3
6
9
Y ( if needed to see) or N
What can be visualized
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Gas?
Urine?
N
Y
N
N
Spleen
Gallbladder
Adrenal glands
Stomach
Veins
kidneys
Colon (gas)
bladder
Pancreas
Ureters
Liver
Sm. Bowel
Y
Y
What is normally visible
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Spleen
Y
Gallbladder
N
Adrenal glands N
Stomach
Y
Veins
N
kidneys
Y
Colon (gas)
Y
bladder
Y
Pancreas
N
Ureters
N
Y ( if needed to see) or N
Gas?
Urine?
N
N
N
Y
N
N
Y
N
N
N
N
N
N
N
N
N
N
Y
N
N
Abdomen Positioning
20. What anatomical landmark is used
to center (longitudinally) a KUB
film? And to what part of film
(top, center, bottom)
21. What anatomical landmark is used
to center (longitudinally) an upright
of the abdomen? And to what part
of film (top, center, bottom)
22-24. What 3 conditions can be
demonstrated on the upright
abdomen, in addition to what
can be demonstrated on the
supine KUB? (Two are shown
here).
Abdomen Positioning
20. What anatomical landmark is used to center
(longitudinally) a KUB film? And to what part of
film (top, center, bottom)
Iliac Crest, center
21. What anatomical landmark is used to center
(longitudinally) an upright of the abdomen? And
to what part of film (top, center, bottom)
Axilla, top
22-24. What 3 conditions can be demonstrated on
the upright abdomen, in addition to what
can be demonstrated on the supine KUB?
(Two are shown here).
Air fluid levels
Free air in the abdomen (pneumoperitoneum)
Ptosis
Radiographic Anatomy
of PA Chest
30
25
28
26
27
31
29
Radiographic Anatomy
of PA Chest
30 Hilum of
Lt lung
25 Lung markings
26 Rt.
Pulmonary a.
28
Aortic
knob
27 Rt
cardiophrenic
angle
31 Lt costophrenic
angle
29 Dome of the Rt
hemidiaphragm
Define:
1
32.
33.
34.
35.
dyspnea
angina
sputum
fibrile
Short answer:
36. How many ribs must be demonstrated
on an inspiration PA CXR, and is it
anterior or posterior ribs that are
counted?
Define:
32. dyspnea – difficulty breathing
33. angina – chest pain (lt arm, neck)
34. sputum – pus/debris from deep in bronchial
tree & alveoli
35. fibrile - fever
Short answer:
36. How many ribs must be demonstrated
on an inspiration PA CXR, and is it
anterior or posterior ribs that are
counted? 10, posterior
Review of
PA Film
Critique
On all films
Patient ID
Rt or Lt marker
Contrast & density
Motion
Artifacts
PA chest criteria
37.
38.
39.
40.
41.
Review of
PA Film
Critique
On all films
Patient ID
Rt or Lt marker
Contrast & density
Motion
Artifacts
PA chest criteria
37. Clipping
38. Inspiration
39. Rotation
40. Scapula free
of lung fields
41. Penetration of
mediastinum
42. Name this position
43. If only a tube angle is used
to accomplish it, what is
the degree and direction
of the CR?
44. Name this position
45. What pathological condition
would be demonstrated
on the up side?
46. What pathological condition
would be demonstrated on
the down side?
42. Name this position
Apical lordotic (lordotic chest)
43. If only a tube angle is used
to accomplish it, what is
the degree and direction
of the CR? 15-200 cephalad
44. Name this position (Rt) lateral
decubitus
45. What pathological condition
would be demonstrated
on the up side? Pneumothorax
46. What pathological condition
would be demonstrated on
the down side? Pleural effusion
48.
47. In which body habitus
would the stomach lie in
this extreme transverse
position?
50.
49.
48. 2nd or
descending
part of d.
47. In which body habitus
would the stomach lie in
this extreme transverse
position? hypersthenic
50. Greater
curvature of s.
49. pyloric antrum
51. What is the atomic number of barium?
52. True or false: Barium is Insoluble in water.
53. Is this film AP,
PA, or RAO?
54. Is this film AP,
PA, or RAO?
55. Is this film AP,
PA, or RAO?
56. What is the range of obliquity for an RAO stomach?
57. What body habitus requires the steepest obliquity?
51. What is the atomic number of barium? 56.
52. True or false: Barium is Insoluble in water. True
53. AP
54. PA
55. RAO
56. What is the range of obliquity for an RAO stomach? 40700
57. What body habitus requires the steepest obliquity?
Hypersthenic
58. “Rule out MI” is sometimes given as the reason for an UGI.
What is an MI?
59. What UGI projection best demonstrates the retrogastric space?
60. What is the range of obliquity for the LPO position of the stomach?
61. Name one reason that barium would be contraindicated for
use in the GI tract.
62. The spot film shown here is
generally taken as the film of
what examination?
58. “Rule out MI” is sometimes given as the reason for an UGI.
What is an MI? Myocardial infarction, or heat attack.
59. What UGI projection best demonstrates the retrogastric space?
Rt lateral
60. What is the range of obliquity for the LPO position of teh stomach?
30-600
61. Name one reason that barium would be contraindicated for
use in the GI tract. Perforated bowel, post surgical, or, obstruction
62. The spot film shown here is
generally taken as the film of
what examination?
Small bowel series (SBS)
Small bowel follow through (SBFT)
Motility series
Radiographic Anatomy
of the colon
63.
64. The folds that
create the
characteristic
appearance of the
colon
67
66
65.
68
Radiographic Anatomy
of the colon
63. Hepatic (Rt. colic) flexure
64. Haustra (haustral
folds, haustrations)
67. Descending c.
66. Terminal ileum
65. Cecum
68. Rectum
69. Other than laxative, what other name is given a medicinal
preparation that stimulates the bowel to evacuate, and is so
used for a bowel prep? (2 possibilities)
70. What is the name of the position used for enema tip insertion?
71. Is this position a steep RAO, LAO, RPO, or LPO?
72. Approximately how high above the table should be barium
bag be hanging?
73. The terms septic and sepsis refer to:
a. infection
b. wall or division between parts
c. toxic chemicals
d. gangrene
69. Other than laxative, what other name is given a medicinal
preparation that stimulates the bowel to evacuate, and is so
used for a bowel prep? (2 possibilities) Cathartic or purgative
70. What is the name of the position used for enema tip insertion?
Sims
71. Is this position a steep RAO, LAO, RPO, or LPO?
LAO
72. Approximately how high above the table should be barium
bag be hanging?
2 feet
73. The terms septic and sepsis refer to:
a. infection
b. wall or division between parts
c. toxic chemicals
d. gangrene
74. Septacemia
75. Ileostomy, jejunostomy, colostomy
76. Stoma
77. Resection
78. Anastomosis
79. Glucagon
74. Septacemia – Pathogenic microorganisms in the blood.
75. Ileostomy, jejunostomy, colostomy – ostomy = a surgically formed fistula,
most commonly between intestine
and the abdominal wall. (vs. otomy =
surgical incision, vs. ectomy = removal)
76. Stoma – A mouth like artificial opening between two body cavities,
or a passageway between a cavity and a body surface
77. Resection – partial excision of a part.
78. Anastomosis – natural or surgical connection between two tubular structures
79. Glucagon – Hormone secreted by alpha cells of pancreas that stimulates
liver to change stored glycogen to glucouse. Parentaral
administration relaxes smooth muscles of alimentary tract.
Significant Pathologies or Pathologic Indicators
of the abdomen
and their
Radiographic Appearances
Mass
Institutional colon
Pneumoperitoneum
Ascites
Ileus
Significant Pathologies
of the lungs, thorax, and mediastinal structures
and their
Radiographic Appearances
Aneurysm
Pleural Effusion
Pneumothorax
Pneumoconiosis
Atelectasis
Granulomatous disease
Congestive heart failure
(CHF)
COPD (Bronchitis and
emphysema)
Significant Pathologies
of the upper gastrointestinal tract
and their
Radiographic Appearances
Thoracic stomach
Diverticula
Ulcerations
Significant Pathologies
of the colon
and their
Radiographic Appearances
Diverticulosis
Abdominal hernias
Tape worms
Polyps
Colorectal Cancer
Chron’s disease
Intussusception
Institutional colon
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 100 RS film, 12:1 grid, 40” SID
Abdomen/Pelvis
Frontal
(2 x cm) + 35 =kVp @ 50 mAs
Lateral
(4x frontal)
(AP + 10 kVp
@ 100 mAs
Oblique
(AP + 40% - 60% of frontal
technique
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 100 RS film, 40” SID
Maternal Abdomen
On occasion a radiograph of the pregnant
abdomen is ordered during labor, to check
for a breech presentation.
Every radiology department should
have at least one high speed
film/screen system for this purpose.
What is required in terms of kVp and
mAs?
High kVp (110 or higher), low mAs.
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 400 RS film, 40” SID
Calculate a maternal abdomen
technique for a 35 cm measurement
1. (2 x 35) + 35 = 105 kVp @ 50 mAs
2. 40 mAs / 4 = 12.5 mAs (film speed)
3. 15% of 105 = 16.5 =
Answer 121 kVp @ 6 mAs
Critique critera: For presentation, only
gross anatomy need be visualized.
Maternal abdomen films are rarely
repeated.
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 100 RS film, medium speed screen, 72” SID
PA Chest:
Lat Chest:
2 x cm + 35 = kVp @ 5 mAs
PA kVP + 10
@ mAs x 2
Chest radiography may be done screen or grid, dependant on
department protocol and circumstance, e.g. surgical or portable.
When done screen
What must be set to use AEC?
Advantage is: lower kVp = greater contrast
Disadvantage is: lower kVp = less penetration1. kVp
When done grid
Disadvantage is: high kVp = less contrast
Advantage is: high kVp = greater penetration
2.
3.
4.
5.
mA
Chambers
Back up time
+ or – density
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 100 RS film, medium speed screen, 72” SID
Compute a technique for a double contrast, and single contrast
UGI for a 26 cm abdomen in an AP position, using 400 RS system
1. (2 x 26) + 35 = 87 kVP @ 50 mAs
2. 50 mAs / 4 (RS) = 87 kVp @ 12.5 mAs (Double contrast)
3. 87 + 13 = 100 kVp @ 6 mAs (Single Contrast)
Now put the patient in an RAO (single contrast)
Up AP technique by 40 – 60 % = 108 kVp at 6 mAs
Now put the patient in a right lateral (double contrast)
Up AP kVp by 10, double mAs = 97 kVp @ 25 mAs
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 100 RS film, 40” SID, 12:1 grid
Colon: Use computation for abdomen, except, kVp above 100 for barium
Problem: For a patient with an AP diameter of 25 cm at the level of
the umbilicus, using a 400 RS screen/film combination,
what techniques would be used for:
AP
Oblique
Axial sigmoid views
& Lateral rectum
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 100 RS film, 40” SID, 12:1 grid
Problem: For a patient with an AP diameter of 27 cm at the level of
the umbilicus, using a 400 RS screen/film combination,
what techniques would be used for:
AP
89 kVp @50
(KUB technique)
89 kVp @12.5
(400 RS)
103 kVp @12.5
(15% rule to increase kVp)
Oblique
103 kVp @19
120 kVp @ 12.5
(50% increase taken in mAs) or
(50% increase taken in kVp)
Exposure Factors
From the “Rules of Thumb”
Based on: 3 phase, 100 RS film, 40” SID, 12:1 grid
Problem: For a patient with an AP diameter of 27 cm at the level of
the umbilicus, using a 400 RS screen/film combination,
what techniques would be used for:
Axial sigmoid is same as oblique technique
103 kVp @19
120 kVp @ 12.5
(50% increase taken in mAs) or
(50% increase taken in kVp)
Lateral rectum
103 kVp @ 12.5 50
118 kVp @ 25 mAs
(AP technique)
(2 x kVp and 2 x mAs)
Note: for a KUB the kVp rule was
increase by 10, but that was in the
70-80 kVp range to start with.
Exposure Factors
From the “Rules of Thumb”
AEC is sometimes used for barium studies, and is usually successful.
When using AEC for barium studies the centering of the
chamber or chambers over solid barium or solid air will lead to
films that are too light or too dark.
Using multiple results in an average of the densities sampled, and
lessens the possibility of error.
Plus and minus density may be needed for some views