Procedures Chapter 13
What is the purpose of supporting the head on a radiolucent sponge for the trauma lateral projection (dorsal decubitus position) of the cranium?
Increases patient comfort
Reduces magnification
Helps ensure demonstration of the posterior portion of the cranium in the image
Absorbs blood from the patient's injuries
Helps ensure demonstration of the posterior portion of the cranium in the image
As a means of improving efficiency in trauma imaging, generally only the most critical projection is obtained for a procedure.
True
False
False
An efficient method of performing multiple imaging procedures on the same patient is to:
Move the tube in one direction (e.g., superiorly to inferiorly)
Refer the patient for a CT
Use the shortest possible exposure time
Use the largest image receptor size available and put more than one body part on each image
Move the tube in one direction (e.g., superiorly to inferiorly)
Which of the following patient status changes require immediate
notification of the ED physician?
(1) Cyanosis
(2)
Seizures
(3) Increasing abdominal distention
1 and 2 only
1 and 3 only
2 and 3 only
1, 2, and 3
1, 2, and 3
Which of the following duties are part of a trauma radiographer’s
responsibilities in the emergency department (ED)?
(1)
Interpreting images for the ED physician
(2) Obtaining quality
images efficiently
(3) Providing radiation protection
1 and 2 only
1 and 3 only
2 and 3 only
1, 2, and 3
2 and 3 only
What is the proper method for lifting an injured limb?
Lift the limb, supporting only the joint that is distal to the injury
Support the limb at the joints proximal and distal to the injury
Lift the limb, supporting only the joint that is proximal to the injury
Log-roll the patient
Support the limb at the joints proximal and distal to the injury
What anatomy should be included on a lateral projection of the lumbar spine taken with the patient in the dorsal decubitus position?
L1 to L5
T12 to L5
T10 to L5
T12 to the sacrum
T12 to the sacrum
If OML is positioned perpendicular to the image receptor for the trauma AP axial projection (Towne method) of the cranium, the central ray is directed:
30 degrees caudad
30 degrees cephalad
37 degrees caudad
37 degrees cephalad
30 degrees caudad
If a trauma patient loses consciousness during an imaging procedure, the imaging professional should:
a. assess the patient's airway
b. check the patient's pulse
c. notify the ED physician immediately
d. check the patient's pupil responses
c. notify the ED physician immediately
All of the following patient status changes require immediate notification of the ED physician except:
Loss of consciousness
Aggression
Seizures
Bluish nail beds
Aggression
If a grid is used to obtain a trauma AP axial oblique projection of the cervical spine, what is the central ray orientation?
Perpendicular
Horizontal
15 to 20 degrees lateromedial
45 degrees mediolateral
45 degrees mediolateral
Which projection is necessary if the top of T1 and the C7-T1 interspace is not clearly demonstrated on the lateral projection, dorsal decubitus position of the cervical spine?
a. AP projection, open-mouth position
b. lateral projection, swimmer's technique
c. lateral projection of the thoracic spine
d. AP axial c-spine
b. lateral projection, swimmer's technique
Examine the image below. What anatomy is of interest?
Cranium
Facial bones
Cervical vertebrae
Brain
Facial bones
Examine the image below. What error is present in this trauma image?
Not all of the required anatomy is demonstrated.
The image displays rotation from a true lateral position.
Preventable artifacts are visible.
There is no error evident in this trauma image.
Not all of the required anatomy is demonstrated.
Examine the image below. What, if any, additional trauma projections are needed to provide a complete projection of the anatomy of interest?
Additional trauma projections are not needed to demonstrate the anatomy of interest.
Trauma oblique projections are required.
A cross-table lateral projection of the knee joint is required.
An AP projection of the knee joint is required.
A cross-table lateral projection of the knee joint is required.
All of the following trauma procedures may first be referred for CT, except:
Cervical spine
Cranium
Abdomen
Pelvis
Abdomen
Moving the x-ray tube in one direction, such as superiorly to inferiorly along the patient, to obtain projections in a trauma patient with multiple injuries is intended to:
Protect emergency department personnel from injury during trauma imaging
Reduce radiation exposure during trauma imaging
Increase efficiency in trauma imaging
This method is not recommended in trauma imaging
Increase efficiency in trauma imaging
Which of the following actions are technical considerations in trauma
radiography?
(1) Monitoring patient status before, during, and
after imaging procedures
(2) Removing immobilization to prevent
artifacts
(3) Providing lead aprons for all essential personnel
1 and 2 only
1 and 3 only
2 and 3 only
1, 2, and 3
1 and 3 only
If a trauma patient loses consciousness during an imaging procedure, the imaging professional should:
a. assess the patient's airway
b. check the patient's pulse
c. notify the ED physician immediately
d. check the patient's pupil responses
c. notify the ED physician immediately
Where does the central ray enter the patient for the trauma AP projection of the abdomen?
MSP at a level 2 inches (5 cm) superior to the ASIS
MCP at a level 2 inches (5 cm) inferior to the ASIS
MCP at the level of the iliac crests
MSP at the level of the iliac crests
MSP at the level of the iliac crests
Examine the image below. Where does the central ray enter the patient for this trauma projection?
MSP at the level of C4
MCP at the level of C4
MSP at the level of the C7-T1 interspace
MCP at the level of the C7-T1 interspace
MCP at the level of C4
Examine the image below. What anatomy is labeled with the number 1?
Body of C3
Body of C4
Pedicle of C3
Pedicle of C4
Body of C4
Which of the following actions are technical
considerations in trauma radiography?
(1) Monitoring patient
status before, during, and after imaging procedures
(2) Removing
immobilization to prevent artifacts
(3) Providing lead aprons for
all essential personnel
1 and 2 only
1 and 3 only
2 and 3 only
1, 2, and 3
1 and 3 only
All of the following actions are best practices in trauma radiography except:
Using image evaluation criteria that take into account the patient's condition
Obtaining quality images in an efficient manner
Moving the image receptor and x-ray tube, rather than the patient, when needed projections are being obtained
Providing a minimum of two projections at right angles to each other
Using image evaluation criteria that take into account the patient's condition
One best practice in trauma radiography is to:
Accommodate the patient’s injury by moving the tube and IR, instead of the patient, whenever possible during positioning for imaging procedures.
Reduce repeats by altering the evaluation criteria of image quality to accommodate the patient’s condition
Anticipate the need to remove immobilization devices to avoid image artifacts
Obtain the single best projection of the injured part as quickly as possible
Accommodate the patient’s injury by moving the tube and IR, instead of the patient, whenever possible during positioning for imaging procedures.
If a grid is used to obtain a trauma AP axial oblique projection of the cervical spine, what is the central ray orientation?
Perpendicular
Horizontal
15 to 20 degrees lateromedial
45 degrees mediolateral
45 degrees mediolateral
Moving the x-ray tube in one direction, such as superiorly to inferiorly along the patient, to obtain projections in a trauma patient with multiple injuries is intended to:
Protect emergency department personnel from injury during trauma imaging
Reduce radiation exposure during trauma imaging
Increase efficiency in trauma imaging
This method is not recommended in trauma imaging
Increase efficiency in trauma imaging
All of the following duties are part of a trauma radiographer’s responsibilities in the emergency department (ED), except:
Obtaining quality images efficiently
Providing ethical radiation for patients, ED personnel, and self
Administering of pain medication under physician’s order
Providing patient care during imaging procedures
Administering of pain medication under physician’s order
While performing trauma imaging of a patient with injuries to the pelvis, you notice that the patient is sweating heavily and becoming drowsy. What should you do?
Continue with the imaging procedure as requested
Document the signs on the requisition after the procedure is complete
Notify the emergency department (ED) physician immediately
Give the patient a drink of water to lower the body temperature
Notify the emergency department (ED) physician immediately
Which imaging modality is often used to evaluate trauma to the abdomen?
a. CT
b. MRI
c. NM
d. sonography
d. sonography
The trauma radiographer must ensure other team members are protected
from unnecessary radiation. Which of the following practices will
accomplish this?
(1) lead aprons for all personnel that remain in
the room during exposures
(2) short exposure times
(3)
announcement of impending exposure to allow nonessential personnel to
exit the room
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 1, 2, and 3
b. 1 and 3
While performing trauma imaging of a patient with injuries to the pelvis, you notice that the patient is sweating heavily and becoming drowsy. What should you do?
Continue with the imaging procedure as requested
Document the signs on the requisition after the procedure is complete
Notify the emergency department (ED) physician immediately
Give the patient a drink of water to lower the body temperature
Notify the emergency department (ED) physician immediately
Examine the image below. What is the anatomy of interest?
Cervical spine
Cranium
Thoracic spine
Facial bones
Cervical spine
Which of the following duties are part of a trauma radiographer’s
responsibilities in the emergency department (ED)?
(1)
Interpreting images for the ED physician
(2) Obtaining quality
images efficiently
(3) Providing radiation protection
1 and 2 only
1 and 3 only
2 and 3 only
1, 2, and 3
2 and 3 only
Where does the central ray enter the patient on a trauma AP projection of the chest?
3 inches (7.6 cm) superior to the jugular notch
3 inches (7.6 cm) superior to the xiphoid process
3 inches (7.6 cm) inferior to the jugular notch
3 inches (7.6 cm) inferior to the xiphoid process
3 inches (7.6 cm) inferior to the jugular notch
Examine the image below. What anatomy is labeled with the number 1?
Body of C3
Body of C4
Pedicle of C3
Pedicle of C4
Body of C4
One best practice in trauma radiography is to:
Accommodate the patient’s injury by moving the tube and IR, instead of the patient, whenever possible during positioning for imaging procedures.
Reduce repeats by altering the evaluation criteria of image quality to accommodate the patient’s condition
Anticipate the need to remove immobilization devices to avoid image artifacts
Obtain the single best projection of the injured part as quickly as possible
Accommodate the patient’s injury by moving the tube and IR, instead of the patient, whenever possible during positioning for imaging procedures.
If OML is positioned perpendicular to the image receptor for the trauma AP axial projection (Towne method) of the cranium, the central ray is directed:
30 degrees caudad
30 degrees cephalad
37 degrees caudad
37 degrees cephalad
30 degrees caudad
What anatomy should be included on a lateral projection of the cervical spine taken with the patient in the dorsal decubitus position?
Everything from the sella turcica to the top of T1
C1 to C7
C1 to T1
Everything from the EAM to the top of C7
Everything from the sella turcica to the top of T1
What is the proper method for lifting an injured limb?
Lift the limb, supporting only the joint that is distal to the injury
Support the limb at the joints proximal and distal to the injury
Lift the limb, supporting only the joint that is proximal to the injury
Log-roll the patient
Support the limb at the joints proximal and distal to the injury
Which of the following would be considered a trauma radiography
guideline?
(1) remove all splints
(2) do not move the
patient unless necessary
(3) obtain a minimum of two radiographs
of each body part
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 1, 2, and 3
c. 2 and 3
All of the following duties are part of a trauma radiographer’s responsibilities in the emergency department (ED), except:
Obtaining quality images efficiently
Providing ethical radiation for patients, ED personnel, and self
Administering of pain medication under physician’s order
Providing patient care during imaging procedures
Administering of pain medication under physician’s order
Which imaging modality has replaced conventional trauma skull radiography in most Level I trauma centers?
a. CT
b. MRI
c. nuclear medicine
d. angiography
a. CT
Which imaging modality is often used to evaluate trauma to the abdomen?
a. CT
b. MRI
c. NM
d. sonography
d. sonography
Extreme eversion of the foot is a sign of traumatic injury to the:
a. tibia and fibular
b. knee joint
c. pelvis
d. hip
d. hip
Whenever possible, the x-ray tube and image receptor should be positioned, rather than the patient, to obtain the trauma imaging projection.
True
False
True
If the infraorbitomeatal line (IOML) is positioned perpendicular to the image receptor for the trauma AP axial projection (Towne method) of the cranium, the central ray is directed:
30 degrees caudad
30 degrees cephalad
37 degrees caudad
37 degrees cephalad
37 degrees caudad
What are the best practices guidelines regarding immobilization in trauma radiography?
The radiographer should remove immobilization only during the imaging procedure and replace it after images have been evaluated.
Immobilization is never removed without a physician’s order.
Immobilization is always removed before imaging to help prevent artifacts.
The radiographer must evaluate the patient’s injuries to determine whether immobilization can be removed for a particular trauma imaging procedure.
Immobilization is never removed without a physician’s order.
Which projection is necessary if the top of T1 and the C7-T1 interspace is not clearly demonstrated on the lateral projection, dorsal decubitus position of the cervical spine?
a. AP projection, open-mouth position
b. lateral projection, swimmer's technique
c. lateral projection of the thoracic spine
d. AP axial c-spine
b. lateral projection, swimmer's technique
Examine the image below. What, if any, additional trauma projections are needed to provide a complete projection of the anatomy of interest?
Additional trauma projections are not needed to demonstrate the anatomy of interest.
Trauma oblique projections are required.
Trauma AP axial projection is required.
Trauma lateral cervicothoracic projection is required.
Trauma lateral cervicothoracic projection is required.
Which of the following procedures are appropriate for trauma
patients?
(1) remove immobilization devices that may cause
imaging artifacts
(2) move tube and IR, instead of injured part,
when possible
(3) perform all AP projections, then all lateral projections
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 1, 2, and 3
c. 2 and 3
Examine the image below. What, if any, additional trauma projections are needed to provide a complete projection of the anatomy of interest?
Additional trauma projections are not needed to demonstrate the anatomy of interest.
Trauma oblique projections are required.
Trauma AP axial projection is required.
Trauma lateral cervicothoracic projection is required.
Trauma lateral cervicothoracic projection is required.
Which of the following are required to produce optimal radiographs
during foreign body localization?
(1) small focal spot
(2)
maximum control of motion
(3) exact AP or PA and lateral projections
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 1, 2, and 3
d. 1, 2, and 3
Which of the following are required to produce optimal radiographs
during foreign body localization?
(1) small focal spot
(2)
maximum control of motion
(3) exact AP or PA and lateral projections
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 1, 2, and 3
d. 1, 2, and 3
What anatomy should be included on a lateral projection of the lumbar spine taken with the patient in the dorsal decubitus position?
L1 to L5
T12 to L5
T10 to L5
T12 to the sacrum
T12 to the sacrum
Which projection must be evaluated prior to taking any other images on a trauma patient?
a. AP projection of the atlas and axis, open-mouth position
b. lateral projection, swimmer's technique
c. lateral projection of the c-spine, dorsal decubitus position
d. AP axial c-spine
c. lateral projection of the c-spine, dorsal decubitus position
What are the best practices guidelines regarding immobilization in trauma radiography?
The radiographer should remove immobilization only during the imaging procedure and replace it after images have been evaluated.
Immobilization is never removed without a physician’s order.
Immobilization is always removed before imaging to help prevent artifacts.
The radiographer must evaluate the patient’s injuries to determine whether immobilization can be removed for a particular trauma imaging procedure.
Immobilization is never removed without a physician’s order.
Which of the following steps is required for the trauma lateral projection (dorsal decubitus position) of the cranium?
Directing the central ray vertically to exit at the level of the foramen magnum
Directing the central ray horizontally to enter at the level of the foramen magnum
Elevating the head on a radiolucent sponge
Increasing SID to overcome increased OID
Elevating the head on a radiolucent sponge
Which imaging modality has replaced conventional trauma skull radiography in most Level I trauma centers?
a. CT
b. MRI
c. nuclear medicine
d. angiography
a. CT
Status of the patient should be noted:
(1) Before the imaging
procedure
(2) During the imaging procedure
(3) After the
imaging procedure
1 and 2 only
1 and 3 only
2 and 3 only
1, 2, and 3
1, 2, and 3
What is the anatomy of interest in this trauma image?
Thoracic vertebrae
Abdomen
Pelvis
Lumbar vertebrae
Pelvis
Sonography is often used in trauma imaging of the:
Cervical spine
Abdomen
Cranium
Pelvis
Abdomen
What is the anatomy of interest in this trauma image?
Thoracic vertebrae
Abdomen
Pelvis
Lumbar vertebrae
Pelvis
An efficient method of performing multiple imaging procedures on the same patient is to:
Move the tube in one direction (e.g., superiorly to inferiorly)
Refer the patient for a CT
Use the shortest possible exposure time
Use the largest image receptor size available and put more than one body part on each image
Move the tube in one direction (e.g., superiorly to inferiorly)
Where does the central ray enter the patient for the trauma AP projection of the abdomen?
MSP at a level 2 inches (5 cm) superior to the ASIS
MCP at a level 2 inches (5 cm) inferior to the ASIS
MCP at the level of the iliac crests
MSP at the level of the iliac crests
MSP at the level of the iliac crests
What is the ideal central ray direction for the AP axial oblique projections of the cervical spine on an injured patient?
45 degrees mediolaterally and 15 to 20 degrees caudad
15 to 20 degrees lateromedially and 45 degrees cephalad
45 degrees lateromedially and 15 to 20 degrees cephalad
15 to 20 degrees mediolaterally and 45 degrees caudad
45 degrees lateromedially and 15 to 20 degrees cephalad
Examine the image below. What error is present in this trauma image?
Not all of the required anatomy is demonstrated.
The image displays rotation from a true lateral position.
Preventable artifacts are visible.
There is no error evident in this trauma image.
Not all of the required anatomy is demonstrated.
How is the central ray directed for the cross-table lateral projections of the humerus?
Vertical and perpendicular to the midhumerus
Horizontal and perpendicular to the midhumerus
Vertical and angled to open the elbow joint space
Horizontal and angled parallel to the angle of the injury
Horizontal and perpendicular to the midhumerus
Extreme eversion of the foot is a sign of traumatic injury to the:
a. tibia and fibular
b. knee joint
c. pelvis
d. hip
d. hip
Examine the image below. What anatomy is of interest?
Cranium
Facial bones
Cervical vertebrae
Brain
Facial bones