American Registry of Radiologic Technologists Certification (ARRT) Radiographic Procedures and Anatomy Flashcards

24 sample cards from the Radiographic Procedures and Anatomy deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What does the AP open-mouth (odontoid) projection demonstrate, and what must be aligned?

   It demonstrates C1 (atlas) and the dens/odontoid process of C2 (axis); a line from the lower incisors to the base of the skull (mastoid tips) must be perpendicular to the IR to avoid superimposing the teeth or occiput.

2. On which oblique do the cervical intervertebral foramina open, and at what CR angle?

   Posterior obliques (RPO/LPO, 45 degrees) demonstrate the foramina farthest from the IR (upside) with CR 15-20 degrees cephalad; anterior obliques (RAO/LAO) demonstrate the side closest to the IR with CR 15-20 degrees caudad.

3. What is demonstrated on a 45-degree oblique lumbar spine, and what is the 'Scottie dog' sign?

   The zygapophyseal (apophyseal) joints; the 'Scottie dog' is formed by the vertebral structures—a fracture/defect of the pars interarticularis (neck/collar) indicates spondylolysis.

4. For the lateral lumbar spine, why is the central ray sometimes angled, and what does the L5-S1 spot view (Ferguson/lateral) target?

   CR may be angled 5-8 degrees caudad if the spine sags (or use support) to open intervertebral disc spaces; the L5-S1 lateral spot uses CR perpendicular or angled to demonstrate the lumbosacral junction and disc space.

5. What positioning lines/landmarks define the cranial base, and what is the OML?

   The orbitomeatal line (OML) connects the outer canthus to the EAM; the cranial base/floor is divided into anterior, middle, and posterior cranial fossae. The IOML, GAL, and AML are other key positioning lines.

6. What does the SMV (submentovertical, Schuller) projection demonstrate?

   The base of the skull, foramina (ovale and spinosum), sphenoid and ethmoid sinuses, mandible, and petrous pyramids; the IOML is placed parallel to the IR with CR perpendicular to it.

7. What does the parietoacanthial (Waters) projection best demonstrate for facial bones and sinuses?

   The maxillary sinuses, orbital floors (blowout fractures), zygomatic arches, and maxillae; the petrous ridges are projected below the maxillary sinuses (OML 37 degrees to IR).

8. Which projection (and angle) best demonstrates the maxillary sinuses free of superimposition by the petrous ridges?

   The parietoacanthial (Waters) projection—erect to show air-fluid levels—projects the petrous ridges below the maxillary sinus floors.

9. What does the PA axial Caldwell projection demonstrate for the sinuses/orbits?

   The frontal and anterior ethmoid sinuses; with CR 15 degrees caudad to the OML, the petrous ridges are projected into the lower third of the orbits.

10. Name two methods/projections used to demonstrate the temporal bone (petrous portion) and what each shows.

    Axiolateral oblique (Law method) shows the mastoid air cells/TMJ region; posterior profile (Stenvers) and anterior profile (Arcelin) demonstrate the petrous pyramid, internal acoustic canal, and mastoid in profile.

11. What does the axiolateral oblique mandible projection demonstrate, and how is the head positioned for the body versus ramus?

    It demonstrates the mandibular body, ramus, and angle; the head is positioned in a true lateral for the ramus, with varying rotation (e.g., 30 degrees toward IR) and CR 25 degrees cephalad to project the side of interest away from the cervical spine.

12. What is the contrast medium and patient prep difference between an upper GI (UGI) and a barium enema (BE)?

    UGI uses orally ingested barium (NPO 8 hours) to study the esophagus, stomach, and duodenum; BE administers barium (and air for double-contrast) rectally after bowel-cleansing prep to study the large intestine.

13. In an upper GI series, which position fills the fundus of the stomach versus the body/pylorus with barium?

    Recumbent/supine fills the fundus (posterior) with barium; prone (PA) fills the body and pylorus/duodenum with barium, while the fundus fills with air in double-contrast studies.

14. What does the RAO position demonstrate in an esophagram, and at what obliquity?

    A 35-40 degree RAO places the esophagus between the vertebral column and the heart, demonstrating it free of superimposition during barium swallow.

15. What is the difference between an excretory urogram (IVU/IVP) and a retrograde pyelogram?

    IVU/IVP injects iodinated contrast intravenously to assess function and anatomy of the renal collecting system (physiologic); retrograde pyelogram instills contrast directly via ureteral catheters during cystoscopy (non-functional, anatomic study).

16. During an IVU, why is ureteric compression sometimes applied, and what does the AP Trendelenburg/RPO/LPO demonstrate?

    Compression over the distal ureters retains contrast in the renal pelves/calyces for better filling; obliques (30 degrees) demonstrate the kidney closest to the IR (upside ureter) and separate the kidneys from the spine.

17. What patient preparation and contrast route are used for an operative (immediate) cholangiogram versus an ERCP?

    Operative/T-tube cholangiogram injects contrast directly into the biliary ducts (during or after gallbladder surgery via a T-tube/catheter); ERCP (endoscopic retrograde cholangiopancreatography) introduces contrast through an endoscope into the common bile and pancreatic ducts via the duodenal papilla.

18. What does a hysterosalpingogram (HSG) demonstrate, and what contrast route is used?

    Contrast injected through the cervix outlines the uterine cavity and fallopian tubes to evaluate patency and uterine anatomy (commonly for infertility).

19. For mobile (portable) radiography, what is the cardinal radiation safety rule for the operator regarding distance?

    Stand at least 6 feet (2 meters) from the patient, tube, and useful beam, at a 90-degree angle to the scatter source, and always wear a lead apron.

20. In surgical radiography with a C-arm, how does positioning the image intensifier versus the x-ray tube reduce operator dose?

    Keep the x-ray tube under the table and the image intensifier on top/close to the patient; this reduces scatter to the operator's head/neck. Increasing tube-to-skin distance and minimizing fluoro time also lower dose.

21. What is the guiding principle for trauma radiography positioning when the patient cannot be moved?

    Move the tube and IR (use cross-table/horizontal beam and CR angulation) rather than the patient; still obtain two projections 90 degrees apart, and never force a body part into position.

22. What special trauma cervical spine view must be obtained first and must include which vertebrae?

    A cross-table (horizontal beam) lateral cervical spine that must demonstrate all 7 cervical vertebrae plus the C7-T1 junction before the collar is removed; a swimmer's (Twining) view may be needed to visualize C7-T1.

23. What exposure-factor adjustments are appropriate for pediatric radiography to reduce motion and dose?

    Use short exposure times with higher mA (to minimize motion blur), appropriate kVp, tight collimation, gonadal shielding, and immobilization devices; follow ALARA and use the smallest field size.

24. What immobilization device is commonly used for pediatric chest/abdomen radiography, and what is a key concern with pediatric positioning?

    The Pigg-O-Stat (with body clamps) holds infants erect for chest/abdomen imaging; key concerns are immobilization to prevent motion, careful gonadal shielding, and minimizing repeat exposures.

What this deck covers

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