NURS 8026 DDX Exam 4 Study
Set 2025
How many views to get on xray - ANSWER At least two
One view is no view
What history to provide on xray - ANSWER Clinical relevant information
Mechanism of injury?
Tenderness?
Deformity?
Positioning to specify on xray order - ANSWER Upright/supine/lateral decubitus
AP/PA/Lateral/Oblique
Flexion/Extension/sunrise
Swimmers View
Weight bearing vs non weight bearing
How to approach an xray - ANSWER Systematically.
Approach each xray the same way
Overview, specific
match up clinically
ABCs of interpreting Xray - ANSWER Alignment and adequacy
Bones (outline and density)
Cartilage (outline, joint space, and loose bodies)
Alignment - ANSWER The type of view taken and anatomical site visualized
Adequacy - ANSWER Correct beam penetration, correct exposure, joints above and
below included
Alignment and adequacy quesitons - ANSWER Is the xray good enough?
,Know which view you are looking at
Is the exposure good enough?
What color is air on an xray? - ANSWER black
What color is fat on an xray - ANSWER dark gray
What color is soft tissue on an xray - ANSWER lightish gray
What color is bone on an xray - ANSWER light gray/white-ish
What color is metal on an xray? - ANSWER white
Simple (closed) fracture - ANSWER Fracture that does not break the skin
Compound (open) fracture - ANSWER Fracture that breaks the skin
Increased risk of infection
Medical emergency even if a small puncture wound
Transverse fracture - ANSWER occurs straight across the bone
Linear fracture - ANSWER the fracture is parallel to the long axis of the bone
Oblique, nondisplaced fracture - ANSWER Diagnonal
Oblique displaced fracture - ANSWER Diagonal, no longer attached
Spiral fracture - ANSWER a fracture in which the bone has been twisted apart
Seen more w/abuse
Greenstick fracture - ANSWER bending and incomplete break of a bone; most often
seen in children
Outer edge is broken
Comminuted fracture - ANSWER fracture in which the bone is splintered or crushed
Multiple pieces
Intra-articular fracture - ANSWER Involves the joint space.
May not be displaced
Must watch closely
Impaction fracture - ANSWER Occurs when the broken ends of the bone are jammed
together by the force of the injury
Fairly stable
,Can impact into self even more - shortening of the bone
Compression fracture - ANSWER occurs when the bone is pressed together
(compressed) on itself
Often occurs in the spine
Can be caused from osteoporosis and/or trauma
Avulsion fracture - ANSWER When a tendon or ligament are injured and a small
fragment of bone is pulled away with the soft tissue
Stress fracture - ANSWER a small crack in the bone that often develops from chronic,
excessive impact
Occurs as a result of over use or repetitive activity
Segmental fracture - ANSWER consists of a segment of the shaft isolated by proximal
and distal lines of fracture
Involves at least two separate fracture lines that together isolate a segment of bone
Pathologic fracture - ANSWER Occurs as a result of an underlying disease rather than
injury
Salter Harris Classifications - ANSWER Growth plate injury
Bones in children are more elastic resulting in unique fracture patterns
Treatment depends on pattern
Interarticular fractures must be reduced
Salter Harris Classification 1 - ANSWER Follows line of growth plate
Salter Harris Classification II - ANSWER comes across bone and splits up through bone
Fx/ Separation
Salter Harris Classification III - ANSWER Comes across and splits down into joint
Fx/Epiphysis
Salter Harris Classification IV - ANSWER Comes across, splits up and down
Fx/ Epiphyseal plate/ metaphysis & premature closing
Salter Harris Classification V - ANSWER Growth plate compacted and crunched down
Glenohumeral arthritis xray findings - ANSWER Space looks good on PA but on axillary
view, it disappears
, Proximal humerus fractures - ANSWER Looks like icecream on a cone, requires surgery
May have an avulsed greater tuberosity and require 4-6 weeks in a sling
Clavical fracture - ANSWER Does not need surgery, bone will reform/remodel
Convoluted fracture does require plate and screws (Make sure there is no tenting in the
skin)
Mid clavicular fractures heal better
AC separation - ANSWER Will heal on its own but will always have a bump on chest
Can be "tied down" surgically
Calcific Rotator Cuff tendinitis - ANSWER Calcification on rotator cuff from chronic
inflammation
Use NSAIDS
Surgical removal or aspiration via U/S
Rotator Cuff Arthropathy - ANSWER A chronic and retracted tear of the supraspinatus
and infraspinatus tendons will allow the humeral head to rise
An x ray often indicates an irreparable rotator cuff tear
Shoulder dislocation - ANSWER Normally anterior
TUBS
-Traumatic
- Unilateral
- Bankhart lesion - Anterior Labrum (80-90%)
- Surgery - due to high reoccurrence rate (90% <20 years of age)
Posterior dislocations: missed in the ER 50% of the time. Seizure and shock
What views to get for shoulder injury - ANSWER Always get an axillary view in order to
see posterior shoulder dislocations
Labral Tears - ANSWER SLAP: superior labrum. Long head of proximal biceps tendon
attaches here
Anterior (bankart)
Posterior
Labrum - ANSWER a ring of cartilage around the glenoid
Set 2025
How many views to get on xray - ANSWER At least two
One view is no view
What history to provide on xray - ANSWER Clinical relevant information
Mechanism of injury?
Tenderness?
Deformity?
Positioning to specify on xray order - ANSWER Upright/supine/lateral decubitus
AP/PA/Lateral/Oblique
Flexion/Extension/sunrise
Swimmers View
Weight bearing vs non weight bearing
How to approach an xray - ANSWER Systematically.
Approach each xray the same way
Overview, specific
match up clinically
ABCs of interpreting Xray - ANSWER Alignment and adequacy
Bones (outline and density)
Cartilage (outline, joint space, and loose bodies)
Alignment - ANSWER The type of view taken and anatomical site visualized
Adequacy - ANSWER Correct beam penetration, correct exposure, joints above and
below included
Alignment and adequacy quesitons - ANSWER Is the xray good enough?
,Know which view you are looking at
Is the exposure good enough?
What color is air on an xray? - ANSWER black
What color is fat on an xray - ANSWER dark gray
What color is soft tissue on an xray - ANSWER lightish gray
What color is bone on an xray - ANSWER light gray/white-ish
What color is metal on an xray? - ANSWER white
Simple (closed) fracture - ANSWER Fracture that does not break the skin
Compound (open) fracture - ANSWER Fracture that breaks the skin
Increased risk of infection
Medical emergency even if a small puncture wound
Transverse fracture - ANSWER occurs straight across the bone
Linear fracture - ANSWER the fracture is parallel to the long axis of the bone
Oblique, nondisplaced fracture - ANSWER Diagnonal
Oblique displaced fracture - ANSWER Diagonal, no longer attached
Spiral fracture - ANSWER a fracture in which the bone has been twisted apart
Seen more w/abuse
Greenstick fracture - ANSWER bending and incomplete break of a bone; most often
seen in children
Outer edge is broken
Comminuted fracture - ANSWER fracture in which the bone is splintered or crushed
Multiple pieces
Intra-articular fracture - ANSWER Involves the joint space.
May not be displaced
Must watch closely
Impaction fracture - ANSWER Occurs when the broken ends of the bone are jammed
together by the force of the injury
Fairly stable
,Can impact into self even more - shortening of the bone
Compression fracture - ANSWER occurs when the bone is pressed together
(compressed) on itself
Often occurs in the spine
Can be caused from osteoporosis and/or trauma
Avulsion fracture - ANSWER When a tendon or ligament are injured and a small
fragment of bone is pulled away with the soft tissue
Stress fracture - ANSWER a small crack in the bone that often develops from chronic,
excessive impact
Occurs as a result of over use or repetitive activity
Segmental fracture - ANSWER consists of a segment of the shaft isolated by proximal
and distal lines of fracture
Involves at least two separate fracture lines that together isolate a segment of bone
Pathologic fracture - ANSWER Occurs as a result of an underlying disease rather than
injury
Salter Harris Classifications - ANSWER Growth plate injury
Bones in children are more elastic resulting in unique fracture patterns
Treatment depends on pattern
Interarticular fractures must be reduced
Salter Harris Classification 1 - ANSWER Follows line of growth plate
Salter Harris Classification II - ANSWER comes across bone and splits up through bone
Fx/ Separation
Salter Harris Classification III - ANSWER Comes across and splits down into joint
Fx/Epiphysis
Salter Harris Classification IV - ANSWER Comes across, splits up and down
Fx/ Epiphyseal plate/ metaphysis & premature closing
Salter Harris Classification V - ANSWER Growth plate compacted and crunched down
Glenohumeral arthritis xray findings - ANSWER Space looks good on PA but on axillary
view, it disappears
, Proximal humerus fractures - ANSWER Looks like icecream on a cone, requires surgery
May have an avulsed greater tuberosity and require 4-6 weeks in a sling
Clavical fracture - ANSWER Does not need surgery, bone will reform/remodel
Convoluted fracture does require plate and screws (Make sure there is no tenting in the
skin)
Mid clavicular fractures heal better
AC separation - ANSWER Will heal on its own but will always have a bump on chest
Can be "tied down" surgically
Calcific Rotator Cuff tendinitis - ANSWER Calcification on rotator cuff from chronic
inflammation
Use NSAIDS
Surgical removal or aspiration via U/S
Rotator Cuff Arthropathy - ANSWER A chronic and retracted tear of the supraspinatus
and infraspinatus tendons will allow the humeral head to rise
An x ray often indicates an irreparable rotator cuff tear
Shoulder dislocation - ANSWER Normally anterior
TUBS
-Traumatic
- Unilateral
- Bankhart lesion - Anterior Labrum (80-90%)
- Surgery - due to high reoccurrence rate (90% <20 years of age)
Posterior dislocations: missed in the ER 50% of the time. Seizure and shock
What views to get for shoulder injury - ANSWER Always get an axillary view in order to
see posterior shoulder dislocations
Labral Tears - ANSWER SLAP: superior labrum. Long head of proximal biceps tendon
attaches here
Anterior (bankart)
Posterior
Labrum - ANSWER a ring of cartilage around the glenoid
