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Anatomy Flashcards

1
Q

types of medical imaging

A

X-rays (Radiography)

Fluoroscopy

Computer tomography (CAT scans or CT)

Ultrasound (US)

Magnetic resonance imaging (MRI or MR)

Nuclear medicine (PET, SPECT)

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2
Q

conventional radiology overview

A

a highly penetrating beam of X-rays transilluminates the patient, showing tissues of differing densities of mass within the body as images of differing intensities (areas of relative light and dark) on the film or monitor

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3
Q

X-rays either pass through the body or are absorbed by the various tissues in different amounts depending on what factors

A

density (g/cc3) (higher -> more absorption)

atomic number of elements in tissue (higher -> more absorption/scattering)

thickness (layering -> more absorption)

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4
Q

conventional radiology mechanism

A

a tissue or organ that is relatively dense in mass (e.g., compact bone) absorbs or reflects more X-rays than does a less dense tissue (e.g., spongy bone), thus denser tissues/organs produce a somewhat transparent area on the X-ray film or bright area on a monitor because fewer X-rays reach the film or detector

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5
Q

principles of X-ray image formation

A

portions of the beam of X-rays traversing the body become attenuated to varying degrees based on tissue thickness and density

the beam is diminished by structures that absorb or reflect it, causing less reaction on the film or by the detector compared with areas that allow the beam to pass relatively uninterrupted.

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6
Q

posteroanterior (PA) projection

A

refers to a radiograph in which the X-rays traversed the patient from posterior (P) to anterior (A); the X-ray tube was posterior to the patient and the Xray film or detector was anterior

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7
Q

radiopaque

A

a dense substance, regarding X-rays

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8
Q

radiolucent

A

a substance of less density, regarding X-rays

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9
Q

anteroposterior (AP) projection

A

refers to a radiograph in which the X-rays traversed the patient from anterior (A) to posterior (P); the X-ray tube was anterior to the patient and the X-ray film or detector was posterior

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10
Q

an X-ray image can be made on:

A

Film in cassette

Computer screen (digital imaging)

Fluorescent screen (fluoroscopy)

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11
Q

contrast radiography definition

A

a contrast material is used to enhance the imaging of the conventional radiology

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12
Q

contrast radiology overview

A

radiodense material and/or lucent material (air) are injected in a cavity

barium or iodine, plus air, for bowel

iodine for everywhere else: joints, vasculature, spinal canal

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13
Q

single contrast definition

A

the use of barium only to outline the gastrointestinal system tract

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14
Q

double contrast definition

A

the use of barium to coat the GI system followed by air to distend the inner lumen

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15
Q

type of radiography using contrast for GI

A

esophogram

cologram

endoscopic retrograde cholangiopancreatography (ERCP)

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16
Q

type of radiography using contrast for vascular system

A

angiogram

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17
Q

type of radiography using contrast for urinary tract

A

intravenous pyelogram (IVP)

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18
Q

type of radiography using contrast for reproductive tract

A

hysterosalpingogram

vasogram

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19
Q

type of radiography using contrast for joints

A

arthrogram

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20
Q

type of radiography using contrast for respiratory tract

A

bronchogram

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21
Q

type of radiography using contrast for spinal canal or cord

A

myelogram

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22
Q

ERCP

A

an endoscopic retrograde cholangiopancreatography

contrast is used to image the pancreas, bile duct and gallbladder

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23
Q

IVP

A

intravenous pyelogram

used to image the kidney and urinary tract

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24
Q

hysterosalpingogram

A

uses contrast to study the uterine tube and uterus

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25
vasogram
images the ductus deferens, formerly called vas deferens
26
double contrast esophogram purpose
assess: motility reflux stricture masses
27
double contrast UGI purpose
assess for: ulcers tumors gastritis
28
double contrast UGI procedure
barium then air often, the patient is rolled in the bed after the barium and air are introduced. This can help to coat the walls of the organ with barium, while the air spreads the walls apart
29
small bowel series purpose
assess for: ``` bleeding lesions obstruction malabsorption post-op evaluation ```
30
small bowel series procedure
AKA small bowel follow-through a descriptive term for a series of images taken at intervals following barium ingestion; the barium is followed through the small intestine
31
double contrast lower GI purpose
assess for: bleeding cancer inflammatory bowel dz
32
double contrast lower GI process
barium can go into the GI tract in either direction, and a barium enema followed by air insufflation reveals the walls of the large bowel, especially if the patient is rolled to coat the walls with barium
33
angiogram
readily reveals blockages in vessels
34
aneurisms
bulging areas in vessel walls can be found through interventional means such as selective embolization, they can be treated
35
digital subtraction angiography
process in which a mask image of the same area made prior to contrast administration can be used to “subtract” the background, non-contrast structures
36
computed tomography (CT) scans
the scans show radiographic images of the body that resemble transverse anatomical sections
37
CT mechanism
A beam of X-rays passes through the body as the X-ray tube and detector rotate around the axis of the body, and multiple overlapping radial energy absorptions are measured, recorded, and compared by a computer to determine the radiodensity of each volumetric pixel (voxel) of the chosen body plane the computer maps the voxels into a planar image (slice) that is displayed on a monitor or printout
38
the radiodensity of each voxel in CT
determined by factors that include the amount of air, water, fat, or bone in that element
39
CT images
relate well to conventional radiographs, in that areas of great absorption (e.g., bone) are relatively transparent (white) and those with little absorption are black
40
how are axial CT (and MRI) images always viewed
as if one is standing at a supine patient's feet—that is, from an inferior view
41
how are coronal CT (and MRI) images viewed
as if the patient is facing you
42
how are sagittal CT (and MRI) usually viewed
as if you are standing at the patient's left side
43
why would one have the computer adjust CT images to highlight certain structures
the adjustments produce windows the common windows are soft-tissue, lung, and bone, each one showing its namesake well
44
common CT windows
soft-tissue lung bone
45
nuclear medicine imaging overview
a radioactive agent is given IV, swallowed, or inhaled, and the scanner detects the radioactive agent and reveals function E.g. PET, SPECT
46
nuclear medicine imaging purpose
can reveal unusual patterns of metabolic activity and possible pathologies, especially neoplasms
47
diagnostic radiology ionizing radiation
radiation used in diagnostic radiology is potentially harmful but adverse effects from ionizing radiation used in diagnostic radiology are extremely rare but since ionizing radiation used in some imaging modalities is potentially harmful, steps should be taken to reduce patient and physician exposure
48
how much does a standard 0.5-mm lead apron reduce radiation exposure from the ionizing radiation of diagnostic radiology
by 95%
49
what width standard lead apron reduces radiation exposure from the ionizing radiation of diagnostic radiology by 95%
a standard 0.5-mm lead apron
50
whole body lethal dose of radiation
400 rads or 8 Sieverts (Sv)
51
cancer therapy radiation dose
6000 rads (not lethal because it is focal)
52
CXR radiation dose
0.1 mSv
53
abdominal CT radiation dose
10 mSv
54
natural radiation radiation dose
3 mSv/year
55
radiation dose enough to cause skin damage
10,000 x-rays = 100 CTs = 30 minutes fluoroscopy
56
RAD
Radiation Absorbed Dose (energy absorbed/mass)
57
Sievert (Sv)
measure of “effective dose” on various tissues, taking into account varying sensitivities.
58
Radiation exposure is measured in what unit/units
RADs or more commonly Sieverts or milliSieverts
59
CT scans involve approximately what times dose of ionizing radiation that standard plain film X-rays do
100 times
60
ultrasound overview
images created by a combination of high-frequency soundwaves and computer manipulation
61
US sound waves frequency
1- 10 MHz
62
what interferes with US transmission
air and bone
63
what tissues are seen best by US
fluid and water-like tissues
64
US benefits
no biologic effects; i.e completely safe to tissues excellent for fluid containing structures (i.e. gallbladder, cysts, bladder, pregnancy) no patient discomfort dynamic (real time) portable device
65
US ideal applications
pregnancy/neonatal solid or fluid-filled internal organs blood vessels (Doppler) joints procedure guidance/intra-operative assistance since it is a live imaging modality
66
US mechanisms
US waves are generated by applying an electric field to a piezoelectric crystal in a transducer, causing the crystal to vibrate and generate sound waves the transducer also functions as a detector, which receives the echoes reflected from within the patient [like sonar!] a thin layer of gel is placed on the skin to serve as a coupling medium to transmit the sound waves from the hand-held transducer into the patient
67
what is crucial in determining the image produced in US
the angle at which the transducer is held
68
US higher frequencies use
the frequencies penetrate less but reveal fairly shallow anatomy well
69
US low frequency use
transducers penetrate deeper and are useful for some deep or large structures, such as liver or kidney
70
Doppler US use
shows blood flow within the heart and blood vessels
71
reading an US
the intensity of the echoes reflected back to the transducer is proportional to the whitening of the film (i.e. no internal echoes = black; internal echoes = grey to white) US images are sectional, but the axis of the slice is controlled by the angle of the transducer
72
MRI overview
magnetic resonance imaging (MRI) provides images of the body similar to those of CT scans, but MRI is better for tissue differentiation MRI studies closely resemble anatomical sections, especially of the brain
73
MRI process overview
the person is placed in a scanner with a strong magnetic field, and the body is pulsed with radio waves signals subsequently emitted from the patient's tissues are stored in a computer and reconstructed into various images of the body the appearance of tissues on the generated images can be varied by controlling how radiofrequency pulses are sent and received
74
reading an MRI
signal intensity refers to the brightness of signal generated by specific tissues I.e. tissues that are: ``` bright = hyperintense (trabecular bone) dark = hypointense (Cortical bone, ligaments) middle = isointense ```
75
MRI mechanism of functioning
the powerful magnet causes an alignment of hydrogen atoms with the patient’s body when the magnetic field is switched off, the hydrogen returns to its original state and gives off a slight amount of energy, which is picked up by sensitive detectors terms usually refer to a signal of pathologic process relative to surrounding tissues
76
MRI strengths and weaknesses
easily image in any plane no biologic effects, no radiation imaging does not depend on tissue density — but on hydrogen content bone, calcifications hard to see (hydrogen poor tissue, i.e. other than cortical bone and metal)
77
T1 and T2 MRI overview
refer to physical properties of the tissues after the exposure to a series of pulses at different intervals (TE) different tissues have different T1 and T2 properties – primarily, water is dark in T1 (solids lighter) and bright in T2 (solids darker)
78
CSF T1 and T2
T1 weighted: dark T2 weighted: bright
79
muscle T1 and T2
T1 weighted: gray T2 weighted: dark gray
80
spinal cord T1 and T2 (MRI)
T1 weighted: gray T2 weighted: light grey
81
fat T1 and T2
T1 weighted: bright T2 weighted: light
82
disc T1 and T2 (MRI)
T1 weighted: gray T2 weighted: bright
83
air T1 and T2
T1 weighted: very dark T2 weighted: very dark
84
inflammation T1 and T2
T1 weighted: dark T2 weighted: bright
85
T2 weighting often replaces radiological procedure
myelograms, which introduces a contrast agent into the CSF to produce images somewhat like T2 images
86
multiple ways to manipulate the magnet for MRI sequences
spin echo (T1 & T2 weighting) gradient echo inversion recovery (STIR, FLAIR, TIRM) fat suppressed MR angiography - contrast enhanced (gadolinium)
87
functional MRI
the area of the brain being used lights up, so brain functions can be studied
88
MR-angiography (MRA)
3D MR-angiography gadolinium is a contrast agent used in MR angiography imaging that reveals vascular patterns in great detail
89
differentiating btw CT scans and MRI scans
cancellous bone and marrow spaces will usually glow white on MRI due to fat within these spaces, so focus on the cortical compact bone which is white on CT and black in MR
90
CT benefits
detailed cross-sectional anatomy computer analysis of tissue differences with reconstruction
91
CT limitations
high cost radiation exposure contrast reactions patient discomfort from IV
92
US limitations
cannot penetrate air or bone relatively expensive vs plain film (less expensive than CT, MRI, nuclear medicine)
93
MRI benefits
no radiation excellent differentiation of soft tissue structures with subtle differences in density (tendons, cartilage, muscle) many possible views (axial, sagittal, coronal, oblique)
94
MRI limitations
time consuming images are very motion sensitive (i.e. breathing, heartbeat, peristalsis, tremors, movement) calcium is poorly evaluated due to lack of signal limited availability and very expensive

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