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AN SPI VOCAB > ARDMS OUTLINE > Flashcards

ARDMS OUTLINE Flashcards

1
Q

What does Occupational Safety & Health Administration (OSHA) implement?

A

1) Wear gear according to how high risk of exposure is
2) SOP Standard Operating Procedures should be developed into the work program
3) Employer must monitor workers to ensure this including records of these procedures

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2
Q

Guidelines to minimize the risk of health care workers to contract bloodborne infection are called what?

A

Standard precautions (including body fluids, secretions, excretions, mucous membranes, airborne particles and non-intact skin)

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3
Q

What percentage of sonographers are thought to experience musculoskeletal pain related to work?

A

80%

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4
Q

What can reduce workplace injuries?

A

Patient scheduling, proper use of equipment, educational programming, patient positioning

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5
Q

What are the conclusions of AIUM?

A

~ no confirmed harmful bioeffects from exposure to U/S have ever been reported
~ it is possible that bioeffects may be identified in the future
~ the benefits to the patient outweigh the risks

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6
Q

Where does the greatest risk arise in U/S?

A

Electrical shock from a cracked transducer housing

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7
Q

What is sterilization vs. disinfection?

A

~ sterilization is destruction of all microorganisms by exposure to extreme heat, chemical agents, or radiation
~ disinfection is application of a chemical agent to reduce/eliminate infectious organisms on an object and attempts to reduce microbial load

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8
Q

How should transducers be disinfected?

A

~ Cidex or other cold germicides

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9
Q

What’s the risk of exposing transducer to extreme temperatures?

A

~ prevent depolarization (loss of piezoelectric properties) as well as damage to adhesives and bonding agents

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10
Q

What is sterile technique?

A

This involves placing a sterile probe cover, generally of non‐latex material over the transducer. Acoustic coupling gel is placed inside the cover. Sterile gel is then also placed between the outside of the cover and the patient’s skin

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11
Q

What is the most common nosocomial infection?

A

Urinary tract infections

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12
Q

What is a rapidly growing problem in hospitals?

A

MRSA staff infections (methicillin-resistant staphylococcus)

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13
Q

What is hydrophone / microprobe?

A

A needle with a tiny piece of piezoelectric material attached to it end. A wire connects PZT crystal to an oscilloscope and placed in sound beam. Acoustic pressure is measured a specific locations in sound beam.

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14
Q

What does hydrophone measure?

A

Period, PRP, PRF, and pulse duration

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15
Q

When is transducer output lowest and highest?

A

Lowest with gray scale and highest with pulsed Doppler. Color flow Doppler and M-Mode are in between.

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16
Q

What is feedback microbalance?

A

The measured force relating to the power in the beam. When the sound beam is entirely absorbed/reflected by the target, the target acts as an extremely sensitive mini postal scale.

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17
Q

When are bioeffects beneficial?

A

Under controlled circumstances (therapeutic U/S for muscular injury)

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18
Q

What is dosimetry?

A

The science of identifying/measuring characteristics of an U/S beam that are relevant to its potential for producing biological effects.

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19
Q

What is dosimetry?

A

The science of identifying/measuring characteristics of an U/S beam that are relevant to its potential for producing biological effects.

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20
Q

What is in vivo?

A

Research performed within the living body of an animal or plant.

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21
Q

What is in vitro?

A

Research performed outside the living body and in an artificial environment. (meaning “in glass”) This indicates that very high intensities can cause genetic damage and cell death.

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22
Q

What is mechanistic approach?

A

a proposal that a specific mechanism has the potential to produce bioeffects. It searches for a relationship between cause and effect at various exposure levels.

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23
Q

What is empirical approach?

A

based on information from patients or animals exposed to U/S. It seeks a relationship between the exposure to U/S and response (effects of exposure)

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24
Q

What are 2 important bioeffects mechanisms?

A

Thermal and cavitation (non-thermal)

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25
Q

What is thermal mechanism?

A

proposed that bioeffects result from tissue temperature elevation. Sound propagates in body and energy is converted to heat. Core temperature is regulated at 37 Degrees Celsius.

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26
Q

What is thermal index / TI?

A

a predictor of maximum temperature increase under most conditions

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27
Q

What are the 3 forms of thermal index?

A

~ TIS sound through soft tissue
~ TIB bone near focus of sound beam (narrowest)
~ TIC cranial bone in near field of sound beam

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28
Q

What determines likelihood of harmful bioeffects?

A

a combination of temperature and exposure time (with higher temperatures, harmful effects can occur with shorter exposure times)

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29
Q

How much rise in testicular temperature can cause infertility?

A

2 to 4 Degree

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30
Q

What is maximal heating related to?

A

~ beam’s SPTA intensity (current FDA limit is 720 m/W cm2

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31
Q

What order do temperature elevations become progressively greater?

A

~ gray scale imaging to color Doppler to spectral Doppler

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32
Q

What is ergonomics?

A

Studies the interaction between the sonographer, patient, and equipment in order to optimize the well-being of sonographers in their professional environment

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33
Q

What are causes of work-related injury?

A 
~ repetitive motions
~ forceful / awkward movements
~ poor posture
~ improper positioning
~ strain
~ pressure on joints for extended periods
34
Q

What are some ergonomic devices?

A 
~ wrist support braces
~ adaptive support cushions
~ cable braces to clear away
~ transducer design
~ adjustable chairs
~ swivel control panel and monitor
35
Q

What are ergonomic best practices?

A 
~ keep arm close to the body
~ stay close to the patient
~ monitor at eye level
~ minimize twisting or bending
~ proper sitting position
~ use palmar grip with transducer (no pinch grip)
~ neutral wrist position
~ proper foot support
36
Q

What can you do to reduce workplace injuries?

A

~ effective patient scheduling
~ avoid same exam type
~ limit number of studies each day
~ incorporate non-scanning activities

37
Q

What is output power?

A

~ affects image brightness by altering strength of sound pulse to body
~ powerful pulse = all returning echoes are stronger
~ brightness causes reflectors to bloom causing lateral and axial resolution to degrade
~ image too dark, increase output power which improves signal-to-noise ratio (echoes stronger, noise level unchanged)

38
Q

What is receiver gain / amplification?

A

~ alters the strength of voltages in the receiver that transducer created during reception
~ higher amplification = brighter image
~ lower amplification = darker image
~ increasing amplification does not alter the signal-to-noise ratio (both meaningful signals and noise are treated identically)

39
Q

What is the distinction between output power and amplification related to bioeffects?

A

Patient exposure to sound energy is affected by alterations in output power, but not by changes in amplification.

40
Q

Which adjustments should be made first regarding ALARA?

A

~ one that will minimize the patient’s U/S exposure
~ image too dark = increase gain (no patient risk)
~ image too bright = decrease output power (decreases risk)

41
Q

The acoustic power of a sound beam emitted from a transducer is determined by the _______ of the pulser’s signal.

A

Voltage

42
Q

What is nonthermal mechanism / mechanical mechanisms?

A

~ consist of cavitation and radiation force
~ cavitation is interaction of sound waves w/microscopic, stabilized, gas bubbles in tissues
~ radiation force is exerted by a sound beam on tissues (can distort/disturb biologic structures)

43
Q

What are cavitation bubbles called?

A

gaseous nuclei from dissolved gases in a fluid

44
Q

What are 2 forms of cavitation?

A

~ stable (bubbles do not burst)

~ transient (bubbles burst) AKA inertial/normal cavitation

45
Q

In stable cavitation, what happens to the fluids surrounding the cells?

A

they undergo microstreaming and the cells are exposed to shear stresses

46
Q

What does transient cavitation produce?

A

~ highly localized, violent effects including colossal temperatures and shock waves (enormous pressures)
~ pressure threshold for transient cavitation is only 10% higher than that required for stable

47
Q

What is mechanical index?

A

~ a calculated number related to the likelihood of harmful bioeffects from cavitation
~ related to peak rarefaction pressure and lower frequency

48
Q

When is there a greater likelihood of cavitation bioeffects and higher Mechanical Index?

A

~ additional negative pressure
~ lower frequency
(HIGHER FREQUENCY HAS LOWER MI

49
Q

The study of the characteristics, attributes, and quantities of a substance that induces bioeffects is called what?

A

Dosimetry

50
Q

Is the intensity limit established for U/S higher for focused sound beams than for broad, unfocused beams?

A

Yes, broad unfocused beams cause greater tissue heating and therefore have a lower limit than focused.

51
Q

Which measure of intensity is related most closely to tissue heating?

A

SPTA (remember the SPCA)

52
Q

What are 4 commonly accepted principles of health care ethics?

A

~ respect for autonomy (patient acts intentionally with free will)
~ nonmaleficence (avoid needless harm/injury)
~ beneficence (benefit patient)
~ justice (fairness for patient)

53
Q

What is informed consent?

A

process by which patients are educated about the essentials of a medical procedure

54
Q

When is it appropriate to question a patient’s ability to participate in decision making?

A

~ Underage
~ patient is incapacitated / incapable of providing consent
~ translator needed to provide consent
(patient can withdraw previously granted consent)

55
Q

What should the sonographer do when first meeting a patient?

A

~ Introduce yourself / describe procedure
~ identify patient (wristband/ask for birthdate or full name)
~ sedated patient w/no wristband, call nurse

56
Q

Can the sonographer cancel the exam?

A

No

57
Q

What is patient dignity?

A

~ dignity is defined as the quality of being worthy, honored or esteemed
~ includes a patient’s perception of being in control and having self worth (dignity loss as a result of advanced age, infirmity and lack of privacy)

58
Q

How are tissue equivalent phantoms similar to soft tissue?

A

~ speed of sound (1540 m/s)
~ attenuation
~ scattering characteristics
~ echogenicity

59
Q

What produces reflections in phantom?

A

Nylon strings

60
Q

What is the device of choice for Doppler systems?

A

Flow phantoms (pumps liquid through tissue equivalent phantom)

61
Q

What are 3 types of DOPPLER phantoms?

A

~ vibrating string
~ moving belt
~ flow phantom

62
Q

Why does slice thickness degrade image quality?

A

the imaging plane is thicker than either the beam width (which determines lateral resolution) or the pulse length (which determines axial resolution)

63
Q

Where does slice thickness measure the beam geometry?

A

perpendicular to the imaging plane

64
Q

What do thicker slices do?

A

diminish spatial resolution (image detail) and reduce the ability to visualize small, low contrast reflectors and cystic structures may appear filled in

65
Q

What refers to the ability of a system to display low-level echoes?

A

Sensitivity (normal and maximum)

66
Q

What is normal sensitivity?

A

all pins, solid masses and cystic structures in the test phantom are accurately displayed

67
Q

What is maximum sensitivity?

A

evaluation with output power and amplification of the system set to the maximum practical levels using a tissue equivalent phantom

68
Q

What is the dead zone?

A

~ the region close to the transducer where images are inaccurate
~ it extends from the transducer to the shallowest depth from which meaningful reflections appear

69
Q

Is information within the dead zone reliable?

A

No, it may not be used in the diagnostic setting

70
Q

What causes dead zone?

A

the transducer ringing and the time it takes the system to switch from the transmit to the receive mode

71
Q

How is the dead zone assessed?

A

the shallowest series of pins in a test object

72
Q

Which have a thinner dead zone?

A

Higher frequency transducers

73
Q

What does an increasingly deeper dead zone indicate?

A

a cracked crystal, detached backing material or a longer pulse duration

74
Q

What is registration accuracy/vertical depth?

A

the system’s accuracy in placing reflectors at correct depths located parallel to the sound beam

75
Q

How should digital calipers be checked?

A

in both the vertical and horizontal directions

76
Q

Where is lateral resolution excellent?

A

in the focal zone surrounding the focus because the beam is narrow

77
Q

What’s the difference between axial and lateral resolution?

A

Axial is the smallest distance where 2 pins positioned parallel to the sound beam are displayed as 2 distinct echoes.
Lateral is the minimum distance at which 2 side-by-side pins are displayed as 2 distinct images.

78
Q

What is a method to evaluate lateral resolution?

A

to measure the width of reflections on the display that are created by point targets in the phantom. this width approximates the beam diameter at that depth

79
Q

How is axial resolution evaluated?

A

Scanning successively closer spaced pins within the phantom

80
Q

What does uniformity describe?

A

the system’s ability to display similar reflectors in the phantom with echoes of equal brightness

81
Q

INDEX: PARAMETERS

A

AN SPI VOCAB (7 decks)

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