Boards Flashcards
vertebral level of thyroid cartilage
c4/5
vertebral level of vertebral prom
T1 on (C7)
vertebral level of sternal angle
T4/5
vertebral level of xiphoid process
T10
vertebral level of umbilicus
L3/4
vertebral level iliac crest
L4/5
greater trochanter is at the level of?
pubic symphysis
any restraint used against will is?
illegal
immobilization is used to?
decrease pt dose
depression along the MSP on the frontal bone
glabella
located at the medial and lateral portion of the eye
inner and outer canthus
inferior and superior bony portion of the orbit
infra and supra orbital margin
lateral bony portion of the orbit
mid-lateral orbital margin
most prominent portion of the mandible along the MSP
mental point
point along the MSP at the top of the bridge of the nose
Nasion
surface landmark located at the occipital protuberance
inion
most superior portion of the cranium
vertex
ridge of bone across the superior portion of both orbits
superciliary ridge
line connecting the pupils of the eye; also known as the inter orbital line
inter pupillary line
line connecting the mid-lateral orbital margin and the external auditory meatus
OML- orbitomeatal line
line connecting the inferior orbital margin and the EAM
IOML- infraorbitomeatal line
line connecting the superior orbital margin and the EAM
SOML - supraorbitomeatal line
line connecting the acanthi on and the EAM
AML- acanthiomeatal line
line connecting the glabella and the EAM
GML- glabellomeatal line
line connecting the mental point and the EAM
MML- mentomeatal line
petrous pyramids project anteriorly and medially at an angle of 47 degrees from the MSP
mesocephalic - typical
petrous pyramids lie at an average angle of 54 degrees
brachycephalic
petrous pyramids form a narrow angle an angle of 40 degrees
dolichocephalic
AP Axial Skull
also known as the town method, occipital is best demonstrated because its closest to the IR, CR is angled 30 degrees caudal through the foramen magnum to the OML, or 37 degrees to the IOML, demonstrates dorsum sellae and posterior cliniods through the foramen magnum
Lateral skull
IOML is perp. to the front edge of the IR, MSP is parallel to IR, IPL is perp to IR, CR is directed perp. to a point 2 inches superior to the EAM, sella turcica in profile
PA Axial skull
also known as the caldwell method, MSP and OML positioned perp to the IR, CR 15 degrees caudal to the MSP, Exiting the nasion, petrous ridges projected in the lower thirds of the orbits
PA Skull
demonstrates the frontal bone, petrous ridges of the temporal bone fill the orbits
Submentovertex
neck is hyperextended until the IOML is parallel to the IR
Facial Bones
facial bone views should be done upright whenever possible to demonstrate air and fluid levels
Facial Bones Lateral
MSP parallel to the IR, IOL perp to IR
parietocanthial projection
waters method, MSP and MML positioned perp to IR, OML forms a 37 degree angle with the IR, CR exits the acantion, petrous ridges projected completely inferior to the maxillary sinuses
What exam would you perform for a blow out fx?
PA modified waters
bones to demonstrate in a blow out fx?
zygomatic arch, pallatine, maxillary
Mandible
CR 25 degrees cephalic, Ramus is demonstrates in a true lateral position, body demonstrated if the pts head is rotated 30 degrees toward the table, mentum is demonstrated if the pts head is rotated 45 degrees toward the table
TMJ
Open and Closed
Nasal bones
performed table top, same technique as a finger, bilateral for comparison, and a Waters method to demonstrate nasal septum
Lateral Sinus
demonstrates all four sinus groups without superimposition
PA Axial Caldwell for Sinus
demonstrates the frontal and anterior ethmoid sinus groups
parietocanthial projection for sinuses
demonstrates maxillary sinus, may also demonstrate sphenoid sinus through an open mouth
AP Cervical Spine
40’’, CR angled 15-20 degrees cephalic to the level of C4, demonstrates intervertebral disk space, and vertebral bodies
AP Cervical Spine open mouth
demonstrates C1-C2 relationship, tip of the mastoid process and the lower margin of the upper incisors is positioned perpendicular to the IR (occlusal plane)
on the AP open mouth cervical spine how would you fix the base of the skull over the odontoid process?
flex the chin
on the AP open mouth cervical spine how would you fix the teeth superimposed over the odontoid process?
extend the chin and neck
Lateral C-Spine
demonstrates zygapophyseal joints of C2-3 to C7-T1, 72” to minimize magnification, depress shoulders to demonstrate lower cervical
RPO/LPO C-spine
demonstrates intervertebral foramina furthest from IR, pt rotates 45 degrees, 15-20 degrees cephalic
RAO/LAO C-spine
demonstrates intervertebral foramina closest to IR, 15-20 degrees caudal
lateral cervicalthoracic projection
twinning method, demonstrates a lateral projection of the lower cervical and upper thoracic vertebrae
displaced joint space
sublux
In AP projection FFC
RPO/LPO= C Furthest, T Furthest, L Closest
When do we perform lateral Cspine with flexion and extension?
Post Whiplash
AP Dens Cspine
Fuchs Method, pt in supine position, image shows AP projection of the dens lying within the foramen magnum
PA Dens Cspine
Judd Method, pt in prone position, adjust the head so that the chin and mastoid top are vertical or the OML is approximately 37 degrees to the plane of the IR, PA projection of the dens seen through the foramen magnum
What position would best demonstrate cervical ribs?
AP Tspine
AP Tspine
CR is directed perp to the level of T7, *may produce more uniform image density by increasing KVP level and utilizing the anode heel effect by placing the lower portion of the tspine toward the cathode end of the X-ray tube (FAT CAT)
Which exams utilize the breathing technique?
T-Spine lateral, AP scapula, lawrence method (transthoracic), STN, RAO sternum
Scoliosis Series
Ferguson Method, PA perferred to reduce radiation exposure of radiosensitive organs
forward slipping of the lumbar vertebrae usually L5-S1
spondylolisthesis
incomplete fusion of the lamina
spina bifida
L5-S1 degrees for males and females
3-5 caudal males, 5-8 caudal females
Scotty Dog ear
superior articular process
Scotty Dog body
lamina
Scotty Dog tail
sup articular process on other side
Scotty Dog back leg
inferior articular process of opposite side
Scotty Dog front leg
inferior articular process
Scotty Dog eye
pedicle
Scotty Dog nose
transverse process
Sacrum
15 to the nose
Coccyx
10 to the toes
contrast media is administered via a spinal puncture in what space for a myelogram
subarachnoid space- intrathecal injection
SI Joints AP Axial
CR is angled 30 cephalic for males 35 cephalic for females
SI joints obliques
on posterior obliques 25-30 degrees of rotation , the side of interest is the elevated side
AP Hip
pt. supine affected food and leg internally rotated 15 degrees, CR perp to a point 2 1/2 inches distal to the midpoint of the line drawn between the symphysis pubis and the ASIS
X table hip
danelius-miller method, IR placed parallel to the affected femoral neck
Unilateral frogleg lateral hip
pt. him and knee are flexed and abducted 40-45 degrees from vertical
axiolateral inferosuperior projection of hip
Clements-Nakayama method, performed in cases of possible bilateral hip fx
AP Pelvis
both feet and legs internally rotated 15-20 to over come ante version of the femoral necks, CR is directed perp 2’’ superior to the pubic symphysis and 2’’ inferior to ASIS
What makes up the acetabulum
Ischium, Ilium, Pubis
AP pelvis, axial anterior pelvic bones-Inlet
CR directed caudad 40 degrees, demonstrates the anterior pubic and ischial bones and the pubic symphysis
AP pelvis, axial anterior pelvic bones-outlet
Taylor Method, Males- 20-35 cephalic, females- 30-45 cephalic, demonstrates the pelvic rami without foreshortening seen
AP oblique projection pelvis- acetabulum
Judet method, pt supine, 45 degree oblique affected side up
hysterosalpingography
procedure that utilizes contrast media to outline the inner contours of the uterus and demonstrate the latency of the fallopian tubes, may be performed as a diagnostic or and interventional **therapeutic procedure, for infertility
Why do we use a 72” SID for PA chest?
reduce heart magnification
Why do we do Chest exams upright?
air and fluid levels, prevent engorgement of the pulmonary great vessels, and allow the diaphragm to drop to lowest point
where does the carina bifurcate?
T5/6
How many ribs should you see on a Chest?
10 pairs of posterior ribs within the lung field
Why do we perform the AP lordotic?
to demonstrate the apices of the lungs without superimposition of the clavicles
AP Lordotic hest
CR angled 15-20 cephalic
Why do we perform an AP supine chest?
for pts in respiratory arrest who have had an endotracheal tube inserted, tube should not go past the level of the carina
Which main stem bronchus is higher and more vertical?
Right Side
What do we perform lateral decubitus chest?
to demonstrate free air or fluid in the pleural space
Position and inspiration for AP or PA ribs above the diaphragm
upright and on inspiration
Position and inspiration for AP or PA ribs below the diaphragm
recumbent and on expiration
Posterior Obliques (AP) for Ribs
demonstrates the axillary portion of the ribs closest to the IR
Anterior obliques (PA) for Ribs
demonstrates the axillary portion of the ribs furthest from the IR
How is the sternum demonstrated in the RAO position?
over the heart shadow to the left of the vertebral column
What is being performed when the pt takes a deep breath and attempts to move the bowels while holding their breath
Valsalva maneuver
What is in the RUQ
liver, gallbladder, duodenum, head of pancreas, common bile duct, transfer colon
What is in the LUQ
Stomach, pancreatic duct, body and tail of the pancreas
What is in the RLQ
ascending colon, cecum, apendix
What is in the LLQ
Ileum, descending colon
AP supine KUB
IR at iliac crest, exposure at the end of full expiration
Why do we perform an AP upright abdomen?
air and fluid levels and or intra-peritoneal air
what should be visualized on an AP upright abdomen
entire diaphragm to visualize the possible existence of free air
how must the CR remain during an AP upright abdomen?
parallel to the floor
When do we perform a lateral decubitus abdomen?
when pt are unable to sit or stand
Why do we do a left lateral decubitus abdomen?
so any free air will rise under the right hemi-diaphragm and not be confused with air in the stomach
where does the CR enter for lateral decubed abdomens?
2-3 inches about the iliac crest
during an upper GI when do you take exposures?
While pt is swallowing
Why do we use barium?
to view the esophageal wall lining
in what position do we see esophageal varices?
trendelenburg/supine
What position best demonstrates the bulb and c-loop?
RAO
what position will best demonstrate hiatal hernia?
trendelenburg
Where will barium be when pt. is supine?
barium will be in the fundus , air will be in pylorus
Where will barium be when pt is prone?
barium will be in the body of the pylorus, air in fundus
When is a small bowel series complete?
ileocecal, terminal ileum, cecum, large intestines ( NEVER ascending colon)
timed sequence procedure based upon the movement of barium through the small bowel
small bowel series
using barium only for a barium enema will demonstrate?
the anatomy and the muscle contraction of the colon
using barium and air for barium enema will demonstrate?
any defects of the mucosal lining, polyps
what position do you use for insertion of the enema tip?
sims
lying on the left side with the right hip and knee flexed and drawn forward in front of the left leg is what position?
sims
how do you insert the enema tip in a sims position?
the tip is directed anteriorly and superiorly
Name the timed procedures that are timed
IVU, SBS, Lateral & Decubed abdomen
during a double contrast barium enema what is the surface of interest?
those outlined by the negative contrast
what is being demonstrated on the right lateral decub double contrast barium enema?
the medial side of the ascending colon and lateral side of the descending colon
what is being demonstrated on the left lateral decub double contrast barium enema?
the medial side of the descending colon and the lateral side of the ascending colon
which flexure is best demonstrated on the LPO?
hepatic flexure and ascending colon
which flexure is best demonstrated on the RPO?
splenic flexure and the descending colon
which flexure is best demonstrated on the RAO?
hepatic flexure and ascending colon
which flexure is best demonstrated on the LAO?
splenic flexure and descending colon
what is performed following the elimination of barium?
post evacuation
this procedure is to demonstrate the latency of the biliary and pancreatic ducts through the retrograde injection of contrast media into the hepatopancreatic ampulla
Endoscopic Retrograde Cholangiopancreatography (ERCP)
what procedure utilizes fluoroscopy and the use of an endoscope for accurate catheter placement into the hepatopancreatic ampulla?
ERCP
Why do we do a cystogram?
to R/O reflux
Non-functional procedure that evaluates the contours and anatomical structure of the urinary bladder, requires 150-500 mL of contrast administered by gravity in a retrograde fashion into the bladder using a Foley catheter?
cystogram
Functional study of urethra and urinary bladder to R/O reflux
Voiding Cystogram
How would you best demonstrate the left kidney?
RPO
how would you best demonstrate the right kidney?
LPO
When in the RPO which ureter do you demonstrate?
Right side
When in the LPO which ureter do you demonstrate?
left side
angle for toes?
perpendicular, can use 15 degree cephalic to open joint spaces
AP foot angle?
towards the 3rd metatarsal, 10 degrees posteriorly, towards the calcareous, cephalic
What are you best demonstrating on the medial oblique of the foot?
lateral structures such as: cuboid, lateral cuneiform, talus, and navicular
how much do you rotate for oblique foot?
20-30
what are you best demonstrating on the lateral oblique of the foot?
medial structures such as: medial and intermediate cuneiform, 1st and 2nd metatarsals
projection for longitudinal arch of the foot?
lateromedial
Axial projection of the calcaneus
dorsiflexion, foot is flexed 90 degrees to the long axis of the lower leg , CR is angled 40 degrees to the long axis of the foot entering at the level of the base of the 3rd metatarsal
AP ankle
ankle is placed in a dorsiflexion position, foot is flexed 90 degrees to the long axis of the lower leg CR is directed perpendicular to the mid-malleolar region
what view is being done with the ankle dorsiflexed and internally rotated 15-20 degrees
AP Mortise
What view will be done if their is a suspected ligamentous tear?
AP projection stress method done with inversion and eversion
who stresses the ankle for a suspected ligamentous tear?
physician
Which bone is the WB bone of the lower leg?
Tibia
which bone is the non WB bone of the lower leg?
fibula
which bone of the lower leg is more medial and anterior?
Tibia
which bone of the lower leg is more lateral and posterior?
fibula
which two bones of the leg makes up the knee joint?
Femur and Tibia
If you over rotate for a lateral knee what will happen to the tin-fib?
will be separated
if the pelvis measures less than 19cm how do you angle for knee?
3-5 caudal
if the pelvis measures 19-24cm how to you angle for knee?
perp
if the pelvis is greater than 24cm how do you angle for knee?
3-5 cephalic
where do you center for AP knee
1/2’’ below the patellar apex
how much do you flex the knee joint for lateral knee?
20-30 degrees
how do you angle the tube for the lateral knee and why?
5-7 cephalic to superimpose the femoral condyles
why do we perform a medial oblique knee?
demonstrates an open proximal tibofibular joint space
Where do you place your film for a femur?
injured site on long cassette
what kind of fx does the sunrise/tangential projections show?
vertical
lateral projections of the 1st, 2nd, and 3rd digit?
mediolateral
lateral projection of the 3rd, 4th, 5th digit?
lateromedial
how would we demonstrate an oblique thumb?
PA hand
Where do you center for a PA hand?
3rd MPJ
how do you demonstrate the fingers with no superimposition?
fan lateral
how do you demonstrate foreign bodies in the hand?
lateral hand with extension
how do you best demonstrate the inter carpal spaces of the wrist?
AP
what is the most fx carpal bone?
scaphoid
how do you demonstrate the scaphoid?
PA with ulnar deviation
how do you perform the stecher method/ scaphoid PA axial
elevate the wrist 20 degrees or angle the CR 20 degrees cephalic (towards the elbow)
What is the name of the nerve that gets pinched in the carpal canal
median nerve
what carpal bones are you demonstrating on the gaynor heart method/ carpal tunnel
on the inferior aspect of the wrist
when the forearm is in the AP position how are the humeral epicondyles?
humeral epicondyles are parallel
why is the AP projection preferred for the forearm?
to prevent overlap of the proximal radius and ulna
how are the humeral eipcondyles when the forearm is in the lateral position
perpendicular
what will be seen in profile on the lateral elbow
olecranon process
What will be demonstrates on the external oblique of the elbow
the radial head with no superimposition over the ulna and the capitulum
what will be demonstrated on the internal oblique of the elbow
the olecranon and coronoid process
what part of the distal humerus articulates with the ulna?
Trochlea (UT)
What part of the distal humerus articulates with the radius?
Capitulum (RC)
position for the AP humerus
arm fully extended with the hand supinated
what does the AP humerus demonstrate?
greater tubercle laterally (GTL)
what does the lateral humerus demonstrate?
lesser tubercle medially (LTM)
what kind of dislocation is when the head is under the corocoid?
anterior
what kind of dislocation is when the head is under the acromion?
posterior
Where do you center for AP shoulder?
1’’ inferior to the coracoid process
what is the tubercle part of?
shoulder
what is the trochanter a part of?
hip/femur
angle for AP clavicle?
15-30 cephalic
angle for PA clavicle
15-30 caudad
how do you demonstrate AC joints?
bilateral, WB
Which hand do you use for bone age?
non dominant
Why do we do shoulder arthography?
R/O torn rotator cuff
why do we do Knee shoulder arthography?
R/O torn menesci
overall amount of X-rays that reach the IR
Receptor Exposure
main controlling factor of receptor exposure?
mAs
difference in adjacent areas
contrast
controllers of contrast
kVp/LUT
as kVp goes up contrast goes?
down
as kVp goes up scatter goes?
up
if more X-rays reach the IR then receptor exposure?
increases
if more X-rays get absorbed in patient then contrast?
increases
as SID increases- receptor exposure?
decreases
as kVP increases- receptor exposure
increases
the only 2 times receptor exposure and contrast change in the same way is?
screen speed, beam filtration
as screen speed increases- receptor exposure
increases
as grids increase- receptor exposure
decreases
as beam filtration increases-receptor exposure
decreases
as subject density increases-receptor exposure
decreases
as beam restriction (collimation) increases- receptor exposure
decreases
two types of shape distortion?
foreshortening and elongation
two types of size distortion?
magnification and OID
main controlling factor of spatial resolution?
Focal Spot Size
as SID increases- spatial resolution
increases
as OID increases- spatial resolution
decreases
as focal spot size increases- spatial resolution will
decreases
as screen speed increases- spatial resolution
decreases
as matrix size increases- spatial resolution
increases
as pixel size increases- spatial resolution
decreases
as PSP plate size increases- spatial resolution
decreases
as field of view increases- spatial resolution
decreases
a 15% increase or decreases in KVP, keeping all other factors contestant, will result in?
doubling or halving of radiographic receptor exposure
by applying the 15% rule what do you change?
ONLY kvp unless the say to maintain density then you change mAs as well
by applying the 15% rule double the receptor exposure of 80kVp 20mAs
92 kVP 20 mAs
A change from a 1.5 mm focal spot to a 0.5 mm focal spot will limit the maximum mA station that may be selected on the control panel. This change in focal spot size will also have what effect on image contrast?
image contrast will remain the same
Which of the following does not affect recorded detail?
A. OID B. Screen Speed C. Grid Ratio D. Motion
C. Grid Ratio
When comparing 100 kV and 70 kV, 70 kV will do which of the following?
1. Produce less compton scatter 2. Produce less exposure latitude 3. Produce shorter scale contrast
1,2,3
When the exit radiation interacts with a photostimulable imaging plate, what of the following occurs?
energy absorption
When proper patient positioning and phototimer selection is employed one would expect abdomen images produced on a variety of patients to demonstrate a consistent level of:
1. radiographic mottle 2. radiographic density 3. subject contrast 4. radiographic contrast
2 only
Grid devices will have no effect on which of the following items?
A.radiographic density
B.effect of secondary and scattered radiation on the image
C.radiographic contrast
D.production of secondary and scattered radiation
D. Production of secondary and scattered radiation
Select the set of exposure factors below that will yield the same density on a high speed film and screen system (200), as that produced on a par speed film and screen (100) system using 70 kVp 2.0 mm focal spot, 40” source to image receiver distance, 200 mA, 0.25 seconds
A. 70 1.5 mm 40” 300 0.20
B. 70 2.0 mm 40” 100 0.25
C. 80 1.0 mm 40” 500 0.15
D. 70 1.0 mm 40” 400 0.025
B
To avoid absorption of the primary X-ray beam by lead strips present within a grid cassette, angulation of the central ray should be limited to:
angulation along the long axis of the grid
Which of the following would reduce the image density by one-half if it was not possible for the technologist to adjust the mAs?
make a 15% decrease in kV
In digital imaging, receptor exposure is controlled by adjusting:
window level
What factor(s) determine the amount of contrast present within a radiographic image?
1. film contrast 2. developer contrast 3. illuminator contrast 4. subject contrast
1,2,4
What is the primary purpose for the use of fast image receptors in radiography?
reduce exposure to the patient
Administrative and computerized clinical data such as patient demographics, medical reports, insurance claims and physician orders are overseen using which of the following standards?
HL-7
A decrease in beam filtration will have what effect on radiographic image contrast?
radiographic image contrast will increase
With all other technical factors remaining constant, what effect(s) will increasing amounts of filtration have on the X-ray beam?
1. decrease patient skin exposure 2. decrease the measurement of the shortest wavelength present within the beam 3. harden the X-ray beam 4. increase the percentage of beam penetration through the objects of interest
1,3,4
Electrons boiling off
Thermionic Emission
__ setting determine the amount of current that will be sent to the filament
mA
electrical potential
Voltage
X-radiation is produced as a result of high speed electrons bombarding the?
anode/ target area
what is the target area made of?
Tungsten laced w/ rhenium
what 2 parts make up the cathode
filament wires, focusing cup
what is the focusing cup made up of?
molybdenum or nickel
what are the filament wires made up of?
tungsten
where is the conversion site of elections to X-ray?
anode/ target area
smallest subdivision of an element
atom
the number of protons in the nucleus
Atomic Number (Z)
the sum of the protons and neutrons in the in the nucleus
Atomic Mass (A)
Atomic Number =
Z
Atomic Mass =
A
negative charged particles located in the orbital shell outside the nucleus and contain no mass
Electrons
how are electrons held in their orbital shell?
electron binding energy
Tungstens Atomic Number (z)
74
Binding k shell of tungsten =
69.53
Valence number can never exceed?
8
removal of an electron from one of the orbital shells
Ionization
during Ionization the previously uncharged atom will now have an _____ electrical charge?
positive
Projectile electron interacts with the electrostatic charge of the target tungsten nucleus
bremsstrahlung radiation
during bremsstrahlung radiation the electron undergoes three processes:
1- slows down 2- changes direction 3 loses some of its energy
below 70 kv what is being produced?
100% brems
Above 70 kv what is being produced?
Characteristic
projectile electron interacts with a tungsten target atom by ejecting an inner shell electron and ionizing the atom
Characteristic Radiation
When the K-shell vacancy is filled by an outer shell electron
Characteristic Radiation
The process of filing the K shell vacancy results in the emission of a _____ X-ray photon
characteristic
The smallest bit of electromagnetic energy is called a?
Photon or quantum
Other forms of radiation, such as beta and alpha radiation, travel in particles called?
Particulate Radiation
The rise and fall of the electromagnetic photon and is measured in the unit Hertz (HZ)
Frequency
The distance between two successive peaks of an electromagnetic photon
Wavelength
As the frequency of the electromagnetic radiation increases the wavelength will?
decrease
X-rays always move at the speed of?
light
Quality
KVP
Quantity
mAs
thickness of an absorbing material required to reduce X-Ray intensity by one half of its original value
Half Value Later
The only technical factors that effect HVL are?
kVp and filtration
intensity is inversly proportional to the square of the distance
inverse square law
inverse square law
intensity 1 / intensity 2 = SID2 squared/ SID 1 squared
Used to maintain radiographic density with changes in SID
Direct Square Law
Direct Square Law
mas1/mas2=sid1 squared/ sid2 squared
useful radiation consisting of the X-ray photons directed through the X-ray tubes window port in a direction toward the patient
Primary Radiation
_____ radiation is the x-ray beam prior to interaction with the patient
Primary
radiation that is emitted from atoms of matter after an x-ray photon from the primary beam interacts with matter
Secondary
____ also known as Exit radiation is the portion of the attenuated x-ray beam that emerges from the patient and interacts with the image receptor
Remnant
____ xray beam is also known as the image forming beam
Remnant
___ is defined as the progressive absorption of the X-ray beam as it passes through matter
attenuation
X-rays travel in _____
straight lines
X-rays contain __ mass and __ electrical charge
no mass, no electrical charge
X-rays have ___ frequencies and ___ wavelengths
high frequencies and short wavelengths
How does a tech receive occupational exposure
compton effect
every time an X-ray photon gets scattered it will leave with ____ of its original intensity
1/1000 (.001)
partial absorption of the incident x-ray photon, interacts with an outer shell electron of a target atom and removes the electron
Compton Effect
1 Coming , 2 Leaving, Outer most shell
Compton
2 results when X-rays interact with matter
photoelectric (absorption) and Compton (scatter)
Total absorption of the X-ray photon
Photoelectric effect
Incident X-ray photon interacts with an inner (K) shell electron of a target atom and removes the electron
Photoelectric Effect
All of the remaining energy of the incident photon is transferred to the ejected electron =
photoelectron
What is the primary source of patient radiation exposure
Photoelectric
1 incoming, 1 leaving, innermost shell
photoelectric
no loss of energy, no ionization=
Unmodified (classical, Coherent)
Quality Factor of X-rays
1
Quality Factor of Gamma Rays
1
Quality Factor of Beta Particles
1
Quality Factor of Fast Neutrons
10
Quality Factor of Protons
10
Quality Factor of Alpha
20
Quality Factor equation
Rad X QF = REMS
Most sensitive = _________ resistant
Least
least radiosensitive cell in the body to most sensitive
Nerve, Muscle, Stem, Lymphocyte
Radio-sensitivity increases with _____ mitotic activity
increase
the more the cell divides the more sensitive it is
mitotic activity
law of bergonie and tribondeau
the more immature the cell the more sensitive
Oxygen Effect
the ability of aerobic conditions to enhance the effectiveness of radiation
amount of radiation that is transferred to the body as the x-ray beam travels through the body
Linear Energy Transfer
the ability to produce biologic damage
Relative Biologic Effectiveness
equal doses of radiation that are delivered with time interval separations
fractionation
radiation dose that is delivered continuously but at a lower dose rate
protraction
radiation interaction with water
radiolysis
highly reactive and unstable substance
free radical
cell division
mitosis
germ cell division
miosis
when a cell divides without attempting to divide
interphase death
cell goes through one or more mitotic phases and then dies
mitotic (genetic) death
can be caused by as little as 10mGy of exposure
mitotic delay ( threshold dose)
can result from exposure doses ranging from 1-10Gy
reproductive failure
Somatic Effects:
short term: epilation, nausea, vomiting, erythema, fatigue
Long Term Effects:
Cancer, cataractogenesis, life span shortening
Acute exposure
More harmful
10 days of life span shortening
10mGy
X-rays have __ LET and RBE
low
Eyes have what radiation dose response?
nonlinear, threshold
Thyroid have what radiation dose response?
linear, non threshold
Breasts have what radiation dose response?
linear, non threshold
sloughing off of skin cells
desquamation
Skin has what radiation dose response?
threshold
Dose that could cause permanent sterility
5-6Gy
Dose that can cause genetic mutations
100mGy
effects that are limited to the exposed individual and the specific area of exposure only
local somatic effects
effects that are limited to the exposed individual but the response to the radiation effects the entire body, not just the site of exposure
general somatic effects
Radiation syndrome that occurs with exposure doses ranging between 1-10Gy,
Hemopoietic syndrome
Radiation Syndrome that could cause blood disorders, depressing the bodies immune system, and depressing the bodies ability to clot. Death occurs 3-6 weeks
Hemopoietic syndrome
Radiation syndrome that requires a dose between 10-50Gy
Gastrointestinal Syndrome
Radiation syndrome that causes nausea, vomiting, fatigue. Death occurs approximately one week following exposure
Gastrointestinal Syndrome
Radiation syndrome that occurs with exposure of 50Gy +
Central Nervous System syndrom
Radiation syndrome that occurs within hours or days
Central Nervous System Syndrom
When is the most radiosensitive trimester
First, because of the large number of stem cells
the dose, which if delivered to every member of a population, would be expected to yield the same total genetic injury as the doses received by the various individuals
Genetic Significant Dose
Gonadal shields should be used anytime the gonads are within ____ of the primary field
5cm
when working in a sterile field what time of shield should you use?
shadow
___ removes low energy, non diagnostic X-ray photons from the X-ray beam
filtration
What is the primary purpose of filtration?
reduce the entrance skin exposure to the patient
____ will increase the effective energy and quality of the X-ray beam
filtration
NCRP #102
Equipment Standards
minimum requirement of filtration needed for below 50kvp
0.5 mm al
minimum requirement of filtration needed for 50-70 KVP
1.5 mm al
minimum requirement of filtration needed for 70kvp+
2.5 mm al
___ speed image receptor systems reduce the required amount of radiation needed to produce a diagnostic image
high
Increasing the speed of the imaging system will _____ the recorded detail
decrease
grids are to be used on body parts that are more that ____ think
10cm
What is an alternative to using a grid?
air gap tech
what type of fluoro reduced pt. dose?
pulsed/intermittent
length of exam fluoro time must be monitored by a ___ minute cumulative timer
5 minute
Where is the image intensifier ?
over the pt table
Cord length for Mobile unit
6 ft, 72’’, 2m, 18cm
largest source of natural radiation?
Radon
largest source of artificial radiation?
medical imaging
minimum lead apron thickness
.25 of pb
recommended leaf apron thickness
.5 mm pb
gloves thickness
.25 mm pb
thyroid shield thickness
.5mm pb
bucky slot cover thickness
.25 mm pb
primary protective barrier
1/16 inch of pb, 7 ft tall
secondary protective barrier
1/32 inch of pb, 1/2’’ of the secondary must overlap the primary
maximum exposure at the table top fluoro
10R/min
Typical fluoro units operate within what mA range
5 or less
minimum source to skin distance for flouro units
15’’
minimum source to skin distance for mobile flouro units
12’’
NRCP # 116
exposure limits
annual whole body exposure
50 mSv
Lens of the eye
150 mSv
cumulative effective dose equation
10 mSv X age in years
annual effective dose for public
5mSv
embryo/fetus exposure for entire gestational period
5mSv for the entire gestational period
embryo/fetus exposure per month during gestational period
0.5 mSv
all or nothing non threshold effects?
Stochastic (probabilistic)
prenatal death due to radiation exposure delivered during the first trimester of pregnancy is what effect?
Stochastic (probabilistic)
Exhibits the existence of a threshold
Non-Stocastic (deterministic)
Erythema site of a radiation therapy patient is cause by what type of effect?
Non-Stocastic (deterministic)
The portion of the image intensifier device that is responsible for converting light photons into free electrons is
photocathode
Which of the following barium/air filled anatomic structures is best demonstrated in the LAO position?
spelnic
Elongation or foreshortening of the image of an object on the radiographic image is a result of:
improper alignment of the tube, part or image on the exam in question
A threshold dose-response relationship is seen in which of the following types of radiation-induced cancers?
skin
Why is limiting the maximum kilovoltage of the useful X-ray beam important when performing exams employing an iodinated contrast media?
excessive kilovoltage reduces the ability of the iodinated contrast media to attenuate the useful X-ray beam
Antiversion of the femoral neck is overcome by a ____ when performing an AP projection.
15 degree inversion
What is the term associated with an object that once contaminated acts as the vehicle for an infection?
fomite
Where in the X-ray circuit does the filament circuit draws its electrical energy?
from the low voltage primary circuit
Which position listed below will demonstrate the broad aspect of the right ilium?
right posterior oblique position
What is the term applied to the blood pressure value when the heart is at “rest”?
diastolic
What feature below is an essential component of modern fixed radiographic equipment, designed to minimize unnecessary radiation exposure to patients?
PBL
As the angle of the face of the anode increases from 14 degrees to 17 degrees the size of the actual focal spot measured for a 1.5 mm filament will:
increase
What position below will be best for demonstrating a fracture with medial displacement of the right mandibular condyle?
AP Axial
Which of the following are mapped by a look-up-table?
image gray scale values
In order to keep the line of gravity close to the center of gravity when carrying a load of cassettes down a long hallway one should:
keep the load close to the body
wheelchair should be what angle to the X-ray table
parallel
What units are radiation film badge reports for diagnostic radiographers stated in?
millirem
Where in the X-ray circuit is the prereading kilovolt meter connected?
primary low voltage circuit
Shape distortion produced on a finished radiograph will vary directly with which of the following factors?
tube angulation
When Bremsstrahlung radiation is produced the incident electron:
is deflected with a loss in energy
At what period during a cell’s life cycle will the cell be at its highest point of radiosensitivity?
mitosis
The violet light emitted by the PSP is transformed into the image seen on the CRT by which of the following:
analog to digital converter
Which of the following signifies high principles of professional behavior and a willingness by the profession to control its own conduct?
code of ethics
A comparison of photon energies would demonstrate that scattered photons resulting from a “Compton” interaction are ____ the energy of the incident X-ray photon.
lower than
Which of the following occurs with interphase death?
the cell dies before before leaving interphase
Which law listed below states “a direct relationship is necessary to compensate for the changes in intensity and receptor exposure (image density).”
direct square law
Sterility of male patients due to excessive radiation exposure to the gonads is an example of what type of radiation effect?
somatic local
The primary side of a high-voltage transformer is supplied by 240 V and has 150 turns, and the secondary side has 25,000 turns. What is the voltage that will be induced into the secondary side of the transformer?
40kV
What is the term applied to radiation injuries that are limited to an exposed individual and the area of exposure only?
local somatic injuries
The use of digital radiography results in _____________exposure to the patient versus conventional radiography.
less
A PA skull radiograph with the structures of the petrous pyramids completely filling the boney orbits, is an indication that the image was produced with:
the orbitomeatal line and central ray perpendicular to the image
What test is performed to determine if you are experiencing rectifier failure of a single phase full wave rectified X-ray unit?
spinning top test
A patient is being scheduled for a series of radiographic examinations. Select the most preferred sequence of exams listed below: IVE, KUB, BE UGI
KUB, IVU, BE, UGI (KUB first bc it doesn’t use any contrast, IVU next bc you can excrete/ urinate it )
A dose of radiation to a patient’s long bones results in a 70% loss of operation of the hematopoietic system making the patient susceptible to developing infections. This is an example of what type of radiation induced injury?
general somatic effect
The proper technique for lifting a heavy load from the floor is to:
1. spread your feet 2. bend knees keeping your back straight 3. bend at the waist 4. keep the load close to the body
1,2,4
Four essentials are necessary for the production of X-rays: sudden deceleration of high speed electrons, a source of free electrons, a sudden acceleration of electrons and:
focusing of electrons
Which of the following emergency medications may be used on a patient experiencing a seizure?
dilantin
Which of the following is demonstrated on the scapular Y view of the shoulder?
1. anterior or posterior dislocation 2. a lateral projection of the shoulder 3. an oblique projection of the shoulder
1,3
What will be the effect on radiographic contrast when the radiation field size is changed from 5”x7” to 8”x10”?
contrast will increase
When insufficient light is produced by the imaging plate phosphor, the image will be:
grainy
What is the minimum lead equivalent thickness that must be present within aprons worn during fluoroscopic procedures?
.5 mm
What will be measured by a meter connected in series in a simple electric circuit?
amperage
What will be measured by a meter connected in series in a simple electric circuit?
1050 volts
Which of the following regions of an ionization chamber instrument would be used to accurately calibrate the output of a radiographic unit?
ionization chamber region
What is the primary reason for employing ureteric compression during an excretory urogram?
1. compression retards the flow of contrast media to the bladder 2. improves the demonstration of renal calculi in the proximal ureters 3. assures an adequate filling of the renal pelves and calyces 4. aids in decreasing the flow of blood through the renal arteries
1 & 3
Total brightness gain of an image intensifier is a result of which of the following:
1. Flux gain 2. Focus gain 3. Minification gain
1 & 3
Frustrated by an extremely uncooperative patient, the technologist shouts out, “I’ve told you to hold still for the last time, next time you move I’m going to have to tie you to the table!” An action such as this is grounds for a legal case of _____ being brought against the technologist.
assualt
For the PA axial projection (Camp Coventry method), which area of the knee should the central ray enter?
poplileal depression
Which of the following emissions released during radioactive decay, produces the greatest amount of radiolysis per mm of irradiated material?
alpha emission
An image produced with the central ray angled along the longitudinal or long axis of a part, is produced in a (an) ____ position.
axial
How many volts will be sent to the primary side of the step up transformer when 75 tap turns have been selected on an autotransformer consisting of 140 primary turns which is connected to a 112 volt alternating current supply?
60 volts
What is the effective dose equivalent limit of a student radiographer under the age of 18?
.1 rem
When performing as part of an upper GI exam, the RAO position places barium in the _______ portion of the stomach.
pylorus
What projection of the chest below is best for demonstrating the retrocardiac space?
RAO
What is the most anterior structure of the scapula?
coracoid process
What view listed below is done to demonstrate the hamular process (hook) of the hamate bone?
view for carpal tunnel
Digital imaging was first used by which modality?
CT
What exam category below is the single greatest form of acute radiation exposure a patient will receive within a diagnostic radiology department? A. upper gastrointestinal exam B. lumbar spine series C. scoliosis series D. skull series
A. upper gastrointestinal exam
What is the proper treatment of a patient who is experiencing a contrast media extravasation into tissues around a vein:
1. apply pressure to the site of injection 2. moist heat should be applied to the affected area 3. a cold pack should be applied to the affected area
1 &2
Bilateral depressed fractures of the zygomatic arches will be demonstrated best using which of the following positions?
SMV
A post processing technique known as shuttering A. is added to the screen image. B. is placed on the patient. C. is placed on the cassette. D. Changes the amount of scatter.
A
Which of the following is the legal document that names the person who is authorized to make all health care decisions when a patient is unable to do so?
1. advanced heath care directives 2. last will and testament 3. living will
1 & 3
Positions requiring that the base of the cranium be placed parallel to the surface of the film will require the cranium to be adjusted to place:
IOML parallel to the image
What is the term given to the area of unsharpness surrounding the image of an object on a radiographic image?
penumbra
What position below is preferred for demonstrating a fracture along the axillary border of the right 7th rib?
right posterior oblique taken on full inspiration
A change from a 1.5 mm focal spot to a 0.5 mm focal spot will limit the maximum mA station that may be selected on the control panel. This change in focal spot size will also have what effect on image contrast?
image contrast will remain the same
How does SID relate to image density/brightness and exposure rate?
as SID increases, image density decreases and exposure rate decreases
With the patient in a PA position, central ray angulation of ____ will be required to free the majority of the clavicle from superimposition of the ribs and scapula.
25 - 30 degrees caudad
What does “The rate of energy deposited per unit track length through an absorber” define?
LET
During normal breathing, the least amount of air volume is exchanged in what portion of the lungs?
apices
What is the prescribed distance used when measuring leakage radiation for the housing of a diagnostic X-ray tube?
One meter from the tube housing
