CAMRT Flashcards
what does flexion/extension views of the c-spine assess?
anteroposterior mobility & anteroposterior movement, motility
what is the CR angle for a AP Coccyx?
10 degrees caudad, 10 degrees caudal CR angulation
What does ERCP stand for?
endoscopic retrograde cholangiopancreatography
why is ERCP done?
diagnose biliary & pancreatic pathologic condictions & investigate gallbladder, common bile duct and pancreatic ducts as well as intervention procedures
why is a ball catchers view done?
assist in detecting early radiologic changes needed to diagnose rheaumatoid arthritis
SC 35 the timer accuracy must be accurate to————–seconds or ————% of the setting which ever is greater
1/60 & 5mas
if a safelight test has become worse than the previous test, the thing to check first would be?
light streaks also bulb wattage,film type, timing etc
orthrostatic hypotension is?
low blood pressure due to standing upright (dizziness after getting up from a supine position)
is a germicide the same as a disinfectant?
germicide solution is a solution that destroys microrganisms and a disinfectant is any substance that inhibits the growth of bacteria. a disinfectant is a type of germicide
what is the difference between a Lauenstein view of the hip and a x-table lateral?
Lauenstein is the lesser trochanter in profile medially and the femoral neck superimposes the greater trochanter. x-table is the femoral neck demonstrated at about the same transverse level
what is the significance of Shenton’s Line?
used to evaluate pathology of the hip
the body part perpendicular to the CR when doing an intercondylar fossa is?
long axis of the leg, calf/lower leg/ tib-fib
purpose of lateral bending for scoliosis is?
compensatory curve will straighten/correct itself on one of these films. employed in patients with early scoliosis to determine the presence of structural change when bending to the right and left
optimal KVP for a chest x-ray and why?
100-130kvp to sufficiently penetrate the heart shadow and visualize the thoracic vertebrae as well as provide the long scale of contrast necessary to visualize lung details
how to adjust CR for a PCXR on a kyphotic patient
angle up slightly or leave the CR straight so the clavicles will be 1” below the apices of the lung
maximum size focal spot for a scaphoid
0.6mm
medication that may be added to the contrast to prevent a reaction
steroids and antihistamines(Benadryl, Medrol) may be used as a premedication but the contrast media should NEVER be mixed with medication
test tool used to test the focal spot is
standard a slit camera, pinhole camera & star pattern
nurse forgets to chart a medication during an IVP what should you do?
must bring omissions to their attention any item that has not been documented on the chart is considered to be “not performed”in a court of law
size of focal spot effects penumbra what does penumbra effect?
recorded detail
state the line focus principal
through angling the target, the effective area of the target is made much smaller than the actual area of electron interaction
the pedicles are sitting to far on the vertebral bodies so the patient is?
to far oblique (if oblique l-spine)
what is the purpose of a CVP line?
used for measuring central venous pressure and allowing nutrients and fluid to be instilled; best location would be the brachiocephalic vein at the junction of the SVC or actually within the SVC itself
what is the purpose and position of a Swan Ganz catheter?
Purpose- to measure wedge pressure, measure central venous pressure, measure systolic, diastolic and mean pressure, withdraw blood samples and to give fluid or inject drugs. Position- right or left pulmonary artery
what does plia circularis mean?
numerous folds of mucous membranes of the small intestine running transversely for about 2/3 of the circumference of the gut
instruments used for sensitometry
sensitometer (step wedge) and densitiometer
why is it suggested to do scoliosis films in the PA projection?
reduce the radiation exposure to selected radiosensitive organs
how often is a sensitometry strip done?
daily
what is demonstrated on a 15 occipitofrontal view of the sinuses
frontal sinuses lying superior to frontonasal suture, anterior ethmoidal air cells lying on each side of the nasal fossas and immediately inferior to the frontal sinuses, sphenoid sinuses projected through the nasal fossa just inferior to or between the ethmoid air cells, petrous ridge is inferior 1/3 of the orbit
what is the difference between spondylolysis vs spondylolithesis?
spondylolysis- defect in the pars interarticularis without displacement if there is displacement occurs in the condiction called SPONDYLOLITHESIS. spondylolysis- breaking down of a vertebra or replacement of a portion of the vertebral arch with cartilage. spondylolithesis- forward displacement of a vertebra over a lower segement usually in the 4th or 5th frequently due to spondylolysis
SC 35 states that mobile exams the target to skin distance be no less than?
30cm
what is the difference between a bennettes fracture & a potts fracture?
Bennett’s fracture- oblique fracture of the base of the 1st metacarpal with proximal and lateral subluxation of metacarpal shaft. the fracture extends into the 1st metacarpal shaft. usuall from a FOOSH
pott’s fracture- fracture of the ankle involving the malleoli. 1st degree pott- fractures of 1 malleolus. 2nd degree potts bimalleolar is a fracture of both malleoli. 3rd degree potts trimalleolar is a bimalleolar fracture with a fracture of the posteroinferior surface of the tibia
difference between a compound fracture and a communited fracture
compound fracture- wound in communication with a fracture, susceptible to infection with blood loss that maybe significant. comminuted fracture is a fracture with more than 2 bone fragments. segmental - divides the long bone into several fragments. butterfly- wedge shaped fragment split off from the main fragement
method to open a sterile tray for a cloth wrapped pkg
should have already washed hands, indicator tape is grey if it was sterilized, place pack on clean tabletop with sealed end toward you, remove tape, move the 1st corner of wrapper back and away from you, open next 2 corners of the pack to the left and right, open the 4th corner by dropping it toward your body, DO NOT TOUCH THE STERILE contents. to move the content to another sterile field grasp underside of the wrapper and let the edges fall over your hand
enema bag should be ———cm above the anus
61
what part of the gown is sterile during surgery?
only parts of a sterile gown considered sterile are the areas from the waist to the shoulders in front and the sleeves from 2” above the elbow to the cuffs
when communicating with a patient, why is humor never used
although humor can be an effective communication tool you must use it with care when there are cultural or age differences. if there is any doubt concerning its appropriateness do not use humor
how can dose be minimized when xraying a pregnant patient
only essential investigations should be taken in the case of pregnant or suspected pregnant patient, must not be accepted for chest photoflurographic mass radiographic exams, when pelvic radiography is needed, exposure must be kept to a absolute minimum with optimal use of gonadal shielding, if a exam of the fetus is required the prone position should be used to reduce fetal dose, radiography should not be used for determination of abnormal presentations of the fetus or for placenta localizations
what is the sterile field area in surgury
ends at the level of the tabletop or at waist of the sterile persons gown, edges of a sterile wrapper are not sterile, cuffs of a sterile gown are not considered sterile
angle and direction of AP knees on a patient with abdominal measurement of 19-24 cm is
perpendicular to the knee joint
what is included in a brain Ct?
base of skull to cranial apex
which vessel ascends through the cervical transverse foramina
vertebral artery
can compression be used for microscopic hematuria when doing IVP
yes, compression is only contraindicated for urinary stones, abdominal mass or aneurysm, a colostomy, suprapubic catheter or traumatic injury
why does excessive rotor prep lead to wear on the xray tube
filament vaporization- gassy tube as well as melting the bearings in the rotor- seized rotor un even wear on anode
when doing a c-spine odontoid in collar, what visible reference line is parallel to the CR
IOML
how is mobility assessed on a wheelchair patient you need to stand
deviations from correct body alignement, immobility or limitations in range of joint motion, ability to walk, repiratory cardiovascular, metabolic and musculoskeletal problems, patient condition, range of motion and weight bearing ability, strength and endurance, maintain balance, understand, acceptance to move, medication history
list exams from highest to lowest dose: lumbar spine, KUB, chest, BE
barium enema, lumbar spine, KUB, chest
what drug would be given to a patient following a severe contrast reaction
medications usually given for anaphylactiv shock are epinephrine, diphenhydramine, hydrocortisone and aminophylline
what is the optimal kvp for an abdomen and why
optimal is 65 to 75kvp technique because it sufficiently penetrates the soft tissue and bony structures of the abdomen. this kvp setting enhances subtle radiation absorption differences among the fat, gas, muscles, solid organs which are mainly water
minimum number of people needed for a stretcher transfer without a slider board
3 one at head, one on each side of patient
what is the fowler position
head of the patients bed is raised 18-20inches above the level with the knees also elevated
what is a colles fracture
transverse fracture through the distal radius with dorsal posterior angulation and often overriding of the distal fracture fragement. most common fracture of the upper extremitiy commonly associated with an avulsion fracture of the ulnar styloid process, radial fragement may be displaced posteriorly like a diner fork
3 anatomical landmarks assessed for perfect position of a “Y” view
coracoid, acromion angle, medial scapular angle
name 3 things found on an emergency crash cart
defibrillator, oxygen tank & tubing, suction machine, oral airways, laryngoscope, endotracheal tube,stethoscope, blood pressure cuffs, IV supplies, syringes, needles, blood tubes, tape, gauze, tourniquets
when inserting an enema tip it should be directed?
anteriorly and superiorly
SID for AC jts and why give weights
72”/ 183cm to reduce magnification and distortion of the joint space, weights will clearly demonstrate an AC jt separation if any
what is most likely the first sign of anaphylactic shock and what drug would you most likely reach for first in an reaction
itchness, redness or swelling of the skin, epinephrine
In terms of communication what must be discussed first before moving a patient
consultation with the nurse in charge of the patient is recommended so that the patients condition and limitations can be understood, if assistants are needed they must be on hand
when a patient is confiding personal information to you about himself what attitude is important for you to assume
neutral non judgmental one
how does cold barium affect the stomach for a GIFT
reduces irritation to the colon reduces spasm and cramping
how do you know if a FB is in the esophagus and not the trachea
if the FB is in the trachea the lungs will still have air in them on expiration of the chest xray, where a FB in the esophagus will have no effect on the lung size/markings
what does quantum mottle indicate
insufficient quantity of photons have stricken the intensifying screen due to low mas/ time factor
normal blood pressure is
110-140mmHg systolic and 60-80mmHg diastolic
what kvp is used in mammography and why
low kvp for high contrast as breast is made up of similarly attenuating parts; technique factors are approx. 23-28kvp used because to low a technique increases dose while a high kvp reduces the image quality
injection site for a myelogram
subarchnoid space by spinal puncture most commonly at L2-L3 or L3-L4 interspace or at the cisterna magna between C1 and the occipital bone
what breathing should be used when xraying a soft tissue neck
slow inspiration so the trachea is filled with air
on an oblique lumbar spine what is the neck of the scottie dog
pars interarticularis
during a mobile exam how far must you stand from the tube housing
3m
mobile cable must be how long
3m
CR angulation for clavicle views are
ap- perpendicular
pa-perpendicular
ap axial- 15-30 cephalad
pa axial 15-30 caudad
during a voiding cystogram patient does not want to continue the exam what should you do? advocate for the patient or the radiologist?
for the patient
name the most often used injection site for abdominal angiogram
percutaneoud femoral artery, catheter positioned at the level of T12
what is the injection site for a cerebral angiogram
done using percutaneous method of the common carotid artery or catheterization method via femoral or transaxiallary puncture by guiding the wire and appropriate positioning of the head and anyone of the cerebral vessels can be catheterized or internal carotid artery
why use an antigolinergic
reduces gastric motility which may help decrease cramping
how is a question of imperforate anus radiographed
infant is held upside down by the heels for 5min to allow swallowed air to rise to the level of closure. films are taken 6-24hrs after birth (allows time for air to reach the rectum). film at 72”SID to minimize distoration. AP & Lateral views are taken while upside down with a radiopaque marker placed at the opening with the distance measured
what vertebral level do the kidneys sit at
between T12 and L3 on either side of the spine. they normally extend from the level of the superior border of T12 to the level of the transverse processes of L3 in persons of sthenic bulid
what does the right lateral stomach demonstrate
shows the anterior and posterior aspects of the stomach the pyloric canal, duodenal bulb. right lateral projection is commonly affords the best image of the pyloric canal and the duodenal bulb in patients with a hypersthenic habitus
what position best shows ap displacement on a fractured mandible
lateral view
what test is done after the collimator light is changed
light field/ beam congruency test
the imaging plate for CR is coated with heavy metal phosphor called
europium activated barium flurohalide compounds which are energized when exposed to xrays
what type of film is used in mammography and why
single emulsion film so no light crossover results in a higher contrast which is useful in mammography
when would you use a slipper pan
when the patient has a fracture or another disability that makes it impossible to use a pan of this height(normal pan is 4”high)
what procedure is done in radiology to relieve the symptoms of artherosclerosis
angioplasty. vascular stenting, thrombolysis
what is a primary barrier. is the control booth a primary barrier
primary barrier prevents radiation from reaching personnel or members of the general public on the other side of the barrier. control booth is NOT a primary barrier as the booth intercepts leakage and scattered radiation and is therefore regarded as a secondary protective barrier
what pathology is seen during the GI associated with cirrhosis of the liver
esophageal varices
give the path and catheter final destination for a femoral angiogram starting with the femoral artery
percutaneous femoral artery approach on contralateral side if unilateral then travel through femoral iliac to the common iliac artery of the affected side. if lower extremities are to be studied an end hole,multiple side hole catheter is employed at the level of L4
what is the ratio of 1 man compression for CPR
15:2 ration (compression:breathes) 80-100 compressions per minute
the cervical spine on a supine patient is being examined the patient is in the RPO position with the CR 20 degrees cephalad what is best demonstrated
left intervertebral foramina and pedicles and an oblique projection of the bodies and other parts of the cervical vertebrae
what is the prep for an elderly patient for an IVP
when time permits have the patient follow a low residue diet for 1 to 2 days to prevent gas formation. have the patient eat a light evening meal on the day before the exam. have the patient take nothing by mouth after midnight on the day of the exam. however the patient should not be dehydrated. patient with multiple myeloma, high uric acid levels or diabetes must be well hydrated before the IVP is performed
what is the SID for a lateral cspine
72” or 183cm
what areas on the body are most prone to bed sores
where the bones are closer to the surface of the skin like hips, elbows, ankles, back, shoulder and behind the head
what joint and anatomical structures must be seen on the patellar view
patellofemoral joint and patella in profile as well as the surface of femoral condyles
if II is close to the patient as possible will this reduce scatter
yes the space between the xray tube and II will eliminate some scatter
how do you know you should start CPR
on realization that a patient has suffered cardiac arrest the appropriate alert should be initiated before the beginning of CPR. CPR must be initiated immediately on verifying that cardiopulmonary distress exists but it is vitally important theses procedures be performed only after it has been determined that true cardiopulmonary distress exists. establish unresponsiveness by shaking and shouting at the victim. if these actions fail to rouse the person then call for help and proceed with CPR
CT number for blood
20
ct number for water
0
ct number for lung
-200
ct number for bone
1000
ct number for air
-1000
ct number for fat
-100
why is it important to have soft tissue on a lateral elbow view
the fat pads are least compressed when the elbow is at 90 degrees and if the fat pads show on the xrays this means that there is effusion in the joint which may indicate an undetectable fracture on the xray. these fat pads are within the soft tissue surrounding the elbow
when doing an AP projection of the knee on a patient that measures 25cm and above what is the angle and direction of the CR
5 degrees cephalad
what is a nosocomial infection
infection acquired in the course of medical care
define an aneurysm
sac formed by dilation of the walls of a blood vessel usually an artery and filled with blood. aneurysm localized dilation of an artery that most commonly involves the aorta
what is the ratio of a 2 man compression for CPR
5:2, each rescuer independently performing compressions or ventilations with periodic switches of position. compressins are delivered at a rate of 80 to 100 per minute with a 2-3 second pause for 2 ventilations after every 5 chest compressions
what are demonstrated on oblique views of a myelogram
ruptured intervertebral disc (sheep nose or anvil like deformity
which of the following has lower dose and which has better resolution? photospot film, cine, 105mm, magnetic tape, radiographic spot film
photospot film has the lower dose and radiographic spot film has better resolution
MPD for student is ———– and a tech is ———— and for a pregnant tech is ————-msv
1, 20, 4
area for possible aspirated FB in child what area is covered by film
nasopharynx to anal canal
what is a nosocomial infection
infection acquired in the course of medical care
define an aneurysm
sac formed by dilation of the walls of a blood vessel usually an artery and filled with blood. aneurysm localized dilation of an artery that most commonly involves the aorta
what is the ratio of a 2 man compression for CPR
5:2, each rescuer independently performing compressions or ventilations with periodic switches of position. compressins are delivered at a rate of 80 to 100 per minute with a 2-3 second pause for 2 ventilations after every 5 chest compressions
the teeth obscure the odontoid how do you reposition
tilt the head back or extend to align the upper incisiors with the base of the skull
which of the following has lower dose and which has better resolution? photospot film, cine, 105mm, magnetic tape, radiographic spot film
photospot film has the lower dose and radiographic spot film has better resolution
MPD for student is ———– and a tech is ———— and for a pregnant tech is ————-msv
1, 20, 4
area for possible aspirated FB in child what area is covered by film
nasopharynx to anal canal
evaluation criteria for a 30 frontooccipital projection of the skull
equal distance from lateral border of the skull to lateral margin of foramen magnum on both sides indication no rotation, symmetric petrous ridges, dorsum sellae and posterior clinoid processes visible with foramen magnum. penetration occipital bone without excessive density at lateral borders of skull
what professional body protects the public
camrt,
the maximum length the enema tip can be inserted is
1 1/2” or 3.8cm
the teeth obscure the odontoid how do you reposition
tilt the head back or extend to align the upper incisiors with the base of the skull
protective clothing MUST provide attenuation equivalent to ————mm of lead at 150kvp
0.5
protective gloves MUST provide attenuation equivalent to ———mm lead at 150kvp
0.25
what professional body assists techs in education
camrt and mamrt
what is situs inversus
total or partial transposition of the body organs to the side opposite the normal
location of a PICC is
superior vena cava
location of a feeding tube is
at 1st part of duodenum
location of a NG tube is
stomach
location of a swan ganz tube is
right or left pulmonary artery
what is the angle and direction of CR for BE sigmoid shot if the patient is prone
30-40 caudad
choosing a grid for chest xray which is the best for 8:1 and 12:1 both focused
8: 1- portable because less critical to center
12: 1 best for high KVP above 80 because easier to center
what is situs inversus
total or partial transposition of the body organs to the side opposite the normal
what position best demonstrates pleural effusion of the right lung
right lateral decubitis
when using a grid what error causes an overall decreased density
off level or off center grid
what is diverticulitis
inflammation of diverticula, small blind pouches that form in the lining and wall of the colon
what is enteroclysis and what would you tell the patient when you are finished the exam
injection of the nutrient or medicinal liquid into the bowel for xray, a procedure in which contrast media is injected into the duodenum under fluro control for exam of the SI. after the procedure you must tell the patient not to eat or drink for a few hours as spray anthesthesia is used to inhibit gag reflex when intubating
after doing a 10 min IVU all the kidneys are well seen except the upper poles of both kidneys what would you do next
a xray during an IVU must include the entire outline of the kidneys and therefore 10min film must be repeated as soon as possible centered the appropriate amount higher to include the entire kidney
how should a agitated patient be approached
from the side not face to face
anatomical landmark for si jts is
1” above the ASIS lower costal margin of L4
anatomical landmark for T10 is
xiphoid tip
landmark for T4/5
sternal angle
anatomical landmark for C5
cricoid cartilage
image density affects tube current by
increase tube current you increase density and vice versa
image density affects increased SID by
decreasing density
image density affects increased field size
decreasing density
image density affects added filtration by
decreasing density
slower speed screen affects density by
decreasing density
smaller focal spot affects density by
no difference if done properly or may be less than 30% to alter image density
a diabetic foot may be associated with what bony pathology
bacterial osteomyelitis
rectifiers are used to convert high voltage AC currents to
DC currents
during angiography what is the rate of pulse control used for
found on the power injector designed to prevent sudden forceful injection
in CT by changing the window width you change the————– and by changing the window level you change the
contrast, center of the window of gray shades that will be displayed
what is the kedge of iodine and why is it significant when doing IVU’s
33kev there is an abrupt increase in radiographic absorption allows for the selection of technical factors during IVUs
`what vessels would you most likely find a berry aneurysm
usually at an angle bifurcation of the cerebral arteries
name 2 common types of ct detectors
scintillation and gas filled detectors
why is it important to know a patients creatine level before the injection of contrast
to check kidney function because injection of contrast is contraindicated by impaired kidney function
how is a radiation reading received from a TLD
the TLD sensing material (lithium fluoride) is heated to a high temperature to release trapped electrons in the form of visible light. the intensity of the light is proportional to the amount of radiation that interacted with the crystals
what is the air gap technique and how is it used
air gap technique is another method of reducing scatter radiation thereby enhancing image contrast. when the technique is used the IR is moved 10-15cm away fro the patient . SID may or may not be increased and technical factors must be increased. the air gap technique has found application in chest xrays and cerebral angiography
what vessel do the R and L vertebral arteries originate from
right and left subclavian arteries
how much must mAs be changed to see a difference in density
30% change
if a trauma patient has not had his or her neck cleared how do you turn this patient? how many people are needed
log roll-5 people are needed. 2 ppl stand at each side of the table/bed, one person keeps the head and neck immobilized, 2 assist with maintaining alignment of the torso and 2 with the legs. patients arms are across the chest, pillow between the knees, place a bolster where head will rest when the turn is complete, unison use a sheet to turn the patient as if a log keeping the head and neck and torso immobile during the move
what is the prep for outpatient BE?
low residue diet 2-3days prior, clear fluids only a day prior to the exam, laxative, colonic lavage if necessary
when doing a skull exam what is the most radiosensitive area
eyes
how is rotation assessed on the Caldwell view of the skull
equal distance from lateral border of skull to lateral border of orbit on both sides
what view best demonstrates Osgoode Schalatters disesase
lateral view of the affected knee
what radiographic position best demonstrates perforation of the intestines
upright or decubitis (dependent on patient) to show air level under the diaphragm or on raised flank
what kvp range is optimal for a abdomen and why
optimal is 60-75kvp to sufficiently penetrate the soft tissue and bony structures of the abdomen. this kvp enhances the subtle radiation absorption differences among the fat, gas, muscles, and solid organs which consist mainly of water
what joint is visible when patient is in an oblique supine position with CR 20-30degrees caudad? how would you demo these joints in the PA upright position (c-spine)
intervertebral foramen on the raised side as well as pedicles. to demo the PA upright position, angle cephalad and put side of interest closest to the film
notice a box of expired xray films what do you do with them
check base + fog if within the limits you may use the film as soon as possible. film must be used before its expiration date
skills necessary when working with mentally impaired
requires a thorough knowledge of equipment and immobilization techniques as well as interaction skills
skills necessary when working with children
patience, technical knowledge, understanding of pediatric patient, and effective use of communication skills and immobilization devices can assist in obtaining a quality image
what are the 4 associated heart abnormalities of the Tetralogy of Fallot
high ventricular septal defect, pulmonary stenosis, overriding of the aortic orifice above the ventricular defect, right ventricular hypertrophy
T or F circuits with a low ripple produce more constant xray output
true
how is density affected when changing from a 400speed to 200 speed screen?
density is increased by a factor of 2 (halved)
what is the correct way to transfer a patient froma wheelchair to a table
if patient can assist, instruct them to push up with upper arm when told to do so. foot rests should be up and locks are engaged with the wheel chair at a 45 degree angle to the table, the patients strong side closest to the table, allow or help the patient to the edge of the wheel chair, on the count of 3 using both arms assist the patient to a sitting position on the table, move the wheelchair out of the way
what is the advantage of slip ring technology in ct
allows for continuous rotation of the xray tube possible by elmininating the cables between the gantry and the generators
what is spiral pitch ration in ct
also referred to as pitch is the relationship between the patient and couch movement and xray beam collimation
pitch= couch movement every 360 degrees (mm)
————————————————————–
slice thickness(mm)
T or F the combination of metformin and iodinated contrast can put the patient at risk for renal failure
true
what does agenesis man
absence of an organ due to nonappearance of its primordium in the embryo
what 4 vessels supply blood to the brain
right and left internal carotid arteries, right and left vertebral arteries
what color are ct numbers of +1000 and a ct number of -1000 and what type of tissue do each of these numbers represent
+1000- white bone
-1000 black air
put the following tissues in order of increasing CT numbers : bone, air, water, CSF, blood, muscle, clotted blood, fat, cartilage
air-1000 fat -100 water 0 CSF 15 blood 20 cartilage 35 muscle 50 clotted blood 75 bone +1000
what test would be performed when changing the speed of films
linerarity test
patient can only dorsiflex 80 degrees for plantodorsal projection of calcaneus how do you adjust the CR
increase the angle 50 cepahald
what is the location of a boxers fracture
neck of 5th metacarpal
what does DNR mean in a chart
do not resuscitate
how much rotation of the foot is needed for an oblique view of the foot? is there an angle on the tube for the oblique foot?
30 rotation perpendicular to the CR
does a high grid ration have smaller or larger focusing range than a low ratio grid
smaller focusing range
can 2 grids with the same grid ratio have different amounts of lead content and which one is more efficient
yes- as the lead content of the grid increases the ability of the grid to remove scatter and improve contrast increases (dependent on grid frequency)
can a patient ever be allowed to get into a wheelchair unassisted
you should never allow a patient to get off the table or onto a wheelchair without some assistance
what is the normal body temperature
36-37 dependent where is taken
by mistake a 400 speed film screen system was used instead of a 200 speed film system. the technical factors set were for the 200 speed system. the density of the film will be affected how and by how much
density will be increased by a factor of 2 (doubled)
where is ct beam collimated
in ct scanning, there is usually 2 collimators one (prepatient) mounted on the xray tube housing adjacent to it and the other (postpatient) is between the patient and the detectors
a patient in the ER has a severe gash on their head would you remove the bandage before xraying
as a xray tech during trauma you should remove anything that can cause an artifact however you should not remove anything that could exacerbate the patient situation. therefore you should keep the bandage on for the xray if the blood loss would create further complications if removed and document this on the film bag
what rib attaches to the sternal angle
2nd rib
is having the tube pointing at the control booth okay
no control booth is a secondary barrier not primary
what must be included on an AP projection of the thumb
from distal tip of thumb to trapezium
what sphincter allows food to pass into the duodenum
pyloric sphincter
when doing a mobile chest in CCU what do you tell visiting family
smile and briefly explain the procedure with extra attention when delays occur is acceptable. ask them to politely leave when taking the xray. if interpretation of images is asked tell the family the findings are available to the referring physician and only he or she can provide the information to them
what is best demonstrated in the LAO view of the cspine
left intervertebral foramina and pedicles
when xraying the pelvis, a 45 caudal angle is used what is the name of this view and what does is best demonstrate
anteroposterior axial “outlet” projection of the pelvis shows the pubic rami without foreshorting
what are the symptoms of hypoglycemia and how is it treated in a radiography room
intense hunger, weakness, shaky, excessive sweat, confused, irritable, mild hostility. glucose tablets, sugar water, orange juice, never administer food to an unconscious patient
is the tib fib visualized anywhere on a patellar view
no
standards of practice was developed by
college of medical radiation technologists for the protection of the public
according to the S and P all requistions must include
patients name, birth, date, time of requisition, procedure requested, legiable signature of requester and their designation
surgical procedure done when a patient is diagnosed with a pneumothorax is an insertion of a
chest tube
CR direction and angle and center pointe for townes view is
direction caudad
angle 30 oml, 37 ioml
center- 7.3 cm above glabella passing though EAM
safety code is prepared by
radiation protection bureau, Ottawa canada
the aim of radiation protection bureau is to minimize dose to the
patient and personnel
name the carpal bones medial to lateral
medial pisiform, triquetrum, lunate, scaphoid, trapezium
hamate, capitate, trapezoid
how do you assess mobility in a wheelchair patient
deviations from correct body alignment, immobility or limitations in range of joint movement, respiratory, cardiovascular, metabolic and musculoskeletal problems, condiction, understanding, accepatance to move , medical hx
how is the male urethra best demonstrated in a voiding cystogram
anterior oblique view- RPO or LPO position. places the penis along soft tissue of the medial side of the lower thigh to obtain uniform density of both the deep and cavernous portions of the urethral canal
what 2 body areas are examined in BMDs?
lumbar spine and hips
what are 2 common causes of film coming out of the processor damp
fixer- depletion or lack of hardner
wash tank- saturation or insufficient fresh water
where would a vesicovaginal fistula be found
between the bladder and the vagina
what are symptoms of pulmonary emboli
80% of patient with PE have no symptoms
what is the tube angle in relation to the lower leg which demonstrate intercondylar notch
perpendicular
why is contrast necessary when doing some ct exams
to distinguish normal anatomy from pathology, make various dieases processes more visable, oral contrast to see between loops of bowel and other structures within the abdomen
name the sinuses demonstrated on the lateral view of the skull
all 4 frontal, maxillary, ethmoid, sphenoid
what is the normal rate of respiration for an adult
15-20 breathes per minute
what 2 tools are used or required to produce characteristic curve when comparing 2 different types of film? what are their purpose?
sensitometer- optical step wedge gives the range of densities on the film
densitometer- a device that measures the optical density
what carpal bone is susceptible to avascular necrosis and why
scaphoid blood enters from distal portion of carpal bone and can get cut off when the bone is fractured
loss of blood supply results in avascular necrosis
where is the needle inserted in a shoulder arthrogram
1/2” inferior (1.3cm) and lateral to the coracoid process into the joint capsule
radiographic signs of crohns disease
aphthous ulcers, cobblestone appearance, fistulas, skip lesions, string sign
for radiation safety at what point of exposure (% of MPD) are radiation workers worried about exposure and need to take medical action to reduce their occupation exposure
5% of MPD
optimum kvp range for IVP after injection and why
75kvp because subject contrast is increased due to addition of radiopaque contrast material
define hydronephrosis
dilation of renal pelvicalceal system due to blockage above the level of the bladder
what MUST be recorded on a requisition after an injection
how much, name of contrast, time and date injected, name and signature of personnel who injected the contrast
the LPO position best demonstrated which distal ureter
right distal ureter
T or F linear tube movement is used for renal tomograms
false
what is the purpose of squeegee rollers
to remove excess water from the film after the wash stage of processing
what is cholelithaisis
presence of gallstones
what type of beam is used by a laser imager (printer) to expose the film
red laser beam
ring artifact in ct on the image would indicate
single detector or bank of detector malfunction
allowing a patient to fall off a stretcher because you neglected to put the side rails up is an example of
negligence
what is an example of professional misconduct
abuse/use of unnecessary drugs during a shift which reduces quality of patient care (A & C)
weight/ volume of a barium for a single contrast GI
30-50%
weight/ volume of barium for a double contrast GI
up to 250%
x table lateral knee film against medial side of knee and direction of angle is
caudad towards the foot
you are asked to do a coned down bladder shot on a male give the center point and angle of direction
center- 1” (2.5cm) above ASIS
angle- 15 degrees
direction- caudad
how do you asses AP mobility of the cspine and why is it necessary
lateral view of cspine in hyperflexion and extension done to demo normal ap movement or absence of movement resulting from trauma or disease (before surgery for anaesthesiologist to see if intubation is possible)
what is the role of the radiation protection officer
oversee the programs daily operation and provide for its formal review each year; developing appropriate radiation safety programs for the facility also has a responsibility for maintaining radiation monitoring records for all personnel
what 3 vessels form the celiac axis and where is it located
common gastric artery, left gastric artery, splenic artery. located beneath the diaphragm at T12
why should a chest xray kvp on a child not exceed 90kvp?
any higher of a kvp would result in a very low mas which in turn results in quantum mottle which can look like pathology pneumonia on a peds chest
during enteroclysis procedure the tube is inserted into the nose to find destination before what procedure is started
duodenojejunal flexure neal the ligament of treitz
what 2 contrast agents are used for enteroclysis
barium and air or methyl cellulose
give post care instructions for a patient following enteroclysis
do NOT eat or drink for 2-3 hrs post procedure as throat anesthesis is used to reduce gag reflex
what part of the xray tube controls penumbra
focal spot
give patient position and angle and direction of CR for apical views of chest
lordotic- perpendicular to CR
pa axial- patient is positioned as normal for CXR PA 10-15 degrees cephalad
ap axial- patient is upright or supine15-20 degrees cephalad
who is in charge of radiation protection during an exam
technologist
can a pregnant technologist work anywhere in the department
no- appropriate steps must be taken to ensure that her work duties during the remainder oft the pregnancy are compatible with accepted maximum radiation exposure. this may mean time in high dose areas like fluro rooms may be reduced
to best demonstrate the iliac wing how would you position the patient
position the patient with the affected side down in a posterior oblique
to best demonstrate the left SI jt would you choose the RPO, RAO, LPO or AP position with the CR perpendicular
RPO
which condition would you most often take inspiration and expiration films for
pneumothroax
T or F pneumonia will appear on a xray as an area of decreased lung markings and increased density
F- decreased density
what position should place your patient with epitaxis
nose bleed- patient should sit up with the head tilted back and the soft portion of the nose grasped firmly between the thumb and forefinger
what is a salter harris fracture
fracture through the epiphysis (growth plate) of a child
what is the MPD per year for a student
1msv
what is the MPD for a technologist
20msv
what is the MPD for general public
1msv
what is the MPD for a pregnant tech
4msv
what is the MPD for the eye
150msv
what is the MPD for skin and hands feet
500msv
what is the MPD for the lens of the eye
150msv
ER patient has arrived with no backboard the patient is not to flex or move their back and needs to be moved to the xray table how is this done
log roll to move the patient onto a sliding board transfer the patient using the slider board
enema tip should be directed
1” or 2.5cm toward the umbilicus
according to the standards of practice each film must be marked with the patients name
medical number, date, time , hospital facility name
according to the scope of practice every female patient between ages ———- &————- is asked whether there is any chance of pregnancy
11 & 55
according to the standards of practice if the patient has to be rescheduled you must ensure that the patient is informed of the
time & date & location of the next appointment
according to the standards of practice the technologist must give the patient an opportunity to ask questions and provide questions within the scope of their responsibility and refer patients questions to
their referring physicians if it is beyond their scope of practice
difference between pulmonary edema vs pulmonary emboli
pulmonary edema- abnormal acculmulation of fluid in the extra vascular pulmonary tissues
pulmonary embolism- occlusion of pulmonary vessels by an embolus or emboli
a pregnant mother wants to stand by her child in the pig-o-stat and will wear a lead apron is this accepatable
no- the lead apron only stops 95% of the primary radiation therefore putting the fetus at risk if she wishes to stay nearby where she can see her child the only option would be to stand behind the control panel
how do you check for allergies on an in patient
check with their medical chart if it is not included call the nurses station where they came from it does not hurt to also ask the patient to verify the information you received
what is the CR angle direction and entry point to demonstrate TM jts
AP AXIAL PROJECTION- 35 degrees caudad, 3” above the nasion
AXIOLATERAL VIEW- 30 caudad, 1/2” anterior and 2” superior to upside EAM
AXIOLATERAL OBLIQUE VIEW- 15 caudad 1 1/2” superior to upside of EAM
when xraying a AP lumbar spine why are the knees bent
to reduce the lumbar curvature in order for the intervertebral joints to be well seen
film contrast depends on 4 main areas which are
kvp, grid ratio, beam restriction, IR used
define intussception
telescoping of one part of the intestine into an adjoining section causing intestional obstruction
how will tube current applied kvp, target material and filtration affect the quality of the xray beam
tube current- affects the quantity of radiation in the beam and therefore how much radiation is in the beam affects the quality of the beam
kvp- as kvp increases a wider range of photon energies is produced
target material-affects interactions that produce xrays due to atomic number
filtration- changes the average photon energy of the beam
what does a prone view of the GI exam of the stomach demonstrate
stomach spreads horizontally and the pyloric canal and duodenal bulb are well demonstrated in patients with an asthenic or a hyposthenic body habitus
give an example of a transitional vertebra
lumbarization SI becomes like a 6th lumbar vertebrae or sacralization L5 becomes fused with the sacrum
what vertebral level would you find the most kidneys
normally extend from the level of the superior border of T12 to the level of the transverse process of L3 in persons with sthenic bulid
which 2 quality control tests should be done BEFORE a linearity test
kvp accuracy and reproducibility
excessive prep time increases the filament boost which will increase filament evaporation and in turn will increase the deposits on the
glass envelope interfering with the electron flow and decrease efficiency of xray production
what is best demonstrated on the LAO of the L-spine
right zygapophyseal jts
subject contrast depends on 3 main areas
patient thickness, tissue density, effective atomic number
what is road mapping in angiography
technique in which a static image of contrast filled vessel allows the radiologist to see the guidewire or balloon catheter
why is inspiration / expiration views ordered for possible aspirated FB
air becomes trapped on the affected side and cannot escape there fore inspiration views will appear normal but will appear abnormal on expiration affected lung will not deflate
what are some signs of an allergic reaction
rash, hives, urticaria, nausea, vomiting, dizziness, pallor, cough, warmth, shaking,flushing, nasal stuffiness, swelling(eyes & face) itching and sweats
how would a xray appear if when exposing the patient the wrong bucky was selected
to dark/ increased density if using AEC
in the construction of the film what is the purpose of the gelatin layer
provides a ridged structure to suspend the silver ions in, flexiable resistant to allow easy handling
what is a normal adult pulse rate per minute
60-90 beats per minute in rested state
when doing a mammogram exam what is best demonstrated by the MLO position
axillary tail and lymph nodes of affected breast
how do you compensate when doing a 5 x 5” coned view from a 14 x 17” field of view to maintain the same density
increase mAs by a factor of 9.5
which body habitus shows the biggest change in stomach position when moving from the supine to the upright position
asthenic
why do you lower a fainting patient to the floor and elevate their feet
to get blood supply to the brain so their is no permanent damage done and consciousness is regained
while doing a portable chest you accidentally pull out a line what do you do
apply pressure to insertion site and call for assistance (nurse) may have to fill out incident report
give three contraindications for compression during a IVU
urinary stones, abdominal mass, aneurysm, colostomy, suprapubic catheter, trauma
what grid error has occurred when the film light is on one side and dark on the other
off center and off focus combined
what area of sterile gown is considered sterile
only the parts of a sterile gown considered sterile are the areas from the waist to the shoulders infront and the sleeves from 2” above the elbow to the cuffs
T or F an image that displays vignetting will be dim around the periphery
true
giver proper way to transfer patient with a back / neck injury
log roll onto transfer board then use the slider board to transfer the patient
why are high frequency transformers the choice of new xray equipment
smaller, improved image quality at a lower patient dose
why is a 72” SID necessary for a PA chest xray
to minimize magnification of the heart and to obtain greater recorded detail of the delicate lung structures
what is a ureterocele
ballooning of the lower end of the ureter into the bladder
increased humidity in the darkroom will cause the films to
fog
privacy act states that the patient is entitled to privacy how does the where who and what apply when taking a patients history
where- in a private location where you cannot be overheard
who- medical professionals those associated with the exam
what- information pertinent to the exam
an ER stretcher patients leg is medially rotated 15 the leg cannot be moved do you angle the tube 30 degrees medially or laterally to open up the proximal tibia articulation
medially
the four D’s of epiglottitis
dysphagia, dysphonia, dyspnea, drooling
what cranial bones are demonstrated on the 15 degree occipitofrontal projection
frontal bone
the maximum permissible entrance skin exposure for an AP projection of the lumbar spine is
500mr
the AEC back up timer must cut off at
3sec or 600mas
name the 4 boarders of the mediastinum
sternum anterior
spine posterior
right lung lateral
left lung lateral
what is the purpose of the thymus
produces several hormones important for the development and maintanace of normal immunological defenses
what age group is the thymus most predominant
those children who have not yet reached puberty
which exam has the highest gonadal dose lspine, BE, abdomen or GI
barium enema
is the ESE the same as absorbed dose
NO-
entrance skin exposure is the quantity of radiation given in SI units of coulombs per KG or traditional units of roentgens incident upon an object backscatter radiation is excluded
absorbed dose- the deposition of energy per unit mass by ionizing radiation in the patients body tissue. this absorbed energy is responsible for whatever biologic damage occurs as a result of tissues being exposed to x-radiation
what is the inverse square law
exposure from an xray tube
secondary barrier is only required to attenuate the——————————-. the primary beam should not be directed toward the barrier
secondary radiation leakage and scatter
difference between genetic and stochastic effects of radiation
genetic effects- biologic effects of ionizing radiation yet unborn
stochastic effects- mutational non threshold, randomly occurring biologic effects somatic changes in which the chance of occurance of the effect rather than the severity of the effect is proportional to the dose of ionizing radiaton
what is atelectasis
a collapsed lung or airless state of lung
the primary factor controlling contrast is
kvp
why is it necessary to show soft tissue on a lateral cspine
to ensure that the prevertebral fat stripe is included on anterior surfaces on vertebrae, if widening of space between the vertebrae surface and fat stripe occurs it may indicate a fracture, mass and inflammation
what is the trendelenburg position
the table of bed is inclined with the patient head lower than the rest of the body
mrs smith is pregnant has arrived at the ER. she has broken her distal tib-fib on the initial film you have included the fracture and the joint closest to the fracture- do you need to include the other joint and increase her exposure
no include only area of interest by carefully collimating
does kvp affect both contrast and density
yes- you increase kvp and decrease contrast a 15%, increase kvp doubles the density
if you have a complaint about a radiologist what body do you contact
college of physicians and surgeons
how do you demonstrate the left UV junction
turn the patient on the unaffected side (RPO)
what is the most common injection site for a myelogram
spinal puncture most commonly at the L2-L3 or L3/L4 interspace
how is the image released on a CR IR
from exposure to a high intensity laser beam
T or F subcutaneous emphysema can be the result of a pneumothroax
false- it is caused by penetrating or blunt injuries
what is the chemical name for Buscopan
butylscipolaminomium bromide (anticholinergic drug)
what is spina bifia and what are the signs and symptoms
posterior defect in the spinal canal resulting from failure of posterior elements to fuse properly
milder form of spina bifida is
spina bifida occulta- spiltting of the bony neural canal at L5-S1 level
more severe form of spina bifida
when a heriniation of the meniges or the a portion of the mengies and spinal cord protrude through may be asymptomatic
when is Buscopan contraindicated and what can be used instead
when the patient has glaucoma or cardiac conditions - glucagon can be used instead
what causes the ball bearings to wear in the xray tube
rotor prep time (melts the bearings)
what is syncope and how do you treat it
syncope- fainting
treat- have the patient lie down if dizzy; place them in a supine position with the legs elevated if syncope has occured
how does stroke show on a CT scan
triangular or wedge shaped area of hypodensity
what is the threshold dose below which no genetic effects can occur
there is no presumed threshold dose below which they can occur CAN HAPPEN WITH ANY DOSE
what is a Monteggia fracture
isolated fracture of the shaft of the ulna with a associated with anterior dislocation of the radius below the elbow
definition of a blow out fracture
fracture of the orbital floor just above the maxillary sinus caused by a direct blow to the front of the orbit that causes a rapid increase in intra orbital pressure
low humidity will cause what marks on film
static
on the oblique lumbar spine what are the eyes of the scotty dogs
pedicles of the lspine
what is the tube housing made of and its purpose
the protective housing is made of cast stell andis capable of absorbing most of the unwanted photons. the housing is usually lined with lead for additional absorption only at the cathode end because the direction of photons being emitted from the anode. the housing also serves as an electrical shock protector and cushion from the xray tube from rough handling
when doing a townes skull the patients head is extended 10 degrees off the perpendicular OML how would you adjust the CR
use a 40 caudad angle instead of 30 caudad (difference between the OML and IOML plus 3 degrees)
difference between a hickmann catheter and a PICC line
hickmann catheter- tunnel type central venous catheter
PICC line- may be peripherally inserted into the patients arm and advanced until its tip lies in a central vein
what landmark for cricoid cartilage
C4-C5
what is a nephrogram and why is it important
xray of the renal parenchyma when the “blushed” with contrast shows the function of the renal parenchyma
what are the 3 main components of the characteristic curve
toe, straight line portion, shoulder
according to SC 35 the xray beam must be limited to the size of the ————— or smaller
IR
location of the ET tube
5-7cm above the tracheal bifurcation (carina)
can you give the patient his or her chart to read? who can
no- their physician can discuss the contents with them
to do a portable chest on a ummunosuppressed / immunocomprimised patient isolation procedure to use is
protective
right lateral stomach best demonstrated an unobstructed view of the
duodenal bulb in a single contrast , duodenojejunal area and the right retrogastric space
fluro timer maximum setting should not exceed
5min
what alteration would be done for a pregnant patient
minimum amount of views are done to reduce the dose
during the reduction (development) process what is the silver halide converted to
metallic silver
how does the developer differentiate between the exposed and unexposed crystals
unexposed silver halide crystal has a negative electrostatic charge distributed over its entire surface.
exposed silver halide crystal has a negative electrostatic charge distributed over its surface except in the region of the sensitivity center
why is started added to fresh developing solution
to match the composition of the fresh solution to that which is in the tanks so that the films do not begin coming out with excessive density (match pH, solutes etc)
how does the development solution temperature affect the process? too hot and the films are ———— too cold and the films are too
dark, light
the correct temperature for a developer solution is
92-96F for a 90 sec automatic processor (33-35C)
what is the pH of the developer
10-10.5 and the fixer 4-4.5
list 5 constituents of the fixer excluding the solvent and their function
clearing agent- clears the film of exposed silver halides
activator- enhances the function of the clearing agent
preservative- permits the clearing agent to continue its function
hardener- prevents scratches and abrasions
buffer- maintains Ph
what is diachroic fog
term generally applied to all chemicals stains, diachroic meaning 2 colors caused by improper or inadequate processing chemistry or chemistry not properly squeezed from the film
what are 4 methods used to demonstrate a hiatus hernia
breathing exercises, water test, compression technique, toe touch maneuver
are most intravenous contrast agents a low or high osmolarity today
low
during sugury how do you pass a sterile nurse
back to back
if the tech touches a patient without permission what complaint could be brought against the tech
battery
what is the difference between the photospot (film) camera and radiographic spot film
photospot- similar to a movie camera except that it exposes only 1 frame when acitivated
spot film- is placed between the patient and II and encased in a lead lined shield until needed
the photospot film camera receives its information from the light from the output phosphor of the II where does the spot film receive its information
directly from the xray beam
what is reverse isolation when finished the exam do you clean the machine
protects the patient with decreased immunity fromt he hospital personnel or ther patients you do NOT need to clean the machine afterward but must do so before the exam
when doing an exam on an immunosuppressed patient with 2 techs who is the clean tech and who is the dirty tech
clean tech- tech in immediate contact with the patient
dirty tech- tech who touches the surface that may ne contaminated so that these contaminations are not in contact with the patient
immunosuppressed patient asks for a Kleenex who should give it to them the clean or dirty tech
clean tech
when doing an abdominal angiogram where does the catheter sit when doing the flush
at level of T12
what is the purpose of a flush during a abdominal angiogram
to assess the nature and number and course of the great vessels extending from the aorta; employed to rule out the presence of aneurysms, congential anomalies, stenosis, or occulsions
what wears the anode of the tube
excessive temperature- melting & pitting
temperature increases too rapidly- anode can crack
bearing damage- electrons focused into one spot on the anode
excessive use of the small focal spot- increased wear on smaller area of the anode
the effective focal spot is controlled by the anode target angle and the
actual focal spot which is controlled by the filament lenght
the smaller the target angle the smaller the effective focal spot and the better the
resolution
which stomach position demonstrates the fundus full of barium and un obstructed view of the duodenal bulb
LPO
when lifting your center of gravity is always over
the base of support
a grids primary function is to improve what
contrast
what distance should the sternum be depressed on an adult during CPR?
1 1/2 to 2”
what is off focus radiation (extra focal radiation)
electrons bounce off the focal spot and land on the other areas of the target, causing xrays to be produced from outside the focal spot
how is off focus radiation controlled
by using a fixed diaphragm in the tube housing near the window of the xray tube another effective solution is the metal envelope of the xray tube
which drug will relieve pain without loss of consciouness
analgesic
there are 3 possible processor faults that could occur if the film contrast is too high list them
- decreased developer temperature
- decreased developer immersion time
- less developer contamination (replenishment too pungent)
how many ribs are visible on the AP/PA projection of the ribs
for ribs above the diapharm (expiration) 1-12th
for ribs below the diapharm (inspiration) 8-12th
who is responsible for the conscent
radiographer
what is a TIA
transient ischemic attack
what are the symptoms of a TIA
headache, dizziness, drowniess, mental confusion, caused by atherosclerotic plaques, most commonly plaque at the bifurcation of the carotid artery can happen during sleep or when awakened
what are 3 important parameters do the daily sensitometric strips check?
fog, speed, contrast
in relation to DR/CR imaging what is a histogram
histogram is a bar graph which may provide useful diagnostic data in some instances. software is available to produce theses graphs by HU and times vs motion
what is the purpose of universal precautions
prevent transmission of disease by body fluids and substances
after doing a portable chest, you notice different lines your radiograph, which lines and tubes could you move? O2, IV, CVP
you can move the O2 tube and intravenous IV supply tube off the chest however the CVP cannot be moved as it is in the patient
what is the last task in the startup of the processor
obtain the sensitometer strip and graph results
what is the temperature of the developer
33-35C for a 90second automatic processor
give 4 factors that will enhance subject contrast on an image
decrease kvp
increase difference between adjacent thickness of body parts
decrease the field size, decrease the body thickness
addition of contrast media (higher atomic #)
if a fellow technologist is talking about something personal what they did last night infront of the patient what would you do
confidentiality- as the radiographer you must not disclose facts concerning the patients health or other personal information
how do you decrease quantum mottle
increase the amount of xrays reaching the IR by increasing mAs, kvp, or choosing slower flim.screen combination
T or F sterilization uses either heat or chemicals and destroys all microorganims
true
can a nurse with an extended class order an acute abdomen series
no- only authorized are to order xrays of the chest, ribs, arms, wrists, hand, leg, ankle and foot or mammograms
what can a nurse with an extended class order?
chest, ribs, arm, wrist, hand, leg, ankle, foot, mammogram
ultrasound- abdomen, pelvis, breast
what is a medical directive
pertain to treatment of preferences and the designation of surrogate decision maker in the event that a person should become unable to make the medical decisions on their own behalf
what are the signs and symptoms of shock
restlessness, apprehension, general anxiety, tachycardia, decreasing blood pressure, cold, clammy skin, pallor
which method of drug administration will provide the fastest response
intravenous
is Compton scatter affected by atomic number
no
is Compton scatter affected by photon energy
yes
why is graphite used as a backing for the anode disc
to move the heat away from the surface of the anode and works as the heat sink because of high melting point and low thermal conductivitiy
who can order xrays
dental surgeons, medical practitioner, osteopath, chiropractors
what are black crescent marks on the film caused by
kinking of the film
if you cannot find a translator for a patient for a BE what should you do
ask a family member or close relative that speaks English to translate
what should the processor temperature be
developer- 33-35C
fixer-20C
wash-5 or 3C lower than the other solutions
what does PACS mean
picture archive communicaton system
what kvp should be used to achieve low contrast
high kvp
another way to define low contrast is to say
long scale contrast
when xraying a supracondylar fracture what should be in contact with the film the humerus or the elbow
humerus
why is carbon dioxide used for BE?
because it is more rapily absorbed than the nitrogen air
when positioning an inpatient her hand is pinched in the bucky and the skin is broken . what 2 places would show the documentation of this
patients record as well as administrative incident report
what grid error has occurred if the center portion of the film is adequate but the periphery is light
upside down grid error
what area does the sterile corridor refer to
area between the patient drape and the instrument table
give the catheter tip location for a percutaneous nephrostogram
renal pelvis
what type of gas is produced when granules are given during a GI series
carbon dioxide
is a cathartic the same as a laxative
yes a laxative with a mild or gentle effect on the bowels is aka aperient one with a strong effect is referred to as a cathartic or purgative
T or F to change a patient who has had a stroke you always take the clothes off the unaffected side first
true
according to torres how often should a MRT assess a trauma patient while they are in the imaging department
every 5-10min
what causes the filament vaporization in the tube
excessive rotor prep time
where would you find Meckels DIverticulum
in the ileum
T or F the technologist has no control over the mA selection when using a falling load generator
true
if you are about to start CPR which artery should be used to assess pulse?
carotid artery
what is ataxia?
incoordination occurring in the absence of apraxia, paresis, rigity, spasticity or involuntary movement
for enteric precautions are masks required
no (contact precautions)
describe the most accurate method of measuring leg lenght
take CT localizer or scout images of the femurs and tibias. measure between joints using the software option most accurate way to measure 3 times and take an average
the axiolateral view of the manible best demonstrates what
whatever region of the mandible that is parallel to the IR (ramus, body or symphysis)
give the patient position and angle of the tube for axiolateral view of the manible
ramus- patients head in true lateral
body- rotate the head 30 degrees twd the IR
symphysis- rotate the head 45 twd the IR
angle- 25 cephald
what is legge perthes disease?
osteochondrosis of the epiphysis of the head of the femur (due to interference of blood supply)
when mixing fresh chemicals for a processor, list 2 chemicals solutions that the tech should use to mix the developer solution
developer solution, starter solution
what is a disadvantage of a capacitor discharge mobile unit
limits available xray tube current and results in falling kvp during the exposure and there is a chance of continued xray emission
for the 10 degree caudad projection of the coccyx where is the coccyx demonstrated above or below the symphysis
above
what type of exam do you do with a single phase generator
8 year old enema
what type of contrast is used for a possible perforated stomach
water soluable iodinated
why is a ERCP performed
to diagnose biliary and pancreatic pathologic conditions as well as treat them
what is the sims position
patient lies either left or right side down with the forward arm flexed and the posterior arm extended behind the body. the body is inclined slightly forward with the top knee bent sharply and the bottom knee slightly nemt
what is the purpose of the reflective layer of the intensifying screen
intercepts light headed in other directions and redirects it to the film
why is the base color of the xray film usually blue
reduces the eyestrain for the interpreting radiolodist
when performing a shoulder exam what is the patient position to best demonstrate the glenoid fossa
posterior oblique of the affected side, RPO or LPO
TLD worn under the lead apron measures the
absorbed dose
TLD worn above the lead apron measures the
effective dose
give the steps to properly bunny wrap a baby
fold a large sheet, place top of sheet at the childs shoulders and bottom at the childs feet, leave the greater portion of the sheet at one side of the child, bring the longer side back over the arm and under the body and other arm, then bring the sheet over the exposed arm and under the body again
after a mild reaction the doctor wants to admister an antihistamine what would it be
benadryl
what is the purpose of hydroquinone in the development solution
responsible for black shades on the xray
there is a DNR on the chart during a IVP the patient has a heart attack what should you do?
call the radiologist that injected
the rate of replishment in automatic processor depends on primarly the
area of film processed
ability of the xray to form a distinct image of 2 or more objects located close together is
resolution
according to sc30 unexposed film must be stored so that no film receives more than
0.2 mr of stray radiation before use
to low humidity in a darkroom causes
static
too high humidty in a darkroom causes
fog
when handling a urinary drainage bag it is important not to allow urine to flow back to the bladder because this could cause
urinary tract infection
film is placed ____________ to the femoral neck when doing a cross table lateral hip
parallel
AEC cell was not changed after doing a PA chest xray. how will the lateral appear
underexposed (light)
when is a small bowel follow through completed
when barium reaches the ileoceceal value
what is best film screen combination for rheaumatoid arthritis
200 speed at 55-60kvp
which position best demonstrates the hepatic flexure on the DC colon series
left posterior oblique
contamination of the developer will cause the film to
fog
increased density or blurring of an area on the film will caused
poor film screen contact
a patient needs the following exams US, IVP, GI, BE
do in US, IVP, GI, BE
can a pregnant patient have an IVP
no ultrasound is better
what should be done if you observe a co worker touching a patient incorrectly
tell the supervising charge technologist who may take it to the manager and or human resources
what is the angle used for bladder shot of male and female
25/40
what is the most likely radiation induced effect on a fetus in the 1st trimester
CNS damage if the dose is more than 200msv death
blood or body fluid has been spilled what can be used to clean it up
clean with a disinfectant
there is a vertical # of the patella can a skyline be done
yes
what instrument is used to measure reproducibility
radiation dosimeter
what is the difference between repeat and rejected film
repeat- poor film caused by the radiographer error positioning, technique, centering etc
reject- poor film that occurred unrelated to human error processor
how is repeat rate calculated
as a % of the total number of images produced during a period of the study
total number of repeats
_____________________
total number of images produced
what is the safe infusion rate for IV drip for a patient without an order
15-20 per minute
what is the safe oxygen rate for a patient without an order
oxygen is considered a medication and must be prescribed
is bleach a disinfectant
yes
is alcohol a disinfectant
yes
what line is primarily used for long term drug therapy
epidural catheter
what CR angle is needed for the plantodorsal projection of the calcaneus given the foot is in a 90 degree flexion
40 cephalad
how do you best communicate with a child
face to face using a soft tone of voice and speaking in terms that are simple and familiar
why are vital signs taken before an intraarterial injection of contrast
for baseline values
what factors affect the intensity of the xray beam
kvp, mas, distance, filtration, target material, voltage waveform
kvp must be accurate with in
+/- 5% of selected kvp
the quality of the xray beam is chiefly governed by
kvp
to demonstrate the SI jts in the AP position give the amt of patient rotation and the center point
25-30, 1” medial to the elevated ASIS
after an IVP injection you notice swelling at the injection site what should be done
apply pressure and cold cloth to the site and monitor the patient for an allergic reaction
why must the elbow be flexed 90 degrees for the lateral elbow
elbow fat pads are least compressed in this position
major source of scatter radiation occurs where
patient
if the exposure detector lies over the center for the PA chest projection what will be the result on the image
over exposed dark and increased density
what do you do if an exam is ordered and you are unsure of the routine
check the department technique routine manual
what kvp would be used to achieve high contrast
low kvp or short scale contrast
why must a knee not be flexed more than 20-39 for the lateral knee
the position relaxes the muscles and shows the maximum volume of the joint cavity
if the film is processed in the fixer too long the outcome is
flim becomes brittle and the emulsion begins to flake off
that is total filtration
inhernet filtration plus added filtration
what is the optimal kv for a double contrast GI
100-110kv
what is an example of inherent filtration
glass or metal window of xray tube housing
during hypovolemic shock would a vasodilator or vasoconstrictive drug used to counter the shock
vasocontrictive drug
what does filtration do to the patient dose
decrease patient dose
in the image intensifier tube what is the purpose of the input phospher
made of cesium iodide converts the xrays into visable light
what is responsible for focusing the electron beam
electrostatic lens
what is the purpose of a back up timer
to terminate the exposure in the event of a phototimer failure
what is the effect of using a grid
increases the contrast
T or F early signs of intracranial pressure due to trauma include drowniess, slow respirations, becoming incoherent
true
quantum mottle will most likely occur with the use of
rare earth screens
what is the difference between tomogram and zonogram
tomogram- predetermined plane of the body is demonstrated in focus on the xray
zonogram- produces a focal plane images of greater contrast than possible with thin section tomography
when doing scoliosis series what do you not want to select
2 outside cells
what tone of voice is best when communicating with the elderly
firm but not condescending, do not yell at them
what respiration should be used when inserting an enema tip
expiration
what should the tech response be if the patient asks if they have seen anything on the film
do not diagnose tell them to ask the physician
an er patient is to have a GI for a possible perforated stomach what contrast would you choose
non ionic water soluble iodinated contrast
an in patient has arrived for an IVP and cannot understand English how do you check for allergies
medical chart
by moving the II closer to the patient how does this effect dose
decreases dose
when turning the patient from the supine position on an xray table that does not turn well you
roll the patient with arm above their head onto their hip and then pull patient toward you
if the AEC is over the petrous ridges for a skull ray how will the rest of the film appear
overexposed increase in density
does a chest xray radiation to breast have any effect on a breast feeding mother
no
what will be demonstrated best when doing a pelvis if the legs were externally rotated
lesser trochanter
T or F a swan ganz catheter measures the pumping ability of the heat
true
according to torres which area of the body is most susceptible to the formation of decubitius ulcers
scapula, sacrum, trochanters, knees, and heels of the feet
primary controlling factor of density
mas
what is the respiration of a soft tissue neck
slow inspiration
what is suggested kvp for a soft tissue neck
75kvp
when positioning SC jts what is demonstrated
side down and which is closest to the spine the side down
how much is the body rotated for the oblique sc joint position
10-15 degrees
where is the coronoid process is located
proximal ulna or mandible
where is the coracoid process located
on the scapula
what is the angle and direction for an AP sacrum
15 degrees cephald
when doing a cervicothroacic lateral position of the cspine what angle is supposed to help separate the 2 shoulders especially with the patient with limited flexibility who cannot depress the shoulders
3-5 caudad
which vein will most likely be used for a IVP injection
antecubital
