Chapter 1 - Preliminary Steps in Radiography Flashcards

1
Q

Review Questions

Who is a radiographer?

A

A radiographer is a radiologic technologist who administers ionizing radiation to perform radiographic procedures.

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2
Q

Review Questions

Explain ALARA

A

ALARA stands for “as low as reasonably achievable” and is the fundamental radiation protection protocol for radiographers.

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3
Q

Review Questions

Define ARRT and list what they do for the radiologic profession

A

American Registry of Radiologic Technologists
- created and maintains Standards of Ethics
- describe necessary education and certification

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4
Q

Review Questions

Define ASRT and list what they do for the radiologic profession

A

American Society of Radiologic Technologists
- wrote and maintains Radiography Practice Standards
- define Radiographer Scope of Practice
- developed Clinical Performance Standards, Quality Performance Standards, and Professional Performance Standards

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5
Q

Review Questions

How often should the radiographic table be cleaned?

A

after each patient

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6
Q

Review Questions

How do members of the radiologic profession help to control pathogen contamination?

A

by following STANDARD PRECAUTIONS and TRANSMISSION-BASED PRECAUTIONS

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7
Q

Review Questions

What is the easiest and most convenient method to prevent the spread of microorganisms?

A

wash hands

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8
Q

Review Questions

When using a free IR to perform an examination on an isolation patient, the IR should be placed ____ the sheet (ON TOP OF or UNDER)

A

under

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9
Q

Review Questions

What protective apparel should radiographers wear if the possibility of touching blood exists?

A

disposable gloves

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10
Q

Review Questions

What procedure should be followed to dispose of used hypodermic needles properly?

A

place them in a standard sharps or puncture-proof container

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11
Q

Review Questions

List procedures that require aseptic technique when performed in the radiology department

A

Cystography, intravenous urography, spinal puncture, arthrography, angiography

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12
Q

Review Questions

TRUE or FALSE - When performing an examination in the OR, position the C-arm next to the operating table on the same side as the surgeon

A

FALSE

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13
Q

Review Questions

Before beginning a radiographic examination, what should the radiographer do to gain the cooperation of a coherent patient?

A

Explain the procedure being performed in a method they can understand.

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14
Q

Review Questions

What is the minimum number of personnel that should be used to transfer a helpless patient from a gurney to the radiographic table?

A

AT LEAST FOUR, but preferably 6

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15
Q

Review Questions

When the radiologist is unable to see the patient, who is responsible for ensuring that an adequate clinical history accompanies the radiographs?

A

the radiographer

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16
Q

Review Questions

What is the role of the radiographer in interpretation of radiographic images?

A

Interpretation of images is outside of the scope of practice for radiographers.

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17
Q

Review Questions

How should requests for interpretations be handled?

A

Requests for interpretations must be referred to a qualified physician, such as a radiologist

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18
Q

Review Questions

List the 3 ways a patient’s colon may be cleansed for an abdominal examination

A
  • limited diet
  • laxatives
  • enemas
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19
Q

Review Questions

TRUE or FALSE - If washable gowns are used, they should be starched; starch is radiolucent, which means it can be penetrated easily by x-rays.

A

FALSE - starch is radiopaque

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20
Q

Review Questions

Why is it necessary to ensure that any folds in cloth gowns are straightened out before making the radiographic exposure?

A

they could make a confusing shadow in the image that could be confused with pathology

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21
Q

Review Questions

What devices must be removed from the patient within the area of interest if the skull is examined?

A
  • dentures
  • removable bridgework
  • earrings
  • necklaces
  • hairpins
  • eyeglasses
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22
Q

Review Questions

What are the 3 types of muscle tissue and the type of motion associated with each of them?

A
  • smooth (involuntary)
  • cardiac (involuntary)
  • striated/skeletal (voluntary)
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23
Q

Review Questions

What is the rhythmic motion of smooth muscle structures called?

A

peristalsis

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24
Q

Review Questions

What exposure factor is used to control voluntary motion?

A

exposure time (shorter)

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25
Q

Review Questions

What body system controls the movement of voluntary muscles?

A

CNS (Central Nervous System)

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26
Q

Review Questions

What are 4 ways in which voluntary motion can be controlled by a radiographer?

A
  • apply immobilization
  • give clear instructions
  • adjust support devices
  • decrease exposure time
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27
Q

Review Questions

TRUE or FALSE - Most exams require the patient to hold their breath at some phase of respiration.

A

TRUE

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28
Q

Review Questions

Define Image Receptor (IR)

A

A device that receives the energy of the x-ray beam
and forms the image of the body part

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29
Q

Review Questions

List 4 types of IRs used in diagnostic radiology

A
  • Solid-state digital detector (DR)
  • photostimulable storage phosphor image plate (CR)
  • fluoroscopic IR
  • cassette with film
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30
Q

Review Questions

According to recommended procedural steps, what should the radiographer do before releasing or returning the patient?

A

evaluate the radiographs

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31
Q

Review Questions

What are the prime technical factors under control of the radiographer?

A
  1. kilovolt peak (kVp)
  2. milliamperage (mA)
  3. exposure time (seconds)
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32
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of ASCITES?

A

INCREASE

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33
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of EDEMA?

A

INCREASE

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34
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of OLD AGE?

A

DECREASE

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35
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of ATROPHY?

A

DECREASE

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36
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of EMACIATION?

A

DECREASE

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37
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of PNEUMONIA?

A

INCREASE

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38
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of EMPHYSEMA?

A

DECREASE

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39
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of ENLARGED HEART?

A

INCREASE

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40
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of PNEUMOTHORAX?

A

DECREASE

41
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of HYDROCEPHALUS?

A

INCREASE

42
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of PLEURAL EFFUSION?

A

INCREASE

43
Q

Review Questions

Would you need to INCREASE or DECREASE exposure for the condition of DEGENERATIVE ARTHRITIS?

A

DECREASE

44
Q

Review Questions

In cases where patients or their caregivers express anxiety about having imaging studies without the use of gonadal shielding, technologists are advised to…

A

try to explain latest AAPM research and why recommendations have changed - ultimately their choice to shield though

45
Q

Review Questions

What are the 3 general positions of the IR and which is used most frequently?

A
  1. Lengthwise (most used)
  2. Crosswise
  3. Diagonal
46
Q

Review Questions

Regardless of the IR size, it is the radiographer’s responsibility to ____ to the bodypart.

A

COLLIMATE

47
Q

Review Questions

What adjustment can be made by the radiographer to compensate for an increase in OID?

A

increase SID

48
Q

Review Questions

List 4 reasons it would become necessary to angle the central ray

A
  1. To avoid the superimposition of overlying or underlying structures
  2. to avoid superimposing a curved
    structure on itself
  3. to project through angled joints
  4. to project through angled structures without
    foreshortening or elongation
49
Q

Review Questions

The distance from the anode focal spot inside the x-ray tube to the IR is the…

A

SID

50
Q

Review Questions

What 3 factors are affected by SID?

A
  1. magnification
  2. spatial resolution
  3. patient dose
51
Q

Review Questions

What is the traditional minimum SID used for most procedures? What has it recently been increased to in some settings?

A

40” / 44” - 48”

52
Q

Review Questions

What is the minimum SID for chest radiography?

A

72”

53
Q

Review Questions

List 2 purposes of collimation when restricted to irradiate only the anatomy of interest

A
  1. minimize radiation exposure to the patient
  2. reduces scatter radiation
54
Q

Review Questions

TRUE or FALSE - Creating an image using a larger than necessary field size is a violation of the ARRT Code of Ethics

A

TRUE

55
Q

Review Questions

TRUE or FALSE - Shuttering of direct digital images is an acceptable substitution for proper collimation

A

FALSE

56
Q

Review Questions

What are 3 practices to be avoided when placing markers?

A
  • electronically inserting a marker into digital images
  • placing the marker in the anatomy of interest
  • placing the marker directly on the body part
57
Q

Review Questions

Which marker should be used and how should it be placed for a PA HAND?

A

appropriate L/R marker for the limb placed anywhere open

58
Q

Review Questions

Which marker should be used and how should it be placed for a PA CHEST?

A

R marker typically used (for AP/PA projections where both sides of the body are included) above shoulder

59
Q

Review Questions

Which marker should be used and how should it be placed for an AP FOREARM?

A

appropriate L/R marker for the limb placed anywhere open

60
Q

Review Questions

Which marker should be used and how should it be placed for a LATERAL SKULL?

A

L/R side that is closer to the IR (for lateral projections of head/trunk) anterior to anatomy

61
Q

Review Questions

Which marker should be used and how should it be placed for a PA SKULL?

A

R marker typically used (for AP/PA projections where both sides of the body are included) to the side

62
Q

Review Questions

Which marker should be used and how should it be placed for an AP CERVICAL SPINE

A

R marker typically used (for AP/PA projections where both sides of the body are included) above shoulder

63
Q

Review Questions

Which marker should be used and how should it be placed for a LATERAL LUMBAR SPINE?

A

L/R side that is closer to the IR (for lateral projections of head/trunk) anterior to anatomy

64
Q

Review Questions

Which marker should be used and how should it be placed for a LATERAL DECUBITUS CHEST?

A

L/R side that is facing upward (for decubitus projections) on the upper portion of IR

65
Q

Review Questions

Which marker should be used and how should it be placed for an AP OBLIQUE LUMBAR SPINE?

A

L/R side that is closer to the IR (for oblique projections of head/trunk)

66
Q

Review Questions

Which marker should be used and how should it be placed for a BILATERAL AP KNEES?

A

use both L & R markers to identify both sides

67
Q

Review Questions

Define and describe the anatomic position

A

Refers to a position in which the patient is standing
erect with the face and eyes directed forward, arms
extended by the sides with the palms of the hands
facing forward, heels together, and toes pointing
anteriorly

68
Q

Review Questions

Describe how a PA projection of the chest should be oriented on the display monitor

A

Radiographs are usually oriented on the display
monitor so that the person looking at the image
sees the body part as though viewed facing the
patient. Therefore, it should be reversed left to right.

69
Q

Review Questions

Describe how lateral projection radiographs should be displayed

A

As though the viewer sees the patient from the per-
spective of the x-ray tube (display the image so that
the side of the patient closer to the IR during the
procedure is also the side of the image closer to the
viewbox)

70
Q

Review Questions

Describe how hand and foot radiographs should be displayed

A

With the digits pointing upward and as viewed from
the perspective of the x-ray tube

71
Q

Review Questions

What are the 4 items of identification that should be on every radiograph?

A
  1. patient’s name
  2. date of exam
  3. institutional identity
  4. side marker
72
Q

Review Questions

Some examinations require an additional information to indicate the ____ ____ after the introduction of a contrast medium.

A

CUMULATIVE TIME

73
Q

Review Questions

How have equipment manufacturers responded to the growing obesity problem in the United States?

A

Radiographic and fluoroscopic table weight lim-
its have doubled to 700 pounds. CT and MRI table
weights and aperture openings have also increased.

74
Q

Review Questions

What is the major risk factor in transportation and transfer of obese patients?

A

RISK OF INJURY to radiographer, other workers, patient

75
Q

Review Questions

Which 3 body parts are most affected, in terms of increased size, by morbid obesity?

A
  • thorax
  • stomach
  • colon
76
Q

Review Questions

What bony landmark is usually palpable on obese patients?

A

jugular notch

77
Q

Review Questions

What is the approximate distance of the pubic symphesis from the jugular notch on a patient measuring < 5’ tall?

A

21”

78
Q

Review Questions

What is the approximate distance of the pubic symphesis from the jugular notch on a patient measuring 5’ - 6’ tall?

A

22”

79
Q

Review Questions

What is the approximate distance of the pubic symphesis from the jugular notch on a patient measuring > 6’ tall?

A

24”

80
Q

Ethics in Radiologic Technology

What are ethics?

A

the term applied to a health professional’s moral responsibility and the science of appropriate conduct toward others

81
Q

Advanced Clinical Practice

What is an RA?

A

Radiologist Assistant

82
Q

Advanced Clinical Practice

What is an RPA?

A

Radiology Practitioner Assistant

83
Q

Standard Precautions

What are standard precautions?

A

common-sense practices and PPE usage that protects healthcare providers from contracting and spreading infections

84
Q

Standard Precautions

List up to 8 standard precautions

A
  • hand hygeine
  • use PPE
  • follow cough etiquette
  • ensure appropriate patient placement
  • properly handle, clean, disinfect equipment & environment
  • handle textiles/laundry carefully
  • follow safe injection practices
  • dispose of sharps properly
85
Q

Interacting with Patients

What 6 considerations should be made when moving a patient who is too sick to move alone?

A
  • move them as little as possible
  • never try to lift a helpless person alone
  • flex knees, straighten back, bend from hips
  • support the head when lifting shoulders
  • flex patient’s knees before moving hips
  • move from bed/stretcher to table with sheet or other moving device with at least 4 people
86
Q

Interacting with Patients

Define AGE-SPECIFIC COMPETENCE

A

the knowledge, skills, ability, and behaviors that are essential for providing optimal care to defined groups of patients

87
Q

Accessory Equipment

What does a filter do and what are some common types?

A

attenuates beam at portions of the exposure field to more clearly represent anatomies of varying density on the same image
- wedge (compensating)
- boomerang (contact)

88
Q

Source-to-Skin Distance

What are the current NCRP recommendations for SSD?

A
  • SHALL NOT be less than 12”
  • SHOULD NOT be less than 15”
89
Q

PA and AP Radiographs

Define PA

A

posteroanterior - xray beam travels from posterior to anterior

90
Q

PA and AP Radiographs

Define AP

A

anteroposterior - xray beam travels from anterior to posterior

91
Q

Working Effectively with Obese Patients

Define BMI

A

Body Mass Index (determined by height and weight)

92
Q

Working Effectively with Obese Patients

What BMI range is considered obese? morbidly obese?

A

OBESE = 30 - 39.9
MORBIDLY OBESE = 40+

93
Q

Self-Test

Which factor will minimize distortion?

a. CR part alignment
b. collimation
c. mAs
d. SID

A

a. CR part alignment

94
Q

Self-Test

Which change most improves spatial resolution when the sternum is imaged?

a. increase the OID
b. decrease the SID
c. decrease the source to object distance
d. increase the SID

A

d. increase the SID

95
Q

Self-Test

Which CR accessory houses the image storage phosphors that acquire the latent image?

a. image reader
b. control panel
c. imaging plate
d. video monitor

A

c. imaging plate

96
Q

Self-Test

When using a fixed, large IR, how is collimation (field size) controlled?

a. manually by the radiographer
b. automatically by an automatic collimator
c. electronically by shuttering
d. all of these control field size in direct digital imaging

A

a. manually by the radiographer

97
Q

Self-Test

The knowledge, skills, and ability, and behaviors that are essential for providing optimal care to defined groups of patients is termed:

a. functional competence
b. age-specific competence
c. patient care competence
d. chronologic competence

A

b. age-specific competence

98
Q

Self-Test

When imaging obese patients, all of the following should be taken into consideration EXCEPT for:

a. locating landmarks such as the jugular notch and pubic symphysis
b. setting the collimator to the smallest dimensions
c. selecting standard IR sizes and standard collimation settings for DR
d. selecting larger IR sizes and larger collimation settings for DR

A

d. selecting larger IR sizes and larger collimation settings for DR

99
Q

Self-Test

Define the CDC and what do they do?

A

Center for Disease Control and Prevention
- provide directives for infection control