Chapter 1 - Preliminary Steps in Radiography Flashcards by Jacquelyn Culley

Review Questions

Who is a radiographer?

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

How well did you know this?

Not at all

Perfectly

Review Questions

Explain ALARA

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

How well did you know this?

Not at all

Perfectly

Review Questions

Define ARRT and list what they do for the radiologic profession

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

How well did you know this?

Not at all

Perfectly

Review Questions

Define ASRT and list what they do for the radiologic profession

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

How well did you know this?

Not at all

Perfectly

Review Questions

How often should the radiographic table be cleaned?

after each patient

How well did you know this?

Not at all

Perfectly

Review Questions

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

by following STANDARD PRECAUTIONS and TRANSMISSION-BASED PRECAUTIONS

How well did you know this?

Not at all

Perfectly

Review Questions

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

wash hands

How well did you know this?

Not at all

Perfectly

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)

under

How well did you know this?

Not at all

Perfectly

Review Questions

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

disposable gloves

How well did you know this?

Not at all

Perfectly

Review Questions

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

place them in a standard sharps or puncture-proof container

How well did you know this?

Not at all

Perfectly

Review Questions

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

Cystography, intravenous urography, spinal puncture, arthrography, angiography

How well did you know this?

Not at all

Perfectly

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

FALSE

How well did you know this?

Not at all

Perfectly

Review Questions

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

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

How well did you know this?

Not at all

Perfectly

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?

AT LEAST FOUR, but preferably 6

How well did you know this?

Not at all

Perfectly

Review Questions

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

the radiographer

How well did you know this?

Not at all

Perfectly

Review Questions

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

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

How well did you know this?

Not at all

Perfectly

Review Questions

How should requests for interpretations be handled?

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

How well did you know this?

Not at all

Perfectly

Review Questions

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

limited diet
laxatives
enemas

How well did you know this?

Not at all

Perfectly

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.

FALSE - starch is radiopaque

How well did you know this?

Not at all

Perfectly

Review Questions

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

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

How well did you know this?

Not at all

Perfectly

Review Questions

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

dentures
removable bridgework
earrings
necklaces
hairpins
eyeglasses

How well did you know this?

Not at all

Perfectly

Review Questions

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

smooth (involuntary)
cardiac (involuntary)
striated/skeletal (voluntary)

How well did you know this?

Not at all

Perfectly

Review Questions

What is the rhythmic motion of smooth muscle structures called?

peristalsis

How well did you know this?

Not at all

Perfectly

Review Questions

What exposure factor is used to control voluntary motion?

exposure time (shorter)

How well did you know this?

Not at all

Perfectly

# Review Questions What body system controls the movement of voluntary muscles?

CNS (Central Nervous System)

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

- apply immobilization - give clear instructions - adjust support devices - decrease exposure time

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

TRUE

# Review Questions Define Image Receptor (IR)

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

# Review Questions List 4 types of IRs used in diagnostic radiology

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

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

evaluate the radiographs

# Review Questions What are the prime technical factors under control of the radiographer?

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

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

INCREASE

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

INCREASE

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

DECREASE

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

DECREASE

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

DECREASE

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

INCREASE

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

DECREASE

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

INCREASE

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

DECREASE

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

INCREASE

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

INCREASE

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

DECREASE

# 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...

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

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

1. Lengthwise (most used) 2. Crosswise 3. Diagonal

# Review Questions Regardless of the IR size, it is the radiographer's responsibility to ____ to the bodypart.

COLLIMATE

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

increase SID

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

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

# Review Questions The distance from the anode focal spot inside the x-ray tube to the IR is the...

SID

# Review Questions What 3 factors are affected by SID?

1. magnification 2. spatial resolution 3. patient dose

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

40" / 44" - 48"

# Review Questions What is the minimum SID for chest radiography?

72"

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

1. minimize radiation exposure to the patient 2. reduces scatter radiation

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

TRUE

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

FALSE

# Review Questions What are 3 practices to be avoided when placing markers?

- electronically inserting a marker into digital images - placing the marker in the anatomy of interest - placing the marker directly on the body part

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

appropriate L/R marker for the limb placed anywhere open

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

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

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

appropriate L/R marker for the limb placed anywhere open

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

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

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

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

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

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

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

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

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

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

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

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

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

use both L & R markers to identify both sides

# Review Questions Define and describe the anatomic position

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

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

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.

# Review Questions Describe how lateral projection radiographs should be displayed

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)

# Review Questions Describe how hand and foot radiographs should be displayed

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

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

1. patient's name 2. date of exam 3. institutional identity 4. side marker

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

CUMULATIVE TIME

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

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

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

RISK OF INJURY to radiographer, other workers, patient

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

- thorax - stomach - colon

# Review Questions What bony landmark is usually palpable on obese patients?

jugular notch

# Review Questions What is the approximate distance of the pubic symphesis from the jugular notch on a patient measuring < 5' tall?

21"

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

22"

# Review Questions What is the approximate distance of the pubic symphesis from the jugular notch on a patient measuring > 6' tall?

24"

# Ethics in Radiologic Technology What are ethics?

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

# Advanced Clinical Practice What is an RA?

Radiologist Assistant

# Advanced Clinical Practice What is an RPA?

Radiology Practitioner Assistant

# Standard Precautions What are standard precautions?

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

# Standard Precautions List up to 8 standard precautions

- 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

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

- 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

# Interacting with Patients Define AGE-SPECIFIC COMPETENCE

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

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

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

# Source-to-Skin Distance What are the current NCRP recommendations for SSD?

- SHALL NOT be less than 12" - SHOULD NOT be less than 15"

# PA and AP Radiographs Define PA

posteroanterior - xray beam travels from posterior to anterior

# PA and AP Radiographs Define AP

anteroposterior - xray beam travels from anterior to posterior

# Working Effectively with Obese Patients Define BMI

Body Mass Index (determined by height and weight)

# Working Effectively with Obese Patients What BMI range is considered obese? morbidly obese?

OBESE = 30 - 39.9 MORBIDLY OBESE = 40+

# Self-Test Which factor will minimize distortion? a. CR part alignment b. collimation c. mAs d. SID

a. CR part alignment

# 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

d. increase the SID

# 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

c. imaging plate

# 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. manually by the radiographer

# 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

b. age-specific competence

# 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

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

# Self-Test Define the CDC and what do they do?

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