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Radiology > Introduction 6/18 > Flashcards

Introduction 6/18 Flashcards

0
Q

How do X-rays travel?

A

From X-ray source through object being imaged to detector film

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1
Q

Which examination methods use X-rays?

A

Plain film, CT, and mammography

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2
Q

What are the four basic densities in a human?

A

Air, fat, water (blood and soft tissue), and bone (mineral)

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3
Q

What could potentially be a fifth density?

A

Man made materials - hip prosthesis, contrast

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4
Q

How is it that we can see edges on an image?

A

Due to a difference in densities

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5
Q

Order densities by decreasing radiolucency.

A

Air, fat, water (blood and soft tissue), bone (mineral)

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6
Q

The more X-rays that get to the detector, the ____ the image.

A

Darker

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7
Q

What absorbs most X-rays ? What color does it appear?

A

Bone. White. (Radiopaque)

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8
Q

Cephalad

A

Toward head

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9
Q

Caudad

A

Toward feet

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10
Q

AP

A

Anterior-posterior

X-rays travel from anterior to posterior of the patient

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11
Q

PA

A

Posterior to anterior

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12
Q

Lateral orientation

A

X-rays travel from one side of pt to the other.

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13
Q

Left lateral means…

A

Left side of pt is closest to detector

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14
Q

Supine orientation

A

Pt is laying on their back

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15
Q

Prone orientation

A

Patient is laying on their belly

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16
Q

Why use prone vs supine orientations?

A

Gravity acts differently to produces different images for each view.

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17
Q

Describe Decubitus orientation

What is it used for?

A

Pt is lying on their side

Used for free air in abdomen, pleural effusions in chest

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18
Q

Name the orientation of a pt lying on their left side

Right side?

A

Left side down decubitus

Right side down decubitus

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19
Q

Upright orientation

Why is this used?

A

Pt is standing

Use gravity to show free intraperitoneal air

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20
Q

Oblique orientation

A

Not 0 or 90 degrees, somewhere in between

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21
Q

Difference between lateral and decubitus views

A

Different orientations

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22
Q

ONE VIEW IS NO VIEW. What is better?

A

At least 2 orthogonal views, often and frontal and lateral.

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23
Q

What is the first thing to do when observing an X-ray?

A

Read name on film, make sure it is who you think it is. Also make sure it is the correct date.

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24
Q

What should be on the label?

A

Correct Name, Correct date, and L and R labels in regard to the patient.

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25
Q

Which side is R on a chest X-ray?

A

THE RIGHT SIDE OF THE PATIENT.

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26
Q

How to ID PA chest X-ray

A

heart is slightly to left

27
Q

What are the types of cross-sectional imaging? (PLANES)

A

Sagittal, Axial, and Coronal.

28
Q

View refers to what type of imaging?

A

plain film

29
Q

Plane referes to which type of imaging?

A

CT and MRI

30
Q

Sagittal cross-section:

A

vertical plane from front to back.

31
Q

Median sagittal plane

A

divides left and right sides. Looks like lateral view but it’s NOT!

32
Q

axial cross-section

A

transverse plane

33
Q

coronal cross-section

A

vertical plane from head to foot parallel to shoulders

34
Q

how many images does plain film give?

A

one

35
Q

how many images does CT/MRI give?

A

many

36
Q

Magnification is determined by:

A
  • distance of source from patient: the closer the x-ray source is to the patient the more magnification occurs.
  • distance of patient from film: the farther the patient is from the detector the more magnification occurs
  • orientation of the patient: the further an organ is from the detector the more magnification occurs
37
Q

What is ideal scenario to minimize magnification?

A

Want source as far away as possible, but detector as close as possible to the area being imaged!

38
Q

Purpose of contrast agents

A

permits visualization of structures not normally visualized

39
Q

What contrast agents are used for GI studies?

A

Barium and Gastrografin

40
Q

Barium vs. Gastrografin

A

Both used for GI studies.

  • Barium: better than Gastrografin, shows up whiter, but more harmful.
  • Gastrografin: water soluble, absorbed more quickly, may cause pulmonary edema if patient aspirates.
41
Q

When is it better to use water soluble Gastrografin?

A

If there is a concern about perforated viscus (bowel loop), but use with caution orally. If patient aspirates, it causes pulmonary edema.

42
Q

Contrast agents for IVP, CT:

Side effects?

A

iodinated contrast - given intravenously.

  • mild allergic rxns in 2-5%: hives, nausea and vomiting.
  • Severe allergic rxns: can cause death
  • Can injure kidneys (nephrotoxic) therefore not used or used with caution in renal impaired patients, diabetics, and patients with multiple myeloma.
43
Q

ionic vs. non ionic contrast:

A

nonionic has less allergic reactions, but is more expensive than ionic.

44
Q

who should avoid iodinated contrast?

A

renal impaired patients, diabetics, and patients with multiple myeloma

45
Q

myeloma:

A

cancer of plasma cell, produces antibodies that can be harmful if too many are being produced

46
Q

Contrast agent used for MRI:

Side effects?

A

Gadolinium - IV

  • less allergic rxns
  • not generally harmful to kidneys
  • can cause nephrogenic systemic fibrosis, so not routinely given to patients with renal impairment
47
Q

Plain film

A
  • typical X-ray.
  • any part of body
  • relatively cheap and lots of access
  • sometimes limited info
  • uses radiation (but less than CT scan)
48
Q

fluoroscopy used for?

A

(real time x-rays) for GI studies, angiography, and guidance with procedures.
uses less x-rays than taking an image

49
Q

CT

A

Computed Tomography (CT/CAT scans)

  • use increased dramatically
  • much more radiation (100x)
  • more cost
  • more info
  • cross-sectional imaging (axial, coronal, sagittal)
  • CT angiography and 3-D imaging
  • guidance for procedures
50
Q

Ultrasound

A
  • No radiation: uses sound waves
  • very operator dependent
  • multiple uses
  • less expensive than CT
  • guidance for procedures
51
Q

What is an ultrasound used for?

A

including cardiac, vascular, OB, abdomen, and pelvis (esp gall bladder and female pelvis), small parts (thyroid and testicles), breast, looking for fluid in chest and abdomen
- guidance for procedures

52
Q

What is a CT scan used for?

A

cross-sectional imaging, guidance for procedures

53
Q

What imaging modality is very operator dependent?

A

ultrasound

54
Q

What imaging modality is better for liver, pancreas?

A

CT

55
Q

MRI

A
  • uses magnetic fields
  • pacemaker and other contraindications; claustrophobia
  • loud
  • multiplanar and multisequence
  • expensive and less available
  • numerous applications including neuro, body, musculoskeletal, vascular (MRA)
56
Q

what imaging modalities do NOT use radiation?

A

ultrasound, MRI

57
Q

procedure of Nuclear Medicine

A
  • inject radiotracer, tracer collets in one area, image with gamma camera, often phsyiologic.
58
Q

applications of Nuclear Medicine

A

bone, cardiac, v/q lug, endocrine, esp thyroid, renal, gall bladder/billiary, GI bleed

59
Q

procedure for PET

what does it tell you?

A

Positron emission tomography
- inject a radiotracer (often flurodeoxyglucose (FDG) or rubidium (cardiac) and image with a scanner
Physiologic: tells how much glucose is being used by the body. ex: brain, heart, cancer

60
Q

applications for PET

A

Major: oncology and solitar pulmonary nodules (FDG). used for looking for cancer. often combined with CT.
Other applications include neuro (dementia)

61
Q

Observing cancer of the brain? Use this type of imaging

A

MRI

62
Q

Mammography

A
  • breast imaging
  • uses radiation and compression (not much radiation)
  • screening and diagnostic - looking for breast cancer
63
Q

Radiation Safety:

A

ALARA = keep radiation As Low As Reasonably Achievable
- when ordering studies consider radiation exposure in all casses, but esp in children and females particularly if pregnant. RIST/BENEFIT ratio.

64
Q

In general, what effects to imagining modalities have?

A

carcinogenic, mutagenic, biological effects

65
Q

Within normal limits:

A

normal variations

normal and abnormal overlap…something might seem normal on one scan, but abnormal on a different imaging modality!

Radiology (2 decks)

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