Keywords Flashcards
What does LATERAL mean in radiography?
An x-ray taken from the side of the patient.
Taking a temperature
Ensure thermometer is properly cleaned, center is poisonous, hold at opposite end of silver Mercury bulb. Shake until Mercury falls below 35 degrees. Place under tongue of fully conscious adult patient or armpit of a child. Keep in place for 3mins.
Read the temp at the level to which the Mercury has has written
Angina
Pt complains of tightness of the chest which can radiate across the left arm to the neck and jaw. They can also experience shortness of breath and nausea. This is due to lack of blood in the coronary artery, most often due to the narrowing of the vessel.
Precautions and drugs used for Angina
Precautions: Make sure medication is available
Use local anaesthetic with adrenaline
Keep pt more upright in chair
Drugs: GTN spray (glyceryl trinatrate) sub lingually
Coronary Thrombisis
This is a complete blockage of the coronary artery. There is no oxygen going to the heart muscle, leading to a heart attack.
Precautions and drugs used for Coronary Thrombosis
Precautions: The pt must see the GP to have an INR check (international normalised ratio). This will reduce the risk of haemorrhage.
Drugs: Anticoagulants, Heparin, Warfarin
Heart failure (attack)
This is not a disease, but it categorises many disorders such as:
- Hypertension
- Ischemic
- Heart Disease
Drugs used for this are: Aspirin, Digoxin (slows heart rate)
Precautions: To use LA without adrenaline
4 main ways X-ray photons can interact with matter
1: Absorption
2: Pure Scatter
3: Absorption and scatter
4: Transmission
Radiolucent
(Type of shadow)
Black areas are where x-ray photons have passed through the patient (no absorption) and hit the film.
Radiopaque
(Type of shadow)
White areas are where the x-ray photons have been totally absorbed by the patient.
Mixture
(Type of shadow)
Grey areas occur where there are varying areas of absorption.
Placement - explain the error and correction
Error: improper area recorded, crowns or apices cut off.
Correction: place receptor according to placement guidelines to cover structures.
Foreshortening - explain the error and the correction
Error - image shortened and smaller than the actual object length
Correction - decrease the vertical angulation of the beam
Elongation - explain the error and the correction
Error - image stretched and longer than the actual image length
Correction - increase the vertical angulation of the beam
Overlapping - explain the error and the correction needed
Error - proximal surfaces of the teeth are closed
Correction - direct the x-ray between the contacts of the teeth
Cone cutting - explain the error and the correction needed
Error - white zone where the x-ray did not strike the image receptor
Correction - center the x-ray beam over the image receptor
Under exposure - explain the error and the correction needed
Error - light or low density image
Correction - increase exposure factors, check for large patient’s size.
What does INR stand for?
International normalised ratio
Leukaemia
Increase of abnormal white blood cells (Leukocytes). Therefore the patient has reduced immunity.
Explain the Frankfort plane
A line from the tragus of the ear through the palpable bony infraorbitbal rim area is relatively parallel to the floor.
What are photons?
Photons are a type of electromagnetic radiation. They come in a wide range of energies which determine their properties.
The very low energy photons make up radio waves, whilst the photons with medium energy are visible to us as a light.
Gamma ray and x-ray photons
These have a high energy compared to other types of electromagnetic radiation. They are classified as ionising radiation.
They are the same thing, the only difference is gamma is naturally occurring and x-rays are man made.
X-ray photons can interact with matter in 4 ways. Name them and try to explain them.
Absorption- they hit the matter and their energy is absorbed.
Pure scatter - they are deflected in another direction with no loss of energy.
Absorption and scatter - they hit the matter and are deflected in another direction with loss of energy
Transmission - they pass straight through the matter without touching anything. Photons with a lot of energy will pass through the patient whereas photons with little energy stops inside the patient, known as absorption.
What does Kv stand for?
Kilovoltage
What does mA stand for?
Milli-amperes per second
Dangers of ionising radiation
Deterministic effects (tissue reactions) - in most cases a threshold does exists where no changes will take place.
Stochastic effects - may occur after any does of radiation.
Which are then divided into
Acute or immediate effects - can appear a short time after the exposure
Chronic/long time effects - can appear a long period of time after the exposure.
What is an atom?
Atoms consist of minute particles held together by electric and nuclear forces. Their dense central nucleus is made up of protons and neutrons. This nucleus is surrounded by other electrons in specific orbits or shells.
Atoms - continued
Positive or negative charge?
Protons = positive charge
Nucleus = positive charge
Electrons = negative charge
Neutrons = no charge
Terminology
What is the acronym?
DC - direct current or contrast potential
AC - rectified alternating current or pulsed potential
FsD - focus to skin distance
mA - milliamperage
Collimator - beam size and spacer cone
What does ALARP stand for?
As Low As Reasonably Practicable
Summarise what a Quality Audit means
The process of external assessment that ensures quality assurance and quality control procedures are all satisfactory, being completed regularly and working effectively.
What is Quality Assurance?
The arrangements the assure that quality control procedures are effective and they lead to relevant change and improvement.
What is Quality Control?
The specific measures for ensuring and verifying the quality of the radiographs produced.
True or false?
A register should be kept and maintained of staff training logs
True
Where should the local rules and employee written procedures be kept?
A) OPG room
B) Radiation protection file
C) Practice managers desk
Answer: B
True or false?
Solid state sensors require a list of Do’s and Don’ts available to ensure staff handle with care
False
Which type of processing is this daily check used on ‘Process cleaning through the processor at the beginning of the day to keep clean rollers’
A) Manual
B) Automatic
C) Digital
Answer: B
What type of developing requires a coin test to take place?
A) Manual
B) Automatic
C) Digital
Answer: A
How often should processing equipment be tested?
Annually
Who is responsible for a Quality Assurance programme in a dental practice?
A) Requires a named person, suitably trained
B) Eveyone in the building
C) Only the clinician who uses the x-ray machine
Answer: A
What does the acronym SLOB stand for?
A) Same Lingual Opposite Buccal
B) Sulcus Line Occlusal Buccal
C) Same Line Opposite Buccal
Answer: A
What does the word parallax mean?
The effect of an item appearing to differ in direction or position from the observer’s viewpoints.
Example: a static object may look bigger or small depending on how close you are to it.
Which tooth is most likely to require localisation due to un-eruption and ectopic positioning?
A) Mandibular canine
B) Maxillary lateral incisor
C) Maxillary canine
D) Mandibular incisor
Answer: C
How is parallax used to localise an un-erupted canine?
By imaging the tooth at two different angles, vertically and horizontally.
Why is a CBCT now more commonly used to localise teeth?
CBCT is more accurate
What anatomy should the upper standard occlusal radiograph demonstrate?
A) The nasal septum
B) The anterior maxillary teeth and the anterior maxilla
C) The posterior maxillary teeth and the anterior maxilla
D) The lower anterior teeth and the anterior mandible
Answer: B
What is a lateral radiograph?
Lateral radiographs are extra-oral images taken to view the jaw, they are taken using a dental x-ray set.
What is true lateral positioning?
The image receptor and the sagittal plane of the patient’s head are parallel to one another. The x-ray beam is vertical to them both.
What is the bimolar technique?
A) A radiograph taken to show the molars for removal.
B) The radiographic projections showing oblique lateral views of the right hand side of the jaw on different halfs.
C) A radiograph projection showing the molars of one side of the jaw.
Answer: B
True or false?
Cephalometric radiography is a reproducible radiograph of the skull and can usually be used for orthodontic treatment to assess the connection between the teeth and the jaw to the rest of the skeleton.
True
What dental specialist commonly would request a cephalometric radiograph?
A) Periodontist
B) Implantologist
C) Orthodontist
D) Maxillofacial Surgeon
Answer: C
What apparatus is used to stabilise the patient’s head during a cephalometric radiographic procedure?
A) Ear rods
B) Head brace
C) Temple holders
Answer: A
What is the most common fault seen on a panoramic radiograph?
A) Movement
B) A positioning error
C) Shadowing caused by jewellery
Answer: B
When using manual and automatic films, which of the below options could cause the image to be too dark?
A) Developer solution too cold causing underdevelopment.
B) Overexposure due to faulty timer.
C) The room being too dark.
Answer: B
How do you correct an exposure error?
Adjust the kV accordingly
What does the quality rating ‘N’ mean?
Not acceptable - errors in either patient preparation, exposure, positioning or image reconstruction which render the image diagnostically unacceptable.
What does quality rating ‘A’ mean?
Acceptable - No errors or minimal errors in either patient preparation, exposure, positioning, processing or image reconstruction and sufficient image quality to answer the clinical question.
What does DPT stand for?
A) Deep panoramic technique
B) Dental panoramic tomography
C) Dental panoramic technique
Answer: B
What is the Compton effect?
A) The radiation exposure to the patient.
B) The scattering and absorption of the x-ray.
C) The photons passing through the matter.
Answer: B
If somatic cells are affected then it is possible radiation induced malignancy:
True or false?
True
Evert exposure of ionising radiation carries the risk of causing damage:
True or false?
True
Is there a safe dose of radiation?
A) Yes
B) No
C) Maybe
Answer: B
What is The Photo-Electric Effect?
A) Pure radiation
B) Pure scatter
C) Pure absorption
Answer: C
Following DNA damage, subsequent chromosomes effects could include:
A) Only temporary damage
B) Abnormal replication
C) Cell death, Abnormal replication, failure to transference of information and only temporary damage.
D) None of the above
Answer: C
A stray electron is also known as?
A) A negative ion
B) A positive ion
C) A stray ion
Answer: A
What is a positive ion?
A) Where the Compton Effect results in an unstable atom.
B) Where both the Photo-Electric Effect and the Compton Effect result in an unstable atom.
C) Where the Photo-electric effect results in an unstable atom.
Answer: B
What is a radiation dose?
A) Dose that is recieved by the patient for the x-ray examinations.
B) A dose recieved over a period of time.
C) The dose given at that particular time
Answer: A
Radiation dose limit is
A) The maximum level given at that one time.
B) The exceeded dose of radiation.
C) The maximum level annually of radiation given to an individual, which should not be exceeded.
Answer: C
Natural background radiation is sourced from:
A) Rocks and soils from the earth’s crust.
B) Rocks and soils from the earth’s crust and certain foods.
C) Rocks and soils form the earth’s crust and certian foods and outer space.
Answer: C
Can higher exposures to radiation cause problems to humans?
Yes
There are two main catergories for the biological effects of ionising radiation, they are:
A) Deterministic effects & Somatic effects.
B) Deterministic effects & Stochastic effects.
C) Genetic and Somatic effects.
Answer: B
What does RPA stand for?
Radiation Protection Advisor
What is the IIR17?
The Ionising Radiations Regulations 2017
What are the dose limits for ionising radiation?
For employees and trainees 18 years above - 20mSv in a calender year
For trainees under 18 - the limits is 6 mSv in any calender year
For any other person including below the age of 16 the limit is 1mSv in one calender year.
Pregnant workers are also protected and asked to inform their employers but are legally required to do so.
What are the 9 GDC principles?
(Try name at least 3)
1) Put patient’s interest first.
2) Communicate effectively with patients.
3) Obtain valid consent.
4) Maintain and protect patient’s information.
5) Have clear and effective complaints procedure.
6) Work with colleagues in a way that is in a patient’s best interest.
7) Maintain, develop and work within your professional knowledge and skills.
8) Raise concern if patients are at risk.
9) Make sure your personal behaviour maintains patient’s confidence in you and the dentsl profession.
What are the three main principles?
A) Justify, Simplify & Optimise.
B) Optimisation, Positive and Negative.
C) Justifiation, Optimisation & Limitation.
Answer: C
Who are the ICRP?
The International Commision on Radiological Protection.
Who selects the dose that is used on a patient with clinical justification for radiographic investigation?
A) The Patient
B) The Clincian
C) The Nurse
Answer: B
Why are dose limits set?
A) To give dental staff a guide on what to use daily.
B) To prevent excessive radiation doses being exposed to patients.
C) To show that rules are set for dental staff.
Answer: B
What is the dose limit set for a non-classified worker?
A) 6mSv
B) 1mSv
C) 3mSv
Answer: A
What are the three main ways to reduce radiation exposure to patients and team members?
Equipment
Clinical judgement
Radiographic technique
What are the Golden Rules?
- Always stand at least 2 meters from the x-ray machine and patient (outside the controlled area) or behind a protective lead screen.
- Never stand in the line of the x-ray beam.
- Always stand outside the ‘controlled area’.
- Never hold the x-ray film packet in the patient’s mouth.
- Never hold the x-ray tube head during the exposure.
- Always use the x-ray equipment safely, following current guidance and good practice.
When did the IIR17 come into affect and who does this concern?
1st January 2018 - replaced IRR99 regulations.
Workers and general public
When did the (IR(ME)R17) come into affect and who does this concern?
6th February 2018
Safety of patients
What is the minimum distance you should stand from the x-ray machine?
A) 1.5 metres
B) 2 metres
C) 2.5 metres
Answer: B
As a member of the dental team, is it a legal requirement to wear a personal monitoring device?
No
What does the outer surface of the maxilla cover?
A) The nasal
B) The sinus
C) The Mental foramen
Answer: B
What is the bone called that supports the cheeks that can be visible on a panoramic radiograph?
A) Nasal bone
B) Palatine bone
C) Zygomatic bone
Answer: C
What is the boney lump above the canines called?
A) Canine alveolar
B) Canine Prominence
C) Buccal Canine Bone
Answer: B
How does the sinus cavity appear on a radiograph?
A) Aradiopaque area with a dark border.
B) A radiolucent area witha white border.
C) An area at the apex of the molars that resembles a bubble.
Answer: B
What is the bone called that finished off the ridge where the wisdom teeth would be situated?
A) Tuberosity
B) Ridge end
C) Trabecular pattern
Answer: A
What is the name of the pattern in the alveolar bone?
A) Trabecular pattern
B) Tracing pattern
C) Triangular pattern
Answer: A
What is the line called that joins the two sides of the palate called?
A) Vertical palatal join
B) Mid palatal suture
Answer: B
What is the main nerve in the mandible?
A) Inferior Dental Nerve
B) Long Buccal Nerve
C) Anterior Superior Alveolar Nerve
Answer: A
What is the name of the bone in the lower border?
A) Alveolar bone
B) Cortical bone
Answer: B
True or false?
The mental foramen is clearly visible on the mandible
True
All staff must be vaccinated against which of the following diseases
A) Hep C
B) HIV
C) Hep B
D) Covid 19
Answer: C
What radiographic view can be used to localise an unerupted maxiallry canine?
A) Bitewing
B) CBCT
Answer: B
Before a radiograph is taken, which of the following must be checked?
A) If the patient has eaten today
B) If the patient is pregnant
C) If the patient has any allergies
Answer: B
True or false?
It IS important to put on PPE before taking a radiograph
True
What regulation should be followed for Health and Safety?
A) Health and Sagety at Work Act 1974
B) Health and Safety at Work Regulations (MHSWR) 1999
Answer: A
Which of the following options is one the main infectious diseases of concern in dental practices?
A) Herpes Zoster
B) Meningitis
C) Herpes Simplex
D) Salmonella
Answer: C
Choose from the options below, which is NOT a reason for taking a periapical radiograph?
A) Detection of an infection located at the apex of surrounding area
B) To help diagnose caries between posterior teeth.
C) To detect curved roots before extractions.
D) Before, during and after endodontic treatment.
Answer: B
True or false?
The film packet should be placed with the long axis of the tooth and ensure the beam hits the film at a 90 degree angle.
True
What does NRPB stand for?
National Radiation Protection Board
From the following options, which is recommended by the NRPB?
A) To take radiographs with or without clinical justification.
B) To use beam aiming devices when taking periapicals.
C) To take radiographs on pregnant patients.
Answer: B
What are the three dimensional of a CBCT?
Saggital, Coronal, Axial
What are the names in dentistry of the two radiation regulations thst relate to dentistry?
IRR(2017) & IR(ME)R (2017)
What is the purpose of Ionising Radiation Regualtions 2017?
A) To ensure the safety of the dental team and the general public.
B) To ensure the safety of the dental team only.
C) To ensure that radiographs are grade A only.
Answer: A
True or false?
Employers are under no legal obligation to supply dosimeters as dental care professionals are non-classified workers although it is recommended to monitor staff for 6-12 month period.
True
Within how many days should a practice acknowlege a written complaint?
A) 7 days
B) 5 days
C) 2 days
D) 14 days
Answer: C
What is the procedure for a dental nurse to take a radiograph?
A) The dentist instructs the dental nurse to take the radiograph.
B) The dentist writes a prescription in the clinical notes with justification for radiograhy.
C) The dental nurse writes up clinical notes after choosing to take the radiograph.
Answer: B
How many hours of verifiable CPD should a dental nurse complete over their 5 year cycle?
A) 10 hours
B) 20 hours
C) 40 hours
D) 50 hours
Answer: D
What does RPS stand for?
Radiation Protection Supervisor
Is a RPS mandatory
Yes or No?
Yes
Who is responsible for justifying a medical exposure?
A) The patient
B) The clinician
C) The processor
D) The operator
Answer: B
If a radiographic image is poor and deemed non-diagnostic, should the operator repeat the exposure?
Yes or No?
Yes
True or False?
The bisected angle technique is when the x-ray beam is aimed perpendicular at an imaginary line which bisects the angle between the long axis of the film packet and the long axis of the tooth.
True
What reason would you use the bisected angle technque and not the parallel technque?
A) It s easier
B) The clinician is unable to place the film packet parallel to the x-ray tube head
C) It is quicker to complete
Answer: B
What angle should the x-ray beam be aimed at the imaginary line?
A) 90 degrees
B) 40 degrees
C) 120 degrees
Answer: A
True or False?
An advantage of the bisecting angle is that if the angulations are correct, the image should be adequate for diagnosis although not ideal.
True
True or False?
The Zygomatic bone shadow is superimposed over the roots of the molars and buccals roots can be foreshortened is a disadvantage.
True
Vertical angualation too large creates the image to be…..
A) Elonagted
B) Foreshortened
Answer: B
Vertical angualtion too short creates the image to be……
A) Elongated
B) Foreshortened
Answer: A
What angle should be used for the practical technique on the canines in the maxilla?
A) 50 degrees
B) 60 degrees
C) 40 degrees
Answer: 50 degrees
What angle should be used for the practical technique on the molars in the mandible?
A) 15 degrees
B) 5 degrees
C) 20 degrees
Answer: 5 degrees
What is a bitewing used for?
A) Pre-op and post of root canal treatment.
B) To detect caries and periodontal disease.
C) To assess bone density.
Answer: B
When taking a bitewing radiograph, where should the x-ray tubehead be aimed?
A) The mandible
B) The contacts points of the teeth
C) The anterior teeth
Answer: B
True or False?
The patients arch should be assessed before taking radiographs as the technique should be adjusted accordingly.
True
What of the following options is not one of the three main projections for bitewings?
A) Adult Vertical Bitewings
B) Adult Horizontal Bitewings
C) Child Veritcal Bitewings
D) Child Bitewings
Answer: C
What teeth should be visible on a horizontal bitweing?
A) 1st premolar to the 3rd molar
B) 2nd premolar to the 2nd molar
C) Canine to the 3rd molar
Answer: A
Why would you take vertical bitewings?
A) Long teeth
B) To prevent overlapping
C) To take four radiographs for one patient
Answer: B
What should be visible on a child’s bitewing?
A) Deciduous E’s to the first permanent molars.
B) Deciduous C’s to the second permanent molars
C) Deciduous D’s to the first permanent molars.
Answer: C
Which of the following options are NOT ideal quality criteria for a bitewing
A) The buccal and lingual parts of the teeth should be superimposed.
B) The approximal surfaces of the teeth should not be overlapping.
C) The alveolar crests of the maxilla and mandible should be shown.
D) The image should show the whole of the tooth including the crown and the root apex.
E) The image should have acceptable definition with no distortion or blurring.
F) Other
Answer: D
What does QA stand for?
Quality Assurance
What is assessed with QA?
A) The dentist’s clinical work
B) Image quality, x-ray equipment, darkroom, films, processing, training and audits.
C) The staff members and the way they work within the practice.
Answer: B
How often should a radiation safety test be carried out?
A) Every year
B) At least once every 5 years
C) At least once every 3 years
Answer: C
What is the regulation 10 of IR(ME)R 2017?
A) The dose limits of non- classified workers
B) The controlled areas of a dnetal practice
C) The information that should be obtained and logged with a dental set.
Answer: C
Whic of the following factors won’t affect the radiographic image?
A) Technique - the operartors techniques when placing x-ray tubehead and the film.
B) The settings on the computer screen.
C) Interpretation of the final image
D) Exposure features - including kV, mA and time are all important to get a quaity image.
E) Computer software for processing - if using digital, the process used is important to create a quality image.
Answer: B
What option does the film contrast not depend on?
A) TYpe of film either direct or indirect
B) Optival density or degree of the blackening of the film
C) Processing
D) Material of the film
Answer: D
If the film is too dark, which of the following is not a possible cause?
A) Overexposed
B) Overdeveloped
C) Underexposed
D) Fogged
Answer: C
Which one of the following oprions is the correct technique demonstrated?
A) Image receptor should be positioned correctly to capture the area required.
B) Not reinforcing the patient, the need to keep still, which could result in blurring the radiograph.
C) Aligning the x-ray tubeheadnwith the vertical plane.
D) Using the image receptor back to front.
Answer: C
In the Quality Assurance policy, why should a record of grade 3 radiographs be kept?
A) To know where to find them
B) To monitor any trends that are taking place
C) To single out patients who moved during radiographs
Answer: B
What soloution could you put in place for better postioning when taking radiographs of third molars?
A) Get the patient to hold the sensor in place
B) Use specially designed holders
C) Take an OPG
Answer: B
What soloution could you put in place for someone who may have a stron gag reflex?
A) Use holders that are specifically designed to assist with accessing the lower molars.
B) Work with the patient to allow them to concentrate on their breathing while the film packet is in the mouth.
C) Use the parallel technique held by the patient.
Answer: B
What method could you use when taking a radiograph for a small child?
A) Take two radiographs of the tooth using different positions with the tubehead
B) Place the film packet flat in the mouth (in the occlusal plane) and use the bisected angle technique
C) Place the film packet or sensor flat in the mouth on the occlusal plane so it misses touching the palate.
Answer: B
What are the three subatomic particles?
Protons, Neutrons, Electrons
Within how many days should a practice acknowledge a written complaint?
A) 7 days
B) 5 days
C) 2 days
D) 14 days
Answer: C
True or False?
Employers are under no legal obligation to supply dosimeters as dental care professionals are non-classifed workers although it is recommended to monitor staff for a 6-12month period.
True
What is the purpose of Ionising Radiation Regulations 2017?
A) To ensure the safety of the dental team and the general public
B) To ensure the safety of the dental team only
C) To ensure that radiographs are only grade A
Answer: A
Are intra-oral or extra-oral radiographs optimal for caries assessment?
A) Intra-oral
B) Extra-oral
Answer: Intra-oral
Which intra oral film has the fastest speed?
A) D
B) E
C) F
Answer: C
What are the thre intra oral film speeds?
A) D,P,T
B) D,E,F
C) D,G,T
Answer: B
True or False?
Intra oral radiographs are known as Direct-Action Films as these are wrapped or in a packet.
TRUE
The film packet contents are:
A) Barrier, envelope, black paper, plastic film
B) Barrier envelope, plastic film, foil, paper
C) Barrier envelope, outer wrapping, foil and film
Answer: B
Emulsion is primarilly sensitive to X-ray photons:
TRUE
What does Lead foil do?
A) Lead foil prevents some residual radiation passing on into the patient
B) Protects the film
C) Helps to hold the film in place and retain the image
Answer: A
True or False?
Intensifying screens are available in different sizes
TRUE
What does QA stand for?
A) Quality Assessors
B) Qualification Assurance
C) Quality Assurance
Answer: C
The different methods of developing a radiograph in the dental practice is:
A) Manual and Digital
B) Manual, Automatic and Digital
C) Automatic and Digital
Answer: B
What is the front view of a radiograph better known as?
A) Coronal view
B) Panoral view
C) Front view
Answer: A
