Merryl and Meaghan Perritti Board Review Flashcards
What is the Scintillator made of?
Cesium Iodide
What is the purpose of the Scintillator?
Converts X-rays to Light
What is a photodiode made of?
Amorphous Silicon
What is a Scintillator made of?
Cesium Iodide
Number of Ionizations in Air
Exposure
Measures the energy of ionizations in air
Air KERMA
Air KERMA unit of measurement is:
Gya
1 Gy=
1 joule/kilogram (J/kg)
KERMA stands for:
Kinetic Energy Released in Matter
Energy absorbed in matter per unit mass
Absorbed Dose (D)
Includes photoelectric and absorption and Compton scatter
Absorbed Dose (D)
Absorbed Dose=
Photoelectric + Compton
If you increase mA how would it effect absorbed dose to patient?
increase
Increase SID how would that effect absorbed dose?
decrease
Expressed as Sieverts
Equivalent Dose
Equivalent Dose is expressed as
Sieverts
Factor reflecting the relative harmfulness of various types of radiation
WR
Wr for X-rays, Beta, Gamma Rays
1
Determined by multiplying the absorbed dose by radiation weighting factor
Equivalent Dose (EqD)
X-rays have a ______ LET and _________ RBE
low, low
The amount of energy deposited per unit length of track
LET
Gy x Wr = Sv
Equivalent Dose
Sv = Gy x Wt x Wr
Effective Dose
Can be used to calculate the risk of cancer
Effective Dose
A calculated dose that takes into account the type of radiation the patient was exposed to (equivalent dose) as well as what part of the body was irradiated
Effective dose
Where is the image intensifier?
-In stationary fluoroscopy room above the patient
-In mobile fluoroscopy + C-arm (it should be placed above the patient, but can be placed in a lateral position)
Input phosphor is made of:
Cesium Iodide
Focuses the beam in the image intensifier
Electrostatic Lens
The output phosphor is made of:
zinc Cadmium Sulfide
Image Intensifier Process:
XLELM
-X-rays are converted to light in the input phosphor, light to electrons in the photocathode, electrons to light, converts the light photons to electrical signal (CCD), see on the monitor screen
Mobile Fluoroscopy SSD:
30 cm
Stationary Fluoroscopy SSD:
38 cm
Spell HIPAA
HIPAA
If you increase the kVp, what will happen to the speed of x-rays?
a. Increase
b. Decrease
c. Remain the Same
Remain the Same
If you are collimated to a 14 x 17 to 10 x 12 what will happen to receptor exposure, contrast, % scatter?
Receptor Exposure: Decrease
Contrast: Increase
Scatter: Decrease
What Projection? What sinuses are seen?
AP Axial, NO sinuses seen
Leakage Radiation Occurs at:
1 mGy per hour at 1 meter
Radiation that comes out of the tube housing is called:
Leakage Radiation
What is a mR or mGy?
1/1000 Gy
What is a milli?
one thousandth
FOV/Matrix
Pixel Size
Pixel Size x Matrix
FOV
FOV/Pixel Size
Matrix
The distance between the center of one pixel to the center of another pixel
Pixel Pitch
Inherent Filtration has to be:
.5 mm of Aluminum
The glass envelope, the oil, the mirror from collimator has to be:
2 mm Aluminum Equivalent
How does filtration minimize patient exposure?
How does filtration effect receptor exposure? Contrast?
Decrease
Decrease
Low kVp is:
increase contrast
High hVp is:
Decreased contrast
When filtration is increased
contrast is decreased
Image Intensifier
label
.000375 ms to seconds
.000000375 seconds
25 cm is how many mm?
250 mm
300 ms to seconds
.3 seconds
1 inch=
2.54 cm
25.4 mm
Lead and Concrete Equivalent for Primary Protective Barrier
1.6 mm
The length of the portable exposure cord?
2 meters
Mortise View of the ankle
15 degrees
Medial Oblique of the ankle
45 degrees
Gall bladder location of a hypersthenic patient
High and Transverse
Level T10-T11
Stomach location for Hypersthenic patient
High and more transverse
Level T9-T12
Duodenal Bulb location for Hypersthenic patient
T11-T12
Stomach location for a Hyposthenic/Asthenic patient
T11-L5
Duodenal bulb location for Hyposthenic/Asthenic patient:
L3-L4
Gallbladder location for Hyposthenic/Asthenic patient:
L3-L4 (just above crest)
Name the Body Habitus.
A.
B.
C.
D.
A. Sthenic
B. Hyposthenic
C. Asthenic
D. Hypersthenic
Identify the body habitus.
A.
B.
C.
A. Hypersthenic
B. Sthenic
C. Asthenic/Hyposthenic
Why is the right hemidyaphragm positioned more superior than the left?
Liver
What condition might cause flattening of the diaphragm?
Emphysema/COPD
What study and what position?
Upper GI
PA (air in the fundus)
The patient is not oblique enough
Oblique the patient more
35-40 degrees
RAO drinking Esophagus
35-40 degrees
What is this? What is it used for?
Swallowing Dysfunction Study (CINE)
Aspiration
Stroke Patients
KNOW ANATOMY
KNOW ANATOMY
KNOW ANATOMY
KNOW ANATOMY
What lives in the C-loop of the duodenum?
Head of the pancreas
What position?
What Projection?
Prone (PA)
What position?
What projection?
Supine (AP)
What position?
RAO
What position?
LPO
What Projection?
What is it demonstrating?
Right Lateral Stomach
Retrogastric Space
What position?
Right Lateral Stomach
Know Anatomy
Know Anatomy
The order of the small Intestine:
- Duodenum
- Jejunum
- IlEum
Performed to best compress the bowel:
Prone Abdomen
Know anatomy
transverse colon sits:
anteriorly to the flextures
Maximum enema bag height is above the table:
18-24 inches ( cm)
BE tip insertion:
sims position
What study?
Supine AP And Prone- Single Contrast Study
If the patient is in an RPO which flexture is opened up?
The Upside
The Splenic
If the patient is in an LPO which flexture is opened up?
The Upside
The Hepatic Flexture
If the patient is in an RAO which flexture is opened up?
Hepatic Flexture
The downside
If the patient is in an LAO which flexture is opened up?
Splenic Flecture
The downside
What position?
LPO
RAO
What position?
RPO
LAO
RAO & LPO will both demonstrate:
Right Hepatic Flexture
LAO & RPO will both demonstrate the:
Left Splenic Flexture
What position? What is best demonstrated?
LPO
Right Hepatic Flexture Best Demonstrated
What position? What is best demonstrated?
RAO
Right Hepatic Flexture is Best Demonstrated
What position? What is best demonstrated?
RPO
Left Splenic Flexture best demonstrated
What position? What is best demonstrated?
LAO
Left Splenic Flexture Best Demonstrated
What study? What position?
Double Contrast Study
Supine
What study? What position?
Double Contrast Study
Prone
What Position?
Right Lateral Decubitus
(Right side is filled with barium, Right side is lower)
What position?
Left Lateral Decubitus
Left Lateral Decubitus
Rectosigmoid Region
Single Contrast Enema
Lateral Rectum
Left lateral
Double Contrast Enema (air) uses X-table lateral Rectum
Air Fluid Levels
AP Axial Sigmoid Tube Angle:
30-40 cephalad
PA Axial Sigmoid Tube angle:
30-40 Caudad
What Method?
PA Axial Sigmoid
“Butterfly Method”
What method?
AP Axial Sigmoid
“Butterfly Method”
Abdomen taken prior to the start of any fluoroscopy study involving contrast:
Scout
Abdomen (PA or AP) taken after a fluoroscopy study with contrast
(Patient should try to evacuate as much contrast as possible prior to taking exposure)
Post- Evacuation
What study? Best Demonstrates?
Hysterosalpingogram
Patency of Fallopian Tubes
Lithotomy Position
Contrast Media is administered vis spinal puncture into the subarachnoid space-intrathecal injection
Myelography
Preferred site for spinal puncture for myelography:
L3-L4
Using Water Soluble Contrast
Primary Pathology for Myeolography:
Herniated Nucleus Pulposus (HNP)
When the nucleus pulposus protrudes into the annulus fibrosis
Herniated Disk
Myelography
L3-L4
Study of Synovial Joints and surrounding tissues with contrast media:
Arthography
Arthrography
Involves Informed and Written Consent, Patient History, Medications, blood thinners, allergies, sterile technique
Arthography
Synarthroses Joints
Immovable, fixed or fibrous joints, no movement
Bones of the Skull
Amphiathrosis Joints
slightly movable (cartilaginous joints)
limited movement
Vertebrae and Spine
Diarthroses Joints
Freely Movable
Synovial Joints
Synovial Fluid
Knee and Shoulder
Where is the saddle joint?
Thumb
IVU is a:
functional test, Antegrade Contrast Method
Know Anatomy
What type of study is this?
IVU study
Intravenous Urography
IVU AP scout, and series
IVU Obliques RPO and LPO
30 degree posterior oblique
Radiographic examination of the bladder
Cystography
To see the posterior aspect of the bladder
Ureterovesical junction (UV)
Voiding Cystourethrogram
Males Voiding Cystourethrogram position:
30 degree RPO
Female Cystourethrography Position:
AP Position
What pathology?
Urinary Reflux
What pathology?
Double Collecting System
What pathology
Horseshoe Kidney
Procedure to adress kidney stones:
Ureteroscopy
Involves the passage of a ureteroscope through the urethra and bladder and up the ureter to the point where the stone is located
Ureteroscopy
Done in the operating room with a urologist
Ureteroscopy
What procedure
Ureteroscopy
Ureteroscopy
Know Anatomy
Know Anatomy
Duct that connects gallbladder
Cystic Duct
Hepatic Duct
Duct that connects the liver
Cystic and Hepatic Duct combine to form this duct
Common bile duct
What procedure?
ERCP
Common bile duct joins the pancreatic duct together they empty into the:
Hepatopancreatic Ampulla (Ampulla of Vater)
Presence of stones in the gallbladder
Cholelithiasis
Inflammation of the pancreas
Pancreatitis
Juandice
Yellow collowing
What procedure
Surgical Cholangiogram
Surgical Removal of Gallbladder
Cholecystectomy
Composed of higher-atomic number elements
Positive Contrast
Appears radiopaque on an image
Positive Contrast
Barium Sulfate
Atomic Number 56
Water soluble iodinated
Atomic Number 53
Composed of low atomic number elements
Negative Contrast
Appears radiolucent on image
Air
CO2
Thoracic Cavity is lined with:
Visceral and Piratial Flora
Abdomin is lined with:
Visceral and Piretial
Three structures of the diaphagm:
Inferior Vena Cava
Aorta
Esophagus
How many ribs are on this image?
10 posterior ribs
What is this structure?
Sphenoid Sinus
The back part of the sella turcica is called:
Dorsum Cella
Cervical Vertebrae
Two top holes: Transverse Foramen
Bottom big hole: intervertebral Foramen
Gaynor Hart method
Carpal Bones
KNOW ANATOMY
- AP
- Internal Rotation (Coronoid Process)
- External Rotation (Head of Radius)
- 2.
A.
B.
A. Greater Tubericle in profile
B. Lesser Tubericle in profile but superimposed
AP Shoulder
Shoulder Internal Rotation
Epicondyles perpendicular to IR
Lesser Tuberosity in Profile
Name this position
Grashey Method for Shoulder (45 degree oblique)
Glenoid Fossa in Profile
Which cell would you choose if this was your patient?
Manual Technique
NO AEC
Wilhelm Roentgen discovered x-rays in
1895
NCRP stands for
national council for radiation protection and measurements
NCRP 116 measures:
limitation of exposure to ionizing radiation of people
NCRP 102:
Medical X-ray, Electron Beam, and Gamma Ray protection for up to 50 MeV, equipment
Avoidance of serious x-ray induced skin injuries to patients during fluoroscopy guided procedures
FDA
Exposure Factors (Fluoroscopy)
High kVp 100 or more, allows the mA to be between 1-5 mA or .1 - 5 mA
-limit the number of spot films
-limit the use of magnification feature
-tightly collimate
For radiation protection purposes the fluoroscopic table top exposure rate must not exceed:
10 mR/min
The table top intensity should not exceed: (fluoroscopy exposure rate)
*2.2 R/min for each mA of current at 80 kVp
(Grids) The use of a 5:1 grid will increase the patient’s exposure by:
2 xs
(Grids) The use of a 10:1,12:1 grid will increase the patient’s exposure by:
5 xs
The relationship between Grids and minimizing patient exposure:
No relationship, they don’t
(positioning) position the patient in fluoroscopy:
with the fluoroscopy off, do what you need to do and then turn the beam on
Where is the radiation coming from in fluoroscopy? (positioning)
Below the patient
Proper positioning of the patient is more important in fluoroscopy or radiography?
fluoroscopy because of the continuous beam
Where do you put the shield in a fluoroscopy room?
Put the shield on the table and then the patient lays on top of it (positioning)
(fluoroscopy time) a cumulative timer must be used after how long in fluoroscopy?
5 minutes
Audio Signal
Where the radiologist periodically activates the x-ray beam instead of using a continuous beam (fluoroscopy time)
Intermittent Fluoroscopy
If you are flouroing you can hold the image so that the doctor can insert the guidewire without the use of fluoroscopy
Last Image Hold, Dose Saving Technique
The fluoroscopic equipment maintains image brightness by adjusting of part thickness by automatically varying the kVp, mA, or both
ABC (automatic brightness control)
To keep the signal to noise ratio (SNR) constant by adjusting the exposure factors automatically:
AERC System
21 CFR states that the source-skin distance (SSD) cannot be less than _________ on stationary fluoroscopes.
38 cm SSD (receptor positioning)
21 CFR states that source to skin (SSD) distance cannot be less than _______ for mobile fluoroscopes.
30 cm SSD (receptor positioning)
During mobile fluoroscopy, the C-arm should be positioned so the x-ray tube is ___________. The image intensifier is ___________.
-under the patient
-close to the patient as possible (receptor positioning)
Magnification Mode:
-conventional, multi field image intensifiers a magnified image is less distorted and makes small details easier to see, but it comes at a cost of more radiation to the patient.
-digital, dynamic flat-panel detectors allow the operator to zoom without an increase in exposure
KERMA stands for:
Kinetic Energy Released in Matter or Mass
Allow for the operator to zoom without an increase in exposure
Magnification Mode
What does this represent?
Cumulative dose AIR KERMA Display. That is documented in the patients chart.
The last frame is displayed when the beam is turned off, allowing the operator to evaluate the image before continuing the procedure
Last Image Hold (LIH)
means shall be provided to limit the source-to-skin distance to no less than ________ on stationary flouroscopes.
38 cm
Source-to-skin distance is no less than _________ on mobile fluoroscopes (C-Arm).
30 cm
Where is the DAP meter located?
on the collimator, in front of it.
*The unit that measures DAP (dose area product):
*Gy-cm^2
OR
*cGy-cm^2
DAP meters measure:
the radiation dose to air x the area of the x-ray field
DAP stands for:
Dose Area Product
*Protective Drapes have to be a minimum:
*0.25 mm Pb (LEAD)
Shielding devices such as lead screen drapes and table sides:
SHALL be provided to minimize over-table scatter radiation from reaching the operator
The Bucky slot cover has to be a minimum of:
0.25 mm Pb
To attenuate all scatter or leakage radiation originating under the table
Bucky Slot Cover
Activated by the fluoroscope exposure switch
Deadman Type Switch
Produces an AUDIBLE signal or interrupts beam after 5 minutes of fluoro time:
Cumulative Timer
What is this?
An installed remotely controlled digital fluoroscopic imaging system with a over-table x-ray tube and under table image receptor
Set Standards for the use of Ionizing Radiation:
NCR, NCRP, CFR-21
Conducts Inspections of Institutions to determine if the radiographic Equipment Meets Standards
The Food and Drug Administration
Doing a regular chest x-ray the wall where the Bucky is:
Primary Protective Barrier
Any barrier that intercepts the primary useful beam.
Primary Protective Barrier
