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Medical Imaging > mi 120 unit 3 > Flashcards

mi 120 unit 3 Flashcards

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USMLE® Step 1 flashcards
1
Q

holistic patient care

A

treat the patient as a whole person rather than a body part

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2
Q

effective communication and body language

A

-introduce yourself
-address the patient properly
-ease patient stress and anxiety
-understanding and dignity
-clear and concise instructions
-increase their cooperation
-give them time to ask questions
-gain their trust
-be professional, be present and watch body language
-reduce repeat exposures

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3
Q

involuntary motion

A

caused by muscles, not controlled
-heart, digestive, chills, tremors, spams, pain, withdrawl

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4
Q

how do you correct involuntary motion

A

reduce exposure time and increase image receptor speed

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5
Q

voluntary motion

A

controlled motion
-lack of control caused by age, breathing, anxiety, discomfort, fear

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6
Q

how do you correct voluntary motion

A

gaining the patients cooperation and use of proper immobilization

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7
Q

piggostat

A

mainly for chest. xray in babies younger than 2, baby needs to be able to hold their head up

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8
Q

octostop

A

used to perform in fluro; good for rotation for toddlers

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9
Q

sponges and sandbags

A

sponges are radiolucent
sandbags are radiopaque

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10
Q

mummy wrap

A

immobilization for babies who keep their hands and arms near their head

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11
Q

tape

A

never stick the tape to patients skin

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12
Q

radiolucent plexiglass

A

plastic like glass that we can xray through

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13
Q

non-radiology employee holds patients because

A

we need someone to hold because we already are getting exposed enough by taking the xray in general

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14
Q

beam limiting device

A

limits the primary beam to a smaller area; decreases exposure by reducing the amount of tissue exposed and reduces SCATTER

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15
Q

aperture diaphragm

A

flat lead with a hole cut in it and placed below the window
-rectangular in the most common, can be square or round
-reduced SCATTER

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16
Q

Cones

A

circular metal cylinder that connect to front of the tube and limits the size of the beam
-can be flared or straight and 10-12 inches away
-mostly used in dental radiography but can be used for heel, skull, and spine images

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17
Q

what replaced cones

A

collimators

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18
Q

collimators

A

also called light localizing variable aperture rectangular collimator
-SHOULD NOT BE OPENED LARGER THAN BODY PART
-can reduce exposure by 20-30%
-dont over collimate (make it too small)
-2 sets of shutters 90 degrees from one another

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19
Q

near (upper)

A

located close to a window
reduce exposure from off focus radiation

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20
Q

far (lower)

A

located close to light source
confines the beam to area of interest

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21
Q

skin sparing

A

minimizes skin exposure by requiring a 15 cm distance from skin to collimator
-can be achieved by spacer bars mounted on the tube

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22
Q

PBL- positive beam limitation

A

electronic sensors in the bucky that senses the size of the IR that is used and opens the collimators appropriately
–slites or pegs
-reduces human error
-aka automatic collimator

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23
Q

filtration

A

hardens the beam by cleaning up low energy
reduces patient exposure to skin and superficial surface
reduces absorbed dose
lower energy photons provide no detail to the image

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24
Q

what is the total filtration in the housing

A

2.5 mm AL (aluminum) equivalent for units that operate above 70kVp

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25
Q

inherent

A

0.5 mm AL
made up of glass envelop, insulating oil, and glass window

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26
Q

added

A

2.0 mm AL
made up of sheets of AL added outside the glass window above the collimator
-can be accessed by a service person and can be changed as tube ages

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27
Q

mobil and fluro require what

A

2.5 mm AL filtrarion
NCRP #102 list minimum requirements for filtraion

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28
Q

what act states xray adequate filtration

A

radiation control for health and safety act of 1981

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29
Q

HVL

A

half value layer
-measures beam quality or effective energy of the beam
-measured once a year by a physiscit

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30
Q

AAPM stated what

A

american association of physicists in medicine
april 2019
shielding of patient gonadal or fetal shielding during diagnostic imaging should be discontinued

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31
Q

what organs need reduced exposure

A

eye, breast, reproductive

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32
Q

gonadal

A

first step to gonadal protection is proper collimation
-due to location of gonads, females receive 3x more exposure

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33
Q

placement of contact of shadow shields for men and women

A

female- at the level of ASIS and should extend 1/2 inches above the superior rim of the pubic bone
male- place shield just below the pubic bone

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34
Q

flat contact/ figleaf

A

most effective in AP or PA view

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35
Q

shadow

A

needs to be carefully placed, not useful in fluoro

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36
Q

shaped

A

contoured to male anatomy, placed by patient, not useful with PA projection

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37
Q

half shield

A

used for gonadal protection of patient, covers front or back of patient and is attached by velcro strap or on wheel

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38
Q

compensating filters

A

used when x-raying a part that has varying thickness to reduce dose and provide a uniform density across the image
-decreases the entrance skin exposure
-constructed or aluminum or lead arcylic that is attached to the bottom of the collimator

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39
Q

wedge

A

used for foot or spine

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40
Q

trough

A

used for chest

41
Q

ferlic

A

used for hips (only)

42
Q

boomerang

A

used for shoulders (gos outside shoulder an cleans up access tissue)

43
Q

kVp

A

the wavelength (speed) going through the body
maximum possible energy of a photon that exits the xray tube
-indirectly proportional to patent exposure

44
Q

mA/milliamperage

A

of xrays that are created
-measurement of xray tube current or the number of electrons crossing the tube from cathode
-directly proportional patient exposure

45
Q

mAs/ milliampere seconds

A

controls the amount of radiation produced by the xray tube
mA X seconds = mAs
directly proportional to patient exposure

46
Q

AEC/ automatic exposure control

A

the cells that are selected on the operating console that will automatically select the mA according to cell selection and body part
-sets the appropiate mA for the body part being xrayed

47
Q

increase what and decrease what

A

kVp; mAs

48
Q

imaging receptor

A

increase in imaging receptor speed, decrease patient exposure by t decreases sharpness

49
Q

correct processing

A

inadequate processing results in image reports

50
Q

radiographic grids

A

-rule of thumb is to use the grid when part of thickness is over 10 cm
-removes scatter that comes form the patient before they reach the image receptor
-grids increase patient dose but improves the quality of the image which provides a better diagnosis
-use the lowest grid ratio appropriate for the body part

51
Q

air gap technique

A

alternative to using a grid to clean up scatter
-patient is placed 6-10 inches away from the image receptor with a 10-12 feet SID

52
Q

repeat images

A

any image that must be done more than once due to human or mechanical error
-patient receives a double dose

53
Q

unnecessary exposure

A

pre admission, pre employment, routine health check ups, screening for TB , check for disease

54
Q

mobil xrays

A

minimal source to skin distance on a mobile fluoroscopy unit is 12 inches or 30 cm
-the smaller the source to skin distance, the larger the entrance exposure

55
Q

fluoro distances

A

NCRP states 15 inches or 38 cm for fixed units and 12 inches or 30 cm for mobile units
-audible alarm at every 5 minutes
-exposure rate limit-federal regulations for table top exposure is 88 mGy per minute

56
Q

fluoro exposure switch

A

called a dead man switch
-foot pedal requires direct pressure to continue with fluoro

57
Q

fluoro guided positioning (unethical)

A

using fluro to: determine if you are positioned appropriately before taking an image

58
Q

DAP (dose area product)

A

newer fluoro systems provide the sum of the air kerma over the exposed are the patient

59
Q

c-arm fluoroscopy

A

used in: OR, cardiac cath, IR
-12 inches or 30 cm minimal distance to the patient
-c-arm should be positioned with the II on top (reduced scatter)

60
Q

cinefluoroscopy

A

used in cardiography and neuro-radiography
-reduce patient exposure and works like a movie

61
Q

interventional radiology

A

invasive sterile procedures performed by a physician under fluoro
-FDA requires documentation in the patient chart if skin dose os 1-2 Gy
-federal regulations for table top exposure of high level control fluoro are 176 mGy per minute

62
Q

radiation dose measurements

A

entrance skin exposure (ESE) includes skin and glandular
-skin dose: absorbed dose to the most superficial layers
-Gonadal dose: US dose is 0.2 mSv
-bone marrow dose

63
Q

pregnant patients

A

-asking LMP
-10 day rule: xrays should be done within 10 days of onset of period
-ACR’s position
-10-25 rad rule (less then 10 and 25 is too high)

64
Q

mammography

A

utilizes low kVp, limit number of projections, adequate compression, avoid axillary exposure unless ordered by radiologist

65
Q

CT

A

-doses are higher than diagnostic radiology
-shielding is not utilized because of the nature of the exposure
-collimators are very tight in CT

66
Q

pediatric patients

A

longer life span can increase chances of developing a radiation induced leukemia or radiologic malignancy such as lung or thyroid

67
Q

morbid obesity

A

skeletal anatomy and organ size does not change except possibly: thoracic cage expanded 2”, stomach may slightly be larger, colon may spread out
-increase the image receptor to increase penetration of the xray beam

68
Q

image gently

A

CT- one size does not fit all
digital- back to basics
NM- go with the guidelines
fluoro- pause in pulse
AIR- step lightly

69
Q

NCRP dose limits

A

annual effective dose is 50 mSv
cumulative effective dose is age in years X 10 mSv
ALARA- collimate, technique, shielding and minimize repeats

70
Q

reducing occupational exposure

A

avoid repeats, collimation, cumulative timer
stand 90 degrees from the patient
pateint is a source of scatter radiation
-3 feet or 1 meter from the patient

71
Q

what is the scatter radiation to tech ratio

A

1/1000 the intensity

72
Q

filtration

A

non useful low energy photons are removed, less scatter

73
Q

exposure factors

A

controls scatter

74
Q

correct image acquisition

A

reduces repeats

75
Q

high speed image receptors

A

high speed systems use smaller exposures which causes less scatter

76
Q

beam limiting devices

A

reduces scatter

77
Q

pregnant personnel

A

after declaring, the second baby badge is used worn at waist level
-0.5 mSv in one month
-5 mSv for the entire pregnancy
-lead apron is worn inside the apron at waist level
-maternal tissue decreases fetus dose by 30%

78
Q

types of radiation

A

primary radiation- useful beam, emerges directly from the tube collimator
scatter radiation- highest dose to the technologist; primary beam passes through matter and goes in various directions
leakage radiation- escapes the tube housing

79
Q

protective structural shielding

A

usually lead or concrete
primary protective barrier- located perpendicular to primary beam travel
-prevents direct or unscattered radiation from reaching personnel and general public
-for 130 kVp of peak energy a 1/16 inches of lead or 7 ft upward form the floor

80
Q

secondary protective barrier

A

any wall or barrier that is never hit by the primary beam
-1/32 inch of lead or lead equivalent
-overlaps the primary barrier by 1.2 inch and extends to the ceiling
-control booth is regarded as a secondary barrier
-window is 1.5 mm lead equivalent

81
Q

protective device requirements

A

lead apron- 0.5 mm lead(Pb) for fluoro, AIR or operatiing
gloves- 0.25 mm lead (pb)
neck and thyroid- must be 0.5 mm lead (pb)
protective eyeglasses-contains lead (pb)

82
Q

protective tube housing

A

lead lined metal that protects personnel and patients from leakage and off focus radiation
-cannot exceed 1 mGy per hour at 1m away from housing

83
Q

fluoroscopy

A

proper position to be standing- avoid scatter areas; stand behind the physician/ radiologist or RA
90 degrees from the patient

84
Q

when wearing a thyroid shield

A

unprotected areas are getting 10-20 x more exposure

85
Q

protective shield linings

A

apron- 0.25mm or 0.5mm
gloves- 0.25mm
thyroid- 0.5 mm
eyeglasses- 0.35 mm

86
Q

protective lead curtain

A

0.2 mm lead equivalent
protects scatter radiation

87
Q

bucky slot cover

A

0.25 mm lead equivalent
protects gonadal protection

88
Q

isoexposure curves

A

dose from scatter radiation at 90 degrees/ 1 metter away= dose x 0.001
cord length should be long enough to stand 6 ft away

89
Q

c-arm

A

properly orient the c arm with II on top
stand on the side of the patient during a lateral view

90
Q

cardinal principles of radiation protection

A

time- amount of exposure is directly proportional to duration of the exposure
distance- most effective means of protection, it is indirectly proportional
shielding- absorbs most of the energy of scatter radiation (85% of effectiveness)

91
Q

ISL

A

I1/ I2= (D2)2/ (D1)2

92
Q

workload

A

radiation on time during a week
measured in mAs/week or mA-minute/week

93
Q

use

A

amount of time the beam is directed at the structure
takes into account primary or secondary radiation

94
Q

occupancy

A

time that the area is occupied behind a barrier
waiting room and empty courtyard

95
Q

calculating barrier requirements

A

W x U x T

96
Q

controlled

A

occupied by workers who are trained and wearing monitoring devices
maximum permitted equivalent dose is 100 mrem per week

97
Q

uncontrolled

A

occupied by the geneal public
maximum ermitted equivalent dose is 2 mrem per week

98
Q

radiation sign posting

A

radiation symbol that is magenta, purple or black on yellow background

Medical Imaging (14 decks)

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