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Spinal X-ray Positioning > Midterm > Flashcards

Midterm Flashcards

1
Q

Most state regulations require QC programs. A good one involves what 3 people?

A

Coordinator
Liscensed Medical physicist
Service engineer

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2
Q

What are the 3 steps of QC for x-ray generating equipment?

A

Acceptance of new equipment
-done by physicist. Check for current or get updated inspection.

Performance evaluation
-annual evaluation and routine maintenance

Correction protocol should begin whenever any problems are detected
-report to service engineer

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3
Q

How do you report equipment problems?

A

Document exactly what happened and when

Write down any error messages on console as they appear

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4
Q

Guidelines for testing equipment: 7 tests

A 
filtration
collimation
focal spot size
kVp calibration
exposure timer accuracy
exposure linearity
exposure reproducibility
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5
Q

WHen does a medical physicist perform testing of equipment?

A
  • newly installed machine
  • at leats once a year
  • if a major component ir replaced or recalibrated
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6
Q

WHo conducts performance evaluations?

A

Physicist

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7
Q

What does the generator do?

A

Generator provides electrical power for the tube, other parts of the machine and other functions

Powers x-ray tube to produce x-rays
Control panel allows radiographer to select:
mA - and the appropriate focal spot size for exam
time (mA x time = mAs: total number of x-rays)
kVp (the energy of the x-rays in the beam)
in some cases: manual or automatic exposure timing

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8
Q

What are the 3 types of generators commonly used in chiro offices?

A
  • single phase (half or full wave rectification) - old
  • Three phase (6 pulse 12 pulse)
  • high frequency or constant potential - newest

-same components
-differ in:
complexity
cost (high frequency :  approx. $4,000 - 5,000)
efficiency in producing x-rays (high frequency higher energy)
exposure to the patient: (high frequency less exposure)

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9
Q

Annual generator & x-ray production test
kVp delivered during exposure must be within ± __% of the selected kVp. A variation of __-__ kVp affects patient dose and image density

A

5

2-3

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10
Q

Exposure timer – __ __ test must be tested annually
patient dose is directly affected by exposure time - very important
accuracy must be within ± __% for times greater than 10 milliseconds
below 10 milliseconds ± __ % is acceptable

A

spinning top
5
20

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11
Q

What is x-ray unit’s ability to produce a constant radiation output for the same mAs using different combinations of mA and time?

A

Linearity

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12
Q

Linearity test must be performed annually.

a dosimeter is used to measure radiation intensity which should be within ± __%

A

10

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13
Q

What is the same combination of kVp, mA and exposure time producing the same density and contrast every time called?

A

Reproducibility

should be within +-5%/ performed annualy

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14
Q

What tools can be used to test the focal spot?

A

Pinhole camera
Slit camera
star pattern

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15
Q

What are some ways to prolong tube life?

A
  • avoid excessive exposure
  • use a warm up procedure- 3 exposures, 5 sec apart, start low with large focal spot
  • avoid unnecessary long exposure times
  • use tube rating and cooling curve charts
  • avoid high mA
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16
Q

What are 3 types of filtration?

A

inherent- from machine design i.e. glass tube

Added (aluminum between x ray and collimator)

COmpensation

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17
Q

Gonad shield face tube side is made of ___ and __ side is against patient

A

copper

aluminum

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18
Q

What is minimal acceptable filtration?

A

2.5mm Al (HVL) equivalent

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19
Q

What isan example of an x-ray and light beam alignment test?

If out of alignment +-__% of the SID additional anatomy is exposed.

A

9 penny test
2%

**Should be performed twice a year

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20
Q

WHat is the inverse square law?

A

Intensity of teh radiation is inversely proportional to the square of the distance

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21
Q

WHat is the anode heel effect?

A

Variation of x-ray intensity

  • Anode less intense, cathode more
  • can be used to balance body part density
  • anode-cervical
  • cathode-lumbar
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22
Q

What is best veiw to see z joints in C spine?

A

Lateral

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23
Q

What is best view to see IVF in C spine?

A

45 degree post. oblique

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24
Q

What is best view to see Z joints in T spine?

A

70 degree post. oblique

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25
Q

What is best view to see IVF in T spine?

A

Lateral

26
Q

What is best view to see Z joints in L spine?

A

45 degree post. oblique

27
Q

What is best view to see IVF in L spine?

A

Lateral

28
Q

Where is central ray for AP pelvis?

A

Horizontal: @ ASIS, @ 1.5 inches below top of iliac crest

Vertical: Midline

29
Q

SID for AP pelvis

A

40”

30
Q

What do you have the pt do with their feet on AP pelvis?

A

Int. Rot. 15 degrees

31
Q

Where do you measure for AP lumbar and what does it demonstrate?

A

Measure 1 ½” above the level of the Iliac crest from front to back

Demonstrates T12-SI Joints

32
Q

Where do you measure for AP lumbosacral and what does it demonstrate?

A

Measure at the level of the Iliac crest from front to back

Demonstrates T12- Coccyx (to include SI Joints

33
Q

Where do you measure for AP lumbopelvic and what does it demonstrate?

A

-Measure at the level of the ASIS from front to back
-Internally Rotate feet 150
-Demonstrates T12- Ischial Tuberosities,
Iliac Crests, Femoral head and necks

34
Q

Where is CR for Lat. Lumbosacral? Where is vertical ray?

A
  • Top of iliac crest

- b/w ASIS and PSIS

35
Q

What does lateral lumbosacral demonstrate?

A

T12-coccyx

36
Q

AP thoracic CR location and vertical ray location

A
  • Inferior Scapula border
  • Midline

*suspend inspiration

37
Q

Where do ou measur for AP thoracic?

A

Over the shoulder from sternum to T spine

38
Q

What does AP thoracic demonstrate and what is SID?

A

T1-T12

SID= 40”

39
Q

Where is Vertical Ray for Laying down Lateral thoracic?

A

Posterior to humeral head

*no tube tilt

40
Q

How do you measure for Lateral thoracic?

A

Side to side under the arms, may have pt. inhale and hold

41
Q

Wjat does lateral thoracic demonstrate?

A

C7-L1

42
Q

Where to shoot on Lat. thoracic if pt. has scoliosis

A

into concavity

*Shoot into the cave!

43
Q

When is swimmer’s view taken?

A

When the lat. thoracic doesnt reveal upper thoracic or lateral cervical does not reveal lower cervical region

44
Q

Tube tilt for swimmer’s view

A

Caudal 5 degrees

45
Q

Pt. position for swimmer’s view

A

Coronal plane is rotated 10-20 degrees off of perpendicular to the bucky with the arm next to the bucky flexed and the arm next to teh tube extended.

-or pt’s coronal plane perpendicular to teh bucky with arm next to buck extended and the shoulder next to the tube hyper-depressed

46
Q

LAteral Cervical SID and Patient position

A

72”

  • pt. erect in a true lateral position
  • Adjust the neutrality of the patient’s head so that an imaginary line between the inferior mastoid tip (or ear lobe) and the maxillary (Anterior Nasal) spine (acanthion) is horizontal (Parallel to the floor).
  • Maximally depress pt’s. shoulders (may need sandbags)
47
Q

Where is CR for Lat. Cervical?

A

Centered at level of C4 along plane of mastoid tip

48
Q

Breathing instructions for lateral cervical

A

Exhale, then hold

  • must see occiput to T1
49
Q

Pt. position for APOM

A

Slight head extension, so that imaginary line between the mastoid tip and bottom of upper teeth are horizontal.
-open mouth as wide as possible

50
Q

CR for APOM

A

Through center of open mouth

51
Q

AP lower cervical structures demonstrated

A

C2-T2

52
Q

Where to measure for Ap lower cervical and SID

A

C4 level

40”

53
Q

Cr angle for AP lower cervical

A

15 degrees cephalad

54
Q

PAtient position for AP lower cervical

A

facing tube, raise chin and extend head so angled central ray is in a line from the lower edge of the chin to base of occiput

55
Q

Cervical Oblique SID

A

40

56
Q

CR for Ant and Post cervical oblique

A

Ant- angle of the mandible

Post- Thyroid Cartilage

57
Q

Lumbar Oblique SID

A

40

58
Q

Lumbar oblique film size

A

14 x 17

59
Q

Where to measure for lumbar oblique

A

level of L-3 obliquely

60
Q

CR for anterior lumbar oblique

A

Vertical and horizontal CR is directed 1” lateral from L3 spinous on side closest to the tube

61
Q

CR for Posterior Lumbar oblique

A

Vertical: 2” medial to teh ASIS on side closest to tube
Horizontal: 1” above iliac crest pn side closest to the tube

Spinal X-ray Positioning (1 decks)

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