Rad Quality - Exam 2 Flashcards
The more dense the tissue, the _______ it appears on the radiographic image
lighter
_________ of body parts affects density
thickness
The risk of _______ from radiologic exams accumulates over a lifetime
cancer
Each exposure from each exam contributes to the ______________ exposure of the patient
lifetime radiation
Radiographic Positioning is:
the placement of the body between the x-ray tube and the film
How many views are necessary to view all of the anatomy
two
What is a “series”?
the minimum number of x-ray views for a complete exam (for insurance)
What does CR mean?
What does IR mean?
CR = x-ray tube IR = film or image receptor
Place the body part as close to the ______ as possible.
IR
- The ______ is centered to the middle of the body part.
- The long axis of the body part is parallel to the long axis of the ____.
- The _____ is directed perpendicular to the body part.
- CR
- IR
- CR
Standard SID = _____ inches
40
What views are exceptions to the standard 40 inch SID and need to be changed to 72 inches to minimize magnification distortion?
all lateral and oblique cervical views
lateral chest view
PA chest view
AP full-spine view
- Mastoid tip
- Thyroid cartilage
- Vertebral prominens
- Sternal notch
- Sternal angle
- Xyphoid tip
- Iliac crest
- ASIS
- Greater trochanter
- Ischial Tuberosities
- Mastoid tip C1
- Thyroid cartilage C4
- Vertebral prominens C7
- Sternal notch T2
- Sternal angle T4
- Xyphoid tip T10
- Iliac crest L4/5
- ASIS S2
- Greater trochanter - P.S./coccyx tip
- Ischial Tuberosities - bottom of pelvis
What does collimation do?
- limits amount of radiation to patient
2. controls unwanted scatter
If using conventional film, always place ID blocker _____ from anatomy of interest.
away
Patient orientation blocker for digital film:
- For cervical, thoracic, lumbar it goes ______.
- For extremities it goes ______ except for hand and wrist it goes _____ toward the elbow.
- up
2. down, up
PUC is done on _______ film.
- lateral - _____
- PUC APOM - _____
- Nasium - ______
- Base posterior - _______
conventional
- up
- down
- down
- down
What are the effects of respiration?
- controls voluntary motion
2. reduces motion artifacts, fuzziness, blurriness
Inhale: diaphragm moves _____, shoulders move _____
Exhale: diaphragm moves ____, shoulders move ______
_____ inspiration inflates lungs to demonstrate most anatomy for chest x-ray
Inhale: diaphragm moves down, shoulders move up
Exhale: diaphragm moves up, shoulders move down
Deep inspiration
Flat aluminum filter:
- placed between ______ and _____
- placed over _____ portion of intended anatomy
- protects patient from some _______
- produces consistent ________ throughout anatomy
- x-ray beam and patient
- thinnest
- exposure
- radiographic density
What is the 10-day rule?
The safest time to x-ray women of childbearing age is within the 10-day period after the onset of menstruation.
Radiographic images are owned by the _____________, not the _________.
- facility where they were created
- NOT the patient
What are the nine steps to prepare to take a CERVICAL x-ray?
- patient prep
- measurements
- shielding
- SID
- select and place film in bucky
- collimation
- patient placement
- central ray
- anatomical marker
How to set up a lateral cervical x-ray view:
- 72 inches SID
- 8x10 film vertical; ID blocker up
- line from the bottom of the front teeth to the mastoid parallel to floor
- vertical central ray through mastoid
- horizontal central ray level with thyroid cartilage (C4) top of light field just above the ear
- collimate to soft tissue
- mark side closest to film under the chin
- “exhale and stop breathing”
How to set up an AP open mouth x-ray view:
- 40 inches SID
- 8x10 film vertical; ID blocker up
- line from the bottom of the front teeth to the mastoid parallel to floor
- central ray to center of mouth
- collimate vertically to below lens of eyes and horizontally to mastoids
- “don’t breathe, don’t move”
How to set up an AP cervical x-ray view:
-40 inches SID
8x10 film vertical; ID blocker up
-line from the bottom of the front teeth to the mastoid parallel to floor
-central ray entering thyroid cartilage (C4)
-collimate 10 inches x skin
-“don’t breathe, don’t move”
What three views are in the cervical NON-TRAUMA series?
- lateral cervical
- AP open mouth
- AP cervical
What five views are in the cervical TRAUMA series?
- lateral cervical
- AP open mouth
- AP cervical
- obliques
- flexion and extension laterals
How to set up an anterior cervical oblique x-ray view:
- 72 inches SID
- 8x10 film; ID blocker up
- line from the bottom of the front teeth to the mastoid parallel to floor
- rotate patient 45 degrees from PA position
- 15 degree caudal tube tilt entering mid cervical region (C4)
- collimate to 8x10
- RAO: right IVF’s ; LAO: left IVF’s
- “don’t breathe, don’t move”
How to set up a cervical flexion lateral x-ray view:
- 72 inches SID
- 10x12 film vertical
- tuck chin and flex to patient’s tolerance
- central ray through mid cervicals
- include VP in collimation field
- “don’t breathe, don’t move”
How to set up a cervical extention lateral x-ray view:
- 72 inches SID
- 10x12 film vertical
- elevate chin and extend to patient’s tolerance
- central ray through mid cervicals
- “don’t breathe, don’t move”
Flexion and extension views are performed to demonstrate both __________ and __________.
- ligament instability
- range of motion
How to measure and place patient for a swimmer’s view:
- measure under arms (axilla to axilla)
- dependent arm (closest to film) is raised
- center to T1, then center film to central ray
How to set up for a swimmer’s x-ray view:
- 40 inches SID
- 8x10 film vertical
- patient seated (reduces motion)
- patient lateral with arm closest to bucky in full extension
- central ray entering T1
- “don’t breathe, don’t move”
raised arm acts as a natural filter for the cervical spine
How to set up for a posterior cervical oblique view:
- 72 inches SID
- 8x10 film vertical
- rotate patient 45 degrees from AP position
- 15 degree cephalic tilt entering mid cervical
- RPO: left IVF’s ; LPO: right IVF’s
- “don’t breathe, don’t move”
What are the two accessory cervical views?
- posterior obliques
2. Fuch’s view (non-traumatic view done to visualize the dens)
central ray = center of ________
center of film to _______ level
anatomy
central ray
Give the two reasons why anterior oblique views are preferred.
- radiation protection
2. shooting into concavity
What are the five types of set-ups at 72 inches?
- all lateral cervicals
- all cervical obliques
- PA chest
- lateral chest
- AP full spine
What does SID stand for?
source-to-image distance
What five things must be done before taking a radiographic examination of a patient?
- de-artifact patient
- obtain informed consent
- gown the patient
- shield the patient
- practice the 10-day rule
“DIGS-10”
What often causes difficulties with APOM x-rays to cause them to be non-diagnostic?
dental hardware
What landmark must you be able to see on the patient when looking at an APOM x-ray?
dens
What are the eight causes of atlantodental instability?
- fractured dens
- traumatic disruption of ligaments
- inflammatory arthritis
- downs
- marfans
- NF 1 (neurofibromatosis type 1)
- osteogenesis imperfecta
- infection
What is quantum mottle?
the image is underexposed causing it to appear grainy on the x-ray
Standing views must be performed recumbent (lying down) if worried about a ___________.
fracture
Always shoot ______ the concavity if the spine is curved.
into
When using film, technique is set for the ________ area of the body part. Filters are placed over the ________ portion of the anatomy.
thickest, thinnest
Filters help to maintain consistent ________ on the final radiographic image.
density
Are filters used with digital imaging?
No because the computer evens out the image.
When taking a THORACIC x-ray, how does the order of the set-up process differ from cervical views?
Set film height to patient, then central ray to center of film
What is the set-up flow for THORACIC views? (11 steps)
- patient prep
- measure for all set-ups in series (AP: calipers over shoulder, Lat: calipers from behind patient)
- patient standing, apply apron
- SID at 40 inches
- select 14x17 cassette and put in bucky
- set collimation 7x17 AP / 10x17 Lat
- position patient at bucky
- align cassette 1.5 inches above patient’s VP
- marker
- filter
- breathing instructions
How do you set up for an AP Thoracic view?
- measure over shoulder, spine to lower 1/3 of sternum
- 14x17 cassette vertical, ID blocker up
- collimate to 7x17
- top of cassette 1.5 inches above VP
- central ray to mid-film (T6)
- top of light field above sternal notch (T2)
- filter upper vertebrae down to cross hairs of central ray
- marker
- “breathe in and hold”
How do you set up for a Lateral Thoracic view?
- arms in prayer, measure right to left, axilla to axilla
- 14x17 cassette vertical; top 1.5 inches above VP
- collimate to 10x17
- center central ray to center of film
- raise arms parallel to floor, elbows together
- vertical central ray 1 inch posterior to humeral head, some light behind thoracic spine when collimated
- filter lower vertebrae (up to under the humeral head, will go past cross hairs of central ray)
- marker
- “inhale and hold”
Breathing instructions = __________
Breathing technique = ____________
Breathing instructions = what you tell the patient to do
Breathing technique = patient breathes during exposure to blur ribs, need minimum 2 seconds exposure, compensate by decreasing MA
What are the 5 image criteria for a lateral thoracic view?
- include T1-T12
- IVF’s and disk spaces open
- pedicles in profile
- posterior border of bodies and ribs superimposed
- uniform density
What are the 2 image criteria for an AP thoracic view?
- distance from pedicles to spinous processes are equal on both sides
- uniform density from top to bottom of thoracics
Why is it beneficial to do the thoracic spine standing if possible?
weight-bearing evens out region
