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Principles II EXAM 1 (Monte) > Radiation and Laser Safety (Cooper) > Flashcards

Radiation and Laser Safety (Cooper) Flashcards

1
Q

What are the 4 types of radiation?

A
  1. Electromagnetic
  2. Mechanical
  3. Nuclear
  4. Cosmic
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2
Q

Match the Correct type of radiation with the appropriate description:

Only travels through substances
Almost speed of light
Combine electricity and magnetism
Unstable atom nuclei

A

Only travels through substances: Mechanical
Almost speed of light: Cosmic (beta)
Combine electricity and magnetism: Electromagnetic
Unstable atom nuclei: Nuclear (neutron)

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3
Q

Describe non-ionizing radiation:

A
  • Can’t knock electrons off atoms
  • Doesn’t break molecular bonds
  • Harmful only due to heat energy (radio wave or microwaves)
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4
Q

With ionizing radiation, what 3 things can occur from the intracellular chemical reactions?

A
  • Break DNA chains…cell apoptosis
  • Mutate DNA chains…cancer
  • Mutated sperm or egg cell… birth defects
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5
Q

Both visible light rays and x-rays are ____ energy.

A

Electromagnetic

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6
Q

What is another term for “energy level”

A

Wavelength

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7
Q

Rank the following in order of longest wavelengths to shortest wavelengths:

UV Rays
X-rays
Microwaves
Radio waves
Gamma Rays
Infrared

A

Radio
Microwaves
Infrared
UV
X-rays
Gamma

Reversed order if talking about energy level

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8
Q

Describe the process as to how light is emitted:

A
  1. Moving particles excite atoms (ie. when heated)
  2. The electron “jumps” to a higher energy level (orbit)
  3. To fall back to the original orbit it must release energy… A photon

Caused by the movement of electrons in atoms

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9
Q

Small Atoms vs Large Atoms:

Less likely to absorb xray photons
Bones
Greater energy differences between orbitals
Soft tissue
More likely to absorb photons
Electron orbitals are separated by low jumps in energy

A

Less likely to absorb xray photons: Small
Bones: Large
Greater energy differences between orbitals: Large
Soft tissue: Small
More likely to absorb photons: Large
Electron orbitals separated by low jumps in energy: Small

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10
Q

In order for an X-ray to work it must contain these 2 things which are also termed an “electrode pair”.

A

Cathode and Anode

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11
Q

Describe a cathode

A

Filament in center
Current heats filament (like a fluorescent lamp)
Heat causes electrons to fly off of filament

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12
Q

Describe an anode:

A

Positively charged
Made of tungsten
Attracts electrons across the tube

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13
Q

Broad list of what medical x-rays can be used for:

A
  • Diagnostics
  • Radiography
  • Mammography
  • CT
  • Fluoro
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14
Q

In order to get a CT, the x-ray is combined with ___ and this combination generates a ___.

A

Computer processing

3D Image

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15
Q

What is the benefit to using fluoro?

A

Real time images

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16
Q

What is one example of an “other” use of medical x-rays?

A

Radiation therapy
* Much higher dose
* Damages cancer cell DNA

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17
Q

What are radiation doses measured in?

A

mrem (1/1000th of a Rem)

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18
Q

Annual allowable doses of radiation:

Whole Body
Extremities
Eye lens
Pregnancy

A

5,000 mrem whole body
50,000 mrem extremities
15,000 mrem lens of eye
500 mrem for pregnancy

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19
Q

Rank the following in order of least amount of radiation to most for the different procedures:

Coronary Angiogram
CT
Angioplasty
CXR

A

CXR: 5-10 mrem
Coronary Angio: 1500 mrem
CT: 5000 mrem
Angioplasty: 5700 mrem

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20
Q

Does obesity increase or decrease radiation scatter?

A

Increases scatter

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21
Q

What 3 factors play a role in increasing or decreasing radiation scatter?

A
  1. Collimation
  2. Object thickness
  3. Air Gap

Narrow Collimation = decreased scatter

22
Q

At what mrem dose would transient erythema be seen?

What level of radiation would you start to see effects in a fetus after 20 weeks?

A

200,000 mrem = erythema

> 10,000 mrem

23
Q

What does the acronym ALARA stand for?

A

As Low As Reasonably Achievable

24
Q

How can we increase our protection from radiation?

A

Time: Reduce time spent near beam
Distance: Farther away = less exposure
Scatter: attempt to be >6ft from patient
Shielding: Lead aprons/glasses, thyroid protection

25
Q

If we are doing a scan delivering 100 mrem at 6 ft, what will moving to 12 ft do to our exposure rate after moving?

A

It will cut it down by 75% (1/4 the exposure)

100 mrem –> 25 mrem

26
Q

How should dosimeters be worn?

A

outside the apron on the collar
and
inside the apron on the waist

27
Q

An MRI is based on interactions between these 2 things:

A

Static magnetic field
Individual atom nuclei

28
Q

What is the contrast generated by in an MRI after the radiofrequency has been turned off?

A

Time til tissue relaxation

29
Q

Which type of MRI “view” is better for looking at anatomy?
What about pathology?

A

T1: Better for anatomy
T2: Better for pathology

30
Q

In this MRI view, fat appears darker than water and can identify tissue edema easily.

A

T2 View

31
Q

How do fat and water appear in a T1 view?

A

Fat appears bright; water dark….provides good grey-white matter contrast

32
Q

This key component in contrast material for an MRI Alters the magnetic properties of nearby water molecules which enhances the quality of MR images.

A

Gadolinium

33
Q

Side effects to Gadolinium

A

Mild side effects: itching, rash, abnormal skin sensation
Rare severe reactions
Clears with normal GFR in 24 hours

34
Q

True or False:
MRI’s can cause artifacts on an ECG, leading to inaccurate interpretation?

A

True:

Electromagnetic interference causes artifacts

35
Q

True or False:
During an MRI of the head and neck, you can still access the airway without pulling the patient out of the scanner?

A

FALSE:

Airway is inaccessible

36
Q

What is one thing we worry about for our patients undergoing an abdominal scan?

A

Brachial Plexus injuries
(arms over head)

37
Q

Safe vs Unsafe for an MRI:

Coronary Stents:
IVC Filter:
Biliary Stent 4 weeks ago:
Implanted Insulin Pump:
Titanium ortho implant:
AICD’s:
Prosthetic Mitral Valve:
Pacemakers:

A

Coronary Stents 1 week ago: SAFE
IVC Filter: SAFE
Biliary Stent 4 weeks ago: UNSAFE (>8wks)
Implanted Insulin Pump: UNSAFE
Titanium ortho implant: SAFE
AICD’s: UNSAFE
Prosthetic Mitral Valve: SAFE
Pacemakers: UNSAFE

38
Q

Laser uses:

A

Cosmetic Surgeries
LASIX (Eye surgeries)
Dental Procedures
General Surgery (condyloma, TURP)
ENT Procedures (sinuses, tracheal tumor, vocal cord polyp)

39
Q

Describe the properties of electrons in the “unexcited state”

A

Electrons orbit the nucleus at the lowest energy
Occupy orbits closest to the nucleus

40
Q

When energy is absorbed, electrons become ___ and move to ___.

A

Excited

Higher orbit

41
Q

Define the following properties of laser radiation:

Monochromatic:
Coherence:
Collimation:

A

Monochromatic:
* All the photons in the laser beam are the same wavelength

Coherence:
* Travel of photons is synchronized in time and space

Collimation:
* The laser beam photons are nearly parallel, small area

42
Q

Which of the following statements regarding Laser use is true? (Select 3)

A. Lasers do not have as high of precision accuracy as an MRI
B. Lasers allow for good hemostasis and rapid healing
C. There are higher infection rates
D. Increased Post-op pain
E. Less Post-op edema
F. There should be less scar formation

A

B. Lasers allow for good hemostasis and rapid healing
E. Less Post-op edema
F. There should be less scar formation

43
Q

This type of laser has minimal scatter, is great for vocal cord procedures and has negligible surrounding tissue damage.

A

CO2 Laser

44
Q

Describe the Argon Laser:

A

Modest tissue pentration (0.05-2 mm)

Used for derm procedures

45
Q

What is the Nd:YAG laser used for?
How deep is the tissue penetration?

A

Used for tumor debulking
2-6 mm penetration

MOST POWERFUL LASER

46
Q

What are the hazards to laser use?

Which 2 are the biggest worries?

A

1. Atmospheric contamination (need a mask)

  1. Perforation of a vessel or structure
  2. Embolism
  3. Inappropriate energy transfer

5. Airway fire

47
Q

What is Laser Plum?
What are some S/E?

A

Fine particulates produced d/t vaporization of tissue (Atmospheric Contamination)

S/E: HA, nausea –> interstitial PNA, bronchiolitis, emphysema
Can be carcinogenic

48
Q

2 Major sources for OR Fires:

A
  1. ESU (Cautery devices)
  2. Laser

Fire Triad: Ignition source, Fuel, Oxidizer

49
Q

What are a couple of things that we can plan out with our surgeon to reduce airway fire?

A

Intermittent apneic oxygenation
Jet ventilation
TIVA

50
Q

What are some ways we can minimize the risk of fire in the OR?

A

Laser-resistant ETTs
Low-inspired (21% if possible) O2 (avoid nitrous)
Wet pledgets around the ETT (saline/gauze)
Methylene blue in the ETT cuff
Use scissors to cut into trachea instead of bouvie
Remove ETT during laser procedure and reinsert ETT prn sats
Short, repeated laser pulses (not long, continous pulses)

Principles II EXAM 1 (Monte) (5 decks)

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