Radiography Flashcards

1
Q

Explain how xrays are produced.

A

energy conversion when a fast-moving stream of electrons suddenly decelerate in the target (anode) of an xray tube . This is called Brems radiation

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2
Q

What technique is used to protect the patient’s skin from receiving unnecessary radiation?

A

filtration (usually made of aluminum)

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3
Q

What is one of the most important actions xray personnel can take in order to avoid unnecessary radiation dose to the patient?

A

collimation

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4
Q

explain collimation.

A

reduces the primary xray beam to the area of clinical interest AND reduces the amount of scattered radiation reaching the xray film

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5
Q

explain filtration

A

material placed in the primary xray beam (usually made of aluminum), it is used to preferentially absorb or eliminate the less penetrating xrays before they reach a patient

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6
Q

explain the function of the grid.

A

reduce the scattered radiation produced in the patient (part being xrayed) before it reaches the xray film ; drawback is the use of grids results in increased patient radiation dose

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7
Q

Explain kVp.

A

determines the maximum photon energy (QUALITY) of the xray beam produced

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8
Q

What is the optimal target-to-film distance for radiographic examinations?

A

40 inch target to film distance

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9
Q

in radiography, what is the main source of scattered radiation?

A

the patient (body part being xrayed)

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10
Q

What factors affect scattered radiation?

A
  1. kvP used
  2. field size (area exposed)
  3. part thickness (volume exposed)
  4. tissue density (z number)
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11
Q

Explain Brems radiation (aka “breaking” radiation or brehmsstrahlung)

A

the process by which xrays are produced; energy conversion when a fast moving stream of electrons is suddenly decelerated in the target of an xray tube

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12
Q

What is the cathode?

A

negative electrode or filament

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13
Q

what is the anode?

A

positive electrode containing the target

i.e. electrons flow from the cathode to the anode

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14
Q

what % of energy deposited in the target by electrons is converted to xrays? what happens to the rest of the energy?

A

1%; while the other 99% is converted to heat

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15
Q

what directions do electrons flow in the xray tube?

A

from the cathode (filament) to the target (anode)

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16
Q

Explain milliamperes (mA).

A

refers to the QUANTITY of electrons flowing per second and is related to the # of xrays produced per second

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17
Q

Which factors, KvP and mA, is quantitative? how about qualitative?

A

KvP- quality of xray

mA- quantity of xray

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18
Q

A tube current of 200mA produces ____ as many electrons as a current of 100mA and ___ as many xrays per second as does 100mA.

A

twice; twice

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19
Q

Which principle allows high anode heating with small effective focal spots?

A

line-focus principle

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20
Q

what is the relationship between the target angle and the effective focal spot?

A

as the target angle decreases, so does the effective focal spot

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21
Q

what is the usual anode angle?

A

12-20 deg

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22
Q

what is the focus spot? why is this important?

A

the area bombarded by the electron stream; the size of the focal spot influences resolution of the image

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23
Q

Explain the “heel effect”. why is this important?

A

the result of the line focus principle that distributes radiation intensity more on the cathode side than on the anode side; results in reduced xray intensity on the anode side because of the abosrption fo the xrays in the “heel” by the target

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24
Q

what does filtration effectively accomplish by reducing the # of low-energy xrays from reaching the patient?

A
  1. reduced scattered radiation
  2. improves quality of the radiograph
  3. the xray beam becomes less polychromatic (more monochromatic)
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25
Q

Explain Half-value layer (HVL).

A

defined as the thickness of absorbing material necessary to reduce the xray intensity to half its original value

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26
Q

what represents the largest contribution to unnecssary patient radiation dose?

A

failure to collimate an xray

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27
Q

The use of 0.5mm lead equivalent sheet of lead to protect gonads reduces gonad dose by approximately what %?

A

92%

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28
Q

What is the minimum depth of lead equivalent for gonad shielding?

A

0.5mm

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29
Q

What techniques help reduce scatter radiation?

A

collimation

use of grids

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30
Q

what is the disadvantage of using a grid?

A

increases patient radiation dose

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31
Q

what is the general grid ratio for tube potentials below 90 kVp?

A

8:1

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32
Q

what is the general grid ratio for tube potentials above 90 kVp?

A

10:1, 12:1

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33
Q

What factors help reduce patient radiation dose?

A
collimation 
use of intensifying screens 
higher KvP
lower mAs
lower time exposure
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34
Q

What factors increase patient radiation dose?

A

use of grids

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35
Q

what is the intensification factor? how is it calculated?

A

magnitude of dose reduction obtained when using an intensifying screen; calculated by exposure without intensifying screens divided by exposure with screens

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36
Q

Examinations taken with intensifying screens reduce the radiation dose of the patient by approximately what %, compared to exams conducted without intensifying screens?

A

95%

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37
Q

What is the notable exception to the 40-inch target to film distance for optimal radiographic examinations?

A

chest radiography, where a 72-inch target to film distance is utilized to diminish magnification of the heart shadow on the radiograph

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38
Q

What 4 factors determine the quantity of scatter radiation?

A
kVp 
part thickness 
field size/area exposed
tissue density
*higher of these factors leads to greater scatter radiation
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39
Q

List in order of increasing density the following: water, bone, lead, muscle, aluminum, air, fat

A

air, fat, water, muscle, bone, aluminum, lead

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40
Q

which areas fo the body require patient shielding?

A

fetus, gonads, lens of the eye, thyroid gland, active blood forming organs such as spleen and bone marrow

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41
Q

What is attenuation?

A

the process by which an xray beam of radiation is reduced in intensity by absorption or scattering when passing through a material

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42
Q

explain the Compton effect.

A

An interaction between an incoming xray photon and an outer shell electron of an atom of the irradiated object in which the photon surrenders a portion of its kinetic energy to dislodge the electron from its orbit and then continues on its way but in a new direction; this process accounts for most of the scattered radiation produced during xray exams

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43
Q

What % of retake studies are due to error in exposure factors? What % of retake studies are due to positioning errors?

A

50% of retakes are due to errors in exposure factors

25% of retakes are due to errors in positioning

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44
Q

How does CT scan produce an image?

A

a fixed ring of detectors surrounds the patient, and the xray tube moves around the patient to collect views of the anatomy from many angular positions

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45
Q

Where does the majority of unnecessary radiation from CT examinations occur?

A

when the prepatient collimator is improperly adjusted

there is also a predetector collimator

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46
Q

which examinations have high dose effect on the bone marrow?

A

lumbar spine exams
retrograde urography
abdominal angiography
chest tomography

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47
Q

which blood cell type is most affected by irradiation of the bone marrow?

A

lymphocytes

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48
Q

what exams are the largest contributors to the genetically significant dose?

A

lumbar and lumbosacral exams

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49
Q

what is the estimated mean annual genetically significant dose (GSD) to the U.S. population in 1970?

A

20 millirads

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50
Q

List in order the cell types of diminishing sensitivitiy.

A

(most sensitive) lymphocytes or WBC> RBC, granulocytes> epithelial cells> endothelial cells> connective tissue cells> bone cells> muscle cells> nerve cells> brain cells (least sensitive)

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51
Q

At what maximum dose for diagnostic radiographic exams show no indications of injury?

A

25 rads or less

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52
Q

What is the order of most frequently occuring radiation-induced cancers? (in descending order of susceptibility)

A

(most susceptible) female breast > thyroid gland >hematopoetic tissue > lungs > GI tract bones

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53
Q

what does ALARA stand for?

A

as low as reasonably achievable

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54
Q

true or false: there is no minimum threshold of radiation dose necessary to achieve a biological event

A

true

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55
Q

explain stochastic effects. give an example

A

the probability of an effect occuring, rather than its severity
Ex. genetic effects, carcinogenesis

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56
Q

Explain non-stochastic effects. give an example.

A

severity of an effect varies with radiation dose (aka deterministic)
Ex. cataracts, bone marrow cell depletion, non-malignant skin damage

57
Q

what is the chief danger to the operator during radiographic procedures?

A

exposure to scattered radiation coming from the patient, and other scattered media

58
Q

by what % is exposure reduced when an operator stands behind the protective barrier?

A

99.87%

59
Q

by what % is exposure reduced from scattered radiation by wearing protective clothing?

A

97%

60
Q

What does “rad” measure?

A

absorbed dose (“Radiation abosrbed dose”)

  • aka gray (Gy)- in SI units
  • 1 Gy= 100 rads
61
Q

What does “rem” measure?

A

dose equivalent

*aka sievert- in SI units

62
Q

what 3 basic principles can be used to reduce dose to X radiation?

A
  1. time
  2. distance
  3. shielding
63
Q

What is the Inverse Square Law?

A

I1 (D1)^2 = I2 (D2)^2
*If the distance from an Xray source is doubled, the radiation intensity is reduced to 1/4 of the intensity a the original distance

64
Q

If the distance from an xray source is tripled, how does this affect the intensity ?

A

reduces the intensity to 1/9

65
Q

What are 3 ways for energy to be lost?

A
  1. photoelectric effect
  2. compton scattering
  3. pair production
66
Q

Explain the photoelectric effect.

A

A collision between a photon of x-radiation and an orbital electron of an atom, where the electron is knocked out of its orbit and the photon loses all its energy

67
Q

Explain compton scattering.

A

interaction of a photon of x-ray with an orbital electron of the absorber atom producing a recoil electron and a photo energy which is less than that of the incident photon

68
Q

explain pair production.

A

incident photos is annihilated in the vicinity of the nucleus of the absorbing atom with subsequent production of an electron and positron pair

69
Q

what is the half value layer?

A

defined as the thickness of a specified material which attentuates the xray beam so to that exposure rate is reduced to one half ; commonly expressed in mm thickness of aluminum

70
Q

Cellular damage occurs on which order of time?

A

seconds/ minutes

71
Q

Cellular death occours on which order of time?

A

minutes/hours

72
Q

What is the maximum occupational exposure to an embryo during a pregnancy?

A

may not exceed 0.5rem (500mrems) or 5 mSv

*may not exceed >0.05 rem in any one month what a

73
Q

What are the units of abosrbed dose?

A
  1. rad

2. gray (Gy)

74
Q

How often should an analysis of the # of retakes be done as part of the quality assurance program?

A

every 3 months (QUARTERLY)

75
Q

How long should records or written logs of maintenance and/or repairs of xray equipment be kept for?

A

at least 3 years

76
Q

what % humidity should be maintained in the dark room?

A

between 40-60%

77
Q

Which personnel monitoring device leaves no permanent record?

A

pocket ionization chamber

78
Q

When must you notify the Department of Radiologic Health Branch about an acquisition of a xray machine?

A

within 30 days of acquisition

79
Q

When do you have to report (in writing) to the Department about any change in: registrant’s name, address, location of the installation, or receipt, sale, transfer, disposal, or discontinuance of use?

A

within 30 days

80
Q

When do you renew a registration for xray machine?

A

July of every even-numbered year

81
Q

What does “whole body dose” refer to regarding the purposes of external exposure?

A

means exposure to ANY of the following:

  • head
  • trunk (including male gonads)
  • arms above the elbow
  • legs above the knee
82
Q

What personnel monitoring devices are considered acceptable?

A

film badge
thermoluminescent dosimeter (TLD)
*note: pocket ionization chambers or audible warning devices may be worn only IN ADDITION to the above devices

83
Q

How sensitive are film badges to detecting radiation exposure?

A

can sense exposure equivalent to doses as low as 10 millirads and up to as high as 700 rads
*Note one rem is approximately one rad

84
Q

What is the most common material used in the thermoluminescent dosimeters?

A

lithium fluoride

85
Q

which personnel monitoring device is more accurate- film badge or TLD?

A

accuracy of TLD (+/- 9%) compared to film badges (+/- 25%)

86
Q

what is a major disadvantage to the TLD?

A

once the TLD exposure has been read, it cannot be read again. Thus it does not provide a truly permanent record of exposure.
TLDs are also generally more costly than film badges

87
Q

Where should the personnel monitoring device be worn?

A

positioned on the collar above the protective apron or on the top of the protective apron itself

88
Q

What is the annual occupational dose equivalent for whole body dose?

A
5 rem (or 0.05 Sv)
*know in SI units (Sv)
89
Q

What is the annual occupational dose equivalent for skin and extremities?

A

50 rem (or 0.5 Sv)

90
Q

What is the annual occupational dose equivalent for lens of the eye?

A

15rem (or 0.15 Sv)

91
Q

What is the occupational dose equivalent for persons under age 18?

A

may receive 10% of the adult occupational dose limits

92
Q

What is the radiation dose limit for the public?

A
  1. 1 rems (1 mSv) in a year OR

0. 002 rems (2 millirems) in any one hour

93
Q

how often should film badges or TLD badges be changed?

A

once every month

94
Q

When was the first case of human injury from x-ray exposure reported in scientific literaturer?

A

1895

95
Q

What % of average population’s exposure from manmade ionizing radiation sources comes from medical uses of radiation?

A

over 90%

96
Q

What does the largest contribution to total radiation dose to the population from manmade radiation source come from?

A

medical radiographic examinations

97
Q

Approximately what percentage of the exposure from diagnostic xray exams could be eliminated without decreasing patient benefit?

A

30%

98
Q

what materials should tabletop and vertical cassette holders be made of?

A
aluminum
Bakelite (plastic)
carbon fiber
cardboard
*all materials must allow xrays to easily penetrate the cover
99
Q

What is this? a thin, rigid light-tight x-ray holder containing intensifying screens mounted within front and back covers that are hinged together?

A

cassettes

100
Q

what is an intensifying screen for?

A

device in cassette that converts the energy of the xray beam into visible light that then exposes the xray film

101
Q

what does the “target” refer to?

A

the origin of the xray beam; xrays are produced when electrons hit a “target” made of tungsten

102
Q

what are intensifying screens made of these days?

A

rare-earth (aka gadolinium oxysulfide) screens

used to be calcium tungstate screens

103
Q

what is the main cause for retaking a film?

A

improper selection of primary exposure factors (KvP and mAs)

104
Q

what principle helps to prevent film retakes?

A

phototiming (the desired degree of film darkening and corresponding density and contrast can be controrlled by the use of automatic timing equipment)

105
Q

what is the patient skin dose for CT examinations?

A

on the order of one to several rads

106
Q

What are the 3 equipment provisions for MOBILE radiographic equipment?

A
  1. dead-man type exposure switch and so that operator can stand at least 6 feet away from patient
  2. source-to-skin distance at least 12 inches
  3. personnel monitoring equipment required for all persons operating the mobile xray equipment
107
Q

What are somatic dose indicators vs. genetic dose indicators?

A

effects of irradiation an individual receives (somatic) vs. effects exhibited in future offspring of persons who have been irradiated (genetic)

108
Q

Are injuries to the developing fetus/embryo considerred genetic or somatic dose effects?

A

somatic dose

109
Q

Give examples of somatic dose indicators.

A
  1. injuries to the superficial tissue
  2. cancer
  3. cataract formation
  4. impaired fertility
  5. life-span shortening
  6. injuries to the developing fetus/embryo
110
Q

What dose of acute radiation exposure may cause temporary sterility in female ovaries?

A

300 rads

111
Q

What dose of acute radiation exposure may cause temporary sterility in male testes?

A

30 rads

112
Q

which radiographic examinations produce the highest gonad exposures?

A

barium enema
IVP (Intravenous pyelogram)
lumbar spine
hips and upper femur exam

113
Q

Biological effects of radiation are influenced by what?

A
  1. dose rate to the tissue exposed
  2. total dose received by the tissue exposed
  3. type of cell irradiated (but not cell size!)
114
Q

According to what hypothesis do we follow that says that any dose, no matter how small is considered to have some degree of effect?

A

non-threshold, linear hypothesis

115
Q

What does the Law of Bergonie and Trribondeau state?

A

The radiosensitivity of tissues depends on:
1. # of undifferentiated cells
2. degree of mitotic activity in the tissue
3. length of time the cells stay in active proliferation
(NOT cell size)

116
Q

What does the radiosensitivity of tissues depend on?

A

(aka Law of Bergonie and Trribondeau)
1. # of undifferentiated cells
2. degree of mitotic activity in the tissue
3. length of time the cells stay in active proliferation
(NOT cell size)

117
Q

Which biological tissues are especially radiosensitive?

A

blood-forming organs (spleen, red bone marrrow)
GI tissue
developing embryo/fetus (1st trimester)

118
Q

Radiation exposure at what doses have been shown to have no indications of acute injurious effect?

A

25 rads or less

119
Q

Radiation exposure at what doses have been shown to cause radiation-induced cataract formation?

A

order of several hundred rads

120
Q

What is the most frequently occurring radiation-induced cancer?

A
#1 is female breast 
#2 is thyroid gland 
#3 is hemopoetic tisue
121
Q

What absorbed dose to the fetus could result in spontaneous abortion?

A

50 rads

122
Q

What radiation dose has been shown to cause deleterious effects to the embryo?

A

as little as 10 rads

123
Q

When must thryoid shields be worn?

A

when the wearer is in close proximity to the patient during fluoroscopy

124
Q

What are accepted personnel monitoring devices?

A
film badge
thermoluminescent dosimeter (TLD)
125
Q

Which personnel monitoring devices may only be worn iN ADDITION to the other accepted devices?

A

pocket chamber or dosimeter

audible warning device

126
Q

Radiation dose to an embryo/fetus may not exceed what?

A

5 mSv (0.5 rem)

127
Q

What other classifications of personnel must be monitored regardless of the exposure they are likely to receive?

A
  1. persons who enter a high radiation area

2. persons who operate mobile xray equpment

128
Q

what is considered a high radiation area?

A

any area accessible to individuals in which there exists radiation levels that could result in an individual receiving a dose equivalent in excess of 1mSv (0.1 rem) in one hour at 30cm from the radiation source

129
Q

When must overexposure of a film badge dosimeter or other personnel monitoring device be reported to the Radiologic Health branch?

A

within 30 days

130
Q

When must immediate notification to the RHB be reported?

A

If an individual has received 5x annual maximum exposure:

  1. total effective dose equivalent of 0.25Sv or more
  2. eye dose equivalent of 0.75 Sv or more
  3. skin or extremities dose equivalent of 2.5 Sv or more
131
Q

When must 24-hour notification be reported to the RHB?

A

if an individual has received within 24 hours the annual dose limits:

  1. total body dose 0.05Sv
  2. eye dose 0.15 Sv
  3. skin and extremities dose 0.5 Sv
132
Q

What is the S.I. unit for absorbed dose?

A
Gray 
1 gray (Gy)= 100 rads
133
Q

What is the S.I. unit for dose equivalent?

A

Sievert

1 Sv= 100 rems

134
Q

When is the “safer” times to perform x-ray exams on females who could be pregnant?

A

10-14 days after the onset of menses

135
Q

What is the max. dose to an embryo/fetus during the ENTIRE pregnancy?

A

5 mSv (0.5 rem)

136
Q

What is the max. dose to an embryo/fetus in any month of pregnancy (once the pregnancy becomes known) ?

A

0.05 rem

137
Q

When is the embryo-fetus most sensitive to rradiation?

A

1st trimester

138
Q

photographic material is sensitive to what?

A

temperature- store in the range of 60-70 deg F

pressure damage- store films standing on edge; never flat

139
Q

What does the BEIR (Biological Effects of Ionizing Radiations) report estimate?

A

the increased risk of mortality from all radiation-induced cancers to an individual in the U.S. population