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Radiology and Ultrasound Flashcards

1
Q

What are the highest EMR energy produced?

A

Gamma

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2
Q

What type of waves are Xray?

A

Short wavelength
High frequency

Leads to cell damage

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3
Q

What is the unit of radiation exposure called?

A

Roentgen

Total dose administered

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4
Q

What is the highest quantity of radiation received by an individual ? (term)

A

Rad - Radiation absorbed dose

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5
Q

What is the unit of occupational radiation exposure?

A

Rem

Effective dose

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6
Q

What is the yearly maximum for adults?

Fetus?

A

5 Rem

.5 rem

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7
Q

What three things x-rays are dependent on?

A

Patients weight and habitus
Density of body part
Orientation of xray

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8
Q

What are the most sensitive human tissues?

A

Bone Marrow
Intestinal lining
Reproductive cells
Fetal tissue

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9
Q

Three ways to limit exposure?

A
  1. Distance
  2. Duration
  3. Shielding
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10
Q

How far away should you be from xray?

A

6 feet

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11
Q

Darkest to lightest on xray?

A

Gas
Fat
Water (soft tissue)
Bone (metal)

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12
Q

What is the most common position of chest xray?

A

Posterior anterior

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13
Q

Most common xray in OR, ICU?

A

Anterior Posterior - not as good as a view

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14
Q

How can you tell the difference between AP and PA xray?

A

AP - scapula Are not retracted

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15
Q

Should the patient be rotated?

A

No

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16
Q

Best angle of the heart?

A

PA

Width of the heart is less than 50%

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17
Q

Is the Left or Right hilum normally higher?

A

Left is normally higher than right

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18
Q

Where should a properly placed ETT be?

A

4-5cm above the carina which is also located at T4-T5

Should be mid trachea

Level with the medial ends of the clavicles

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19
Q

What happens if the CVC is too shallow?

A

16 times more likely to clot

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20
Q

How should a PAC look on an Xray

A

Coils in a circle

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21
Q

How many views are necessary to see a misplaced pacemaker?

A

Two

Lateral and PA

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22
Q

Where should a CVC be located?

A

Distal 1/3rd of the SVC

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23
Q

What is the first sign on an xray for pulmonary edema?

A

1st stage -Cephalization

2nd stage- Kerley lines

3rd Stage - edema, effusion, increased cardiac size

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24
Q

How does atelectasis look on an Xray?

A

White - blotchy

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25
When can a pneumo occur?
CVC placement Thyroid and parathyroid surgery Mediastinoscopy Infraclavicular block
26
Signs of a pneumo?
Widening of intercostal spaces Retains general shape of lung Deep sulcus sign
27
Signs of a tension pneumo?
Depression of the diaphragm Flattening of the cardiac border Tracheal deviation
28
What are the 3 stages of ARDS?
1.Exudative 2.Proliferative 3.Fibrotic
29
How fast does ultrasound propagate through tissue?
1,540 m/sec
30
What is frequency a measure of?
Pitch
31
Does higher frequency produce a higher or lower pitch?
Higher pitch
32
Does higher frequency produce a shorter or longer wavelength?
shorter
33
What does amplitude measure?
The sounds loudness
34
Does a higher amplitude produce a louder or softer sound?
Louder
35
How fast does sound propagate through air? Soft tissue? Bone?
Air -343 seconds Soft tissue - 1540 Bone - 3000
36
What is the piezoelectric effect?
Can transduce electrical energy to mechanical energy and vice versa
37
What is the primary determinant of the vertical placement of each illuminated pixel on the ultrasound?
Time delay - how long it takes to return
38
What is the term for something that does not produce echoes?
Anechoic
39
What structures appear white?
Hyperechoic Bright - White Bone Muscle surfaces High amplitude and high impedance
40
What structures appear dark grey?
Hypoechoic Weak amplitude and low impedance Organs Skin Muscle
41
What structures appear black?
No echo Vascular structures, cysts, ascites
42
How do peripheral nerves appear on ultrasound?
Black Brachial plexus
43
How do distal nerves appear? Why?
Hyperechoic or honeycomb Enveloped in fascia
44
Will nerves or tendons change in size as you scan?
Tendons do Nerves don't change in size
45
Where is the best resolution on ultrasound?
In the focal zone
46
Where is the second best resolution on ultrasound?
Near field or Fresnel zone
47
Where is the worst resolution on ultrasound?
Far field or Fraunhofer
48
What produces the greatest degree of attenuation?
Bone
49
What is attenuation?
How the sound wave strength naturally decrease and reduces image quality
50
How can you reduce reflection?
Ultrasound gel
51
What is the reason why vessels appear anechoic?
Scatter of the soundwaves in the fluid
52
What is snells law?
The refraction of the ultrasound wave bending
53
What frequency is the best resolution?
High frequencies >10MHZ good for < 3 CM below skin
54
What frequency is best to see deep into the tissues?
Lower frequencies <5MHZ Good for >6cm below skin
55
What is the term that allows you to adjust the strength of returning echoes or the brightness?
The gain
56
What is B mode?
Brightness of the pixel (most use this)
57
What is M mode?
A time lapse
58
What is the doppler effect?
Change in perceived frequency of a sound wave when there is motion
59
What three things does doppler shift depend on?
Frequency of beam Blood flow velocity Angle of transducer
60
Which way should the transducer point for standard? Cardiac?
To the head and to the right For cardiac to the head and to the left
61
What are 4 assumptions of ultrasound?
1. Always goes through tissue at 1540 2. Always propagate in a straight line 3. Brightness parallels degree of reflection 4. All returning echoes originate from structures in the beam axis
62
When might you see an acoustic shadow?
When the bone blocks the ultrasound wave
63
When might you see acoustic enhancement?
When waves go through a vessel
64
When might see a mirror image ?
Ultrasound beam gets trapped.
65
What is bayoneting?
Ex: A needle
66
What are the three standard imaging windows for cardiac exam?
Parasternal Apical Subcostal
67
What is a grade 1 fluid volume for gastric volume?
<1.5ml/kg
68
What is grade 2 for fluid volume?
>1.5mL/kg
69
Which view shows the "bat sign"
Lung view
70
What cardiac view is the only one to show the liver?
Subcostal 4 chamber
71
What do you see on a parasternal short axis?
Two chambers of the heart only

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