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Monitoring > Radiology and Ultrasound > Flashcards

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
Q

When can a pneumo occur?

A

CVC placement
Thyroid and parathyroid surgery
Mediastinoscopy
Infraclavicular block

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26
Q

Signs of a pneumo?

A

Widening of intercostal spaces

Retains general shape of lung

Deep sulcus sign

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27
Q

Signs of a tension pneumo?

A

Depression of the diaphragm

Flattening of the cardiac border

Tracheal deviation

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28
Q

What are the 3 stages of ARDS?

A

1.Exudative

2.Proliferative

3.Fibrotic

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29
Q

How fast does ultrasound propagate through tissue?

A

1,540 m/sec

30
Q

What is frequency a measure of?

A

Pitch

31
Q

Does higher frequency produce a higher or lower pitch?

A

Higher pitch

32
Q

Does higher frequency produce a shorter or longer wavelength?

A

shorter

33
Q

What does amplitude measure?

A

The sounds loudness

34
Q

Does a higher amplitude produce a louder or softer sound?

A

Louder

35
Q

How fast does sound propagate through air? Soft tissue? Bone?

A

Air -343 seconds
Soft tissue - 1540
Bone - 3000

36
Q

What is the piezoelectric effect?

A

Can transduce electrical energy to mechanical energy and vice versa

37
Q

What is the primary determinant of the vertical placement of each illuminated pixel on the ultrasound?

A

Time delay - how long it takes to return

38
Q

What is the term for something that does not produce echoes?

A

Anechoic

39
Q

What structures appear white?

A

Hyperechoic

Bright - White

Bone

Muscle surfaces

High amplitude and high impedance

40
Q

What structures appear dark grey?

A

Hypoechoic

Weak amplitude and low impedance

Organs

Skin

Muscle

41
Q

What structures appear black?

A

No echo

Vascular structures, cysts, ascites

42
Q

How do peripheral nerves appear on ultrasound?

A

Black

Brachial plexus

43
Q

How do distal nerves appear? Why?

A

Hyperechoic or honeycomb

Enveloped in fascia

44
Q

Will nerves or tendons change in size as you scan?

A

Tendons do

Nerves don’t change in size

45
Q

Where is the best resolution on ultrasound?

A

In the focal zone

46
Q

Where is the second best resolution on ultrasound?

A

Near field or Fresnel zone

47
Q

Where is the worst resolution on ultrasound?

A

Far field or Fraunhofer

48
Q

What produces the greatest degree of attenuation?

A

Bone

49
Q

What is attenuation?

A

How the sound wave strength naturally decrease and reduces image quality

50
Q

How can you reduce reflection?

A

Ultrasound gel

51
Q

What is the reason why vessels appear anechoic?

A

Scatter of the soundwaves in the fluid

52
Q

What is snells law?

A

The refraction of the ultrasound wave bending

53
Q

What frequency is the best resolution?

A

High frequencies

> 10MHZ

good for < 3 CM below skin

54
Q

What frequency is best to see deep into the tissues?

A

Lower frequencies

<5MHZ

Good for >6cm below skin

55
Q

What is the term that allows you to adjust the strength of returning echoes or the brightness?

A

The gain

56
Q

What is B mode?

A

Brightness of the pixel (most use this)

57
Q

What is M mode?

A

A time lapse

58
Q

What is the doppler effect?

A

Change in perceived frequency of a sound wave when there is motion

59
Q

What three things does doppler shift depend on?

A

Frequency of beam
Blood flow velocity
Angle of transducer

60
Q

Which way should the transducer point for standard? Cardiac?

A

To the head and to the right

For cardiac to the head and to the left

61
Q

What are 4 assumptions of ultrasound?

A
  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
Q

When might you see an acoustic shadow?

A

When the bone blocks the ultrasound wave

63
Q

When might you see acoustic enhancement?

A

When waves go through a vessel

64
Q

When might see a mirror image ?

A

Ultrasound beam gets trapped.

65
Q

What is bayoneting?

A

Ex: A needle

66
Q

What are the three standard imaging windows for cardiac exam?

A

Parasternal
Apical
Subcostal

67
Q

What is a grade 1 fluid volume for gastric volume?

A

<1.5ml/kg

68
Q

What is grade 2 for fluid volume?

A

> 1.5mL/kg

69
Q

Which view shows the “bat sign”

A

Lung view

70
Q

What cardiac view is the only one to show the liver?

A

Subcostal 4 chamber

71
Q

What do you see on a parasternal short axis?

A

Two chambers of the heart only

Monitoring (10 decks)

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