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Unit 6 Apex Equipment & Monitors > Radiology and Ultrasound > Flashcards

Radiology and Ultrasound Flashcards

1
Q

Which unit of measurement quantifies occupational exposure to electromagnetic radiation?

A

Rem

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2
Q

Roentgen (R) measures

A

unit of radiation exposure

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3
Q

Radiation absorbed dose (Rad) measures

A

quantity of radiation received by an individual

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4
Q

Radiation equivalent man (Rem) measures

A

unit of occupational radiation exposure

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5
Q

Curie (Ci) measures

A

a quantity of radioactive material

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6
Q

What is the significance of the inverse square law?

A

Radiation exposure obeys the inverse square law. It states that the amount of exposure is inversely proportional to the square of the distance of the source.

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7
Q

Inverse square law

A

Intensity = 1 / Distance^2

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8
Q

Diaphragm normal appearance on xray

A

domed shaped, with the right being slightly higher than the left due to the influence of the liver

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9
Q

Left hilum vs right hlium on an xray

A

The left hilum is normally higher than the right.

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10
Q

Why is the right part of the diaphragm higher than the left?

A

Because of the liver

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11
Q

Recite the mnemonic for systematically evaluating the CXR.
ABCDEFGHI

A

A: Assess film quality and airway
B: Bones and soft tissue
C: Cardiac
D: Diaphragm
E: Effusion
F: Fields, fissures, and foreign bodies
G: Great vessels and gastric bubble
H: Hila and mediastinum
I: Impression

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12
Q

List 4 ways you can determine whether the ETT is at the correct depth on CXR.

A

Mid-trachea
4 - 5 cm above the carina
4 - 5 cm above T4 - T5
At level of the medial ends of the clavicles

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13
Q

Describe the proper location of the distal tip of a central venous catheter on CXR.

A

It should reside in the distal 1/3rd of the SVC between the right atrium and the most proximal venous valves.

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14
Q

What is the FIRST radiographic sign of pulmonary edema?

A

Cephalization

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15
Q

What is cephalization?

A

redistribution of vascular markings to the upper lung.

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16
Q

The deep sulcus sign represents which abnormality?

A

Pneumothorax

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17
Q

How fast does ultrasound propagate through soft tissue?

A

1,540 m/sec

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18
Q

Define compression.

A

A region of high pressure that forms the peak of the sound wave.

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19
Q

Define rarefaction.

A

A region of low pressure that forms the trough of the sound wave.

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20
Q

What is frequency?

A

Frequency is a measure of pitch. It tells us how many cycles occur in a given period of time.

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21
Q

How does frequency relate to wavelength?

A

A higher frequency produces a shorter wavelength, and a lower frequency produces a longer wavelength.

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22
Q

What is amplitude?

A

It represents the sound’s loudness. It’s determined by the degree of pressure fluctuations from the displacement of the molecules within the medium.

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23
Q

Which concept BEST explains why lead zirconate titanate is commonly used in ultrasound transducers?

A

Piezoelectric effect

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24
Q

Piezoelectric effect

A

piezoelectric material that can transduce electrical energy into mechanical (sound) energy and vice versa

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25
What is the process a bat uses to produce a conceptual map of its physical environment?
Echolocation
26
What is a common piezoelectric material commonly used in ultrasound transducers?
Lead zirconate titanate
27
What is the primary determinant of the vertical placement of each illuminated pixel on the ultrasound monitor?
Time delay
28
What determines the vertical placement of each dot on the ultrasound screen?
How long it takes for the echo to return to the transducer (time delay).
29
What determines the horizontal placement of each dot on the ultrasound screen?
The particular crystal that receives the returning echo.
30
Hyperechoic description
Produces high amplitude echos
31
Hypoechoic description
Appear as dark shades of grey
32
Anechoic description
Does not produce echos
33
Hyperechoic structures appear
Bright. They produce high amplitude echoes (i.e., these tissues have a high impedance).
34
Hypoechoic structures appear
As a darker shade of grey. They produce low amplitude echoes (i.e., these tissues have a lower impedance).
35
Anechoic structures appear
Black. They don't produce any echo.
36
These structures will appear as (hyperechoic, hypoechoic, anechoic) Bone Fascial lines on muscle
Hyperechoic
37
These structures will appear as (hyperechoic, hypoechoic, anechoic) Solid organs Cartilage Adipose
Hypoechoic
38
These structures will appear as (hyperechoic, hypoechoic, anechoic) Cyst Artery Vein Ascites
Anechoic
39
How do nerves appear on ultrasound?
It depends on the echogenicity of the surrounding structures. They can appear anechoic (e.g., roots of brachial plexus) or hyperechoic with a honeycomb appearance (e.g., distal nerves).
40
Which process describes a sound wave that bounces off a tissue boundary that has a different acoustic impedance?
Reflection
41
Reflection is the process where
a sound wave bounces off a tissue boundary of differing acoustic impedance.
42
Absorption occurs as the
ultrasound waves are lost to the body as heat.
43
Scatter occurs when the
ultrasound wave encounters an object smaller than the wave.
44
Define Lateral resolution
The ability to differentiate structures that are side-by-side in the x-axis (horizontal).
45
Define Axial resolution
The ability to differentiate structures that are in the same plane of the ultrasound beam in the y-axis (vertical).
46
Define Elevational resolution
The ability to differentiate structures that are in the thickness of the ultrasound beam in the z-axis (depth).
47
What is Refraction
The bending of the ultrasound wave that encounters a tissue boundary at an oblique angle.
48
Which type of transducer produces the BEST image resolution?
High frequency
49
Which frequency is used to see deeper structures?
Lower-frequencies (which have longer wavelengths)
50
Linear Array Transducer
The linear array transducer has a flat footprint that contains piezoelectric crystals arranged in parallel.
51
Curvilinear Array Transducer
The curvilinear array transducer has a convex footprint, and the arrangement of the piezoelectric crystals inside follows suit.
52
Phased Array Transducer
A phased array transducer is very narrow in the nearfield and fans out with increasing depth.
53
Which setting on the ultrasound machine is used to adjust the strength of the returning echoes displayed on the screen?
Gain
54
What is gain?
Gain allows you to adjust the strength of returning echoes displayed on the screen.
55
What is depth?
Depth determines how deep you can see into the body.
56
Where should you focus your image?
You should adjust the focus so the target sonoanatomy resides in the focal zone.
57
What is B-mode imaging?
The “B” in B-mode image stands for the brightness of the pixels on the screen. B-mode imaging produces a real-time image of the sonoanatomy.
58
What does gain do and not do?
While adjusting the gain can enhance or reduce the overall brightness of the screen, it does not change the relative contrast of the anatomy.
59
What is M-mode imaging?
M-Mode (where “M” stands for motion) is an alternative ultrasound modality. You can think of it as a time-lapse photo that illustrates the relative movement of structures over time.
60
What do the axes of an M-mode image represent?
The y-axis represents the degree of movement of the structures in a defined plane of the body. The x-axis represents time.
61
According to the Doppler effect, what 2 changes occur when the sound source moves closer to a person listening to that sound?
Wavelength becomes shorter Pitch increases
62
The Doppler effect describes the
change in the perceived frequency of a sound wave when there’s relative motion between the sound’s source and an observer.
63
Positive Doppler shift.
The source moves towards an observer, then the wavelength gets shorter in this direction, and the frequency (pitch) appears to increase
64
List 3 factors that determine the degree of Doppler shift.
Frequency of the ultrasound beam Blood flow velocity Angle of insonation
65
What is the degree of Doppler shift when the ultrasound beam is perpendicular to blood flow? Why?
Zero - The cosine of 90 degrees = zero
66
What do the red and blue colors signify when applying color Doppler to your image?
All the red and blue colors tell you is the degree of Doppler shift relative to the transducer.
67
When applying color Doppler, what does blue indicate?
Negative Doppler shift
68
When applying color Doppler, what does red indicate?
Positive Doppler shift
69
When applying color Doppler, does arterial blood flow always appear red?
No
70
According to the standard convention, the orientation marker on the ultrasound probe should point towards the patient's (2)
Right (short axis), head (long axis)
71
Standard convention | Short-axis image orientation
Marker points towards the patient's anatomic right
72
Standard convention | Long-axis image
Marker points towards the patient's head
73
Cardiology convention | Short-axis image
Marker points towards the patient's anatomic left
74
Cardiology convention | Long-axis image
Marker points towards the patient's head
75
What is the angle of incidence?
It describes the angle at which the ultrasound waves encounter a structure.
76
What angle of incidence will produce the highest quality image?
90 degree angle to the target sonoanatomy
77
Which technique improves image resolution by reducing the distance between the transducer and anatomical target?
Compression
78
Does ultrasound always propagate through soft tissue at 1,540 m/sec?
No. Propagation velocity is a function of the medium through which sound travels. Therefore, the same frequency moves through different tissues at different rates, and this can impact your image in some circumstances.
79
Do sound waves always propagate in a straight line from the transducer to the structure and back to the transducer?
No. The directionality of the sound wave depends on the physical characteristics of the tissues through which it passes.
80
Does brightness always directly parallel the degree of reflection?
No. There are times when pixels light up when no structure is present.
81
Do all the echoes that return to the transducer only originate from structures in the beam’s axis?
No. Sound bounces around inside the tissue, and the ultrasound machine’s algorithms can't accurately predict the degree of attenuation.
82
During a cardiac POCUS examination, what 2 structures are visible on a parasternal short-axis view of the heart?
Left ventricle Pericardium
83
What does the absence of lung sliding suggest?
Pneumothorax or endobronchial intubation
84
Describe A lines on lung ultrasound.
A lines are horizontal lines that result from reverberation artifact due to the pleura acting as a strong reflector.
85
Describe B lines on lung ultrasound.
B lines (sometimes called comet tails) are vertical lines. They can be a normal finding, but they can also suggest pathology such as pulmonary edema.
86
How does the gastric antrum appear on gastric ultrasound when the patient has an empty stomach?
It will either appear flat or like a small oval, which is sometimes referred to as a “bull’s eye.”
87
On which ultrasound structure would you expect to see the bat sign?
Lung
88
Thyroid cartilage will appear as (hyperechoic/hypoechoic/anechoic)
Hyperechoic
89
Liver will appear as (hyperechoic/hypoechoic/anechoic)
Hypoechoic
90
Cysts will appear as (hyperechoic/hypoechoic/anechoic)
Anechoic
91
What is the "Bat sign"?
The pattern of the two ribs and the pleural line is called the bat sign, where the ribs form the wings, and the pleural line forms the body.
92
What is the BEST way to minimize the influence of a shadow artifact?
Adjust the acoustic window
93
The use of conductive gel during ultrasonography reduces which form of attenuation?
Reflection
94
Which type of artifact can be leveraged to better visualize deep structures?
Acoustic enhancement
95
Best transducer for a interscalene block
High frequency
96
Best transducer for a sciatic block
Medium frequency
97
Best transducer for a spinal block
Low frequency
98
What 4 chamber cardiac view is the only one that contains the liver?
Subcostal 4-chamber

Unit 6 Apex Equipment & Monitors (7 decks)

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