su14_-_radiology_exam_1_20141210195314 Flashcards
What is the definition of oral and maxillofacial radiology?
the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders, and conditions of the oral and maxillofacial region
What is the definition of radiology?
the art and science of using ionizing radiation in diagnosis and treatment of diseases
What are the 2 subcategories of radiology?
- diagnostic radiology- therapeutic radiology (radiation therapy)
What is the definition of radiography?
the use of radiation to produce an image on a receptor
What is the definition of a radiograph?
the image produced on a receptor by exposing it to x-rays; susequent processing/developing produces a positive image in case of digital radiography and negative-like image on film
What was Wilhelm Conrad Roentgen known for?
discovered x-rays in 1895; first nobel prize in physics in 1901
What was the first radiograph taken of?
Anna Berta Roentgen’s hand
What was Dr. Otto Walkhott known for?
took the first dental radiograph
What was William D. Coolidge known for?
making the “hot cathode ray” tube
What were Sir Godfrey N. Housfield and Dr. Allan Cormack known for?
computed tomography (CT) scans
What was Nikola Tesla and Dr. Raymond Damadian known for?
improving the field strength of MRI and being the “father of the modern MRI,” respectively
What is the difference between a fluoroscope and an “x-ray”?
fluoroscope does dynamic imaging while an x-ray is a static image
Who is known as the “father of radiation protection”?
William Herbert Rollins, D.M.D., M.D.
True or false: About half of the x-ray units in the US are dental.
true
How many dental radiographs are acquired per year worldwide?
300 million
Dental radiographic examinations are second to what type of radiograph in terms of number and cost?
chest radiographs
What are the 2 types of biological effects of radiation?
- deterministic- stochastic
Which effect of radiation has a dose theshold?
deterministic
In which effect of radiation is the severity of response proportional to the dose?
deterministic
In which effect of radiation is the probability of occurence of effects dose dependent (all or none)?
stochastic
Oral changes after radiotherapy is an example of what biological effect of radiation?
deterministic
Radiation-induced cancer is an example of what biological effect of radiation?
stochastic
Radiation-induced mutations is an example of what biological effect of radiation?
stochastic
Radiation sickness after whole body irradiation is an example of what biological effect of radiation?
deterministic
True or false: Deterministic effects of ionizing radiation include short-term acute injury.
true (stochastic = long term)
What is affected in a patient’s body after it is exposed to ionizing radiation?
- biological molecules- cell structures- cell cycle- tissues and organs
What are the final products of the radiolysis of water?
- H2O2 (hydrogen peroxide)- H+ (hydrogen ion)- H2O (water)
What proportion of biological effects are caused by direct action of x-ray photons on water?
1/3
What proportion of biological effects are cuased by indirect action?
2/3
What are some effects of radiation on cell structures?
- chromosomal break- vacuolization- mitotic changes- impaired function- recovery- cell death
What are some effects of radiation on the cell cycle?
- mitotic delay (G1 arrest, G2 block)- cell death (G2 phase, M phase)
Is this the correct sequence of cell cycle radiosensitivity (the least sensitive being #1 and most sensitive #4)?1. M2. G13. G24. S
NOT correctCorrect:most sensitive: MG2G1least sensitive: S
What do short-term effects of radiation of tissues and organs depend upon?
sensitivity of parenchymal cells
What do long-term effects of radiation of tissues and organs depend upon?
the extent of damage to the fine vasculature
Do all cell types respond the same to radiation?
NO
What does the Law of Bergonie and Tribondeau state?
cells tend to be radiosensitive if they have these 3 properties:- high division rate- long dividing future- are of unspecialized type
Rank these types of cells from most radiosensitive to most radioresistant:- neurons/muscle cells- stem cells- cells of salivary gland/pancreas- spermatocytes/oocytes- endothelial cells/fibroblasts
most radiosensitive- stem cells- spermatocytes/oocytes- endothelial cells/fibroblasts- cells of salivary gland/pancreas- neurons/muscle cellsmost radioresistant
Do fine vasculature, growing bone, salivary glands, lungs, kidney, and liver have a high, intermediate, or low radiosensitivity?
intermediate
Do optic lens, mature erythrocytes, muscle cells, and neurons have a high, intermediate, or low radiosensitivity?
low
Do lymphocytes, bone marrow, testes, intestines, and mucous membrane have a high, intermediate, or low radiosensitivity?
high
What is the acute effect of radiation with an exposure of 100 Gy (Gray)?
death occurs within hours from apparent neurological and cardiovascular breakdown
What is the acute effect of radiation with an exposure of 5-12 Gy (Gray)?
death occurs within days and is associated with bloody diarrhea and destruction of intestinal mucosa (gastrointestinal syndrome)
What is the acute effect of radiation with an exposure of 2-5 Gy (Gray)?
death occurs several weeks after exposure due to damage to bone marrow (hematopoietic syndrome)
What is the acute effect of radiation with an exposure of 0.5-3.5 Gy (Gray)?
can produce varying degrees of nausea, vomiting, diarrhea, reddening of skin, loss of hair, blisters, and depression of immune system
What is the acute effect of radiation with an exposure of 1 Gy (Gray)?
mild radiation sickness, depressed white blood cell count (prodromal symptoms)
What is the acute effect of radiation with an exposure of 0.25 Gy (Gray)?
erythema, blistering and residual smooth, soft, depressed scar
True or false: A study has shown that there can be effects of genetic mutation from radiation used in diagnostic radiology.
FALSE. Currently, there is no evidence of genetic mutation from a radiation used in diagnostic radiology. (most genetic effects have been observed in atomic bomb survivors)
What is the most important somatic effect of radiation exposure?
radiation-induced cancer
Do the bladder, liver, thyroid, skin, cortical bone, brain, and salivary glands have a high, moderate, or low susceptibility to radiation-induced cancer?
low
Do the breast and esophagus have a high, moderate, or low susceptibility to radiation-induced cancer?
moderate
Do the colon, stomach, lung, and bone marrow have a high, moderate, or low susceptibility to radiation-induced cancer?
high
What does ALARA stand for?
As Low As Reasonably Achievable
What are the 3 key points of ICRP recommendations (ALARA)?
- no practice shall be adopted unless its introducation produces a positive net benefit- all exposures shall be kept as low as reasonably achievable- the dose equivalent to individuals shall not exceed the limits recommended
What is the annual occupational limit for human exposure to ionizing radiation?
50 mSv
What is the annual non-occupational limit for human exposure to ionizing radiation?
1-5 mSv
True or false: The probability of occurence of radiation-induced cancer increases with an increase in dose.
true
Who is more radiosensitive for cancer induction: children or adults?
children
What is the risk of dental radiography in terms of inducing cancer?
approximately 20% of the population die of cancer; estimated risk from dental radiography is approximately 2.5 extra fatal cancers per million dental radiographic examinations
What are the two effects (direct and indirect) of radiation on biological molecules?
- free radical production- radiolysis of water
What are the 2 main attributes of x-rays?
- ionization- excitation
What is the definition of ionization?
ionization occurs when an atom gains or loses an electron; occurs when particulate or electromagnetic radiation energy is greater than the binding energy
During ionization, is the ejected electron a positive or negative ion? Is the remainder of the atom a positive or negative ion?
- ejected electron: negative ion- remainder of atom: positive ion
What is the name of the radiation that causes ionization (usually in biologic molecules)?
ionizing radiation
What is the definition of excitation?
when the transferred energy is not sufficient to overcome the binding energy, the electron is not ejected from its orbit; electron receiving the extra energy is raised to a higher energy level within the orbit and then instantaneously gives up this excess energy and returns to its normal energy level
What property of x-rays causes its effects?
the ability to ionize
What is the penetrability of x-rays related to? Is it related to each directly or inversely?
- photon energy: directly- number: directly- atomic number, thickness, and density of absorber: inversely
Name the 3 salient properties (effects) of x-rays.
- photographic effects- fluorescent effects (useful in intensifying screens)- biologic effects
True or false: X-rays are invisible, highly penetrating electromagnetic waves.
true
What is the charge of an x-ray? Why is this significant?
neutral charge; cannot be deflected by electrical or magnetic field
Are x-rays heterogeneous or homogeneous?
heterogeneous (variable wavelengths and energy photons)
True or false: X-rays radiate from source in curved lines and tend to diverge from focal spot.
FALSE. X-rays radiate from source in STRAIGHT LINES.
Are x-rays capable of ionizing gases?
yes!
At what speed do x-rays travel?
speed of light
True or false: X-rays cause fluorescence of certain crystals.
true
What is the useful wavelength range of an x-ray in dentistry?
0.1-0.5 oA
True or false: X-rays produce a latent image on an image receptor which can be processed.
true
What type of radiology are low energy x-rays used for? High energy x-rays?
- low energy: diagnostic radiology- high energy: radiation therapy
What is the inverse square law?
intensity (amount or quantity) of radiation is inversely proportional to the square of the distance between the source and point of measure
What are the 3 primary means of x-ray beam absorption?
- photoelectric absorption- comptom scattering- coherent scattering
What percentage of primary photons pass through without any interaction?
9%
What occurs during photoelectric absorption?
incident photon interacts with an inner shell electron (usually in a K shell) and overcomes the binding energy; electron is ejected (ionization) which is called photoelectron or recoil electron; ejected electron acquires the remainder of the KE
What other ionizations can be caused by a photoelectron?
secondary and tertiary ionizations
What does absorption depend upon for photoelectric absorption?
absorption depends upon atomic number of the object; the greater the number, the greater the absorption
True or false: Radiography is based on absorption of only one material.
FALSE. Differential absorption by different materials makes radiography possible.
Describe Compton absorption.
incident photon interacts with an outer electron and overcomes binding energy to eject the electron (ionization); ejected electron (called a Compton electron) acquires part of KE and the remainder of the energy is given off as a scattered photon
True or false: Compton electron cannot cause secondary or tertiary ionization.
FALSE. Compton electron CAN cause secondary or tertiary ionization.
What is Compton absorption a major source of?
major source of scatter radiation
Describe coherent scattering.
low energy photons (less then 10 keV) pass near outer electron of an atom; electron vibrates at the same frequency as incident photon; entire energy given off as scattered photon which is usually absorbed by the tissues
What are the 2 main components of radiographic film?
- base- emulsion
What are the properties of the base of radiographic film?
- polyester- supports film emulsion- flexible (to allow film handling), translucent, chemically inert, and tinted blue to enhance contrast- 0.125-0.225 mm thick
What are the properties of the emulsion of radiographic film?
- silver nitrate and potassium bromide in gelatin form AgBr crystals- a small amount of potassium iodide and trace amount of silver sulfide are added to increase sensitivity of emulsion- emulsion is coated on both sides of the base
What is emulsion sensitive to? (hint: 8 things)
x-rays, chemicals, light, pressure, heat, static electricity, humidity, and aging
How is a latent image formed on a film?
- image forms in emulsion when it is exposed to x-rays or light- the AgBr in the emulsion forms metallic silver when exposed to x-rays and constitutes the latent image- the metallic silver is chemically processed to form a radiograph
What causes radiographic fog?
radiographic density produced by causes/sources other than the primary beam of radiation; it reduces the radiographic contrast
What are the 4 types of radiographic fog?
- emulsion fog- chemical fog- scatter radiation fog- safelight fog
What is the cause of emulsion fog?
due to AgBr crystals made developable by catalytic action of contaminants in the emulsion
What is the cause of chemical fog?
due to development of unexposed AgBr crystals due to impurities in the developer solution
What is the cause of scatter radiation fog?
due to exposure of film by scatter radiation; it is the most common cause of film fogging
What is the cause of safelight fog?
due to exposure of film by unsafe safelight; 100% avoidable
What is the most common cause of film fogging?
scatter radiation fog