su14_-_radiology_final_exam_20141210195330 Flashcards
For intraoral dental equipment, according to the State of Ohio, the source-to-skin distance (SSD) is not to be less than ____ cm if operable above 50 kVp or ____ cm if operable at 50 kVp.
- 18 cm- 10 cm
For intraoral dental equipment, according to the State of Ohio, x-ray field at the minimum SSD (source-to-skin distance) shall be containable in a circle having a diameter of no more than ____ cm if operable at or above 50 kVp.
7 cm
For intraoral dental equipment, according to the State of Ohio, a means shall be provided to terminate the exposure at a preset ____ or ____ or ____ or ____.
- time interval- product of current and time- number of pulses- radiation exposure to the image receptor
For intraoral dental equipment, according to the State of Ohio, the operator shall be able to ____ the exposure at any time during an exposure of greater than ____ second(s).
- terminate- one-half second
For intraoral dental equipment, according to the State of Ohio, the kVp accuracy shall be within plus or minus ____ % of the indicated value.
10%
For intraoral dental equipment, according to the State of Ohio, for manual exposures, the accuracy of the ____ device shall be within plus or minus ____ % of the indicated setting.
- timing device- 10%
For intraoral dental equipment, according to the State of Ohio, ____ indication shall be provided whenever x-rays are produced. Certified equipment also shall provide ____ indication to the operator while x-rays are produced or on termination of the exposure.
- visual- audible
For intraoral dental equipment, according to the State of Ohio, the coefficient of variation for reproducibility of ____, ____, and ____ shall not exceed ____ for four consecutive exposures.
- kVp- timing- radiation exposure- 0.05
For shielding requirements, according to the State of Ohio, ____ and ____ units shall be provided with primary barriers at all areas struck by the useful beam.
- intraoral- panoramic
For shielding requirements, according to the State of Ohio, when intraoral or panoramic units are in ____, protective barriers shall be provided between the rooms or areas.
adjacent patient occupied rooms or areas
For protection, according to the State of Ohio, no individual shall be permitted to hold ____ during exposure.
any part of the x-ray tube housing, cone, or mechanical support of the x-ray tube
For protection, according to the State of Ohio, each installation of an x-ray unit shall provide a protective barrier for the operator or shall be arranged so that the operator stands at a minimum distance of ____ feet from the patient and out of the useful beam.
six
For panoramic x-rays, according to the State of Ohio, dental panoramic x-ray machines shall be ____.
certified
For panoramic x-rays, according to the State of Ohio, when the operator is behind a protective barrier, a ____ shall be provided large enough and so placed that ____.
- a viewing system- the operator can see the patient without having to leave the protected area during exposure
For panoramic x-rays, according to the State of Ohio, x-ray field shall be limited to the dimensions of ____.
the slit in the image receptor holder
According to the State of Ohio, what type of imaging is not allowed for use in dental examinations?
fluoroscopy
For sectional imaging, according to the State of Ohio, handlers of radiation-generating equipment capable of sectional imaging, used only for dental procedures, shall comply with ____ and be included in the ____.
- all manufacturer’s specifications- registrant’s quality assurance plan
For hand-held equipment, according to the State of Ohio, hand-held radiation generating equipment shall be used for ____ only.
intraoral
For hand-held equipment, according to the State of Ohio, operators of the hand-held radiation-generating equipment shall wear ____.
a full lead apron of not less than 0.25 mm lead equivalent
For hand-held equipment, according to the State of Ohio, ____ for the hand-held radiation-generating equipment shall be in place during all radiographic exposures.
back scatter shield
For hand-held equipment, according to the State of Ohio, all operators of hand-held radiation-generating equipment shall be provided and wear a ____ in order to ____. The operator must wear the ____ on the ____.
- personnel dosimeter- monitor the dose to the operator’s hand- personnel dosimeter- hand holding the beam limiting device
For hand-held equipment, according to the State of Ohio, storage and security procedures shall be developed and implemented to assure hand-held radiation-generating equipment is secured against ____ or ____ when not under the control and constant surveillance of the registrant.
- unauthorized use- removal
For hand-held equipment, according to the State of Ohio, ____ specific to the hand-held radiation-generating equipment shall be developed and implemented.
safe operating procedures
For hand-held equipment, according to the State of Ohio, operator training shall include ____.
documented specific instruction to the x-ray operator regarding the prohibition on placing any part of their body into the useful beam
According to the State of Ohio, dental equipment with nominal fixed kVp of less than ____ shall not be used to make diagnostic dental radiographs of human beings.
50
The NCRP (National Council on Radiation Protection) #145 was released in December 2003 recommending ____ for children (and for adults) and ____ collimation.
- thyroid collar- rectangular
True or false: The ADA recommends a lead apron and thyroid collar for only children.
FALSE. They recommend it for all patients.
The NCRP #145 did not recommend ____-speed film and instead, recommended ____-speed film or faster.
- D-speed- E-speed
The NCRP #145 recommended rare earth screens for ____ radiography. They also recommended for shielding design for new or remodeled dental offices to be done by ____.
- extraoral radiography- a qualified expert
The NCRP #145 did not recommend ____ development. They did recommend ____ for all pregnant personnel.
- sight development- film badges
What is panoramic radiography?
a technique for making detailed radiographs of a plane section of a solid object while blurring out the images of adjacent planes
What is body section radiography?
a radiographic technique in which the film and x-ray tube are moved in opposite directions to produce a more distinct image of a selected body plane
What is focal trough/image layer?
a 3D curved zone in which structures are reasonably well-defined
A panoramic image is obtained by rotating a narrow beam of radiation in the ____ plane. The image receptor is rotated in ____ (the same/different) direction while the object (jaws) is ____.
- horizontal- the same- stationary
Vertical magnification in panoramics varies ____ (a little/a lot) with object depth (focal spot to object distance).
a little
True or false: Horizontal magnification of panoramics is the same for the anterior and posterior region.
FALSE. It varies in the anterior and posterior region because of the two centers of rotation (anterior and lateral centers of rotation).
Horizontal magnification in panoramics varies ____ (a little/a lot) with object depth (focal spot to object distance).
a lot
Ghost images in panoramic radiographs arise from structures located where?
on the posterior aspect of the opposite side
Where are ghost images projected in relation to the real object?
projected on the opposite side of corresponding real image higher than the real object
What are the steps for panoramic radiography?
- set exposure factor- have patient removal metallic objects from head and neck area- have the patient wear the radiation protection apron plus thyroid shield in pediatric patients- walk patient into machine- have patient bite on bite stick- have patient stand up straight- position the ala-tragus line- position the lateral guide- have patient swallow, place tongue in roof of mouth and hold still- make exposure
The panoramic radiograph is light/pale film with few dark areas. What is the cause of this problem and how can it be corrected?
- too little exposure- increase mA or kVp or use next higher setting on machine*also, rule out worn-out or reversed screens
The panoramic is dark film with loss of details and amalgams and unexposed areas are still clear. What is the cause of this problem and how can it be corrected?
- too much exposure- decresae machine settings*don’t confuse with film fogging which is an overall grayness to film
The panoramic has white opacities on film and little or no image is visible on the film. What is the cause of this problem and how can it be corrected?
- ghosts of metal jewelry- remove prior to exposure*watch out for necklaces
The panoramic has a white opacity in the palate. What is the cause of this problem and how can it be corrected?
- tongue bar- remove prior to exposure*image is projected high onto palate instead in floor of mouth
The panoramic has a white opacity at the bottom of the film shaped like an inverted “v” or “shark fin”. What is the cause of this problem and how can it be corrected?
- lead apron above collar line and in x-ray beam- adjust and properly place apron*watch for bunching at back of neck
What type of magnification occurs in the center of the focal trough?
Trick question! No magnification (horizontal or vertical) magnification in the focal trough so there is no distortion.
True or false: No image distortion occurs outside the focal trough.
FALSE. Image distortion occurs outside the focal trough, not in it.
The panoramic has anterior teeth that are blurry, too small and narrow, and spine visible on the sides of the film. What is the cause of this problem and how can it be corrected?
- patient biting too far forward on bite rod- make sure anterior teeth are located in grooves on rod*make sure mandibular incisors are in groove also and bite rod is not being bent forward
The panoramic has anterior teeth blurry and wide with ghosting of the mandible and spine and condyles that are close to the edge of the film. What is the cause of this problem and how can it be corrected?
- patient is biting too far back on rod or not at all- make sure anterior teeth are located in grooves on rod*if anterior teeth are missing, use edentulous guide
The panoramic has roots of lower incisors blurry, the mandible is shaped like a “v”, there is too much smile line, the condyles are at the tope of the film, and spine forms an arch or “gazebo effect”. What is the cause of this problem and how can it be corrected?
- patient’s chin is tipped too far down- reposition using proper guidelines for that machine, such as alar-tragus line*make sure patient does not have unusual occlusal plane orientation
The panoramic has maxillary incisors blurry, hard palate superimposed on roots, flat occlusal plane, mandible is broad and flat, and condyles are at the edge of the film. What is the cause of this problem and how can it be corrected?
- patient’s chin is tipped too far up- reposition using proper guidelines for that machine such as alar-tragus line*make sure bite rod remains seated in its guide
The panoramic has teeth that are wide on one side, narrow on other side of midline, ramus that is wider on one side than on the other, uneven pattern of blurring throughout arch, and nasal structures are not clear. What is the cause of this problem and how can it be corrected?
- patient’s head is twisted in machine causing midline asymmetry- reposition using proper guidelines for that machine*make sure patient doesn’t try and look toward technician but straight ahead; always use front-surface mirror on machine to check alignment
The panoramic has condyles that are not equal in height and nasal structures that are distorted. What is the cause of this problem and how can it be corrected?
- patient’s head is rotated in machine (tipped)- reposition using proper guidelines for that machine*make sure patient’s head remains level through ears
The panoramic has white tapered opacity in the middle of the image (in the shape of the Washington monument). What is the cause of this problem and how can it be corrected?
- ghost of spinal column due to slumping- have patient take a step forward and straighten neck*don’t allow patient to reach forward into machine; make them step forward
The panoramic has dark vertical line extending from the top to bottom edge of the film. What is the cause of this problem and how can it be corrected?
- cassette hit shoulder and temporarily slipped- straighten neck; check apron for interferences*have patient keep elbows tucked in to sides to reduce shoulder height
The panoramic has a large dark shadow over the maxillary teeth between the palate and dorsum of the tongue. What is the cause of this problem and how can it be corrected?
- patient’s tongue not in the roof of mouth- instruct patient to place tongue in the roof of mouth prior to exposure*having patient swallow first can make it easier for them to obtain proper tongue position
The panoramic has portions of the radiograph blurred with large step defects in inferior border of the mandible. What is the cause of this problem and how can it be corrected?
- patient moved during the 15 seconds of exposure time- instruct patient to hold still prior to exposure*tell patient exposure will last 15 seconds so they will expect it
How does exposure change with an obese patient? With a patient with a large bone structure?
use the next highest kVp or mA setting for both
How does exposure change with a patient with a small bone structure? A patient that is edentulous?
use the next lower kVp or mA setting for both
What are the advantages (6) of panoramic radiography?
- large size (helpful in visualizing the maxilla and mandible plus teeth and associated structures)- approximate measurement of large lesions (ex. cysts) is possible- simplicity- time- 20% less dose than a full mouth series using F-speed film- patient comfort/cooperation
What are the disadvantages (8) of panoramic radiography?
- image quality (magnification, geometric distortion, and poor definition)- magnification (about 20-32% due to external placement of image receptor and an increased object to image receptor distance)- limited use in caries diagnosis, evaluation of periodontium, periodontal defects, and root canal measurements- focal trough (image layer) (structures outside the focal trough are poorly visualized or not seen at all)- overlap- superimposition- ghost images- overuse
Who invented Computed Tomography (CT)?
Sir Godfrey Hounsfield (“father of modern radiology”)