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RAD 370 - Techniques and Applications > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Continuous improvement of healthcare services through the systematic eveluation of processes

A

Quality improvement (QI)

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2
Q

A set of philosophies, methods, and tools for continuously quality improvement factors (ex: Lean and Six Sigma programs)

A

Continuous quality improvement (CQI)

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3
Q

Professional performance standards that define activities in the areas of education, interpersonal relationships, personal, and professional self-assessment, and ethical behavior

A

Total quality management (TQM)

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4
Q

3 things quality improvement (QI) does

A

Decrease costs, increase efficiency
Increase customer satisfaction
Ensure quality throughout the healthcare organization

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5
Q

4 problems quality improvement (QI) responds to

A

Increased competition
Escalating costs
Quality concerns
Demands for increased accountability = know who’s responsible (ex: computer logins)

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6
Q

W.E. Deming’s 14 points of management

A

Create constancy of purpose for improving products and services
Adopt the new philosophy
Cease dependence on inspection to achieve quality
End the practice of awarding business on price alone; instead, minimize total cost by working with a single supplier
Improve constantly and forever every process for planning, production and service
Institute training on the job
Adopt and institute leadership
Drive out fear
Break down barriers between staff areas
Eliminate slogans, exhortations and targets for the workforce
Eliminate numerical quotas for the workforce and numerical goals for management
Remove barriers that rob people of pride of workmanship, and eliminate the annual rating or merit system
Institute a vigorous program of education and self-improvement for everyone
Put everybody in the company to work accomplishing the transformation

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7
Q

An independent, not-for-profit organization dedicated to improving the quality of healthcare settings
This accreditation is not required, but is desired by most healthcare organizations
Hospital may not receive reimbursement without accreditation (medicare)

A

The Joint Commission (TJC)

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8
Q

The totality of features and characteristics of a radiation therapy process that bear on its ability to satisfy stated or implied needs of patients

A

Quality

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9
Q

All those planned of systematic actions necessary to provide adequate confidence that a product or service will satisfy given requirements for quality
Important in therapy because you need to hit the right spot (lasers lined up) with right dose

A

Quality assurance (QA)

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10
Q

Operational techniques and activities used to fulfill those requirements for quality (tests, procedures, etc.)
Ex: 9 penny test for congruence

A

Quality control (QC)

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11
Q

Type of radiation therapy in which a very few high doses of radiation are delivered to small, well-defined tumors

A

Stereotactic body radiation therapy (SBRT)

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12
Q

Measurable dimensions of quality that defines what is to be monitored; get from QA
Measurement tool used to evaluate an organization’s performance

A

Quality indicators (QI)

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13
Q

Systematic collection of data and QI encompasses the activities directed to improve the quality of a system by reducing the error or variation of that system (same as quality assurance)

A

Quality assessment (QA)

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14
Q

3 other names for quality improvement (QI)

A

Continuous quality improvement (CQI)
Continual improvement (CI)
Total quality management (TQM)

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15
Q

What is the daily quality indicators (QI) output?

A

3%

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16
Q

5 members of the quality improvement (QI) team (all personnel who interact with patients and families)

A 
Staff physicians
Physics (physicists, engineers, dosimetrists)
Radiation therapists
Oncology nursing
Support staff
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17
Q

What is the responsibility of the staff physicians on the quality improvement (QI) team?

A

Do weekly chart rounds with dosimetrists, therapists, etc. to see if treatment plan has changed (boost) and needs re-simmed

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18
Q

Initial or images taken through treatment to make sure the right place is still being treated

A

Port film/portal image

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19
Q

What are the responsibilities of the physics team on the quality improvement (QI) team?

A

Equipment, weekly chart check

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20
Q

What are the responsibilities of the radiation therapists on the quality improvement (QI) team?

A

“Gatekeepers”; morning warmups, sim QA, verifying prescriptions

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21
Q

What are the responsibilities of the oncology nurses on the quality improvement (QI) team?

A

Evaluate physical and psychology of patients; education of patients (skin care, diet, etc.)

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22
Q

2 things TJC requires the medical directors to do

A

Make sure staff is qualified (trained, credentials)

Establishment and continuation of quality improvement (QI) plan

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23
Q

5 QA activities that are the responsibilities of members of the QA committee

A 
Develop and monitor a QA program
Collect and evaluate data
Determine areas for improvement
Implement change as necessary
Evaluate results of actions taken
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24
Q

What is the goal, frequency, and reporting mechanism of developing and monitoring a QA program

A

Goal: oversee departmental peer-review activities
Frequency: ongoing
Reporting mechanism: QA committee meeting minutes

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25
Q

What is the goal, frequency, and reporting mechanism of collecting and evaluating data for QA?

A

Goal: develop and implement new policies and procedures as needed
Frequency: monthly meetings
Reporting mechanism: chart rounds reports

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26
Q

What is the goal, frequency, and reporting mechanism of determining areas for improvement for QA?

A

Goal: oversee implementation of and adherence to departmental policies and procedures
Frequency: monthly meetings
Reporting mechanism: policies and procedures

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27
Q

What is the goal, frequency, and reporting mechanism of implementing chance as necessary and evaluating results of actions taken for QA?

A

Goal: oversee implementation of and adherence to departmental policies and procedures
Frequency: monthly meetings
Reporting mechanism: incident reports

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28
Q

8 components of a continuous quality improvement (CQI) plan

A

Evaluation of both quality and appropriateness of care (peer review)
Evaluation of patterns or trends
Assessment of individual clinical events
Action to be taken to resolve identified problems
Identification of important aspects of care for assessment
Identification of indicators to monitor and of acceptable thresholds
Methods of data collection
Annual review of quality improvement plan for effectiveness

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29
Q

What is the frequency, tolerance and who is responsible for the quality checks of the collision/door interlocks and warning lights and sounds for kilovolt and megavolt in-room CT imagers?

A

Frequency: daily
Tolerance: functional
Person responsible: therapist

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30
Q

What is the frequency, tolerance and who is responsible for the quality checks of the laser/image/treatment isocenter coincidence and phantom localization and couch shift for kilovolt and megavolt in-room CT imagers?

A

Frequency: daily
Tolerance: +/-2 mm
Person responsible: therapist

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31
Q

What is the frequency, tolerance and who is responsible for the quality checks of the kV/MV/laser alignments and accuracy of couch shift motion for kilovolt and megavolt in-room CT imagers?

A

Frequency: monthly
Tolerance: +/-1 mm
Person responsible: therapist or physicist

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32
Q

What is the frequency, tolerance and who is responsible for the quality check of the high-contrast spatial resolution of kilovolt and megavolt in-room CT imagers?

A

Frequency: monthly
Tolerance: ≤2 mm
Person responsible: physicist

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33
Q

What is the frequency, tolerance and who is responsible for the quality checks of the CT number accuracy and noise and uniformity of kilovolt and megavolt in-room CT imagers?

A

Frequency: monthly
Tolerance: baseline
Person responsible: physicist

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34
Q

What is the frequency, tolerance and who is responsible for the quality checks of the imaging dose and x-ray generator performance (kV only) of kilovolt and megavolt in-room CT imagers?

A

Frequency: annually
Tolerance: baseline
Person responsible: physicist

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35
Q

What is the frequency and tolerance of the QA procedure for the localizing lights of fluoroscopy-based simulators?

A

Frequency: daily
Tolerance: 2mm

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36
Q

What is the frequency and tolerance of the QA procedure for the field size indicator of fluoroscopy-based simulators?

A

Frequency: monthly
Tolerance: 2mm

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37
Q

What is the frequency and tolerance of the QA mechanical checks of the collimator, gantry, and couch rotation isocenter of fluoroscopy-based simulators?

A

Frequency: annually
Tolerance: 2-mm diameter

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38
Q

What must the homogeneity results be for CT scanners as recommended by the American Association of Physicists in Medicine (AAPM)?

A

Must be within 5 Hounsfield units (HU)

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39
Q

Daily tolerance of the alignment of gantry lasers with the center of the imaging plane for QA procedures of CT simulators

A

+/-2 mm

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40
Q

Monthly and after laser adjustments tolerance of the orientation of gantry lasers with respect to the imaging plane for QA procedures of CT simulators

A

+/-2 mm over the length of laser projection

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41
Q

Monthly and after laser adjustments tolerance of the spacing of lateral wall lasers with respect to lateral gantry lasers for QA procedures of CT simulators

A

+/-2 mm and scan plane

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42
Q

Monthly and after laser adjustments tolerance of the orientation of wall and ceiling lasers with respect to the imaging plane for QA procedures of CT simulators

A

+/-2 mm over the length of laser projection

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43
Q

Monthly or when daily laser QA tests reveal rotational problems tolerance of the orientation of the CT scanner tabletop with respect to the imaging plane of CT simulators

A

+/-2 mm over the length and width of the table top

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44
Q

Monthly tolerance of the table vertical and longitudinal motion for QA procedures of CT simulators

A

+/-1 mm over the range of table motion

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45
Q

Semiannual tolerance of the sensitivity profile width of QA procedures of CT simulators

A

+/-1 mm of nominal value

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46
Q

Annual tolerance of table indexing and position of QA procedures of CT simulators

A

+/-1 mm over the scan range

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47
Q

Annual tolerance of gantry tilt accuracy of QA procedures of CT simulators

A

+/-1 degree over the gantry tilt range

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48
Q

Annual tolerance of gantry tilt position accuracy of QA procedures of CT simulators

A

+/-1 degree or +/-1 mm from nominal position

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49
Q

Annual tolerance of scan localization of QA procedures of CT simulators

A

+/-1 mm over the scan range

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50
Q

Annual tolerance of radiation profile width of QA procedures of CT simulators

A

Manufacturer specification

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51
Q

Tolerance after replacement of major generator components of QA procedures of CT simulators

A

Manufacturer specification or AAPM report 39 recommendations

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52
Q

Daily dosimetry tolerance for non-IMRT, IMRT, and SRS/SBRT machines of x-ray output constancy (all energies) and electron output constancy (if not equipped, then weekly) for QA procedures of medical accelerators

A

3%

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53
Q

Daily mechanical tolerance for non-IMRT machines of laser localization, distance indicator (ODI) at isocenter, and collimator size indicator for QA procedures of medical accelerators

A

2 mm

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54
Q

Daily mechanical tolerance for IMRT machines of the distance indicator (ODI) at isocenter and collimator size indicator for QA procedures of medical accelerators

A

2 mm

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55
Q

Daily mechanical tolerance for IMRT machines of laser localization for QA procedures of medical accelerators

A

1.5 mm

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56
Q

Daily mechanical tolerance for SRS/SBRT machines of laser localization and collimator size indicator for QA procedures of medical accelerators

A

1 mm

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57
Q

Daily mechanical tolerance for SRS/SBRT machines of the distance indicator (ODI) at isocenter for QA procedures of medical accelerators

A

2 mm

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58
Q

Grainy appearance of an image

A

Image noise

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59
Q

Clarity of an image; relationship between the number of pixels or voxels

A

Resolution

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60
Q

Pixels of gray on image; represent various tissue densities and linear attenuation coefficients
Range from +1000 to -1000
Air = -1000, water = 0, bone = about 650-1000

A

Hounsfield Units (HU)

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61
Q

Projects a scale onto the patient’s skin that corresponds to the SSD used during the simulation or treatment process; tells us how deep we’re going

A

Optical distance indicator (ODI)

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62
Q

Process for continuously monitoring the movement of tumors during the patient’s breathing

A

Respiratory gating

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63
Q

The software and hardware requirements of a linac which provides the user daily image verification capabilities

A

On-board imaging (OBI)

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64
Q

First step in treatment planning that localizes a target volume and helps physician’s and staff come up with treatment planning

A

Simulator

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65
Q

About what percent of cancer patients will be treated with radiation at some point?

A

50-60%

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66
Q

Conventional = mechanical C-shaped device that supports the x-ray tube and collimator device at one end
CT = circular ring housing the x-ray tube and solid state detectors
Rotates 360°
Rotates around a fixed point in space known as the isocenter (100 cm)

A

Gantry

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67
Q

6 basic elements of a simulator

A 
Gantry
Patient support assembly (PSA)
X-ray tube
Collimator device
Imaging system of fluoroscopy unit
Optical devices
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68
Q

Allows the tabletop its mobility, permitting the precise and exact positioning of the isocenter during simulation or treatment
Couch/table
Where patient is positioned
Don’t want it to attenuate beam
Conventional CT table is curved so you have to place a hard, flat insert if you’re using it for simulation

A

Patient support assembly (PSA)

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69
Q

Arrangement of shielding material used to define the “x” and “y” dimensions of the beam of radiation
Attached to gantry and rotates 360°

A

Collimator device

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70
Q

Field defining lights/lasers

A

Optical devices

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71
Q

3 steps of treatment planning

A

Tumor localization
Computation of dose distributions (isodoses to tumor and critical structures)
Fabrication of treatment aids (ex: bolus)

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72
Q

Determine the extent of the tumor and location of critical structures

A

Tumor localization

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73
Q

Tells distance from source to depth of isocenter

A

Source skin distance (SSD)

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74
Q

Image from CT simulator

A

Digitally reconstructed radiograph (DRR)

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75
Q

Designed to simulate the mechanical, geometrical, and optical conditions of various treatment units

A

Conventional simulator

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76
Q

3 mechanical components of the gantry of a conventional simulator

A

Gantry arm
Gantry head
Image intensifying/film holder screen

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77
Q

C-shaped structure of the gantry of a conventional simulator

A

Gantry arm

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78
Q

2 edges of the beam

A

Divergent edges

Nondivergent = central axis

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79
Q

2 scales

A

IEC

Varian

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80
Q

Does the SSD or SAD method of treatment take longer?

A

SSD takes longer because the tumor is still in the patient and distance is further than SAD

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81
Q

6 gantry head components

A 
Collimator assembly
ODI
Field defining wires
Beam restricting diaphragms
Fudicial plate
Accessory holder
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82
Q

6 steps of patient’s process through the oncology department

A 
Diagnosis
Consultation
Simulation
Treatment planning (dosimetrist)
Treatment
Follow-up
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83
Q

Daily QA safety tolerance for NON-IMRT,IMRT, and SRS/SBRT machine of the door interlock (beam-off), door closing safety, and audio/visual monitors?

A

Functional

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84
Q

Compromises the gantry head and rotates around the isocenter

A

Collimator assembly

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85
Q

Not on treatment machine, represent diaphragms

If blocks were used on conventional simulation, you couldn’t see as much anatomy on the x-ray film

A

Field defining wires

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86
Q

Defines size and axis of the x-ray beam

A

Beam restricting diaphragms
Collimators
Shutters
Blades

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87
Q

Plate with hash marks that is used to measure on port films
Allows us to make shifts (point of measurement) and helps measure magnification
Made of plexiglass or plastic and is removeable (if it is left in the treatment field, it will absorb some of the radiation and the patient won’t receive the right dose)

A

Fiducial plate/reticule

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88
Q

Holds blocks, cones, etc. for treatment; have to keep distance the same

A

Accessory holder

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89
Q

OFD

A

Object-film distance (larger = more magnification)

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90
Q

SFD/TFD

A

Source/target-film distance

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91
Q

Distance from the radiation source to the patient’s skin

A

Source-skin distance (SSD)

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92
Q

DIstance from the source of radiation to the patient’s skin

A

Source-axis distance

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93
Q

FAD

A

Focal spot-axis distance

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94
Q

Line perpendicular to the cross-section of the simulation or treatment field; not divergent

A

Central axis (CA)

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95
Q

Patient thickness; measurement used for treatment planning purporses to determine the thickness of a body part from entrance to exit point, often measured along the CA

A

Intrafield distance/separation

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96
Q

Tabletop to isocenter

A

TT

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97
Q

Lasers that project a small red or green beam of light toward the patient during the simulation process; provide the therapist several external reference points in relationship to the position of the isocenter

A

Positioning laser

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98
Q

The procedure room must be a minimum what square feet?

A

400 ft^2

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99
Q

4 room shielding materials

A

Lead
Concrete
Borated polyethylene
Aqueous materials (for neutrons)

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100
Q

How much the primary beam is pointed toward an area in the room (wall, floor, etc.)

A

Use factor (U)

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101
Q

Fraction of time an area is occupied by people; full = shielding increase

A

Occupancy factor (T)

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102
Q

How often treatment machine is running
Time integral of the absorbed dose rate (cGy per minute or rad/min) determined at the depth of maximum absorbed dose, 1 m from the “source”

A

Workload (W)

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103
Q

Limited access area in which the occupational exposure of personnel to radiation producing equipment or radioactive materials is supervised by an individual in charge of radiation protection (ex: treatment room, control console); allows more dose

A

Controlled area

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104
Q

2 factors of permissible dose (P)

A

Controlled area

Uncontrolled area

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105
Q

Limit for controlled area

A

0.1 rad/wk

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106
Q

Any area in the environment (ex: lobbies, offices, waiting rooms, etc.); limits dose

A

Uncontrolled area

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107
Q

Limit for uncontrolled area

A

0.01 rad/wk

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108
Q

Distance from radiation source

A

Distance (d)

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109
Q

What’s being allowed to transmit; transmission determines barrier thickness/shielding (radiation)

A

Barrier transmission (B)

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110
Q

Shielding has to be how high?

A

Up to 7 ft

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111
Q

Barriers/walls that intercept the primary beam

Portions of the floor, ceiling, and walls that receive the primary barrier

A

Primary barrier/wall

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112
Q

Barriers/walls that receive only leakage and/or scatter radiation

A

Secondary barrier/wall

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113
Q

Beam emitted directly from the accelerator that is “aimed” at the patient (i.e. the treatment field)

A

Primary beam

“Useful beam”

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114
Q

Radiation that arises from radiation interactions in the treatment head

A

Leakage radiation

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115
Q

Operates with treatment planning computer; make marks and set up treatment field
Creates DRR; physician can define target volume in 3D

A

Virtual simulation (current method)

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116
Q

Barrier transmission (B) formula

A

B=Pd^2/WUT

P = permissible dose
d= distance
W = workload
U = use factor
T = occupancy factor
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117
Q

How big is the bore in CT simulation and why?

A

80-90 cm to fit treatment devices and different patient positions

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118
Q

The delivery of interventions aimed at relieving symptoms and side effects of the disease and treatment and improving quality of life for the patient

A

Palliative

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119
Q

Average slice thickness for CT simulation

A

3x3

120
Q

Slice thickness of areas of non-interest for CT simulation

A

5x5 (less information, have to interpolate)

121
Q

Estimate values between two measured values

A

Interpolate

122
Q

Slice thickness of head and neck for CT simulation

A

1x1 (more anatomy but more data to store)

123
Q

How fast patient is translating through the table

A

Pitch

124
Q

Moving through the CT machine

A

Translating

125
Q

Pitch formula

A

Couch movement in longitudinal direction per 360° rotation of the tube/ beam width or slice thickness

126
Q

What dose an increase in pitch do?

A

Less time but lose information/more interpolation

127
Q

What gives us image by converting radiation to light

A

Detector

128
Q

___-___ generations of CT machines based on the number of detectors; ___-___ detectors per cm or ___-___ per degree

A

4-5 generations of CT machines based on the number of detectors; 1-8 detectors per cm or 1-5 per degree

129
Q

Solid-state = ____% efficient

A

90%

130
Q

Patient is positioned at a fixed point and while the x-ray tube is rotating, the patient moves into the aperture to create a scan patterns that resembles a coiled spring

A

Helical/spiral CT

131
Q

3 disadvantages of helical/spiral CT

A

Increased processing time
Increased noise/artifacts
Lower axis resolution along Z-axis (restrictions)

132
Q

Any systematic discrepancy between the CT numbers in the reconstructed image, undesired

A

Artifacts

133
Q

2 main functions of CT simulation

A

Target localization and critical structures (make marks on patient’s skin and use BB’s to see on CT)
DRR’s printed out

134
Q

Use multiple imaging sources to get anatomical information for patient (PET scan over CT)
CT defines edge of structures more clearly than MRI but MRI shows soft tissue better

A

Fusion

135
Q

Fuse a scan with patient in one position (ex: diagnostic position) with a scan in a different position (ex: treatment)

A

Deformable fusion

136
Q

Attenuation rates or tissue density differences displayed as pixels of different shades of gray
Range from +1000 to -1000

A 
Hounsfield units (HU)
CT numbers
137
Q

HU of air, water, cerebrospinal fluid (CSF), blood, graymatter, muscle, bone, and dense bone (ex: enamel)

A 
Air = -1000
Water = 0
CSF = 15
Blood = 20
Graymatter = 40
Muscle = 50
Bone = 650
Dense bone = up to +1000
138
Q

Missing the tumor __-__ times or ___% of the dose can result in treatment failure or recurrence of the disease

A

1-2 times

10%

139
Q

___% of patients treated had errors (pelvis, abdomen, chest more common areas because they’re bigger)

A

15%

140
Q

Aid in setup (hold patient still and maintain position)
Allow patient positioning
Make treatment more accurate
Durable (last whole treatment)

A

Immobilization devices

141
Q

2 reasons immobilization devices are used

A

Reproducibility

Accuracy

142
Q

What is the most advantageous thing to do with the patient is on the table in the right position in simulation?

A

Make sure they are comfortable (communication and consent are also important)

143
Q

3 categories of immobilization devices

A

Patient positioning aids
Simple immobilization devices
Complex immobilization devices

144
Q

Devices that place the patient in a particular position for treatment but don’t ensure that patient doesn’t move; general/not customized, used for all patients

A

Patient positioning aids

145
Q

Devices that restrict movement but require a patient’s voluntary cooperation; customized and restrict patient movement
Commonly used in addition to positioning aids

A

Simple immobilization devices

146
Q

Individualized devices that restrict patient movement and ensure reproducibility

A

Complex immobilization devices

147
Q

Supports chest and holds head; need to put arms in same place every time

A

Prone pillow

148
Q

Abducts affected arm and shoulder from chest wall

A

Breast board

149
Q

Abducts both arms from chest wall (CT simulation)

A

Wingboard

150
Q

Commonly used to treat pelvic malignancies with patient in prone position; has adjustable inserts to accommodate a variety of patients and provides a means of reducing the amount of small bowel in the treatment field

A

Belly board

151
Q

Move and position tongue

A

Bite block

152
Q

5 patient positioning aids

A 
Head holder
TX sponges for head and neck support (C-sponge opens lymph nodes, F-sponge is more comfortable and less flat)
Prone pillow
Arm board
Rubber rings/bands
153
Q

2 simple immobilization devices

A

Bite block

Arm stretcher

154
Q

Can be used to pull arms/shoulders out of head/neck field

A

Arm stretcher

155
Q

4 complex immobilization devices

A

Alpha cradle
Vac bag
Aquaplast mask
Aquaplast breast

156
Q

Complex immobilization device created from styrofoam shell and foaming agents

A

Alpha cradle

157
Q

Complex immobilization device that consists of a cushion and has vacuum compression pumps

A

Vac bag

158
Q

Complex immobilization device; thermoplastic that becomes pliable in a hot water bath
Patient markings can be made directly on it
Nose point and zygomatic arches important
Attenuates some of beam (minimal)
Casts may be cut further to increase patient comfort but this reduces the integrity of this immobilizer

A

Aquaplast mask

159
Q

Complex immobilization device that keeps large breasts from falling
Cups disadvantage: can get sticky/hot and make it harder to maneuver breast

A

Aquaplast breast

160
Q

2 imaging modalities used in simulation and tumor localization; both needed to visualize all structures

A

Ionizing

Non-ionizing

161
Q

Use ionizing radiation to produce images that primarily show anatomy
X-ray, CT, nuclear medicine, PET, PET/CT

A

Ionizing imaging modality

162
Q

Use alternative means of imaging the body such as magnetic fields (MRI) and echoed sound waves (US)

A

Non-ionizing imaging modality

163
Q

Ionizing bipedal (contrast administered in feet) angiogram good for visualizing Hodgkins

A

Lymphangiogram

164
Q

Uses radioisotopes and ionizing radiation to provide information about physiology (function) and anatomic structures

A

Nuclear medicine bone scan

165
Q

Uses short-lived radioisotopes (carbon-11, nitrogen-13, oxygen-15) which circulate through the body and emits positrons (positively charged electrons) which collide whatever in body tissues and cause the release of gamma rays that are detected and recorded by a gamma camera

A

PET

166
Q

Towards the abdomen, anterior

A

Ventral

167
Q

Towards the back, posterior

A

Dorsal

168
Q

Divides body vertically into right or left sides

A

Sagittal plane

169
Q

Divides body into two symmetric right and left sides

A

Median/midsagittal plane

170
Q

Vertical plane that is parallel to the median sagittal and divides into right and left unequal components

A

Parasagittal plane

171
Q

Vertical plane that divides the body into anterior (front) and posterior (back) sections; perpendicular (at right angle) to the sagittal plane

A

Coronal/frontal plane

172
Q

Divides the body into superior and inferior parts; perpendicular to midsagittal, parasagittal, and coronal planes

A

Transverse/horizontal plane

173
Q

Physique varies internal anatomy

A

Body habitus

174
Q

Short wide trunk, great body weight and heavy skeleton
Long abdomen with great capacity, high alimentary tract, and almost thoracic stomach
Small pelvic cavity
5% of the population

A

Hypersthenic

175
Q

Well-built; slightly lower stomach

Highest occurance at 50%

A

Sthenic

176
Q

Average physique
35% of the population
Abdominal cavity falls between sthenic and asthenic

A

Hyposthenic

177
Q

Slender physique, light weight, and light skeleton
10% of the population
Thorax has long, narrow lung fields with its widest portion in upper zones
Heart seems to “hang” almost like a pendant in the thoracic cavity
Longer abdomen and pelvis with great capacity
Lowest alimentary tract

A

Asthenic

178
Q

Spaces within the body that contain internal organs

A

Body cavities

179
Q

2 main body cavities

A

Posterior/dorsal

Anterior/ventral

180
Q

2 cavities the posterior/dorsal cavities divides into

A

Spinal/vertebral

Cranial (brain)

181
Q

Cavity protected by the vertebrae and contains the spinal cord

A

Spinal/vertebral

182
Q

2 cavities the anterior/ventral cavity is divided into by the diaphragm

A

Thoracic

Abdominopelvic

183
Q

2 cavities of the thoracic cavity

A 
Pericardial (heart)
2 pleurals (right and left lungs)
184
Q

2 sections of the abdominopelvic cavity

A

Upper abdomen

Lower pelvic

185
Q

Houses the peritoneum, liver, gallbladder, pancreas, spleen, stomach, and most of the large and small intestines

A

Upper abdominal cavity

186
Q

Houses the rest of the large intestine and the rectum, bladder, and internal reproductive system

A

Lower pelvic cavity

187
Q

4 abdominal quadruants

A

Right upper quadrant (RUQ)
Left upper quadrant (LUQ)
Right lower quadrant (RLQ)
Left lower quadrant (LLQ)

188
Q

Hypo-

A

Under/belo

189
Q

-chondriac

A

Ribs

190
Q

9 regions of the abdomen

A 
Right hypochondriac
Epigastric
Left hypochondriac
Right lumbar
Umbilical
Left lumbar
Right iliac
Hypogastric
Left iliac
191
Q

Region of abdomen centrally located around the naval

A

Umbilical

192
Q

Regions of abdomen to the right and left of the naval; lower back

A

Lumbar

193
Q

Central region of abdomen superior to the umbilical region

A

Epigastric

194
Q

Regions of the abdomen to the right and left of the epigastric region and inferior to the cartilage of the ribcage

A

Hypocondriac

195
Q

Central region of the abdomen inferior the the umbilical region

A

Hypogastric

196
Q

Regions of the abdomen to the right and left of the hypogastric region; hip bones

A

Iliac

197
Q

3 main functions of the lymphatic system

A

Drains tissue spaces of interstitial fluid that escapes from the blood capillaries and loose connective tissue, filters it, and returns it to the bloodstream
Absorbs fat and transports them back to bloodstream
Plays major role in body’s defense and immunity

198
Q

Excessive tissue fluid that consists mostly of water and plasma

A

Lymph

199
Q

____ of body’s lymph nodes in neck

A

1/3

200
Q

Bring in/to

A

Afferent

201
Q

Bring lymph into lymphatic vessel, many points of entry

A

Afferent vessels

202
Q

Carry lymph away; larger but fewer to slow the flow through the nodes, permitting the node to effectively filter the lymph

A

Efferent vessels

203
Q

Excessive accumulation of fluid in a tissue that produces swelling
Can occur when excessive foreign bodies, lymph, and debris are engulfed in the node or when altered lymphatic pathways cause greater than normal amounts of lymph filtration
Ex: swelling after mastectomy of arm on affected side

A

Edema

204
Q

__________ leaves the cellular interstitial spaces and becomes ________; as it enters a ___________ it merges with other capillaries to form an _________ which enters a __________ where lymph is filtered. It then leaves the node via an __________, which travels to other nodes, then merges with other vessels to form a ___________ which merges with other trunks and joins a _______________, either to the right lymphatic or the thoracic, which empties into a _________ where lymph is returned to the bloodstream

A

Tissue fluid leaves the cellular interstitial spaces and becomes lymph; as it enters a lymphatic capillary it merges with other capillaries to form an afferent lymphatic vessel which enters a lymph node where lymph is filtered. It then leaves the node via an efferent lymphatic vessel, which travels to other nodes, then merges with other vessels to form a lymphatic trunk which merges with other trunks and joins a collecting duct, either to the right lymphatic or the thoracic, which empties into a subclavian vein where lymph is returned to the bloodstream

205
Q

3 lymphatic organs

A

Spleen
Thymus
Tonsils

206
Q

Largest lymph node in the body, about 12 cm in length
Located posterior to and to the left of the stomach in the abdominal cavity, between the stomach’s fundus and diaphragm
Actively filters blood, removes old red blood cells (RBCs), manufactures lymphocytes (particularly B cells which develop into antibody-producing plasma cells) for immunity surveillance, stores blood; doesn’t filter lymph

A

Spleen

207
Q

Located along trachea superior to heart and posterior to sternum in the upper thorax
Larger in kids than adults (goes from size of orange to pea) and is more active in kids because their immune system is developing
Where T lymphocytes can mature

A

Thymus

208
Q

Series of lymphatic nodules embedded by a mucous membrane located at the junction of the oral cavity and pharynx; protect against foreign body infiltration by producing lymphocytes

A

Tonsils

209
Q

2 lymphatic ducts

A

Thoracic duct

Right lymphatic duct

210
Q

Lymphatic duct on the left side of the body, usually larger
About 35-45 cm long; starts at from and L2 at cisterna chyli
Serves the lower extremities, abdomen, left arm, and left side of head and neck into the left subclavian vein

A

Thoracic duct

211
Q

1-2 cm long lymphatic duct; drains right arm and right side of head and neck into right subclavian vein

A

Right lymphatic duct

212
Q

____ bones in the body; _____ in infant

A

206; 350

213
Q

3 parts of the axial skeleton

A 
Skull (29 = cranial, facial, and ossicles [ear])
Vertebral column (33 = C7, T12, L5, S5, and Co4)
Thorax (sternum, ribs, T-spine)
214
Q

Spinal cord ends at _______ and cauda equina begins

A

L1-L2

215
Q

Excessive curvature of the vertebral column that’s convex posteriorly

A

Kyphosis

216
Q

Cervical vertebrae that holds the skull

A

Atlas/C1

217
Q

Cervical vertebrae that head pivots on

A

Axis/C2

218
Q

Junction of manubrium and sternal body at T4

A

Sternal angle/angle of Louis

219
Q

Cartilage that connects the sternum to the ribs

A

Costal cartilage

220
Q

______ of ribs connects to vertebrae

A

Head

221
Q

Manubrium articulates with ribs _____

A

1 & 2

222
Q

Sternal body articulates with ribs _______

A

2-10

223
Q

Ribs 1-7 articulate posteriorly with vertebrae and anteriorly with sternum directly through costal cartilage

A

True/vertebrosternal ribs

224
Q

False ribs

A

8-12

225
Q

Ribs that join with vertebrae posteriorly and anteriorly with the cartilage of the immediately anterior rib; share common cartilaginous connection to sternum

A

8-10

226
Q

Ribs 11 & 12 attach to the vertebrae only

A

Floating/vertebral ribs

227
Q

Extends from the base of the skull to the esophagus

A

Pharynx (throat)

228
Q

The lowest point of the pharynx to trachea

A

Larynx (voice-box)

229
Q

8 bony landmarks of the skull

A 
Glabella
Nasion
Superciliary arches
Superior orbital margin
Maxilla
Mastoid process
External occipital protuberance
Angle of the mandible
230
Q

Secretes the aqueous layer of the tear film

A

Lacrimal gland

231
Q

Drains conjunctiva to the nose; tears drained through this duct into the lacrimal duct

A

Punctum lacrima

232
Q

Expanded outer wall of cartilage on each side of the nose

A

Ali nasi (lateral and inferior)

233
Q

Where vermillion border connects to the mucous membrane of the mouth; located at the junction of the vermillion border of the lip with the skin of the face

A

Mucocutaneous junction (MCJ)

234
Q

Lips; exposed pink or reddish margin of a lip

A

Vermillion border/surface

235
Q

Vertical groove between the base of the nose and the border of the upper lip

A

Philtrum

236
Q

Lower portion of nose connected to mouth; located at the junction of the skin of the nose with the skin of the face at the superior end of the philtrum

A

Columella

237
Q

External/visible part of ear

A

Auricle/pinna

238
Q

Rounded portion of ear

A

Helix

239
Q

Bony anterior 2/3 of the mouth

A

Hard palate

240
Q

Fleshy, upper posterior portion of oral cavity/mouth

A

Soft palate

241
Q

Bone that aids in the movement of the tongue

A

Hyoid

242
Q

Blocks nasal cavity and assists with speech

A

Uvula

243
Q

Muscle attached to the mastoid and occipital bones superiorly and sternal and clavicular heads inferiorly; lateral movement of neck

A

Sternocleidomastoid muscle

244
Q

SSN is at the level of

A

T2

245
Q

Sternal angle is at the level of

A

T4

246
Q

Xiphoid is at the level of

A

T9-10

247
Q

Outer portion of breast that extends into the axilla (muscle)

A

Tail of Spence

248
Q

Inferior point of breast attachment; where fold is, helps set treatment borders and skin breakdown is commonly seen here

A

Inframammary sulcus

249
Q

4 quadrants of the breast

A

Upper outer
Upper inner
Lower outer
Lower inner

250
Q

Most common breast quadrant for disease

A

Upper outer

251
Q

If breast tumor is located in an inner quadrant, what nodes are usually involved?

A

Medially located nodes (ex: inframammary)

252
Q

If breast tumor is located in an outer quadrant, what nodes are usually involved?

A

Axillary nodes (principal pathway)

253
Q

Breast lymph nodes at 2nd-3rd intercostal space

A

Axillary/principal pathway

254
Q

Breast lymph nodes that go through pectoralis major and drains supra- and infraclavicular fossa nodes

A

Transpectoral

255
Q

An intermediate breast lymph node in the infraclavicular fossa

A

Rotter’s node

256
Q

Breast lymph nodes that run toward the midline and passes through the pectoralis major and intercostal muscles close to the body of the sternum (T4-9); about 2.5 cm from midline and 2.5 cm deep

A

Internal mammary nodes

257
Q

Supraclavicular breast lymph node often biopsied on ipsilateral side of disease

A

Scalene

258
Q

On same side

A

Ipsilateral

259
Q

With radical breast surgery, lymph flow is often compromised; this slowed drainage causes edema that’s sometimes seen in the arms
Exercise, elevation, and compression sleeves help drain stagnant lymph

A

Lymphedema

260
Q

Part of the airway that begins at the inferior cricoid cartilage at C6
About 10 cm long and extends to carina at T4-5 and corresponds to the angle of Louis

A

Trachea

261
Q

Lower border of larynx and is only complete ring of cartilage in the respiratory passage

A

Cricoid cartilage

262
Q

Point of bifurcation of the trachea that forms beginning of the right and left main bronchi

A

Carina

263
Q

Dome-shaped muscle that separates the thorax and abdomen at T10-T11

A

Diaphragm

264
Q

Prevents lungs from overinflating into throax

A

Pleural cavity

265
Q

Right has 3 lobes and left has 2 because of the heart

A

Lungs

266
Q

Level of base of the heart

A

T4

267
Q

Ascending aorta runs from aortic orifice at the medial end of the third left intercostal space up to the second right costochondral joint and continues above the right side of the sternal angle and then turns down behind the second left costal cartilage

A

Aortic arch

268
Q

5 structures the superior mediastinal/tracheal/superior tracheobronchial lymph nodes of the thorax drain

A 
Thymus
Heart
Pericardium
Mediastinal pleura
Anterior hilum (wedge-shaped area)
269
Q

Lymphatics of the thorax that drain lungs: right into right lymphatic duct and left into thoracic duct

A

Inferior mediastinal nodes

270
Q

3 inferior mediastinal nodes

A

Inferior tracheobronchial/carinal
Bronchopulmonary/hilar (commonly involved in lung cancer)
Pulmonary/intrapulmonary

271
Q

Para-

A

Around/near

272
Q

Cuts through the pylorus of the stomach, the tips of the ninth costal cartilagesm and the lower body of L1

A

Transpyloric plane

273
Q

BIT

A

Bottom of ischial tuberosity

274
Q

BOF

A

Bottom of obturator foramen

275
Q

Muscle that attaches to the scapula and humerus

A

Teres major muscle

276
Q

Largest muscle in the back

A

Latissimus dorsi

277
Q

Why is the right kidney lower than the left kidney?

A

Due to the large size of the liver on the right side

278
Q

Kidneys can move as much as _____ during respiration

A

2cm

279
Q

Digestive organs

A

Alimentary organs

280
Q

Level of pancreas

A

L1

281
Q

Lymphatics of the abdomen and pelvis that drain the stomach, greater omentum, liver, gallbladder, spleen, pancreas, and duodenum

A

Celiac

282
Q

Lymphatics of the abdomen and pelvis that drain the head of the pancreas, portion of the duodenum, jejunum, ileum, appendix, cecum, ascending colon, and most of the transverse colon

A

Superior mesenteric

283
Q

Lymphatics of the abdomen and pelvis that drain the descending colon, left side of the mesentary, sigmoid colon, and rectum

A

Inferior mesenteric

284
Q

Lymphatics of the abdomen and pelvis that drain the bladder, prostate, cervix, and vagina

A

Common iliac

285
Q

Lymphatics of the abdomen and pelvis that drain the bladder, prostate, cervix, vagina, testes, and ovaries

A

External iliac

286
Q

Lymphatics of the abdomen and pelvis that drain the vagina, cervix, prostate, and bladder

A

Internal iliac/hypogastric nodes

287
Q

Lymphatics of the abdomen and pelvis that drain the vulva, uterus, ovaries,vagina, scrotum, and penis

A

Inguinal/superficial

288
Q

Use factor (U) for 0 degree (down) [IEC]

A

31%

289
Q

Use factor (U) for 90 and 270 degree (IEC)

A

21.3%

290
Q

Use factor (U) for 180 degree (IEC)

A

26.3%

291
Q

Occupancy factor (T) for full occupancy areas

A

1

292
Q

Areas occupied by full-time individual; ex: work offices, treatment planning areas, nurses stations, attended waiting areas, occupied space in nearby building (same people in there everyday)

A

Full occupancy areas

293
Q

Occupancy factor (T) for adjacent treatment room, patient examination room adjacent to shielded vault

A

1/2

294
Q

Occupancy factor (T) for corridors, employee lounges, staff rest rooms

A

1/5

295
Q

Occupancy factor (T) for treatment vault doors

A

1/8

296
Q

Occupancy factor (T) for public toilets, unattended vending rooms, storage areas, outdoor waiting areas with seating, unattended waiting rooms, patient holding areas, attics, janitors’ closets

A

1/20

297
Q

Occupancy factor (T) for outdoor areas with only transient pedestrian or vehicular traffic, unattended parking lots, vehicular drop off areas (unattended) stairways, and unattended elevators

A

1/40

RAD 370 - Techniques and Applications (6 decks)

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