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RAD 100 CH 9 and 10
Chapter 9 and 10 Radiology
| Question | Answer |
|---|---|
| BE- Barium Enema | radiographic examination of the colon (flouro exam) indicate tumors, obstructions, diverticula & inflammation ACBE: air introduced for double contrast study – better visualization of diverticula and polyps Failed colonoscopy |
| IVP (fluoroscopic) | Intravenous pyelogram (IVP) AKA Intravenous urogram (IVU) (fluor exam) urinary system study Ionated contrast agent injected into the bloodstream through a vein in the arm Helps visualize stones in the urinary system and evaluated kidney functions |
| HSG | (special study) Hysterosalpingogram: evaluation of uterus & fallopian tubes; oil-based iodinated contrast introduced & filmed with DF or spot films and overheads |
| Figure 9-3 | A- Arteriogram (looks like stick person) B- Myelogram (white tube) |
| Figure 9-1 | A- failure to remove patients jewelry B- Contrast medium provides contrast between and organ and surround tissue C- RAD prepares an injection of an ionated contrast agent |
| Conditions limiting use of barium as a contrast medium | Contraindicated if surgery appears imminent or if perforated stomach/intestine is suspected – water-soluble iodinated contrast agent instead |
| ERCP | (fluoroscopic) Endoscopic retrograde cholangiopancreatography o To dx anomalies in biliary system or pancreas o Contrast injected into common bile duct after located with fiberoptic scope passed down esophagus, thru stomach & into small intestine |
| Sialogram | (special study) Study of salivary glands after injection of contrast; rad and/or fluoro |
| Arthrogram | (special study) Evaluate joint spaces; knee & shoulder most common; iodinated contrast injected into joint filmed with DF or spot films following fluoro |
| Tomography | (special study) Tomography: modality primarily used for urography, if at al |
| Esophogram | (fluoroscopic) Requires patient to swallow Ba during fluoro, which is followed from mouth to stomach to visualize tumors, constrictions & spasms |
| Cystography | (urinary study) Filling bladder with contrast then taking spot films & radiographs |
| Myelography | (special study) Fluoro exam of the spinal cord (subarachnoid space) to remove CSF & inject iodinated contrast into back or neck; DF or spot films & overheads |
| Mammography | (special study) Radiographic study of breast with compression to aid visualization |
| Panoramic tomography | Used for radiographic studies of the skull and headwork (above neck) image of a curved body surface, such as the upper and lower jaws, on a single film. |
| Double-contrast study | Adding a second element to first contrast, allows for better visualizations of abnormalities Air May be used w/ barium or iodine agents |
| General types of contrast media used | iodine-based barium-based air |
| Medium of choice for chest radiography | Air Easily penetrated by x-rays Provides contrast between lung tissues, vessel markings & air sacs |
| Reasons for performing extremity studies | To evaluate bone fractures (fx), dislocation, arthritis, osteoporosis, tumors, developmental conditions, & other pathologies > Require great care in handling 2nd most radiographed area of body |
| Reasons for performing headwork studies | For evaluation of possible fractures, locate foreign bodies or to examine abnormalities |
| Medium of choice for GI studies & why | Ba (barium sulfate) to evaluate for hiatal hernias & peptic ulcers from stomach to the pyloric sphincter Allergic reactions almost nonexistent |
| Reasons for performing abdominal studies | To evaluate the presence of foreign masses, calcifications, distribution of air in intestines, bony & soft tissue damage, and size, shape & location of major organs: liver, kidneys, spleen For children, fb ingestion (coins; marbles) |
| Studies used to supplement or replace BEs | Virtual Colonoscopy and Colonoscopy with endoscope |
| Skills required for patient preparation | Proper examination of patient is responsibility of radiographer,Checking for unwanted objects should be verbal, visual, and tactile |
| Common patient preparation mistakes | Forgetting to remove necklace in chest x-ray |
| Reasons for performing thoracic cavity studies | evaluate fluid in lungs, over-expansion, collapsed lungs, tumors, cardiomegaly, other heart/lung abnormalities (pneumonia, CHF), and fxs of ribs, sternum and SCJs |
| The rationale for using nonionic contrast media | reduces potential side effects |
| The most commonly radiographed area of the body | Thoracic Cavity – chest bones & tissues |
| Who carries patient preparation | Preparation of the patient for radiographic exam is responsibility of the physician who ordered the exam, nurse, and radiographer |
| External preparation | Must be done with EVERY examination,Removing any material that is covering the body area through which x-rays may pass,Clothing; buttons/zippers; jewelry: necklaces; hair; dentures; piercings; tattoos,Verbal, visual and tactile checks |
| Internal preparation | To be done with some (contrast) exams, Preparation is performed on nursing unit (IP) or at home (OP),Cleansing enemas; diet instruction; suction |
| Venogram | to evaluate the veins after contrast injection; very similar to arteriogram but more rare |
| Arteriogram | to visualize the arteries; iodinated contrast is injected to show blood flow & to evaluate shape/condition of arteries. Requires use of DF, auto-injectors & sterile field |
| Excretory urography, IVP and IVU | Excretory urography is also called intravenous pyelogram (IVP) AKA Intravenous urogram (IVU) |
| Density | Measurement of darkness on radiograph (over expose: black, under: white), Affect quality of radiograph, Most important, detail & contrast are nonexistent without it Presents a difference in the degree of absorption of radiation |
| Contrast | Differences in density makes differentiation of structures possible Can not have without density |
| Fog and its effects | Unwanted density on IR- caused from scatter Increases density/volume of tissue, Detracts from quality of image, overall grayness obliterates small structures |
| Kilovoltage (kV, kVp) | Unit of electrical potential,affects amount of x-ray produced; determines energy of x-rays > penetrability,greater the power, greater the remnant radiation reaching IR, Higher kVP- great energy of radiation, more x-rays traverse patient and strike IR |
| Advantages of using cones/collimators | Beam Limiting Devices, Attached to x-ray tube to reduce exposure field size- improve image, Decreases amount of radiation, Decreases scatter radiation, Decreases fog |
| Factors that affect the visibility of detail | Fog- decreases contrast, Patient Motion- (greatest factor) blurring image |
| Factors that can increase radiographic density | Atomic number tissue density (air, fat, muscle, bone, metal) |
| Relationship between kVp, tissue densities and Z#s, penetrability, and radiographic contrast, including scales of contrast: | The more dense a tissue (higher the z#), more kVp (energy) will be needed to penetrate the area. Short Scale Contract • Low kVp • High Contrast (Black and White) Long Scale Contract • High kVp • Low Contrast (Black, White, Shades of Grey |
| The inverse square law and how to apply it to changes in distance/intensity | I=Intensity, D=Density I1 (D2)2 I2 (D1)2 100 = (72)2 X (36)2 100 = 5184 Cross multiply, 5184x=12960 divide, x=25mR X 1296 |
| Determine how changes in mAs effect the film and calculate for over- or underexposure | Over exposure is black- place on film where many photons hit screen (too much time) o Under exposure is white- place on film where no photons hit screen (not enough time) Losing contrast with under or over exposure. |
| Relationship between magnification and radiographic detail | o more magnification of object, less radiographic detail o farther OID, greater magnification o increase SID, decrease magnification and increase detail |
| Relationship between mA/mAs and radiographic density | o The denser the object, the more mA/mAs needed to show areas of darkness if the exposure to a radiographic film is increased, the radiographic film density will also increase |
| Primary determinant of object shape on a radiograph | Beam Alignment alignment of the object in relation to the x-ray tube and IR will determine the shape objects placed at right angle of direction of the beam and parallel, can be seen in true shape |
| Factors that can increase radiographic contrast | Greater the absorption differences, the greater the contrast Density of bone and density of air Age State of health Body habitus Pathology Thickness of part Contrast media |
| Relationship between mA and mAs, & exposure time and mAs (be able to calculate each factor to solve numerical problems) | Seconds: change in exposure time is directly proportional to radiation exposure or output mAs - mA × sec 20 mAs - 200 mA × 0.1 sec 20 mAs - 100 mA × 0.2 sec |
| Film Screen Receptor | Emulsion on both sides, silver bromide in gelatin Sandwiched between 2 intensifying screens Intensifying screens fluoresce w/ x-ray decrease patient dose 95% of image created from light of intensifying screens processed in chemicals to manifest image |
| Computed Radiography | Latent image on phosphor plate (PSP) X-rays strike plate and e trapped in high energy state, Latent image in grains of phosphor, Laser light used to release synergy, Light signal is amplified and digitized, Manifest image |
| OID | object to image receptor distance, increase OID=increase magnification, increase distortion- decreases detail |
| SID | source to image receptor distance reduce magnification= need to increase SID, limited to usually 48” (40′′) and 72′′ If increased OID, need to increase SID to decrease magnification |
| Image (radiographic) vs. subject contrast | Greater absorption differences create great contrast- resulting in a better image (Bone and Air), Little absorption differences create low contrast (Tissues (anatomic part with little difference in z#)) |
| Quantitative | mAs used to express quantity of radiation milliamperage- greater=more radiation, less=less radiation time- greater time= greater amount, less time= less amount |
| Qualitative | kilovoltage, great the energy the great the ability to penetrate object and reach IR, creating a better image. |
| Exposure factors that affect density | Kilovoltage: ENERGY, Milliamperage: AMOUNT, Time: LONGER/SHORTER, Distance: DIVERGE, Film (speed): some emulsions respond more readily than others to light/x-rays; generally, the thicker the emulsion the faster the film |
| The four radiographic densities inherent in the body | Gas or Air (least dense) Fat, Muscle, Bone (most dense), Metal, |
| Relationship between intensifying screens and radiographic density | if the exposure to a radiographic film is increased, the radiographic film density will also increase |
Created by:
juaire30
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