Chapter 9 and 10 Radiology
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| 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
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
juaire30
Popular Science sets