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Radiology

QuestionAnswer
1. Name the parts of Radiology diagnostic interventional therapeutic
2. Define the parts of Radiology diagnostic- uses the definite/different types of radiationand mechanical vibration to study the structure and function of normal and abnormal organs and tissues of the human body
3. Name the parts of Diagnostic Radiology x-ray/roentgenology nuclear medicine-radioisotope diagnostics diagnostic ultrasound NMR/ MRI thermography
4. When did W.K.Rentgen invent X-rays? 1895
5. When did H.Bekkerel invent Radiactive rays? 1896
6. When was the thermal image used for diagnosis for the first time? early sixties
7. When did G.Haunsfield perform the first CT study? 1972- 70's
8. Who generated the idea of NMR phenomenon possible application for diagnostic imaging? p. lauterbure
9. What’s the basic concept of Diagnostic Radiology? make investigated organ visible get the image of the investigated organ
10. Name the consistent parts of the principal scheme of radiological studies patient radiologist source of radiation/mechanical vibration receiving device
11. What can we achieve increasing Signal/Noise Ratio? increased sensitivity
12. How can we decrease the noise? filtration (dont show below certain amplitude) averaging (average all waves)
13. Name the types of rays, used in Diagnostic Radiology em--> gamma, x ray, infrared, radiowaves corpuscular--> beta mechanical--> ultrasound to study structure and unction of normal and abnormal organs and tissues of the human body
14. What is the physical nature of rays, used in Diagnostic Radiology? electromagnetic corpuscular mechanical
15. Name the X-rays main properties 1. em radiation 2. straight lines 3. penetrates tissues 4. different attenuation 5. not perceived 6. ionizing 7. photochemical effect 8. fluorescent effect 9. ability to change charged particles 10. affects gm tube/scintillation detector
16. Name the parts of the X-ray tube principal scheme anode cathode collimator produced by converting electrical energy into em waves electrons accelerated from -ve cathode to +ve anode strike the target decelerated rapidly lost energy converted to heat + X rays
17. Is the X-Ray radiation uniform, homogenous? can be homogenous and heterogenous heterogenous after leaving the body
18. X-ray generation principal: conversion of kinetic energy of electrons
19. What is generally the meaning of “beam attenuation”? decrease of roentgen beam intensity decrease of roentgen beam energy by absorption, reflection, and scattering through a medium
20. What is the physical basis for X-ray beam attenuation? absorption scattering absorption is the interaction with the electrons in the substance through which it passes, causing ionization
21. What does X-ray absorption depend on? chemical composition density thickness greater the molecular weight, density, thickness, greater the absorption
22. What is the source of diagnostic contrast on X-ray studies? specific degree of attenuataion of roentgen beam by different tissues
23. Name the sensitive elements of receiving devices, used for X-ray studies photographic film fluorescent screen charged semi-conductor plate scintillation detector
24. What is the relationship between X-ray film darkening and attenuation? the greater the x ray density passing through, the darker the image (less attenuated, more dark) (the more the attenuation, the lighter the image) (so bone appears light)
25. What is the relationship between fluorescent screen shining and attenuation? x-rays pass through a patient's body and cause the fluorescent screen to light up when they strike. Some parts of the body attenuation is more than others, so the amount of x-rays hitting the screen at any one spot depends on what they had to pass through
26. What is the meaning of the term “superpositioned image”, which is referred to plain X-ray study? the 3 dimensional structure is merged into one plane to give a 2 dimensional image so you cannot say which is in front or behind everything is overlapped
27. How can we get the image of one plane performing X-ray planigraphy (conventional tomography)? movement of the xray tube and the film cassette in certain specified directions produces an image which shows the structures in detail in the predetermined plane while blurring the structures in the other planes
28. What is the main advantage of spiral CT versus conventional one? -no superimposed image -more detailed due to high contrast (t1/2; proton) -3D image with saggittal, coronal, and axial views
29. What is the concept of natural X-Ray contrast? the differences in attenuation of the beam by adjacent tissues is significant enough to be seen by the human eye on the x ray image
30. The region, where natural X-ray contrast is the most prominent, is: pelvis then thorax?
31. How can we differentiate the tissues with the same degree of X-ray beam attenuation on the X-Ray image? use contrast agents to produce artificial roentgenocontrast
32. What is the concept of artificial X-Ray contrast? change the attenuation of the roentgen beam by the investigated area or the background SIGNIFICANTLY so that the difference is enough to be visualized on the x-ray image
33. How can we change signal to noise ratio using the contrast agents? increase it by: strengthening the signal reducing the noise: by filtration and averaging
34. What is the meaning of “single”, “double” and “triple” contrast? single- using a single contrast media in the patient at 1 time double- using 2 contrast media or routes in a patient at 1 time triple- using three contrast media or routes in a patient at 1 time routes can be: oral, IV, rectal. media: air, dye
35. What kind of sensitive element is used in CT equipment? scintillation detector
36. Principle of “In-Vivo” and “In-vitro” studies In vivo - investigation performed by administering the patient with NM contrast media study is done using the living body in vitro- (glass) done on patient's blood,tissue sample,excretions in a controlled env. outside the living body
37. Basic principle (concept) of Nuclear Medicine studies detection and subsequent processing of radioactive radiation of the investigated probe (human body/tissues)
38. What is the meaning of the term “radioactivity”? ability of some chemical elements for spontaneous nuclear break-up accompanied by specific radioactive radiation +formation of a new chemical element
39. Is the radioactive radiation uniform, homogenous? homogenous-->in a beam of radiation containing photons of the same wavelength heterogenous--> in a beam/bundle containing photons of many wavelengths
40. Name the types of radioactive radiation corpuscular: alpha, beta electromagnetic: gamma
41. What is the penetration ability of radioactive rays? alpha- cannot penetrate thin sheet of paper beta- 1cm/ skin gamma- whole body/few cm of lead
42. Which type of radioactive radiation is not used for diagnosis and why? alpha highly ionizing non-penetrating
43. Which type of radioactive radiation is corpuscular? alpha beta helium nucleus; electron
44. Which type of radioactive radiation is electromagnetic? gamma high frequency; short wavelength
45. What is the meaning of the term “half-life time”? the period of time for the radioactivity to decrease to half of the initial amount
46. What is the meaning of the term “effective semiexcretion period”? the time taken for the radioactivity of the administered RPP to be halved to its initial value by physical break-up and biological excretion processes
47. What is the source of diagnostic contrast on NM studies? difference in radioactive radiation emitted by the investigated organ and the surrounding more the difference, better the contrast, better the sensitivity
48. What are the requirements the NM contrast media (RPP) have to meet? radiopharmacopreparation nontoxic strong β or γ emission property of specific uptake (relationship to definite organ/tissue) optimum ESP (effective semiexcretion period)
49. What are the possible ways of NM contrast media (RPP) administration? peroral/enteral parenteral inhalent
50. What is the advantage of “In-Vitro” studies? no exposure to ionizing radiation can determine different substances at critically low concentrations
51. What kind of detectors are used for NM studies? scintillation detector gas discharge counter
52. What is the sensitive elements scintillation detector? NaI crystal photomultiplier (gamma rays)
53. How is the radioactive radiation detectyed by gas-discharge counter? sealed metallic tube -ve cathode(tube) and +ve anode (rod) -filled with argon gas -no current b/w the anode and cathode -if there is radiation, argon gas ionized -current flows/ electric discharge -measured as a sound/reading on screen (b rays)
54. What is the advantage of gas-discharge counter? small size of the sensitive element
55. What is principle of functional studies in NM? administer RPP monitor accumulation and lead out processes
56. What is principle of morphological studies in NM? administer RPP monitor distribution in studied organs and construct image
57. Name the end-information types, might be received on NM studies numerical data (radiometry) curves (NM radiography) scannograms (NM scanning) scintigrams (scintigraphy)
58. What is the concept of thermography? distant registration of spontaneous infrared radiation of investigated patient
59. What kind of radiation is detected on thermography studies? infrared
60. What is the main advantage of thermography? non-invasive
61. Name 2 main factors, the heat production by tissues depends on blood supply metabolism
62. What is the physical nature of sound? mechanical oscillation of a medium (vibration) represents mechanical energy
63. Name the sound wave variables pressure density temperature particle motion
64. What are the main parameters of any wave? frequency wavelength period amplitude propagation speed intensity
65. Define, what is the wave period the time taken for one complete wave
66. Define, what is the wavelength the distance between two consecutive points in the same phase on a wave eg. trough or a crest
67. Define the Ultrasound sound waves with frequency greater than 20KHz above the range of human hearing (20-20,000 Hz)
68. What is the frequency range, mainly used in Diagnostic Ultrasound 1-20 MHz
69. What does the sound propagation speed depend on? depends on the medium (medium stiffness and density)
70. What medium parameters determine the wave propagation speed in this medium? medium stiffness medium density
71. What is the sound propagation speed in soft tissues? 1.54 mm/μs 1540 m/s
72. Which parameter determines the medium acoustic properties? acoustic property is measured as impedence (impedence = density X propagation speed) (z=pc)(row c) so density?
73. What is the physical nature of “Echo”? sound reflection
74. What is the relation between sound beam incident and reflection angle? incident angle = reflected angle
75. What is the relation between incident and transmission angle? If speed increases 1% as sound enters medium 2: transmission angle ~1% > incident angle
76. What is the meaning of the term “refraction”? change in direction of the wave when it enters a new medium (bending)(due to a difference in speed in the different mediums)
77. What is the Pulse Repetition Frequency (PRF)? no. of pulses of repeating signal produced in one second (unit time)
78. What is the Pulse Repetition Period(PRP)? time between the beginning of one pulse and the beginning of a second pulse
79. What is the Pulse Length? length covered by one pulse
80. What are the causes of sound beam attenuation? reflection absorption scattering
81. What is the unit of sound attenuation? decibel dB
82. How can we calculate the sound attenuation in tissues, knowing the sound frequency? attenuation= (1/2)(frequency MHz)(path length cm) =1/2fl
83. What is the main principle of ultrasound study? echolocation
84. What is the physical nature of Doppler Effect? the incident sound frequency is different from the reflected sound frequency for a moving reflector
85. What is the “Doppler Shift”? the difference between incident and reflected frequency
86. Does Doppler Shift depend on insonation angle? Yes, doppler shift Fd = 2f0 Vcos α\c if the angle is 0, Fd=1 if the angle is 90, Fd=0 α = 0 , Fd = 1 α = 90 , Fd = 0
87. How is the sound beam generated by Ultrasound Transducer? the transducer has a piezoelectric element in between two electrodes an oscillating current is applied this causes the piezoelectric element to vibrate rapidly producing ultrasound waves the summation of all the waves produces an ultrasound beam
88. What are the main (basic) 2 formats of ultrasound transducers? linear sector
89. What is concept of detail (spatial) resolution? depends on the smallest separation between two reflectors which can produce separate echoes on the instrument display
90. Name the types of detail (spatial) resolution axial lateral
91. How is the axial resolution of pulse-waive ultrasound system calculated? Axial resolution = spatial pulse length (SPL)/2 where SPL = λ × no. of cycles improved by higher frequency (shorter wavelength) transducers at the expense of penetration Higher frequencies--> image structures close to the transducer
92. What is the axial resolution of 2 cycle pulsed waive 3 MHz ultrasound (the propagation speed is 1,53 mm per microsecond) Speed =F x wavelength (calculate wavelength use SPL equation And then the axial resolution equation =0.51 calculate and double check once more 
93. What is concept of “Real-Time Imaging”? temporal resolution: measurement with respect to time
94. Name the basic types of Ultrasound study A mode- amplitude B mode- brightness M mode- motion
95. Name the basic types of Doppler study Continuous wave Doppler Pulsed wave Doppler (CW-->spectral) (PW-->spectral, color, power (amplitude and echo energy)
96. Name the basic components of MRI equipment strong magnet strong computer generator of RF pulse receiving coil
97. Name the advantages of MRI study no ionizing radiation air and bone not a hindrance for visualization lot of criteria for imaging (T1T2 relaxation times, proton density) possibility of IN-VIVO NMR spectroscopy
98. Which chemical element is used for MR diagnosis and why? H (hydrogen) -->most common element found in the human body -->highest sensitivity for magnetic resonance
99. Define the concept of “Spin” and “Spin magnetism” spin-->inherent rotation of a particle about its axis spin magnetism--> due to spin (of charged particle), a magnetic field is produced, with a north and south pole it is a vector quantity as it has direction and magnitude
100. What is the net magnetization of spin ensemble without external magnetic field? 0
101. The magnetization vector M appears, when the investigated probe (patient) is applied to ………………. an external magnetic field?
102. The magnetization vector M magnitude depends on the number of oriented spins, which are called ………… excess spins? (phase coherance??) (or spin spin relaxation time??)
103. What is the unit of magnetic filed strength ? tesla; T
104. What is the precession and Larmor frequency? precession--> change in the orientation of the rotational axis of a rotating body (signals from precessing magnets can be received as radio signals) larmor frequency--> spin precession frequency
105. To what frequency radiofrequency signal should be patient applied in order to get the magnetic resonance phenomenon? Larmor frequency
106. Which magnetization creates the MR signal? the rotating transverse magnetization creates the MR signal M-xy
107. Name the MR relaxation types Longitudinal Relaxation (Spin-Lattice Interaction) Transverse Relaxation (Spin-spin interaction)
108. What are diagnostic criteria for MR study? sensitivity is based on the difference of T1 and T2 relaxation constants of healthy and pathological tissues depends to a lesser degree on proton density too
109. What is the concept of MR Image Selected In-Vivo Spectroscopy (ISIS)? chemical analysis of any sample
110. The main concept of Interventional Radiology (IR) radiologist can see the pathology better than a surgeon after invasion into the body IR is diagnostic and low invasive treatment procedures performed under imaging guidance using the percuataneous and endocavity approach and also intra-operative study
111. Which radiological modalities might be used for IR procedures guidance? CT, MRI Ultrasound fluoroscopy
112. Advantages of Ultrasound as a IR procedures guidance tool in real-time non-invasive (no ionizing radiation) needle aiming and guiding capability doppler capability endocavity approach(endorectal/vaginal) can be done repeatedly cost-saving no surgical trauma no surgical aneasthesia no contraindications
113. What is the theoretical basis for radiotherapy? radiobiology--> biological object's response to ionizing radiation --> biological object's paradoxically BIG response to a relatively small amount of absorbed ionizing radiation
114. Name the electromagnetic rays, used for radiotherapy x rays gamma rays dampened radiation
115. Name the corpuscular rays, used for radiotherapy electrons protons slow neutrons alpha, beta, pi mesons
116. Define the unit (and derived units) of ionizing radiation energy corpuscular radiation--> electron volt (KE gained by an electron in an electrostatic field of 1V) KEV (1000) MEV(million) electromagnetic radiation-->quantum (photon) =hv (planck's constantXfrequency)
117. Name the cell response phases to ionizing radiation, leading to cell death altered biochemistry altered DNA nucleus swelling membrane disruption
118. What is RAD and it’s unit radiation absorbed dose (the energy absorbed by tissues) unit- G gray(s)
119. What does the tissue radiosensitivity depend on? metabolic activity tissue oxygen partial pressure mitotic activity
120. Name the most radiosensitive tissues hematopoietic tissues small bowel mucosa gonads
121. Name the most radioresistant tissues bone muscle neural tissue
122. The concept of radiotherapeutic interval the radiosensibility difference between normal tissue and abnormal tissue
123. The main principle of radiotherapy maximum impact on tumour minimum damage to normal tissues
124. Name the effects of ionizing radiation, used for nononcological pathologies treatment analgesic spasmolytic anti-inflammatory anti-secretory immunosuppresive
125. Name the types of radiotherapy due to expected results radical palliative symptomatic
126. Name the types of radiotherapy due to use with other treatment options combined complex conjoined
2. Define the parts of radiology therapeutic- uses ionizing radiation for treatment interventional- provides the possibility to perform invasive diagnostics and low invasive treatment procedures under imaging guidance
Created by: amra24