Rad Tech & Patient Care Quiz 1 Chapters 1-5

When and who discovered xrays?

Wilhelm Conrad Roentgen on November 8th, 1895

When and who discovered flouroscopy? What did he discover?

1. Thomas Edison in 1898

2. Discovered the 1st fluoroscope

Name the characteristics of xrays

1. travel in straight lines at the speed of light 

2. affect photographic emulsions (x-ray film)

3. affects biological tissue (ionizes atoms)

4. cannot be focused or refracted

5. cannot be detected by human senses 

What does the cathode consist of and charge does it have?

1. filament (large and small) 

2. focusing cup

3. negatively charged

What is the filament and what is it made of?

1. source of electrons

2. made of coiled tungsten wire

3. small & large filament

What does the focusing cup do and what is it made of? What charge does it have?

1. Focuses stream of electrons toward the anode target

2. made of nickel

3. Negative

What does dual focus mean on the beam?

1. small & large filament

2. only one gets energized to produce a large/small effective focal spot size

3. large body part= large filament, small body part= small filament

What does the target do and what is it made out of?

1. decelerates & stop electrons

2. energy is converted into heat and x-rays

3. tungsten-rhenium alloy target

What does the stator do and what charge does it have?

Electric motor that turns the rotor at very high speeds

What does the rotor do and what charge does it have?

1. causes the target to rapidly rotate during x-ray production

2. made of copper

3. high strength ball bearings for rotation

What is the tube housing and what are it’s functions?

1. protective covering around the x-ray tube

2. protects and supports the components

3. shields from off-focus radiation

What are grids/buckys are used for?

1. used to reduce the effect of scatter radiation on the image

2. prevents the scatter from reaching the IR

3. scatter radiation causes fog and reduces image contrast

When is a grid/bucky used?

1. for thicker body parts (large fields of exposure)

2. when using higher kVp 

3. when high image quality is needed (chest, abdomen, pelvis, spine)

Explain the overview of a radiographic procedure

1. X-ray photons pass thru the patient based on tissue types

2. X-ray photons that exit the patient strike the IR to create latent image

3. manifest image is obtained based on IR type

What are the 4 basic requirements for the production of x-rays?

1. a vacuum (x-ray tube)- removes air

2. electron source (filament)- cathode end, tungsten

3. target for the electrons (anode)- sites where electrons travel, tungsten

4. high potential difference (voltage) between the electron source and target- oppiste charges attract

How do we calculate mAs? What does greater mAs mean?

1. mA x s 

-if ms; divide by 1000, move 3 decimal places over

2. Greater mAs= more x ray photons = darker image

Define ionizing radiation?

high energy radiation that causes the ejection of an electron from an atom, can cause biological damage

Define exposure time and what is it measured in? What is AEC?

1. measure of how long the exposure will continue

2. measured in units of seconds or ms

3. Automatic exposure control: ends exposure when reached specific quantity of radiation has reached the IR (effects exposure time)

What is mA? what is mAs do to patient dose and image quality?

1. # of xray photons produced per second

2. selects for large/small filament size (focal spot size)

   1. higher = larger focal spot size

1. controls the quantity of xrays (# of photons)

2. affects image density/brightness (blackness)

3. proportional to patient dose: double mAs=double dose

Define kVp and explain how it affects patient dose and image quality

1. *controls the quality (energy) of xray beam

2. measure of the potential difference across the tube, determines speed of electrons in stream

3. higher kVp= more penetration, less absorption by patient

4. higher kVp= lower contrast, more grey

5. lower kVp= higher contrast, more black & white

What combo of kVp and mAs results in the lowest patient dose?

high kVp + low mAs

Which technique is a lower patient dose?

A- 60 kVp, 10 mAs

B- 80 kVp, 5 mAs

B: lower patient dose ( more penetration, fewer photons)

What is SID and what does it affect?

1. source to image receptor distance, from tube to IR

2. affects beam intensity and beam divergence (field size)

What is the inverse square law?

I₁ / I₂ = SID²₂ / SID ²₁

I₁= original beam intensity

I₂= new beam intensity

SID²₁ = original SID²

SID²₂ = new SID²

What is the inverse square law when mAs is used to compensate for changes in SID?

mAs₁ / mAs₂ = SID²₁ / SID²₂

What is the only method to determine if an image has been overexposed/underexposed?

Exposure indicators

What are the 4 factors of image quality and what do they mean?

1. optical density (OD)- overall blackness of image

2. image contrast- difference in optical density of similar structures

3. image detail- sharpness of image

4. distortion

Describe the relationship between kVp and contrast?

1. high kVp= lower contrast, more shades of grey

2. low kVp= higher contrast, less shades of grey

What 2 factors affect image detail

1. OID

2. SID

What is an intensifying screen, when and why do we use them?

1. layer inside film cassette coated with phosphors

2. use in film-screen radiography, mammography

3. reduces patient dose and allows for shorter exposure times

Define the two types of distortion and what causes them

1. size: magnification

   1. Increased SID and decreased OID

2. shape: unequal magnification, foreshortening & elongation

   1. CR misalignment

   2. angle of the part, tube, IR

What are the traditional (British) vs SI units?

Traditional:

1. Roentgen (R)

2. Rad

3. Rem

SI:

1. Columbs/Kilogram (C/kg)

2. Gray (Gy)

3. Sievert (Sv)

Define Roentgen, rad, rem, sieverts, gray

R: measurement of radiation intensity in air (similar to air kerma)

rad: old unit for radiation absorbed dose

rem: old unit for equivalent/effective dose 

Gray: SI unit for absorbed dose, measures patient dose

Sievert: SI unit for equivalent/effective dose of occupational exposure

Describe the conversions for gray, rad, sievert, and rem.

1 Gy= 100 rad; absorbed dose 0.01 Gy= 1 rad

1 Sv= 100 rem; equivalent/effective dose for occupational exposure 0.01 Sv=1 rem

What does ALARA stand for?

As low as reasonably achievable

Define dose equivalent

absorbed dose x weighting factor= dose equivalent

SI unit of dose equivalent is Sv

What is the professional organization ASRT?

American Society of Radiologic Technologists 

-oldest and largest national professional association of imaging sciences

-founded to advance profession and promote high standards of education & patient care

-tracks CEU credits to ARRT

-mandates state licensure

-open to all radiologic technologists

What does the AHRA do?

American Healthcare Radiology Administration

-provides network & resources for technologists with administrative positions

What does the ACERT and AEIRS do?

Association of Collegiate Educators in Radiologic Technology

Association of Education in Imaging and Radiologic Sciences

-provides forums (public places) to meet the needs of technologists and others who teach in the field

What does SDMS, SNM, and AVIR do?

Society of Diagnostic Medical Sonography

Society of Nuclear Medicine

Association of Vascular and Interventional Radiographers

-international organizations for other modalities

Describe moving up the career ladder in Radiology

promotion/advancement based on interests, skills, experience, and education

1. Staff radiographer

2. Lead technologist, team leader, or coordinator

3. Department (Radiology) manager/radiology director (needs bachelors/masters)

4. Educator- classroom, lab, clinical

5. Program director or dean of health sciences (needs masters)

6. Commercial positions- sell equipment, repair, research

What does emergency department physician do?

Specializes in trauma and emergency situations; a triage expert in disaster situations

What does family practice physician do?

treats people & families in context of daily life

What do these physicians do?

1. Gastroenterologist

2. geratrician

3. gynecologist

4. hospitalist

5. internist

6. intensivist

7. obstetrician

1. diagnoses/treats diseases of GI tract

2. diseases of elderly

3. diseases of female reproductive system

4. specialist, often internist, who treats patients in hospital

5. medical care/treatment of adults

6. Specialist, often pulmonologist, who treats patient in ICU

7. pregnancy, labor, delivery, immediate postpartum

What do these physicians do?

1. Oncologist

2. Ophthalmologist

3. Otorhinolaryngologist

4. Pathologist

5. Pediatrician

6. Pulmonologist

7. Psychiatrist

8. Radiologist

1. tumor identification and treatment

2. treats problems of eye

3. conditions of the ear, nose, and throat

4. the scientific study of alterations in the body caused by disease and death

5. diagnosis and treatment children

6. diseases of the lungs

7. treatment and prevention of mental illness

8. diagnosis by means of medical imaging

Define:

1. felony

2. misdemeanor

3. tort

1. serious crime that may be punished by imprisonment

2. less significant crime punished by a fine/imprisonment less than a year

3. civil wrong committed by one person against the person/property of another

What are the 2 categories of Torts?

1. Intentional misconduct

2. Negligence (unintentional)

Define the types of intentional torts:

1. Assault

2. Battery

3. False imprisonment

4. Defamation

5. Fraud

1. threatening a patient where they believe bodily harm may exist

2. touching patient without consent (even if no injury)

3. patient being restrained against their will

4. spreading of info causing loss of reputation

5. willful misrepresentation of facts that may cause harm/loss of rights/property

What are the 2 types of defamation?

1. Slander- involves spoken word

2. libel- written/published comments or pictures

Define informed consent

-patients need to be informed of all benefits, risks, alternatives to invasive procedures

-need explanation of procedure

-written documents need signatures before procedure starts

-only written doctor can perform

-patient can withdraw @ any time

What are the 3 items used to validate informed consent?

1. legal age/mental competency

2. adequately informed

3. consent offered voluntarily

As an RT, what is your scope of practice? Where does this come from?

-ASRT Code of Ethics #6

-must never assume roles of other medical personnel

-not within our scope of practice to read/diagnose radiographs and impart the results to the patient/family members

What does res ipsa loquitor mean?

“the thing speaks for itself”

when negligence is so apparent, it is obvious to anyone

What does respondeat superior mean?

“let the master respond”

employer is liable for employee’s negligent acts

What does “borrowed servant” mean?

physician may be liable for wrongful acts committed by employees under the physcian’s orders

Define:

1. plaintiff

2. defendent

1. suing party

2. party being sued

Name some HIPPA things that go along with privacy and confidentiality in the xray room?

1. same sex chaperones needed when exam requires undraping/exam of breasts

2. students and other not required to be in exam need consent from patient

3. photographs for any other purpose than for patient’s care need written consent

What departments use ionizing radiation?

1. X-rays

2. CT scans and PET scans

3. mammography

4. nuclear medicine

5. radiation therapy

What departments don’t use ionizing radiation?

1. MRI (magnetic fields and radio waves)

2. Ultrasound (sound waves)

What are the radiation safety rules?

1. personnel safety: time, distance, shielding

2. personal monitoring: dosimeters

3. effective dose limits: 50 mSv per year

4. patient protection: shield, avoid errors/repeats, collimate, use highest kVp, use lowest mAs

5. gonad shielding: lead shields of 0.5 mm lead eq.

What is the law of Bergonie and Tribondeau state? Explain which characteristics of cells are the most sensitive?

Defines the characteristics of cells that affect their sensitivity to radiation injury:

1. age: younger= more sensitive

2. differentiation: nonspecialized cells= more sensitive

3. metabolic rate: cells that use energy faster= more sensitive

4. mitotic rate: cells that divide/multiply faster= more sensitive

Differ between somatic & genetic, short term & long term, and deterministic & stochastic.

1. genetic: reproductive cells; somatic: all other cells

2. short term: within 3 months of exposure associated with high radiation exposure long term: could not show for 30 years, latent effects

3. deterministic: predictable; stochastic: random

Give examples of Somatic effects short term and long term

1. short term: epilation (hair loss), erythema (skin reddening), nausea

2. long term: cataracts, increased cancer risk, shortened life span

What do these special modalities mean?

1. R.T. (R)

2. R.T. (T)

3. R.T.(N)

4. R.T.(MR)

5. R.T.(S)

6. CT

7. BS

8. VS

9. CI

10. VI

11. BD

12. QM

1. Radiography

2. radiation therapy

3. nuclear medicine technology

4. magnetic resonance imaging

5. sonography

6. computed tomography

7. breast sonography

8. vascular sonography

9. cardiac-interventional

10. vascular-interventional

11. bone densitometry

12. quality management

What is accreditation? Who accredits our hospitals?

A process that applies to educational institutes and results in documentation attesting to the attainment of certain minimum standards

Joint Review Commission on Education in Radiologic Technology (JCERT)

Explain Maslow’s Hierarchy

Top → bottom

Self-actualization: morality, creativity, spontaneity, acceptance, experience purpose, meaning, and inner potential

Recognition & Self-Esteem: confidence, achievement, respect of others, need to be a unique individual

Love & belonging & acceptance: friendship, family, intimacy, sense of connection

Safety & Security: health, employment, property, family & social ability

Physiological Needs: oxygen, nutrition, elimination, sleep, clothing, water

Define:

1. Beneficence

2. Nonmaleficence

3. Veracity

4. Fidelity

5. Justice

6. Autonomy

1. Beneficence: goodness

2. Nonmaleficence: no evil

3. Veracity: truth

4. Fidelity: faithfulness and loyalty

5. Justice: fairness to all

6. Autonomy: respecting independence of other’s decisions

Describe how to correct errors on medical documents

1. draw a single line thru the error, add correction, and sign with date

2. no liquid paper; always pen and pencil

3. never leave blanks; use N/A or 0

4. never insert loose pieces of paper

5. include all 4 digits for DOB year

6. date and sign entries with full signature and title

Differentiate between the ARRT Rules of Ethics vs. ASRT Code of Ethics

ARRT: sets mandatory professional conduct standards required of all technologists

ASRT: moral compass for technologist, not legally enforced, centered toward care and what is morally right 

Who should incident reports be reported to and when what happens?

1. immediately reported to department supervisor and/or radiologist

2. any fall, accident, occurrence that results in injury or potential harm

In SI units, how many radiation dose is equivalent to 1 rad?

1 cGy

What is the term for a physician specialist in medical imaging who interprets diagnostic images and provides reports to referring physicians?

Radiologist

T/F: signed forms can be filled out after the procedure is completed

false