Radiographic Positioning Workbook Unit 1 Answers

Who is a radiographer?

Is a radiologic technologist who administers ionizing radiation to perform radiographic procedures

Explain ALARA

As Low As Reasonable Achievable

A fundamental responsibility of the radiographer to ensure that each radiation exposure is as low as possible

Define ARRT

American Registry of Radiologic Technologists

Define ASRT

American Society of Radiologic Technologists

What do the ASRT and ARRT do for the radiologic technology profession?

The ASRT wrote and maintains the Practice Standards of Medical Imaging and Radiation Therapy which defines the practice standards and scope of practice for thirteen imaging disciplines.

ARRT created and maintains the Standards of Ethics that apply to all registered technologists who are certified by the organization

Which set of guidelines lists professional behavior to which registered imaging professionals may aspire and is intended to assist in maintaining a high level of ethical conduct in the profession?

ARRT

Which set of regulations is enforceable and defined as "mandatory standards of minimally acceptable professional conduct for all Registered Technologists and Candidates?"

ARRT

How often should the radiographic table be cleaned?

After every Patient

How do members of the radiologic technology profession help control pathogen contamination?

Following Standard Precautions and Transmission- based precautions

What is the easiest and most convenient method to prevent the spread of microorganisms?

Washing your hands

When using a free image receptor (IR) to perform an examination on an isolation patient, the IR should be placed _______ the sheet ( on top of or under)

Under

What protective apparel should radiographers wear if the possibility of touching blood exists?

Disposable Gloves

What procedure should be followed to dispose of used hypodermic needles properly?

Place them in a puncture- proof container

List procedures that require aseptic technique when performed in the radiology department

Cystography, Intravenous urography, Spinal puncture, Arthrography, Angiography

True or false.

When performing an examination in the operating room (OR), position the C- arm next to the operating table on the same side as the surgeon

False

Before beginning a radiographic examination, what should the radiographer do to gain the cooperation of a coherent patient?

Give an explanation of the procedure to be performed

What is the minimum number of personnel that should be used to transfer a helpless patient from a gurney to the radiographic table?

4

When the radiologist is unable to see the patient, who is responsible for ensuring that an adequate clinical history accompanies the radiographs

Radiographer

What is the role of the radiographer in interpretation of radiographic images? How should requests for interpretations be handled

Outside of the scope of practice

Must be referred to a qualified physician

List the three ways a patient's colon may be cleansed for an abdominal examination

Limited diet, laxatives, and Enemas

True or false

If washable gowns are used, they should be starched; starch is radiolucent, which means it can be penetrated easily by X-rays.

False

Why is it necessary to ensure that any folds in cloth gowns are straightened out before making the radiographic exposure?

Prevent confusing shadows or artifacts

What devices must be removed from the patient within the area of interest when the skull is examined?

Dentures, removable bridgework, earrings, necklace, all hairpins, and eyeglasses

Identify the three types of muscular tissue and state the type of motion (voluntary or involuntary) associated with each

Smooth, involuntary (peristalsis); cardiac, involuntary (systole); and striated, voluntary

The rhythmic motion of smooth muscle structures is called

Peristalsis

What export factor is used to control involuntary motion?

Control the length of exposure time

Less is better

What body system controls the movement of voluntary muscles?

Central nervous system

From the following list, what are the five ways voluntary motion can be controlled by a radiographer

A. Increase mAs

B. Decrease kVp

C. Apply immobilization

D. Give clear instructions

E. Adjust support devices

F. Increase exposure time

G. Decrease exposure time

H. Provide patient comfort

C, D, E, G, H

True or false

Most exams require the patient to hold their breath at some point of respiration, such as the end of inhalation or exhalation.

True

Define breathing technique.

Explain the purpose of using a breathing technique for a radiographic examination

Instructing the patient to breathe during a long exposure time combined with low mA technique setting

Blurs overlying anatomic structures for demonstration of specific anatomy, such as the anterodemonstration of specific anatomy, such as the anteroposterior (AP) scapula and lateral thoracic vertebrae

Define Image Receptor (IR)

The device that receives the energy of the x-ray beam and forms the image of the body part

What is the most common and fastest IR type for radiography?

Solid-state digital detector, also called flat-panel detector

According to the recommended procedural steps, what should the radiographer do before releasing or returning the patient?

Evaluate the radiograph

What are the prime technical factors under control of the radiographer?

Milliamperage (mA), Kilovolt Peak (kVp), and exposure time (seconds0

Match the patient conditions with the appropriate radiation exposure compensation necessary to provide a diagnostic image

Ascites - Requires an increase

Edema- Requires an increase

Old age- Requires a decrease

Atrophy- Requires a decrease

Emaciation- Requires a decrease

Pneumonia- Requires an increase

Emphysema- Requires a decrease

Enlarged heart- Requires an increase

Pneumothorax- Requires a decrease

Hydrocephalus- Requires an increase

Pleural effusion- Requires and increase

Degenerative arthritis- Requires a decrease

List the three best radiation protection tools under the radiographer's control

Proper positioning, Appropriate collimation of the exposure field, and optimum technical factors

In cases where patients or their caregivers express anxiety about having imaging studies without the use of gondola shielding, technologists are advised to

Attempt to explain the latest AAPM research

What are the three general positions of the IR?

Which IR position is used most frequently?

Lengthwise, Crosswise, and Diagonal

Lengthwise

Regardless of the IR size, it is the radiographer's responsibility to ________________ the anatomy of interest for the radiographic exam.

Collimate the exposure field to

What adjustment can be made by the radiographer to compensate for an increase in object-image receptor distance (OID)

Increase the SID

List four reasons why it would become necessary to angle the central ray.

1. To avoid the superimposition of overlying or underlying structures

2. To avoid superimposing a curved structure on itself

3. To project through angled joints

4. To project through angled structures without foreshortening or elongation

The distance from the anode focal spot inside the x-ray tube to the IR is the

SID

Source-to-image receptor distance

What three factors are affected by SID?

Magnification

Spatial resolution

Patient Dose

The traditional minimum SID used for most conventional radiographic exams is ________ cm (_______ inches), but recently the SID has been increased to ____________ cm (___________ inches)

102, 40

112-122, 44-48

What is the minimum SID for chest radiography?

183 cm (72 inches)

List two purposes of collimation when restricted to irradiate only the anatomy of interest

1. Minimizes the amount of radiation to the patient by restricting exposure to essential anatomy only

2. Reduces the amount of scatter radiation that can reach the IR

True or false

Creating an image using a larger than required (necessary) field size is a violation of the ARRT Code of Ethics

True

True or false

Shuttering of direct digital images is an acceptable substitution for proper collimation

False

From the following list, indicate which of the following is NOT RECOMMENDED OR UNACCEPTABLE for right and left side marker placement

A. Use of electronic insertion of the side marker in digital imaging

B. Placement of the marker in the anatomy of interest

C. Placement of the marker on the border of the collimated field

D. Placing the marker directly on the body part

A,B,D

Each projection select the best choice for how side markers should be used for that particular projection (R= right side; L= left side)

PA hand - Appropriate R or L marker used

AP abdomen- R marker typically used

AP forearm- Appropriate R or L marker used

Lateral skull- Mark side closer to the IR

PA skull- R marker typically used

AP cervical spine- R marker typically used

Lateral lumbar spine- Mark side closer to the IR

Lateral decubitus chest- Mark the side up (opposite of side laid on)

AP oblique lumbar spine- (Mark side closer to the IR

Bilateral AP knees (side-by-side on one IR) - Use both R and L marker to identify both sides

Define and describe the anatomic position

The patient is standing erect with the face and eyes directed forward, arms extended by the sides with the palms of the hands facing forward, heels together, and toes pointing anteriorly

Describe how a PA projection radiograph of the chest should be oriented on the display monitor

Oriented on the display monitor so that the person looking at the image sees the body part as though viewed facing the patient, referred to as anatomic position

Describe how lateral projection radiographs should be displayed

The viewer sees the patient from the perspective of the x-ray tube

Describe how hand and foot radiographs should be displayed

Digits pointing upward and as viewed from the persecutive of the x-ray tube

From the following list, what are the four items of identification information that should be on every radiograph

A. Patient's name

B. Patient's diagnosis

C. Date of examination

D. Institutional identity

E. Patient's marital status

F. Side marker (right or left)

G. Requesting physician's name

A, C, D, F

Some examinations require additional information to indicate the ______________ after the introduction of a contrast medium

Cumulative Time

AP

Anteroposterior

AEC

Automatic Exposure Control

ASRT

American Society of Radiologic Technologists

IR

Image Receptor

CR (x-ray beam reference)

Central ray

mAs

Milliampere second

DR

Digital Radiography

APR

American programmed radiography

ARRT

American Registry of Radiologic Technologists

ASIS

Anterior Superior Iliac Spine

BMI

Body Mass Index

SID

Source-to-image receptor distance

ALARA

As Low As Reasonably Achievable

How have equipment manufacturers responded to the growing obesity problem in the United States

Radiographic and fluoroscopic table weight limits have doubled to 700 pounds

CT and MRI table weights and aperture openings have also increased

What is the major risk factor in transportation and transfer of obese patients?

Risk of injury to radiographers, other health care workers, and the patient

Which body parts are most affected, in terms of increased size, by morbid obesity?

The thorax, stomach, and colon

What bony landmark(s) are usually palpable on obese patients?

A. Jugular notch

B. Xiphoid process

C. Anterior- superior iliac spine (ASIS)

D. Iliac crest

A

What is the approximate distance of the pubic symphysis from the jugular notch on a patient who measures 160 cm (5 feet, 3 inches) tall?

About 56 cm (22 inches)