RAD 120 Quiz #1 Ch. 1-2

Radiographer

Radiologic technologists who administers ionizing radiation to perform radiographic procedures

Radiology practice standards

Define practice of radiography and each modality

Describe necessary education and certification for each modality

Radiographer Scope of Practice

Clinical Performance Standards

Quality Performance Standards

Professional Performance Standards

Organization that creates and maintains ethics in Radiologic Technology

ARRT (American Registry of Radiologic Technologists)

Radiographer & diagnosis rules

Radiographers cannot provide a diagnosis to a patient, it is outside the scope of practice

Care for the radiographic room

Radiographer is responsible for:

Keeping room clean to minimize transmission of infection and provide for patient confidence (electrical parts: alcohol or a clean dry cloth, metal parts: disinfectant, tabletop: clean after each patient with disinfectant)

Standard precautions

Hand hygiene

PPE (personal protective equipment such as masks, gowns, gloves, eye coverings) if there is possible exposure to infectious material

Handle/dispose of contaminated: disposable items in biohazard container and linens in appropriate colored bag and put in linen bag

Properly handle, clean and disinfect equipment and instruments/devices

Properly handle sharps and needles/syringes

IR covers (placed under nonporous cover)

Follow safe injection practices: wear a mask when performing lumbar punctures

Transmission based precautions (Airborne-chickenpox, Droplet-flu, Contact-MRSA)

CDC provides directives for infection control and foundation is included in the standard precautions for all patient care

Basic principles of sterile technique

Surgery scrubs

Scrub cap

Mask

Shoe covers

Minor special procedures, interventional procedures, and surgical areas in which sterile technique is used

Myelography

HSG

Arthrography

Interventional Radiography

How to interact with patients

Communication (provide explanations and instructions)

Emotional and physical support

Clinical History (verify procedure ordered and observe abnormalities/condition)

Use immobilization devices

Use proper body mechanics

Transfer patients

Patient assessment and monitoring

Age specific competencies (pediatric and geriatric)

Bowel preparation

Limited diet

Laxatives

Enemas

Techniques used to cleanse entire colon so that diagnostic-quality radiographs can be obtained

Causes & types of artifacts that can be displayed on an image

Patient gown

Sheets

Clothing (bra)

Jewelry

Diaper

Buttons/Zippers

Dentures/removable bridgework

Hairpins

Types of motion

Involuntary motion caused by pulse, chill, peristalsis, tremor, spasm, pain

Voluntary motion caused by nervousness, discomfort, excitability, mental illness, fear, age, breathing

How motion can be minimized

Involuntary: control the length of exposure time (less)

Voluntary: clear instructions, providing patient comfort, adjusting support devices, applying immobilization, decreasing the length of exposure time

Types of respiration instructions

Inspiration

Full inspiriation

Expiration

Suspend breathing

Shallow breathing

Inspiration

Take a breath in and hold it

Full inspiration (double breathing)

Take a breath in, blow it out, take a breath in and hold it

Suspend breathing

Stop breathing

Shallow breathing

Breathing during exposure purposefully so we can see the motion

IR acronym

Image receptor

Purpose of IR

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

Types of IR

Computed radiography - imaging plate (CR-IP)

Digital radiography - flat panel detector (DR-FPD)

Digital fluoroscopy (DF)

Accessory equipment used in the field

Positioning aids (sponges)

Grids

Exposure factors

Patient size

Age

Pathological conditions

The radiographer’s responsibility is to select the combination of exposure factors that produce the desired quality of radiographs for each region of the body and to minimize radiation exposure to the patient

Placements of image receptors

Lengthwise - portrait (most common)

Crosswise - landscape

Diagonal

Central ray (CR)

Central or principal beam of x-rays, centered on the anatomy of interest and the image receptor

SID acronym

Source to image receptor Distance

Two standardized values used in radiography

40 inch SID (table)

70 inch SID

Collimation

Beam restriction (exposure field)

Purpose of collimation

Decreases patient dose

Decreases scatter radiation

Benefit of collimation

Minimizes the amount of radiation to the patient

Restricts beam to the anatomy of interest

Reduces amount of scatter radiation that can reach the image receptor, which reduces the potential for a reduction in contrast resolution

Anatomic markers

Marker that clearly identifies the patients right (R) or left (L) side

Purpose of anatomic markers

idk

Identify which side of the patient you are imaging

Radiograph

Image recorded by exposing the image receptor to x-rays that shows the presence or absence of abnormality or trauma

Image evaluation criteria

Acceptable image features

Proper radiation safety procedures (collimation)

Objectives for performing the procedure were met

Presence of patient identification

Proper marker placement

Evidence of patient shielding

Absence of artifacts

How images are viewed in the anatomic position including how digits are viewed differently

As though you are facing the patient (patient’s left side is on the right and vice versa)

Digits (fingers) pointed to ceiling

Digits (toes) pointed to ceiling

Image display (ID) required to be on an image

Date

Patient’s name or ID number

Right or left side marker

Institution identity

Difference in obese and morbidly obese patients

Body mass index (BMI)

Obese: 30-39.9

Morbidly obese: 40+

How manufactures have modified equipment to accommodate obese patients

Increased weight limits for radiography tables

Difference in how obese patients are transported

Larger wheelchairs, stretchers, and transport beds

Larger doorways

Always be sure adequate personnel are available to assist

Communicate each part of the transfer process to patient

Communication techniques with obese patients / How to work with obese patients

Avoid offending the patient

Empathetic communication is essential (sensitivity training, avoid mentioning weight, avoid discussion within hearing distance of patient about poor image quality or difficulty in obtaining images)

Body diameter and weight are the two important considerations - one or both of these factors can determine whether a radiographic examination can be performed

Imaging challenges with obese patients

Explain positioning required for imaging procedure

Provide support and assistance to maximize patient comfort and security

Difficulty in palpating landmarks

Fat is layered in folds

Localization tips that can be used with obese patients of different heights

Most palpable landmarks are not accessible in morbidly obese patients - never prod unnecessarily

Locate the jugular notch and locate the pubic symphysis based on the patient’s height (<5 feet: 21 inches, 5 to 6 feet: 22 inches, >6 feet: 24 inches)

Anatomy

Term applied to the science of the structure of the body

Physiology

Study of the function of the body organs

Osteology

Detailed study of the body of knowledge relating to the bones of the body

Body planes

Imaginary planes that subdivide the body in reference to anatomic position

Planes “slice” the body in all directions at designated levels

Sagittal plane

Divides the body into right and left segments, passing vertically from front to back

Midsagittal plane (MSP)

Specific sagittal plane that passes through midline and divides the body into equal right and left halves

Coronal plane

Passes through the body vertically from side to side, dividing the body into anterior and posterior parts

Midcoronal plane (MCP)

Specific plane that passes through midline and divides the body into equal anterior and posterior halves

Horizontal/Axial

Passes crosswise through the body or body part at right angles to the longitudinal axis and divides the body into superior and inferior portions

Also called transverse or cross-sectional

Oblique plane

Pass through a body part at any angle

Interiliac plane

Transects the body at the pelvis at the top of the iliac crests at the level of L4-L5

Occlusal plane

Formed by the biting surfaces of the upper and lower teeth with jaws closed

Types of body cavities

Thoracic cavity

Abdominal cavity

Pelvic cavity

Quadrants of the abdomen

Right Upper Quadrant

Left Upper Quadrant

Right Lower Quadrant

Left Lower Quadrant

External landmark for the level of the jugular notch

T2, T3

External landmark for the thyroid cartilage

C5

External landmark for the inferior border of the scapula

T7

External landmark for the superior most aspect of the iliac crests

L4, L5

Body habitus

The common variations in the shape of the human body

Determines size, shape. and position of organs of the thoracic and abdominal cavities

Types of body habitus

Sthenic

Hyposthenic

Hypersthenic

Asthenic

Sthenic body habitus

Average (considered average)

Hyposthenic body habitus

Thin (considered average)

Hypersthenic body habitus

Larger (considered extreme)

Heart axis is nearly transverse

Lungs are short, reaches clavicles

Diaphragm is high

Asthenic body habitus

Extremely thin (considered extreme)

Heart is nearly vertical and at midline

Lungs are long, reaches clavicles, may be broader at the base

Diaphragm is low

Ligaments

Connect bones to bones

Tendons

Connect muscle to bone

Functions of bones

Attachment for muscles

Mechanical basis for movement

Protection of internal organs

Support frame for body

Storage for calcium, phosphorus, and other cells

Production of red and white blood cells

It is a living object

Two major divisions of bones

Axial

Appendicular

Axial skeleton

Supports and protects the head and trunk

Appendicular skeleton

Provides means for movement

General bone features

Compact bone

Spongy bone

Red marrow

Yellow marrow

Medullary cavity

Endosteum

Periosteum

Compact bone feature

Strong, dense outer layer and serves the purpose of strength for supporting the body

Spongy bone feature

The inner portion of less dense spongy bone and contains spiculated network of interconnecting spaces called trabeculae

Red marrow feature

Produces red and white blood cells

Yellow marrow feature

Stores adipose (fat) cells

Medullary cavity feature

Central cavity in long bones that contains trabeculae filled with yellow marrow

Endosteum

Tissue lining the medullary cavity of bones (specifically long bones)

Periosteum

Tough, fibrous connective tissue that covers all bony surfaces

Muscles, tendons, and ligaments attach to the periosteum at tuberculae and tuberosities

Blood vessels and nerves enter and exit the bone through the periosteum

Outermost part of bone

Bone development

Ossification is the term that applies to the development and formation of bones

Begins in the second month of embryonic life

Classification of bones

Long bones

Short bones

Flat bones

Irregular bones

Sesamoid bones

Long bones

Found only in the limbs

Consist of body and two enlarged articular ends

Ex. humerus, phalanges, femur

Short bones

Consist mainly of cancellous bone with a thin outer layer of compact bone

Ex. carpals and tarsals

Flat bones

Consist of two plates of compact bones

Middle layer of cancellous bone called diploe

Ex. scapula and sternum

Irregular bones

Peculiarly shaped

Ex. vertebrae and hip bone (pelvis)

Sesamoid bones

Very small and oval

Develop inside and beside tendons

Protect the tendon from excessive wear

Ex. patella (largest)

Bone vessels and nerves

Bones are alive so they must receive a blood supply for nourishment

Contain a supply of nerves

Foramina: holes through which blood vessels and nerves enter and exit the bone

Classifications of joints

Functional classification: based on mobility of joint

Structural classification: based on connective tissue

Functional classifications of joints

Synarthoses

Amphiarthroses

Diarthroses

Synarthroses

Immovable

Ex. sutures on the skull

Amphiarthroses

Slightly moveable

Ex. pubic symphysis (joins hip bones together)

Diarthroses

Freely moveable

Ex. elbow

Structural classifications of joints

Fibrous

Cartilaginous

Synovial

Fibrous joints

Do not have a joint cavity

United by various fibrous and connective tissues and ligaments

Strongest joints in the body

Types of fibrous joints

Syndesmosis

Suture

Gomphosis

Syndesmosis

Immovable or very slightly moveable

United by fibrous sheets

Ex. inferior tibiofibular joint

Suture

Immovable joint only in the skull

Gomphosis

Immovable joint only in the roots of teeth

Cartilaginous joints

Do not have a joint cavity (only cartilage)