Chapter 1 Workbook

who is a radiographer?

a radiologic technologist who administers radiation to perform radiographic procedures

explain ALARA

“as low as reasonably achievable”

ensures patient safety by minimizing radiation exposure

ARRT

American Registry of Radiologic Technologists

ASRT

American Society of Radiologic Technologists

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

they both write and maintain standards and codes that radiographers must follow.

ASRT —> defines the practice, education standards, and more

ARRT —> created the standards of ethics

how often should the radiographic table be cleaned?

after each patient procedure

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

by following standard precautions when interacting with patients, as well as knowing how to handle patients who are on isolation status

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

handwashing

when using a free IR to perform an examination on an isolation patient, the IR should be placed _____ the sheet

under

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

scrubs

shoe covers

scrub cap

mask

gloves

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

needles should never be recapped and they should be placed in a puncture proof sharps container

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

cystography

spinal puncture

angiography

intravenous urography

arthrography

T or F:

when performing an examination in the operating room, 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?

alleviate their fears while also being clear and honest about their procedure. be nice and do not rush them

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

at least 4

preferably 6

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

the radiographer

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

interpreting images is outside the radiographer’s scope of practice. patients should be told that their physician will receive and tell them reports

list three ways a patient’s colon may be cleansed for an abdominal examination

limited diet

laxatives

enemas

T or F:

if washable gowns are sued, they should be starched; starch is radiolucent, which means it can be penetrated easily by x-rays

False

(starch is radiopaque; cannot be penetrated easily by x-rays)

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

to prevent artifacts on the radiograph

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

any radiopaque object

zippers, necklaces, snaps, thick elastic, buttons, dentures, bridgework, earrings, hairpins, diapers, surgical dressings

the rhythmic motion of smooth muscle structures is called _____

peristalsis

what exposure factor is used to control involuntary motion?

time

the less exposure time, the better

what body system controls the movement of voluntary muscles?

central nervous system

from the following list, circle four ways voluntary motion can be controlled by a radiographer

a. increase mAs

b. decrease mAs

c. apply immobilization

d. give clear instructions

e. adjust support devices

f. increase exposure time

g. decrease exposure time

h. provide patient comfort

c. apply immobilization

d. give clear instructions

e. adjust support devices

h. provide patient comfort

T or F:

most exams require the patient to hold their breath at some phase of respiration, such as the end of inhalation or exhalation

True

define image receptor (IR)

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

list the four types of IRs used in diagnostic radiology

1. solid-state digital detector (DR —> digital radiography)

2. photostimulable storage phosphor image plate (PSP IP) for CR (computed radiography)

3. fluoroscopic IR

4. cassette with film

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

evaluate the radiograph to make sure it is acceptable for the radiologist, as well as make sure the patient’s needs are met

fig 1.1 shows two images demonstrating differences in range of brightness between anatomic structures of varying tissue densities. Compare these images and identify which image was exposed using a compensating filter

image A: without filter (looks radiopaque at the bottom, darker)

image B: with filter (brighter, defined vertebrae outlines)

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

milliamperage (mA)

kilovolt peak (kVp)

exposure time (seconds)

ascites

requires an increase in radiation exposure

edema

requires an increase in radiation exposure

old age

requires a decrease in radiation exposure

atrophy

requires a decrease in radiation exposure

emaciation

requires a decrease in radiation exposure

pneumonia

requires an increase in radiation exposure

emphysema

requires a decrease in radiation exposure

enlarged heart

requires an increase in radiation exposure

pneumothorax

requires a decrease in radiation exposure

hydrocephalus

requires an increase in radiation exposure

pleural effusion

requires an increase in radiation exposure

degenerative arthritis

requires a decrease in radiation exposure

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

try to explain the latest AAPM research and NCRP recommendations, but if that doesn’t work, shielding may be used

what are the three general positions of the IR?

lengthwise (portrait)

crosswise (landscape)

diagonal

which IR position is used most frequently?

lengthwise (portrait)

regardless of the IR size, it is the radiographer’s responsibility to _________ to the body part

collimate the exposure field

what adjustment can be made by the radiographer to compensate for an increase in OID?

increase the SID (reduces the magnification)

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

1. when overlying/underlying structures must not be superimposed

2. when a curved structure (like sacrum or coccyx) must not be superimposed on itself

3. when projection through angled joints (like knee joint and lumbosacral junction) is necessary

4. when projection through angled structures must be obtained without foreshortening or elongation (like lateral image of neck of femur)

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

SID

what three factors are affected by SID?

magnification of anatomy

spatial resolution (sharpness and detail)

dose of radiation to patient

the traditional minimum SID used for most conventional radiographic exams is _______, but recently the SID has been increased to _____

40 in

44-48 in

what is the minimum SID for chest radiography?

72 in

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

minimizes the amount of radiation to the patient by reducing exposure to essential anatomy

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

T or F:

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

True

-unnecessary radiation

-increased scatter makes image harder to read, hindering diagnosis

T or F:

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 acceptable 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. use of electronic insertion of the side marker in digital imaging

b. placement of the marker in the anatomy of interest

d. placing the marker directly on the body part

PA hand

appropriate R or L marker used

PA chest

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 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 anatomic position is a reference position that aids in describing the location of body structures

in this position, the body is standing upright with feet flat on the ground, facing forward, arms at sides, palms facing forward with thumbs pointing away from the body, and legs are parallel with toes facing forward

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

the radiograph should be oriented as