Pos Exam 3 Flashcards
(204 cards)
1
Q
With the tube and intensifier in a horizontal position, at which side of the patient should the surgeon stand if he or she must remain near the patient - the x-ray tube side or the intensifier side?
A
intensifier
2
Q
what are the two primary componhents of a mobile fluoroscopy unit
A
x-ray tube and image intensifier
3
Q
why shouldn’t the mobile fluoroscopy unit be placed in the AP projection (tube on top)?
A
increased dose to operator
4
Q
Of the two monitors found on most mobile fluoroscopy units, which one is generally considered the “active” monitor (one displaying dynamic imaging) - the right or the left?
A
L
5
Q
name the feature that allows an image to be held on the monitor while also providing continuous fluoroscopy imaging.
A
roadmapping
6
Q
true/false: Wearing a protective lead apron is optional if the technologist is at least 8 feet from the x-ray source in surgery
A
false
7
Q
what is the primary advantage of the “pulse mode” on a c-arm unit
A
reduce dose
8
Q
true/false: the exposure dose is greater on the image intensifier end than on the x-ray tube end of the c-arm
A
false
9
Q
true/false: a 30 degree tilt of the c-arm II away from the operator will increase dose to the head and neck region by a factor of four
A
true
10
Q
CST is the acronym for
A
certifies surgical technologist
11
Q
true/false: scrubs worn in radiology may also be worn in surgery provided they were not worn outside the facility
A
false
12
Q
What is “boost” on a c-arm?
A
high level fluoro
13
Q
true/false: intramedullary rod insertion (to reduce tibial, humeral, and femoral shaft fx’s) requires the use of a c-arm
A
true
14
Q
who gowns the members of the surgical team?
A
scrub
15
Q
the newer type of prosthetic device for using for a total hip replacement
A
modular bipolar endoprostheses
16
Q
this procedure introduces an orthopedic cement directly into the weakened vertebrae.
A
vertebroplasty
17
Q
the CR is aligned is aligned parallel to the ___ line for the acanthiomeatal (reverse waters) projection for the facial bones.
A
MML
18
Q
a radiographer recieves 25-50 mR/hr standing this distance from the C-arm fluro unit
A
3 ft
19
Q
the primary pathologic indication for an operative cholangiogram
A
billiary calculi
20
Q
soaking moisture through a sterile or non sterile drape, cover, or protective barrier permitting bacteria to reach sterile areas.
A
strike through
21
Q
______ is a formal term describing a total hip replacement
A
arthroplasty
22
Q
th AP reverse caldwell projection for a trauma skull exam requires the CR to be 15 degrees cephalad to the ______ line.
A
OML
23
Q
this procedure uses a high-powered stereoscopic microscope to provide illumination and magnification of the impinged nerve and surrounding structures.
A
microdisnectomy
24
Q
Luque of Harrington rods are used to correct ________.
A
scoliosis
25
device commonly used during a hip pinning to reduce a fracture of the proximal femur.
cannulated screw asserbly
26
a radiographer receives 400 mR/hr when standing this distance from the c-arm fluro unit.
2 ft
27
this device is an alternative to traditional spinal fusion procedures.
enterbody fusion cage
28
this C-arm function provides image recording in rapid succession
cine loop capability
29
misalignment of a distal fracture that is angled toward the midline.
varus deformity
30
the C-arm orientation(projection) that generally results in greatest exposure to the operators head.
AP projection
31
the most effective cardinal rule of radiation protection in reducing exposure during mobile and surgical procedures.
distance
32
post reduction projections of the upper and lower limbs generally need only to include the joint___ to/from the fracture site.
nearest
33
how many feet should a technologist should stand away from the x-ray tube during an exposure when using a mobile x-ray unit.
6 ft
34
the degree of rotation required for an AP oblique projection of the sternum on a hypersthenic patient
15º
35
a 30 degree tilt of the c-arm from the vertical position will increase radiation exposure to the face and neck region of the operator standing next to the c-arm by approximately by a factor of ____.
4
36
orthopedic wire that tightens around a fracture site to reduce shortening of a limb.
cerclage wire
37
absence of infectious organisms.
asepsis
38
an internal pacemaker implantation can be performed under_____ anesthesia.
local
39
the maximum degree of incline a self-propelled battery-driven x-ray unit will go up.
7º
40
OR tables are considered sterile only at the level of the _____ ______.
table top
41
What are the three types of mobile x-ray equipment?
Battery powered, Standard powered, capacitor-discharge, and C-arm digital mobile fluoroscopy
systems
42
Performing AP CXR, what are the 3 differences to a PA CXR?
magnified heart, air-fluid levels not well defined, and frequently not full inspiration (8-9 ribs)
43
CR for AP Semiaxial Lordotic CXR?
CR 15-20º cephalic
44
main criteria for lordotic CXR?
clavicles above apices
45
how much do you obl pt for obl CXR?
45º
46
which side of thorax is elongated with 45º RAO CXR?
L side
47
which side of thorax is elongated with 45º RPO CXR?
R side
48
which side of thorax is elongated with LPO CXR?
L side
49
if pt cannot be rotated for AP obl ribs, what CR is used?
30-40º mediolateral angle (grid crosswise)
50
degree of obliquity for RAO sternum for hypersthenic pt?
15º
51
degree of obliquity for RAO sternum for hyposthenic/asthenic pt?
20º
52
CR centered where on RAO sternum?
1" to L of midline and midway btw jugular notch and xiphoid process
53
For a RAO projection of the sternum what should the SID be?
40"
54
What should the SID be for a lateral projection of the sternum?
The SID should be 60 to 72 inches to reduce magnification of sternum caused by increased OID.
55
What are the breathing instructions for the Ribs projections?
Inspiration for upper projections nad expiration for lower projections.
56
What is the position of the IR for a Unilateral AP upper ribs projections?
Top of the IR is 3" above the acromion process.
57
What is the position of the IR for a Bilateral AP lowr ribs projections?
The bottom of the IR is at the top of the iliac crest.
58
What is the position of the IR for a Unilateral Oblique upper ribs projections?
Top of the IR is 3" above the acromion process.
| top of IR about 1 1/2 inches above the shoulder
59
List the three structures that make up the bony thorax.
Sternum
Thoracic Vertebra
12 pairs of ribs
60
The most distal aspect of the sternum does not ossify until a person is approximately how old?
40
61
What is the name of the joint that connects the upper limb to the bony thorax?
SCJ
62
What is the name of the section of cartilage that connects the anterior end of the rib to the sternum?
costocartilage
63
Which are the false ribs?
8-12
64
A flail chest is defined as a what?
Pulmonary injury caused by blunt trauma to two or more ribs
65
A proliferative bony lesion of increased density is generally termed:
osteoblastic
66
A radiograph of an RAO sternum reveals that part of the sternum is superimposed over the thoracic spine. Which specific positioning error is visible on this radiograph?
under-rotation of pt
67
A patient enters the emergency room on a backboard after being involved in a motor vehicle accident. Because of the condition of the patient, the physician orders a portable study of the sternum in the ER. Which two projections of the sternum would be most diagnostic yet minimize movement of the patient?
LPO and horizontal beam lateral projections
68
A patient with trauma to the right upper anterior ribs enters the ER. He is able to sit in an erect position. Which positioning routine of the ribs should be performed?
Erect PA and LAO ( or RPO) position with suspended inspiration
69
A patient with trauma to the left lowr anterior ribs enters the ER. Which positioning routine of the ribs should be performed?
Recumbent PA and RAO positions with suspended expiration
70
what members make up surgical team?
surgeon, 1-2 assistants, surgical tech, anesthesia provider, circulating nurse, various support staff
71
What 2 classifications make up the surgical team?
sterile members, non-sterile members
72
what is the common name for certified surgical technologist?
scrub tech
73
who is responsible to keep sterile team supplied, provide direct patient care, respond to requests that arise during procedure?
nurses
74
who provides intraoperative imaging in a variety of examinations with a variety of equipment?
radiographer(s)
75
what is worn at all times in the OR?
masks
76
what is put on at the start of each shift at the OR?
protective eyewear, masks, fresh scrubs
77
what would require immediate notification to OR staff?
if field is compromised
78
when IR is retrieved by radiographer, what must he/she have?
gloved hands, incase ir cover is contaminated with blood or other fluids
79
how must cleaner be applied to surfaces in OR?
pour onto rag, NOT sprayed
80
what results in some of the highest occupational radiation exposure for radiographers?
mobile radiography and fluoroscopy in OR
81
what is the minimum source to skin distance?
12" (30 cm)
82
How must shield be placed for fluorscopy?
place shield under patient, because source of radiation is below
83
what must be done for SID for transphenoid resection of Pituitary tumor?
place image intensifier CLOSER to skull to magnify pituitary region(magnification is desired)
84
the area of the OR that immediately surrounds and is specially prepared for the patient
sterile field
85
what people make up the sterile team?
surgeon, scrub nurse, Surgical assistant, physicians assistant
86
a nonphysician allied health practitioner who is qualified by academic and clinical training to perform designated procedures in the OR and in other areas of surgical patient care
PA (physician's assistant)
87
a registered nurse (RN) who is specially trained to work with surgeons and the medical team in the OR
scrub nurse
88
responsible for maintaining the integrity, safety, and efficiency of the sterile field throughout the surgical procedure
CST
89
is preferably an RN. The _________monitors and coordinates all activities within the OR, provides supplies to the CST during the surgical procedure, and manages the care of the patient.
circulator
90
the __________ 's role in the OR is to provide intraoperative imaging in a variety of examinations and with various types of equipment
radiographer
91
where are large amounts of bacteria located?
nose/mouth
92
what should be worn at all times in restricted areas, but not necessarily in all semirestricted areas?
masks
93
what should cover hair at all times in restricted and semirestricted areas of the OR?
caps
94
who started boiling surgical instruments?
Galen
95
what should NON sterile team members never do?
should not reach over sterile field
96
what items should be avoid being set on the floor?
placing IRs, lead aprons, and shields on the floor
97
how often should less commonly used equipment be cleaned?
cleaned once a week and immediately before use
98
what is the recommened placement of fluoro tube for OR?
under pt
99
Because of the significant amount of exposure to the facial and neck region, the x-ray tube should never be placed ?
above pt, unless absolutely necessary
100
Chemical disinfection of the skin
antisepsis
101
Principles involved with manipulation of sterile and nonsterile items to prevent or minimize microbiologic contamination
aseptic technique
102
Presence of pathogenic microorganisms
contamination
103
Microorganisms normally shed from skin that can contaminate sterile surfaces or areas
microbial fallout
104
Area of peripheral support, such as hallways or corridors leading to restricted areas
semirestricted area
105
Substance or object that is completely free of living microorganisms and is incapable of producing any form of organism
sterile
106
Areas in which street clothes are permitted
unrestricted area
107
C-Arm Orientation and Exposure Patterns:
| Vertical PA
* Least exposure to operator
* X-ray tube below
* I.I. above patient
108
C-Arm Orientation and Exposure Patterns:
| 30° C-arm tilt
Increased exposure to face and neck by a factor of
| four
109
C-Arm Orientation and Exposure Patterns: Horizontal
Increased exposure at x-ray tube end
110
What does the Surgical Team do?
*. Prepares and maintains sterile
surgical field and instruments
*. Gowns members of surgical team
111
What 3 methods are used in Protecting the Sterile Environment?
* . Draping C-arm
* Draping patient
* Shower curtain
112
What is Surgical Asepsis
Separation between sterile and nonsterile areas
113
What is the radiation Protection in Surgical Suite?
Protective apron, Thyroid shield, Personnel dosimeter
114
How do you maximize radiation portection with C-arm?
```
*. Place x-ray tube under table to
reduce head and neck exposure
to operator
*Minimize use of boost exposures
*Minimize distance between
anatomy and image intensifier
* Provide lead aprons for those
remaining in area not behind lead
shields
```
115
What are the Total Hip Replacement—Arthroplasty?
```
* Austin-Moore and Thompson hip
endoprostheses (one-piece
devices)
*Modular bipolar hip
endoprostheses (three-piece
device)
```
116
angle of petrous ridges for avg head/mesocephalic
47º
117
approx angle for petrous ridges for a short broad head/brachycephalic?
+/- 54º
118
approx angle of petrous ridges for long narrow head/dolichocephalic?
+/- 40º
119
CR for SMV?
CR perp to IOML, 3/4" ant. to EAM (or 1.5" inf. to mandibular symphysis)
120
where are the mandibular condyles in an SMV XR?
mandib condyles are ant. to petrous ridges
121
what is perp to IR for PA Axial skull (Haas method)
OML
122
CR for PA Axial (Haas) skull?
(w OML perp to IR) CR 25º cephalic, exit 1.5" sup. to nasion
123
what are the 2 main differences when performing a PA Axial (Haas) v. AP Axial?
1. dorsum sellae appears larger w/in foramen magnum, 2. magnified occiptial
124
what is perp to IR for modified parietoacanthial/modified waters?
LML
125
CR for modified waters (parietoacanthial)?
CR perp to IR, exit acanthion (w LML perp to IR)
126
what degree is the OML to the IR during a modified waters?
55º
127
what is ideally seen on a modified waters?
possible orbital fx's & foreign bodies in the eye
| **facial bone & orbits
128
where are the petrous ridges on a modified waters?
lower 1/3rd of maxillary sinuses (orbital floors not distorted)
129
which XR shows the orbital floors w/o distortion?
modified waters (parietoacanthial)
130
IR is perp to what during the superoinferior tangential: axial nasal bones?
GAL
131
CR for superoinferior tangential: axial nasal bones?
CR II to GAL
132
what shows possible med.-lat. displacement of nasal bones w/o superimposition?
superoinferior tangential: axial
133
what is II to the floor for a panorex view?
IOML II to floor
134
what is perp to IR for AP Axial (modified Towne)
OML perp to IR
135
CR for AP Axial (modified Towne)
CR 35º caudad to level of TMJ (2" ant. to EAMs; or to glabella), when OML perp to IR
or, CR 42º caudal when IOML is perp to IR
136
what is seen on the AP Axial Mandible (modified Towne)?
condyloid processes & TM fossa
137
how much is the skull rotated for axiolat obl (modified law)
15º toward IR
138
CR for axiolat obl (modified law)?
(w skull rotated 15º toward IR) CR 15º caudad to 1.5" sup. to upside EAM - open and close mouth projections!!
139
which TMJ is demonstrated on Axiolat obl (modified law)
TMJ nearest IR
140
what pos. is the skull in for the axiolat TMJ (Schuller method)?
true lat
141
CR for axiolat TMJ (Schuller method)?
CR 25-30º caudad to 2" sup. & 0.5" ant. to upside EAM - open & closed mouth
142
what starts perp to IR w PA transoral (waters) sinuses?
MML
143
CR for PA transoral (waters) sinuses?
CR perp to IR (w MML perp to IR), open mouth w/o moving head (MML not perp to IR anymore), exit acanthion
144
what degree is the OML to the IR for PA transoral (waters): sinuses?
37º to IR
145
what is a good alt. for sphenoid sinuses when pt cannot do SMV?
PA transoral (waters) sinuses
146
which sinuses are demonstrated for PA transoral (waters) sinuses?
sphenoid well seen, frontal & maxillary
147
where are the petrous ridges located for the PA transoral (waters) sinuses?
below maxillary sinuses
148
CR for (T) lat skull?
CR 2" sup. to EAM
149
CR for AP 0º (T) skull?
CR II to OML to glabella
150
CR for (T) AP "reverse caldwell"?
CR 15º cephalic to OML, to nasion
151
CR for (T) AP Axial skull?
CR 30º caudal to OML to level of EAMs
152
which pos best shows the axillary portion of L ribs?
LPO
153
(T/F) national pt safety goals are to protect healthcare staff
false
154
(T/F) when performing a special tangential view of ribs, tech is interested on the upside from the IR when pt is obl?
false
155
CR for lat facial bones (T)?
CR midway btw outer canthus & EAM
156
CR for AP Reverse Waters (acanthioparietal) (T)
CR II to MML, enters acanthion
157
where are the petrous ridges for an AP reverse waters (T)?
petrous ridges just below maxillary sinuses
158
CR for modified AP waters (acanthioparietal) (T)?
CR II to LML, enters acanthion
159
where are the petrous ridges on a modified AP waters (T)?
in mid-aspect of maxillary sinuses (lower 1/3rd)
160
what is best demonstrated for modified AP waters (acanthioparietal)
best shows orbital floors/rims
161
CR for AP Axial mandible (T)
CR 35-40º caudal to OML, 2" ant. to EAM
162
CR for AP Mandible (T)?
CR II to OML, to lips
163
skull rotations for axiolat obl mandible (T)?
30º to IR - body
0º (true lat) - rami
45º to IR - mentum
10-15º to IR - general survey
164
CR for axiolat obl mandible (T)
CR 25º cephalad, exit mandibular region of interest
165
(T/F) an erect CXR is performed w rib XRs to eval. pneumothorax, hemothorax, and/or pulmonary contusion
true
166
technique for RAO sternum?
orthostatic w long exposure T
167
lat sternum shows ribs superimposed over sternum,....what should tech do?
ensure pt not rotated
168
kV range for AP lower ribs?
75-80 kV
169
magnification mode for C-arm should frequently?
be seen at specified distance to monitor
170
pulse mode in C-arm?
timed incriments to reduce exposure
171
snapshot/digital spot mode results in what?
higher qual. computer-enhanced img (v. held flour img)
172
subtraction (C-arm)?
initial img recorded during contin. fluoro & filters next img's so stationary objects are removed/subtracted and only new/different/moving structures are imaged
173
roadmapping (C-arm)?
specific flour img held on screen in combo w contin. fluoro
174
how much does vertical AP CR in C-arm increase the dose to operators eyes?
up to 100 times
175
0.5mm ob equivalent aprons reduce exposure by a factor of?
50+
176
walking speed of battery driven port XR machine?
2.5-3 mph
177
how many batteries in battery operated port XR?
10-16 rechargeable 12-V batteries
178
standard power source, capacitor-discharge port XR is usually not what?
motor-driven
179
operative (immediate) cholangiography
to show biliary duct , drainage to duodenum, & residual stones; gall stones
180
laparoscopic cholecystectomy
less invasive removal of gallbladder thru sm. opening in umbilicus
181
3 advantages of laparoscopic cholecystectomy
out-patient, minimally invasive, less hospital stay/cost (return to work in 2-3 days)
182
XRs for biliary tract surgeries?
AP, slight RPO & LPO
183
which XR helps project biliary ducts away from spine (especially. w hyposthenic pt)
RPO
184
retrograde urography
non-functional contrast study of pelvicalyceal system
185
3 XRs of retrograde urography
scout, pyelogram, & ureterogram
186
ilizarov external fixator
to correct length defect
187
intramedullary fixation
rods/nails w/in bone shaft of long bones to stabilize fx's
188
3 advantages of intramedullary fixation?
minimal amount of exposed tissue, less healing time, less risk of infection
189
3 common hip fx's
femoral neck fx, intertrochanteric fx, subtrochanteric fx
190
hip fx's require?
ORIF
191
lat hip has the XR tube of C-arm positioned where?
superiorly
| (I.I. inf.)
192
arthroplasty
THR (Austin-moore & Thompson; modular bipolar)
193
intramedullary IF antegrade procedure
nail/rod inserted from prox. end
194
intramedulary IF retrograde procedure
nail/rod inserted from dist. end of long bone
195
laminectomy
alleviate pn from neural impingement
196
spinal stenosis
(usually elderly) condition where degenerative changes --> enlargement of facet joints --> pressure on nerves
197
what is usually done for spinal stenosis?
lumbar laminectomy
198
diff. btw cervical and lumbar laminectomies?
cervical - ant. approach w pt supine
| lumbar - post. approach w pt prone
199
alternate to lumbar laminectomy?
microdiskectomy
200
what is done for scoliosis?
post. spinal fusion w insertion of IF's (Harrington & Luque rods)
201
vertebroplasty
stability and pn relief to pt's w vertebral compression fx's
202
kyphoplasty
modification to vertebroplasty where balloon is inserted first into collapsed vertebra and inflated before introducing oath (acrylic) cement into the vertebrae
203
how many americans have pacemakers?
500,000+
204
where are the electrodes places in pacemaker insertion?
thru vein in arm/chest to the R ventricle
