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RAD Boards Flashcards

1
Q

projection

A

It is where the CR enters and exists the patient towards the IR

ex: AP is anterior posterior the CR enters the pt anteriorly and exists posteriorly before it interacts with the IR

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2
Q

Position

A

How the pt body is placed or the placement of the body part in relation to the IR

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3
Q

Axial

A

angulation of the x-ray tube

ex: cephalic (head) or caudal (feet)

if you see the feet angle to the feet

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4
Q

Pt is laying on their back

A

supine

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5
Q

what is the term for laying down?

A

recumbent

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6
Q

Pt is laying on their stomach

A

prone

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7
Q

What is the Sims position?

A

Pt is in left lateral, right leg is moved in front of patient

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8
Q

Trendelenburg

A

Head is lower then the head

“Toes are higher”

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9
Q

Fowlers

A

Feet are lower than the head

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10
Q

In a decubitus position the patient is supine what is this referred to?

A

dorsal

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11
Q

In a decubitus position the patient is prone what is this referred to?

A

ventral

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12
Q

Pt is in a left lateral decubitus what marker do you put?

A

Right- always mark the side up

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13
Q

Pt is in a left dorsal decubitus what marker do you put?

A

Left-mark the side closest to the IR

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14
Q

Plane that divides the body into left and right halves (equal)

A

Mid sagittal

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15
Q

coronal plane

A

divides the body into anterior and posterior parts

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16
Q

What does the prefix “mid” refer to when speaking about body planes

A

means split into equal halves

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17
Q

plane that divides the body into superior and inferior parts

A

transverse or horizontal

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18
Q

movement away from the center of the body

A

abduction

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19
Q

movement toward the midline

A

adduction

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20
Q

Pt is asked to rotate their arm towards the midline of the body what kind of movement is this?

A

medial rotation

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21
Q

RT positions pt’s arm so that it is moving away from midline

A

abduction

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22
Q

In a PA chest why do you have the PT roll their shoulders forward

A

puts the scapulas in a more lateral position which allows better visualization of the lungs

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23
Q

how many ribs must be seen on a PA chest

A

10 posterior ribs

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24
Q

why is the lateral chest performed on the left

A

heart dips down to the left and it reduces magnification

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25
Q

where is the CR entrance point for a lateral chest

A

midcoronal plane at the level of T7

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26
Q

what is the purpose of the lordotic view

A

shows apices of the lungs

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27
Q

is there a tube angle for lordotic?

A

No

PT takes a few steps forward while having their back against the board

72 inches

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28
Q

what makes a good lordotic image

A

clavicles are projected above the apices

clavicles appear to be straight

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29
Q

CR of a lordotic chest

A

3-4 inches below the jugular notch

PT is leaning backward 15-20 degrees

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30
Q

how many posterior ribs are needed to be seen on an AP portable chest

A

8-9 posterior ribs

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31
Q

for a sthenic pt the top of the IR for a portable AP chest should be placed

A

1.5 inches (4cm) superior to the soft tissue of the shoulder

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32
Q

how do you know if there is rotation in an AP portable chest

A

asymmetrical ribs and clavicles

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33
Q

what is the SID for lateral view of a soft tissue neck?

A

72 SID

ensure that the top of the light field is above the EAM

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34
Q

what is a diagnostic lateral soft tissue neck?

A

air filled trachea from the pharynx to the midthoracic region

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35
Q

what is the CR for AP soft tissue neck?

A

1 inch superior to jugular notch

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36
Q

what is the carina associated with?

A

bifurcation of the trachea

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37
Q

how should the Vascular markings of the lungs appear on a PA chest

A

should appear thin in the superior portion of the lungs

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38
Q

what health condition demonstrates absence of the diaphragm contour and blunting of the CP angles

A

pleural effusion

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39
Q

which abnormalities are found in a pt with CHF?

A

enlarged cardiac size
pulmonary edema

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40
Q

types of radiation measurements

A

radiation in the primary beam

leakage radiation

amount of radiation absorbed by the pt

amount of radiation absorbed by the healthcare provider

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41
Q

what is leakage radiation measure?

A

the amount of secondary radiation escaping the x-ray tube

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42
Q

what are the common radiation measurements?

A

exposure
air KERMA
absorbed dose
equivalent dose
effective dose

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43
Q

what are the two categories of radiation measurement?

A

air and tissue

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44
Q

what does the radiation in air measure?

A

measures the radiation intensity

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45
Q

what are the units used to measure radiation intensity (air)

A

exposure
air KERMA

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46
Q

what does the radiation in tissue measure?

A

measures dose

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47
Q

what are the measurements used to determine the effects of radiation on tissue?

A

absorbed
equivalent
effective

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48
Q

how is the intensity of the X-ray beam measured?

A

exposure
air KERMA

tells us how radiation is coming out of the x-ray tube

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49
Q

how is the leakage radiation from the tube measured?

A

exposure
air KERMA

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50
Q

how is the INITIAL dose the healthcare provider and pt receive called?

A

absorbed dose

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51
Q

what does absorbed dose tell us?

A

absorbed energy

short term effects-skin erythema or hair loss

does NOT do a good job of detecting long-term effects such as cancer

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52
Q

effective dose

A

solely used to detect long-term effects such as cancer

not used to calculate short-term effects and absorbed energy

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53
Q

if mA is increased what happens to intensity, exposure KERMA, and absorbed equivalent, effective doses?

A

it increases everything because each calculation is influenced by the same variables

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54
Q

radiation in the air is measured by

A

exposure

Air KERMA

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55
Q

absorbed dose measures

A

radiation in tissue

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56
Q

equivalent dose measures

A

effects of radiation on tissue

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57
Q

what does ESE stand for

A

entrance skin exposure

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58
Q

ESE measures

A

the intensity or quantity of radiation in air at the level of the patient’s skin

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59
Q

what does DAP stand for

A

dose area product

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60
Q

DAP is used to measure

A

the total amount of radiation delivered to the patient from diagnostic imaging equipment

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61
Q

if kvp is increased what happens to intensity, exposure KERMA, and absorbed equivalent, effective doses?

A

it increases everything because each calculation is influenced by the same variables

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62
Q

if distance is increased what happens to intensity, exposure KERMA, and absorbed equivalent, effective doses?

A

results in the decrease of all the values due to the inverse square law

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63
Q

how does a decrease in kvp affect the absorbed dose to the pt?

A

decrease in kvp affects the absorbed dose

it also decreases the average energy of the x-ray beam and the total number of photons created

fewer photons means less dose is absorbed by the pt

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64
Q

what are the three types of methods used to quantify radiation in tissue

A

effective dose

absorbed dose

equivalent dose

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65
Q

radiation that escapes the protective housing of the tube is known as what?

A

leakage

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66
Q

what is another form of secondary radiation?

A

scatter

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67
Q

how is scatter produced?

A

Compton scattering

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68
Q

what is attenuation

A

is a loss of intensity of the X-ray beam as it passes through matter

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69
Q

what is considered primary radiation

radiation that:

  1. produced within the pt
    2.scatter from interactions within the pt
  2. that escapes the protective housing
  3. exits the window in the tube housing
A

radiation that exits the window in the tube housing

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70
Q

what does an X-ray beam interact with as it interacts with matter?

A

interact with air molecules and knock out an electron out of its orbit

ionization

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71
Q

what does exposure measure?

A

the number of ionizations in air

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72
Q

how is the X-ray beam’s intensity measured?

A

through exposure

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73
Q

increase in the x-ray beam leads to the increase of what?

A

ionizations and exposures

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73
Q

the number of ionizations is directly proportional to what?

A

number of photons in the x-ray beam

this is the reason why if ionization is increased then exposure (the number of ionization in the air) will increase too

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74
Q

what are the units of exposure?

A

coulombs/kilogram

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75
Q

what does Coulombs measure?

A

measures charged particles

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76
Q

1 coulomb is equal to what?

A

6.242x10^18 ionizations

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77
Q

if mA is increased what happens to photons, ionization, exposure

A

all increased because the same variables influence all the calculations

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78
Q

if distance is increased what happens to photons, ionization, exposure

A

all decrease because the same variables influence all the calculations and due to the inverse square law

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79
Q

what does air KERMA measure

A

measures the energy of ionizations in the air

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80
Q

what does KERMA stand for

A

kinetic

energy

released per unit

mAss

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81
Q

if the intensity of the beam is increased what happens to ionization energy and air kerma

A

it increases

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82
Q

what are the units for kerma?

A

gray

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83
Q

what does 1 gray equate to

A

1 joule/kilogram

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84
Q

you can use exposure and air kerma to measure

A

test radiation coming from the tube

measure leakage radiation

measure scatter radiation

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85
Q

how is exposure different from air kerma?

A

measures only the # of ions in the air

units are coulombs/kilogram

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86
Q

how is air kerma different from exposure?

A

measures the energy of ions

units are gray

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87
Q

when measuring the intensity of the primary beam what dosimeter position will demonstrate the highest air kerma

A

the measurement that is closest to the tube

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88
Q

primary bi-product of x-ray interactions in air is

A

free electrons

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89
Q

the process that x-rays created charged particles such as free electrons

A

ionization

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90
Q

which of the following best describes radiation exposure

quantity of radiation:

  1. directed at the pt
  2. absorbed in the pt
  3. Passing through the pt
  4. energy absorbed in the air
A

quantity of radiation directed at the patient

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91
Q

some of the radiation is absorbed by the tissues of the body where does some of this energy go?

A

it is absorbed in the photoelectric effect and Compton scattering

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92
Q

what is the total amount of energy absorbed in the body as a result of Compton scattering and photoelectric effect is known as?

A

absorbed dose

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93
Q

what is the definition of absorbed dose?

A

energy absorbed in the body per unit mass

remember to think of its units

joule=energy
kilogram=mass

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94
Q

The SI unit of measurement for absorbed dose

A

gray

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95
Q

radiation effects on tissue

A

equivalent dose

effective dose

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96
Q

absorbed dose formula

A

joules/kilograms

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97
Q

what effects does the equivalent dose take into account?

A

the effects of different radiation types have on anatomy

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98
Q

the type of radiation with the highest equivalent dose

A

alpha radiation = 2EqD

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99
Q

what is the effective dose used for?

A

used to assess the degree of radiation including biological damage per different tissue types

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100
Q

what tissue has the lowest tissue weighting factor?

A

brain (0.01)

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101
Q

what is the weighting factor for X-ray?

A

1

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102
Q

why is the absorbed dose used?

A

it is used to predict short-term or early radiation injuries

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103
Q

examples of short-term radiation injuries

A

sperm depression

skin erythema

epilation

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104
Q

what kind of tissues absorb more radiation

A

tissues that have

a high atomic number

high density

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105
Q

when looking at a radiograph what do the dark areas represent?

A

low absorbtion of the x-ray

means it has low z# and low density

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106
Q

what are examples of tissues that absorb a minimal amount of radiation?

A

tissues that have air

fat

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107
Q

what is an example of a tissue that absorbs a moderate amount of radiation (appears gray on a radiograph)

A

muscle

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108
Q

what is the absorbed dose affected by?

A

mA

kVp

distance

density and z#

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109
Q

what is the definition of linear energy transfer?

A

the rate at which radiation energy is deposited in matter

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110
Q

what causes more biological harm?

A

higher LET

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111
Q

true or false X-rays have a high LET

A

false

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112
Q

true or false alpha particles have a high LET

A

true

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113
Q

what is the formula for an equivalent dose?

A

EqD=D(absorbed dose) xWr (radiation weighting factor)

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114
Q

what happens to relative biological effectiveness, radiation weighting factor, and equivalent dose if LET is increased?

A

everything is increased

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115
Q

what is the purpose of the equivalent dose?

A

used to compare the biological damage from different radiation types

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116
Q

factors that affect equivalent dose?

A

radiation type

absorbed dose

mAs

kVp

exposure time

distance

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117
Q

units for equivalent doses?

A

sierverts

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118
Q

the formula for effective dose

A

EfD= D (absorbed dose) x Wr (radiation weighting factor) x Wt (tissue weighting factor)

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119
Q

the most sensitive tissue to radiation is

A

bone marrow

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120
Q

the least sensitive tissue to radiation is

A

brain

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121
Q

why are the values of effective dose and equivalent dose different despite having the same value of absorbed dose?

A

tissues have different sensitivities to radiation therefore they have different tissue weighting factor

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122
Q

what is another term for effective dose?

A

whole body dose

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123
Q

why would we use an effective dose?

A

to compare the risk of cancer based on different radiation types and tissue types

identify long-term effects of radiation exposure

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124
Q

factors that affect effective dose?

A

absorbed dose

radiation type (Wr)

tissue type (Wt)

mAs

kVp

distance

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125
Q

what do you do if a question asks you to calculate the effective dose when there are two different types of tissues?

A

you add the values up and then multiply by the absorbed dose and radiation weighting factor

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126
Q

what factors are needed to calculate an effective dose?

A

absorbed dose

exposed tissue types

radiation type

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127
Q

true or false the skin is sensitive to radiation

A

false

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128
Q

the risk of radiation-induced stochastic effects is reduced by adherence to which of the following dose limits?

A

effective dose limits to the whole body

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129
Q

why are vital signs important in medical imaging?

A

helps evaluate the critical functions of the body

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130
Q

what is the normal temperature for an adult?

A

98.6 (oral)

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131
Q

how many degrees difference is the tympanic temperature?

A

+1

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132
Q

how many degrees of difference is the axillary temperature?

A

-1

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133
Q

how many degrees difference is the rectal temperature?

A

+1

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134
Q

what is the pulse rate?

A

the number of pulses per minute

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135
Q

what is pulse amplitude?

A

signifies the strength of the pulse

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136
Q

what is the average pulse rate?

A

60-100bpm

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137
Q

what is the definition of blood pressure?

A

The lateral force exerted on the arterial walls.

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138
Q

what is the average blood pressure of a healthy adult?

A

systolic (contraction)=100 to 120

diastolic(relaxing)= 60-80

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139
Q

what is the definition of respiratory rate?

A

is the number of breath cycles (inspiration and expiration) per minute

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140
Q

what is the average respiratory rate?

A

12-20 breaths per minute

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141
Q

what tool is used to measure oxygen saturation in the blood?

A

pulse oximeter

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142
Q

what is the normal percentage of oxygen saturation?

A

90-100%

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142
Q

which blood pressure reading is associated with the left ventricle?

A

systolic

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142
Q

what should a technologist do if you identify an abnormal viral sign in a pt?

A

stop the procedure

help stabilize the pt

call for help

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142
Q

the diastolic bp is a measurement of the pressure exerted on the arterial walls during

A

relaxation of the left ventricle

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143
Q

In a trauma situation which two arteries are best for assessing a pt pulse due to their larger size?

A

carotid

femoral

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144
Q

what is an EKG?

A

it is an electrical image of the heart

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145
Q

what is the P-wave in an EKG?

A

represents the electrical activity through the atria

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146
Q

what is the QRS complex?

A

movements of electrical pulses through the ventricles

aka ventricular systole

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147
Q

what is the ST segment?

A

shows the ventricles contracting but no electrical activity is flowing through it

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148
Q

what is the T-wave?

A

shows when the ventricles are resetting electrically and preparing for their next muscle contraction aka ventricular diastole

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149
Q

when is ekg used in medical imaging?

A

EKG gating

it allows images of the heart without motion blur and images are collected in between beats

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150
Q

the first phase of contraction of the heart involves the contraction of the

A

right and left atria

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151
Q

from the ventricles, blood is pushed

A

into the pulmonary artery and aorta

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152
Q

how many leads are connected to the pt during an EKG

A

3

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153
Q

what are the two types of lab testing that are used in diagnostic imaging?

A

kidney function

blood clotting

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154
Q

what is BUN?

A

blood, urea, nitrogen

normal: 7-21

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155
Q

What kind of health condition is associated with a BUN above 21

A

means the kidneys are struggling to function properly

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156
Q

What kind of health condition is associated with a BUN above 50

A

suspected renal failure

do not give intravenous contrast

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157
Q

what is creatinine?

A

chemical byproduct of metabolism (muscles)

normal: 0.7-1.5

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158
Q

creatine value of 1.5 indicates

A

pt kidney cant filter iodinated contrast

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159
Q

what factors affect the value of creatinine?

A

age

gender

muscle mass

hydration status

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160
Q

why is identifying creatinine levels important in diagnostic imaging?

A

can be a contraindication for injecting IV contrast

ONLY when the level is HIGH

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161
Q

what is GFR

A

glomerular filtration rate

estimates the filtration of the kidneys

normal: 90-120

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162
Q

what does a GFR level below 90 indicate?

A

pt kidney is not properly functioning to filter out the contrast

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163
Q

what factors affect GFR?

A

age

gender

muscle mass

hydration status

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164
Q

what is a pt test?

A

prothrombin time measures the liquid portion of blood to clot

normal: 11-13.5s

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165
Q

what contraindication is associated with a patient whose pt is above 13.5s

A

patient’s blood is not clotting properly

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166
Q

what is a ptt test?

A

partial thromboplastin time

normal: 25-35s

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167
Q

what is an INR test?

A

international normalized ratio

identifies blood coagulation

normal: 0.8-1.2s

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168
Q

what is the platelets test?

A

identifies blood coagulation

normal: 150k-400k

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169
Q

what does a high platelet count indicate?

A

clotting disorders

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170
Q

what does a low platelet count indicate?

A

bleeding disorders

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171
Q

what are the contraindications for interventional or invasive procedures?

A

PT

PTT

INR

platelets

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172
Q

what are the contraindications for intravenous contrast?

A

BUN

Creatinine

GFR

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173
Q

what information would a GFR test provide?

A

rate at which the kidneys filter waste from the blood

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174
Q

true or false water-soluble iodine is the only contrast that is considered safe for IV injection

A

true

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175
Q

what is an ionic contrast?

A

when placed in a solution it breaks up into ions (charged)

NOT desirable

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176
Q

why is ionic contrast not desirable?

A

due to charged particles, it is highly toxic

high osmolarity

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177
Q

what does the term osmolarity refer to?

A

concentration of particles in a solution

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178
Q

what factors should be taken into account before a pt is given contrast?

A

diet

renal function

allergy premedication

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179
Q

what are the diet factors pts need to take into account before contrast injection?

A

pre-hydrated for 1 day

NPO for 1 hour

post hydration 1 day- reduces the toxicity of contrast

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180
Q

what lab tests need to be done before IV contrast injection?

A

BUN

creatinine

GFR

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181
Q

what are some medications that are used for pt who have an allergy to iodine?

A

corticosteroid (prednisone)

anti histamines (benadryl)

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182
Q

what is the most common complication of IV contrast injection?

A

extravasation- leakage of contrast outside the vessel

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183
Q

what can the pt experience when there is extravasation?

A

swelling

burning

tightness

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184
Q

what do you do if there is extravasation present?

A

inform radiologist

elevate the extremity

hot and cold compress

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185
Q

what are some common allergic reactions to contrast (mild)

A

scattered hives
pruritus
rhinorrhea
coughing

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186
Q

what do you do if a pt is experiencing a mild reaction?

A

monitor 20-30 mins
monitor vital signs
antihistamines

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187
Q

what are examples of a moderate reaction?

A

diffuse hives
persistent vomiting
laryngeal edema
tachycardia

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188
Q

what do you do if a pt is experiencing a moderate reaction?

A

monitor pt
vital signs
IV access
antihistamines

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189
Q

what are examples of a severe reaction?

A

altered mental status
pulmonary edema
laryngeal edema
tachycardia

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190
Q

what do you do if a pt is experiencing a severe reaction?

A

code blue
epinephrine

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191
Q

what is nephrotoxicity?

A

decrease in renal function following contrast administration

risk is increased if there are past renal issues

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192
Q

what drug is administered to a pt who is experiencing an allergic reaction to iodinated contrast?

A

diphenhydramine

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193
Q

why is barium a common contrast agent?

A

high atomic number (56)
allows for a higher attenuation

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194
Q

is barium sulfate water soluble?

A

No

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195
Q

what is it called when barium is introduced into the GI tract?

A

enteral

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196
Q

what is it called when barium is introduced outside the GI tract?

A

parenteral

intrathecal
intra-articular
intravenous

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197
Q

is barium sulfate water safe for parenteral injections?

A

no

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198
Q

what do you do if there is a perforated bowel in the GI tract?

A

do not use barium

only use water-soluble iodinated contrast

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199
Q

what is the CR for RAO sternum?

A

center at T7 and 1 inch from the midsagittal plane

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200
Q

what is the recommended SID for an RAO view of the sternum?

A

30 inches

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201
Q

how much rotation is needed for an RAO view of the sternum?

A

15-20 degrees

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202
Q

in a ribs series for a PA view where do you pout the affected side?

A

place anterior injuries or affected side close to the IR

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203
Q

What is the SID for a rib series?

A

40 inches

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204
Q

what is the CR for AP lower ribs?

A

on the midsagittal plane midway between the xiphoid process and the lower rib margin

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205
Q

what ribs need to be included in the lower rib view?

A

ribs 8-12

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206
Q

what ribs need to be included in the upper rib view?

A

ribs 1-10

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207
Q

what is the SID for oblique upper ribs?

A

72 inches

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208
Q

what is the CR for oblique upper ribs?

A

midway between the jugular notch and xiphoid process then move towards the lateral side in question

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209
Q

what is the purpose of doing oblique ribs?

A

shows the posterior portion

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210
Q

what is the appropriate placement of the top of the IR for an AP above ribs?

A

1.5-2 inches above the shoulder

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211
Q

which two views of the following would best demonstrate a pt who is experiencing left anterior rib pain?

A

PA of the affected side

RAO

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212
Q

what needs to be demonstrated on a diagnostic AP KUB

A

lower diaphragm

pubic symphysis

soft tissue anatomy within the abdominal cavity

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213
Q

For AP upright KUB how is the midsaggittal plane positioned?

A

perpendicular to the IR

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214
Q

what is a diagnostic dorsal decubitus KUB?

A

free of motion

superimposed ilia

lumbar vertebrae pedicles and open intervertebral foramina

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215
Q

what is the CR for dorsal decubitus KUB?

A

2 inches above the crest

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216
Q

when performing a decubitus KUB why do you need to place the pt on a radiolucent pad? (PT is a on a stretcher)

A

elevates the pt off the stretcher or x-ray table. Ensures that the side down is included in the radiograph

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217
Q

why are KUBs ordered?

A

tube and line placement

abdominal pain

kidney stones

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218
Q

what is the most distal portion of the small bowel?

A

ileum

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219
Q

which quadrant is the gallbladder found in?

A

RUQ

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220
Q

which organ is positioned transversely across the upper abdomen?

A

pancreas

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221
Q

what is a series circuit?

A

a circuit where all the lines are connected end to end in a line

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222
Q

What is the difference between a series and a parallel circuit?

A

series circuit has one line and the current flows in one direction and is constant but the voltage drops at each resistor.

parallel circuit has multiple sections that break off from the main circuit. The current is not constant but the voltage is

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223
Q

pro of series circuits?

A

uses simpler wiring

easier detection of faults in a circuit

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224
Q

cons of series circuits?

A

if one component stops working then the entire circuit stops working

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225
Q

total current forumla

A
  1. the total current in a series current is the same as any current through any resistor
    I(t)=I(1)=I(2)=I(3)

this is because the current flows in one direction

  1. total resistance is equal to the sum of all individual resistances
    Rt=R1+R2+R3
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226
Q

voltage drop

A

voltage changes at each resistor

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227
Q

total voltage

A

Vt=V1+V2+V3

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228
Q

what is Ohm’s law?

A

V(voltage)=I(current) x R(resistance)

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229
Q

the resistance of electric flow through a circuit is measured in

A

ohm

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230
Q

a series circuit is a circuit in which components are connected.

A

to the power source end to end in a line

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231
Q

in a series circuit, all resistors share what?

A

the total voltage of the circuit

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232
Q

in a series circuit question when it asks what is the total voltage how do you solve the problem?

A

multiply the Amps to each of the resistances and then add their values together

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233
Q

in a series circuit question when it asks what is the total resistance how do you solve the problem?

A

you just add up all the resistance

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234
Q

what is a parallel circuit?

A

network of electrical components each connected to the power source by a different path

maintains the consistent voltage across the circuit

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235
Q

if a component fails in a parallel circuit what happens?

A

the circuit continues to operate but because each component is connected to the power separately

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236
Q

formula for calculating total resistance in a parallel circuit

A

1/rotal resistance(Rt)=1/R1 + 1/R2 + 1/R3

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237
Q

in a parallel circuit does voltage fluctuate across the circuit?

A

no

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238
Q

which of the following measurements remains constant in a parallel circuit?

A

volts

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239
Q

what is the purpose of Ohm’s law?

A

describes the relationship between voltage, resistance, and current within an electrical current

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240
Q

what does Ohm’s law state?

A

current is directly proportional to voltage and inversely proportional to resistance

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241
Q

what is voltage

A

the force that pushes electrons through a circuit

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242
Q

what is resistance

A

the force that slows down electrons in a circuit

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243
Q

what is current?

A

the rate at which electrons flow through the circuit

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244
Q

what is the voltage formula?

A

V= I x R

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245
Q

what is the resistance formula?

A

R= V/I

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246
Q

what is the current formula?

A

I= V/R

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247
Q

what is the relationship between current and voltage according to Ohm’s law?

A

as current increases, voltage increases

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248
Q

what is the relationship between current and resistance according to Ohm’s law?

A

as current increases, resistance increases

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249
Q

in a series circuit, all resistors share which of the following

A

the total voltage of the circuit

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250
Q

what remains constant in a series circuit

A

current

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251
Q

The name of the first X-ray tube?

A

Crookes tube

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252
Q

The modern X-ray tube is based on this type of tube.

A

Coolidge tube

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253
Q

leakage radiation must fall below this number

A

100m Roentgens /h at one meter (3.2 feet) from the tube

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254
Q

The charge of the cathode

A

negative

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255
Q

the charge of the anode

A

positive

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256
Q

the glass envelope of the X-ray tube is composed of

A

Pyrex glass

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257
Q

the filaments are located within

A

the focusing cup

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258
Q

the lowest kv setting possible for producing characteristic radiation

A

69 kvp

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259
Q

what is the purpose of the cathode?

A

creates free electrons through thermionic emission

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260
Q

what is the purpose of the anode?

A

absorbs electrons and creates X-rays

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261
Q

what is the purpose of the glass envelope?

A

creates an air-free vacuum around the cathode and anode

prevents the tube from blowing up or corroding

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262
Q

what is the glass envelope made out of?

A

borosilicate glass (pyrex), metal, or ceramic

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263
Q

what is the purpose of the tube housing?

A

prevents X-rays from being emitted throughout the exam room

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264
Q

how much leakage radiation does the tube housing need to keep?

A

maximum (0.88 mGy/hr)

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265
Q

what is the effective limit of mA that can be used?

A

1000

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266
Q

what is it called when a cathode tube has 2 filaments?

A

dual focus

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267
Q

what is the purpose of the small filament (cathode)?

A

creates a tight and very narrow X-ray beam which allows for high spatial resolution

small mA

used on small anatomy

small exposures

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268
Q

A narrow electron beam increases what?

A

spatial resolution

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269
Q

what are the benefits of stationary anode?

A

simple design

used for low exposures

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270
Q

what are the cons of stationary anode?

A

low heat capacity

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271
Q

benefits of a rotating anode?

A

high heat capacity

high exposures

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272
Q

what is responsible for rotating the anode?

A

induction motor

induces the anode to spin

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273
Q

what is the induction motor composed of?

A

2 stators- electromagnets that help turn the rotor

rotor- rotating tube shafe attached to the anode disc

bearings- low friction spheres that allow for free rotation of the rotor

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274
Q

the term space charge within the X-ray tube refers to

A

free electrons

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275
Q

what are the two interactions that occur on the anode and are responsible for the creation of X-ray photons?

A

bremsstrahlung radiation and characteristic radiation

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276
Q

what is the principal advantage of using the large filament within a dual-focus X-ray tube?

A

increased heat capacity

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277
Q

The typical angulation of the anode is between

A

6 to 20 degrees

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278
Q

what is the purpose of the anode angle?

A

increases the surface area of the focal spot which increases the ability of the anode to absorb heat

decreases focal spot size which increases spatial resolution

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279
Q

what are the cons of the anode angle?

A

causes a variant of the beam intensity

higher intensity on the cathode side rather than the anode

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280
Q

what is the anode heel effect?

A

decreased x-ray beam intensity on the anode side of the beam

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281
Q

as the anode angle decreases heat dissipation

A

decreases

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282
Q

as the anode angle decreases the heel effect

A

increases

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283
Q

as the anode angle increases spatial resolution

A

decreases

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284
Q

as the anode angle increases the surface area

A

increases

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285
Q

beam intensity is greatest closer to

A

cathode

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286
Q

It is recommended to place the abdomen under the ________ side of the x-ray tube

A

cathode

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287
Q

As SID increases, the heel effect

A

decreases

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288
Q

As field size increases, the anode heel effect

A

increases

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289
Q

how can the anode heel effect be used as an advantage?

A

In a KUB for example place the thinnest portion of the patient under the anode side of the beam this allows for a more even exposure of the IR

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290
Q

the anode heel effect is defined as a variation in which of the following?

A

beam quality across the X-ray field

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291
Q

the use of an X-ray tube with a large anode angle results in

A

increased

focal spot size

heat capacity

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292
Q

the use of an X-ray tube with a large anode angle results in

A

decreased:

focal spot size

heat capacity

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293
Q

True or false the cathode side always have a higher intensity than the CR?

A

true

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294
Q

what is a potential negative consequence of an increased anode angle?

A

increased effective focal spot

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295
Q

what happens if the anode angle decreases?

A

effective focal spot decreases and the heel effect increases

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296
Q

what is the line focus principle?

A

relationship between the actual focal spot on the anode and the effective focal spot that extends from the anode

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297
Q

what does the line focus principle affect?

A

heat capacity, spatial resolution, and beam coverage

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298
Q

what is the actual focal spot?

A

located on the anode

the physical area where electrons are converted into X-rays

299
Q

what is the effective focal spot?

A

the width of the X-ray beam as it is projected at the patient

300
Q

what does an effective focal spot influence?

A

affects the creation of penumbra and spatial resolution

301
Q

what does a small effective focal spot allow for?

A

decrease penumbra

increase spatial resolution

302
Q

what are the pros of having a smaller anode angle?

A

very narrow effective focal spot

well aligned beam

high spatial resolution

303
Q

what are the pros of having a smaller anode angle?

A

reduces the size of the actual which means more concentrated heat

smaller exposure factors

smaller field size (beam coverage)

304
Q

when would you use a small anode angle?

A

extremity imaging

dental

mammography

305
Q

when would you use a large anode angle?

A

large exposure techniques and large field size

ex: spine, KUB, pelvis

306
Q

does off-focus radiation increase patient dose?

A

yes because it exposes the pt outside the collimated area

307
Q

does off-focus radiation reduce spatial resolution?

A

maybe processed as part of the image resulting in decreased spatial resolution

caused by failure of histogram analysis

308
Q

how would you fix off-focus radiation?

A

use post-shuttering to eliminate any miss exposed areas

309
Q

how does off-focus radiation occur?

A

occurs when electrons collide with tube components outside of the focal spot

310
Q

which component of the X-ray tube contains the focal spot?

A

anode target

311
Q

during the histogram process, the computer may identify off-focus radiation as

A

values of interests

312
Q

what areas should be shuttered? (off-focus radiation)

A

bright white

collimator shadows

313
Q

what does tube loading refer to?

A

refers to the heat created within the X-ray tube

314
Q

what is the equation for heat units?

A

kvp x mAs x w

w=wave form factor

315
Q

what is the purpose of a tube rating?

A

refers to max exposure allows exposure factors can be safely used without overheating the tube (kvp, mAs)

316
Q

what are the tube loading factors?

A

exposure time

anode angle

filament size

anode rotation speed

317
Q

if the exposure time was increased and the mA was decreased what happens to the heat capacity?

A

it increased due to the longer exposure time which gives it more time to dissipate heat

318
Q

what is the waveform factor for a 3-phase six pulse x generator?

A

1.35

319
Q

you can reduce the chance of excessive heat production and X-ray tube damage by modifying the

A

filament size

320
Q

what is the purpose of the anode cooling chart?

A

time before taking another exposure (mAs)

321
Q

when using a large anode angle this results in

A

increased focal spot (larger)

increased heat capacity

322
Q

what is contrast?

A

visible difference in brightness between two adjacent areas in the image

323
Q

an image with a large number of BLACK and WHITE shades

A

high contrast

short grayscale

324
Q

an image with many shades of grey

A

low contrast

long grayscale-more white or grey

325
Q

short scale

A

high contrast

less shades of gray

326
Q

the material used for strips in grids

A

lead (most common)

tungsten

platinum

327
Q

what affects image contrast?

A

kVp and grids (procedural factors)

patient factors (size and pathology)

computer processing

post-processing

monitordisplay caibraation

328
Q

what is a part of the computer processing step?

A

histogram analysis

lookup tables

both affect contrast if values are wrong

329
Q

which of these terms describes a radiographic image with widely varying brightness

A

short scale

high contrast

330
Q

which factor is the most important factor controlling image contrast in radiography

A

computer processing

331
Q

what is the grayscale?

A

total brightness levels visible in the image

332
Q

high contrast is defined by

A

short grayscale and a few shades of grey

333
Q

low contrast is defined by

A

long grayscale and many shades of grey

334
Q

which of the following might make it difficult to visualize the anatomy and pathology of the abdomen

A

long grayscale and many shades of grey

335
Q

long grayscale is synonymous with

A

low contrast and many shades of grey

336
Q

large visible differences in brightness are defined as

A

short gray scale
high contrast
few shades of grey

337
Q

factors that influence image contrast

A

kVp

OID

grids

filtration

collimation

338
Q

decrease OID=______________image contrast

A

decreased image contrast

low contrast

339
Q

high grid ratios=___________image contrast

A

increased

high

340
Q

increased collimation=______________image contrast

A

increase

341
Q

tight collimation=_____________scatter

A

decrease

342
Q

increasing exposure field=____________________image contrast

A

decreased

343
Q

large exposure field=______________scatter

A

increase

344
Q

decreasing kVp by 15% has what effect on image contrast?

A

increase image contrast

345
Q

which is preferable in diagnostic images high or low contrast?

A

high contrast because it makes anatomic structures more visible

346
Q

what are procedural factors?

A

variables that the technologist can control as part of the exposure

347
Q

true or false procedural factors such as kvp, grid ratio, and collimation have more influence on image contrast

A

false because computer processing algorithms are good at correcting images

348
Q

why does image contrast exist?

A

signal differences in the remnant beam called differential attenuation

349
Q

high signal difference=

A

high contrast

350
Q

what are the signal intensity influencing factors?

A

kvp

grid

collimation

351
Q

when changing the kvp what does that affect in terms of image contrast?

A

influences signal difference in remnant beam

352
Q

why do we use grids?

A

high signal difference=less scatter

increased contrast

353
Q

what is the term to describe the signal difference in the remnant beam?

A

differential attenuation

354
Q

which tissue type corresponds to the highest signal intensity at the IR

A

bowel gas

has extremely low density which means it attenuates with very little radiation

355
Q

what is the definition of image contrast?

A

visible difference in adjacent brightness levels within the radiographic image

356
Q

what is the definition of subject contrast?

A

magnitude of the signal difference in the remnant beam as a result of the different absorption characteristics of the tissues and structures making up the part

357
Q

when looking at the heart on a cxr it will have a low absorption and high signal

A

no, it will have a high absorption due to its high density and a low signal

358
Q

why is barium used in GI studies?

A

because the abdomen has uniform moderate absorption which means they have lower image and subject contrast. Barium helps highlight the anatomy.

359
Q

A pt has a bowel obstruction How does that affect image and subject contrast?

A

both increase due to the large amount of air in the abdomen

360
Q

A pt has bowel ascites (fluid in the abdomen) How does that affect image and subject contrast?

A

both decrease due to the large amount of liquid in the abdomen

361
Q

when imaging a bariatric pt for a cxr what happens to the subject and image contrast?

A

decreases causing the image to look more washed out

362
Q

what is the primary factor controlling subject contrast?

A

the absorption characteristics of the tissues and structures being exposed

363
Q

what term describes a body section that creates a remnant beam having widely varying signal intensities

A

high subject contrast

364
Q

imaging subject contrast increases the visibility of anatomy and pathology due to

A

increased brightness differences between adjacent structures

365
Q

which contrast factor has the most influence on the image contrast?

A

digital factors

366
Q

what is a histogram?

A

collection of all exposure frequencies capture by detectors

367
Q

what is a lookup table?

A

mathematical process that converts low-contrast raw data into high-contrast image data

368
Q

what does window width show?

A

shows the contrast displayed within the image

369
Q

what happens when the window width is increased?

A

increases the amount of grey within the image (less contrast)

370
Q

what computer process adjusts raw radiographic data to create more contrast in the processed data?

A

lookup table application

371
Q

which of the following is an image processing factor that influences radiographic image contrast?

A

histogram analysis

372
Q

what is the definition of structural resolution?

A

structural sharpness recorded in the radiographic image

differentiate between different anatomy in a certain area

373
Q

what are the units for spatial resolution?

A

line pair per millimeter (LP/mm)

374
Q

what affects spatial resolution?

A

patient factors

beam geometry

IR factors

digital image factors

digital display factors
-pixel size
-pixel pitch
-matrix size

375
Q

which anatomical parts can be used as an indicator of the spatial resolution recorded in a radiographic image?

A

trabecular bone

376
Q

what are the patient factors?

A

-PT size
-PT movement

377
Q

what are the beam geometry factors?

A

-SID
-OID
-Focal spot size

378
Q

what are the image receptor factors?

A

-detector element size
-pitch
-fill factor

379
Q

what are the digital imaging factors?

A

-pixel size
-matrix size

380
Q

what are the digital display factors?

A

-pixel size
-pixel pitch
-matrix size
-fill factor

381
Q

what happens if OID is increased?

A

leads to lower spatial resolution which causes blurriness this is known as penumbra

382
Q

what should you do when pt size or pathology is degrading the spatial resolution?

A

increase SID

383
Q

focal spot blur formula

A

FSS x (OID/SOD)

SOD= SID-OID

384
Q

what is an ideal scenario for maximum spatial resolution?

A

large SID

Small OID

small effective focal spot

no tube angles

385
Q

decrease in element size would lead to

A

increase spatial resolution

386
Q

what is pitch

A

it is the distance between one detector element to the next

387
Q

what is the fill factor?

A

fraction of the del surface area that is capable of measuring incoming X-ray beams

388
Q

which part of the X-ray beam has different signal intensities that correspond to the anatomy represented on the image IR

A

remnant beam

389
Q

what does DEL stand for in digital radiography?

A

detector element

390
Q

which of the following describes the detector element pitch

A

distance from one DEL to another

391
Q

what is the definition of matrix size?

A

the number of pixels in an image

392
Q

if the matrix size increases_______________

A

pixel size decrease

393
Q

what happens to the image if there is a low receptor exposure (fewer photons hit the IR)

A

quantum mottle

393
Q

what is the recommended size for monitors for routine radiography?

A

3MP

394
Q

what happens to the image if there is a high receptor exposure

A

saturation

395
Q

what affects receptor exposure?

A

prime exposure factors

influencing factors

396
Q

what are the prime exposure factors?

A

mA
exposure time
kVp
SID

397
Q

what are the influencing factors?

A

AEC
Grids
filtration
collimation
anode heel effect
patient factors

398
Q

if mAs is increased________________

A

the number of photons increases which means there will be more photons striking the IR

399
Q

if kVp is increased how does this affect the beam?

A

adds more penetrability

400
Q

15% rule

A

increasing kVp by 15% will double receptor exposure

401
Q

a technologist can identify an image with excessively high mAs based on

A

an exposure indicator outside of the acceptable range

402
Q

if the angle of the tube is increased how does that affect the anode heel effect?

A

decreases it

403
Q

magnification is the consequence of the

A

divergent beam

404
Q

factors that affect magnification

A

OID
SID
SOD

405
Q

magnification factor formula

A

SID/SOD

tells us the actual size of the object-based image on the radiograph

406
Q

what are the two types of shape distortion?

A

foreshortening
elongation

407
Q

how does foreshortening occur?

A

when the anatomy is not parallel with the IR

408
Q

how does elongation occur?

A

tube and receptor are not perpendicular to each other

409
Q

law of isometry

A

central ray should be set at half of the angle formed between the object and IR

410
Q

what projection has foreshortening

A

lordotic chest

411
Q

an increase in tube potential would increase receptor exposure by increasing which two of the following?

A

penetrating ability of the beam

number of photons in the beam

412
Q

what is most likely the adverse effect of processing an image under the wrong anatomic part?

A

incorrect image contrast

413
Q

what term describes the light-emitting components within display monitors?

A

picture element (pixel)

414
Q

what computer processing features influence radiographic image contrast?

A

histogram analysis

look up table

415
Q

what is referred to as size distortion?

A

magnification

416
Q

how does increased kvp affect differential attenuation of the X-ray beam

A

decreased differential attenuation

417
Q

large signal differences in the remnant beam will produce a radiographic image demonstrating

A

high image contrast

418
Q

how does increasing window width affect the displayed image?

A

decreased contrast

419
Q

receptor exposure is affected by

A

generators

collimation

filtration

420
Q

the distance between the anatomy being imaged and the focal spot within the X-ray tube is called

A

source to object distance

421
Q

when the anatomy being imaged is PARALLEL to the IR and the beam is angled what type of shape distortion is this?

A

elongation

422
Q

the term used to describe signal differences in the remnant beam

A

differential attenuation

423
Q

matrix size increases______________________

A

increased spatial resolution

424
Q

matrix size increases the size of the pixels_________________

A

increase

425
Q

grayscale

A

the total brightness levels that are visible in an image

426
Q

what post-processing factor affects image contrast?

A

window width

427
Q

what is the CR for AP thumb?

A

1st MCP joint

428
Q

for PA hand the pts arm should be bent ______________________

A

90 degrees

429
Q

Coyle method for the coronoid process

A

Entering the joint at mid-elbow at a 45° angle towards the coronoid process

the tube is positioned above pt

80 degree elbow bend

430
Q

Coyle method for radial head

A

Entering the joint at mid-elbow at a 45° angle towards the radial head

tube in front of pt

90 degree elbow bend

431
Q

CR for transthoracic humerus

A

Injured humerus against the image receptor

Perpendicular to the image receptor

Level of the surgical neck

Mid-coronal plane centered to the midline of the image receptor

432
Q

for transthoracic humerus what must be seen in the lungfield

A

proximal humerus

greater tubercle in profile

433
Q

What is ALARA?

A

as low as reasoning achievable

time
distance
shielding

434
Q

what is the primary source of occupational dose?

A

the pt

435
Q

why is lead used for shielding?

A

high atomic number
high mass density
high attenuation

436
Q

what is used to measure shielding?

A

half-value layers

437
Q

what lead thickness equivalence is required for protective lead aprons in surgery, general radiography, and fluoroscopy?

A

0.50mm lead

438
Q

lead thickness for glasses

A

0.35mm lead

439
Q

lead thickness for gloves

A

0.25mm lead

440
Q

lead thickness for bucky slot

A

0.25mm lead

441
Q

what does positive beam limitation do?

A

automatically adjusts collimation to adjust to detector size

442
Q

use of lead to reduce the exposure field size has what effect on radiographic image quality?

A

increase image contrast

442
Q

what material are the collimator blades made out of?

A

lead

443
Q

positive beam limitation is a safety feature that ensures the size of the X-ray field is no larger than

A

the detector dimensions

444
Q

the component of the X-ray assembly that is manipulated by the operator to precisely define the size of the X-ray field

A

adjustable collimation

445
Q

the primary benefit of collimating the exposure field size to the required anatomy is

A

decrease in pt effective dose

446
Q

entrance skin dose

A

photons that do not have enough energy to penetrate the pt which are then absorbed in the pt’s skin

447
Q

what is the most common filtration material?

A

aluminum

gets rid of low-energy photons

448
Q

why is aluminum used for filtration?

A

low atomic number
absorbs most low-energy photons
allows transmission of most high-energy photons

449
Q

inherent filtration

A

results from the construction of the tube itself and filters the x-ray beam

glass envelope
insulating oil
window
mirror

450
Q

inherent + added filtration=

A

total filtration

451
Q

what is added filtration?

A

anything added to the X-ray machine

ex: aluminum

452
Q

what is the minimum thickness of diagnostic filtration for x-ray tubes operating above 70kvp

A

2.5mm Al eq

453
Q

the thickness of inherent filtration for general x-ray tube assemble is equal to

A

0.5mm AL eq

454
Q

the thickness of added filtration for general x-ray tube assemble is equal to

A

2mm AL eq

455
Q

how does decreasing filtration thickness affect the quantity of the beam

A

increased quantity

456
Q

What is the CR for external rotation of the shoulder?

A

1 inch inferior to the coracoid process or 1 inch of light above the shoulder

457
Q

What is seen in profile when performing external rotation of the shoulder?

A

Greater tubercle

458
Q

What is seen in profile for a internal rotation of the shoulder?

A

Lesser tubercle

459
Q

How is the hand position for an AP neutral view of the shoulder?

A

It is the palm of the hand is on the hip

460
Q

How is the pt positioning for the Lawrence view?

A

Pt is spine
Affected arm is abducted (sticking out) and externally rotated resting on a sponge
CR enters the axila
Tube is turned 30 degrees to the table
IR and tube are parallel to each other

461
Q

What is the purpose of doing the inferosuperior axial or Lawrence method (shoulder)

A

Demonstrates the relationship of the lateral humerus to the Scapulohumeral joint.

462
Q

When performing the shoulder Y view where is the CR

A

Scapulohumeral joint

463
Q

How do you position AP scapula?

A

40 SID
CR: 2 inches inferior to the coracoid process or put the top of the light field 2 inches above the shoulder
Place arm above arm to remove scapula from ribs
Exposed on slow respiration

464
Q

How is lateral scapula positioned?

A

Affected side against IR
CR at medial aspect of scapula

If affected arm is placed behind back supinated=coracoid and acromion

Across chest= body of scapula

465
Q

Appropriate criteria for a lateral view of scapula

A

Scapular body free of rib superimposition

Humerus does not superimpose area of interest

466
Q

Why must a pt arm be abducted 90 degrees for AP scapula

A

Moves the scapula laterally to minimize superimposition of ribs

467
Q

What is the breathing technique for AP clavicle?

A

Taken on expiration

468
Q

What is the angle for AP axial clavicle?

A

15-30 degrees cephalad

469
Q

What is the breathing technique for AP axial clavicle?

A

Inspiration

470
Q

What is the SID for bilateral AC joints?

A

72 inches

471
Q

What is the CR for bilateral AC joints?

A

CR is at the jugular notch

472
Q

For weighed AC joints what breathing technique is used?

A

Exposed on expiration

473
Q

What cassette size do you use for bilateral AC joints?

A

17x14

474
Q

What breathing technique is used for AP external rotation of the shoulder

A

Suspend respiration

475
Q

For AP hip why do we invert the pt feet?

A

Elongates the neck of the femur and puts the greater trochanter in profile

476
Q

Where is the CR for unilateral frog leg hip?

A

Midway between the ASIS and pubic symphysis

477
Q

What is the tube angle for danielus miller method

A

15 degrees posteriorly perpendicular to femoral neck

478
Q

Positioning for AP axial anterior pelvis outlet view

A

Cepahilic angle: 20-35 men, 30-45 female
CR:1-2 inches distal to the superior border of pubic symphysis

479
Q

Positioning for pelvis inlet view

A

40 degree cuadal
CR: at ASIS

480
Q

what anatomic structures should be included in an AP axial outlet projection Taylor method?

A

pubic and ischial bones magnified with pubic bones superimposed over the sacrum and coccyx

481
Q

what anatomy needs to be seen on the superior inferior axial inlet projection Bridgman method?

A

superimposed superior and inferior rami of the pubic bones and anterior pelvic bones

482
Q

what are the requirements for x-ray production?

A

source of electrons

acceleratation of electrons

deceleration of electrons

483
Q

where are the electrons produced in the tube?

A

the filament (cathode)

484
Q

how are the electrons accelerated?

A

an electron voltage (kVp) is applied and causes a strong negative charge moving the electrons to the anode side

485
Q

how are the electrons decelerated?

A

they strike the anode and release heat and X-ray

486
Q

an increase in mA increases the number of ________________ and the number of _____________

A

electrons and photons

487
Q

an increase in kVp increases the of ________________ and increases _____________

A

the energy of electrons and x-ray energy

488
Q

true or false exposure time increases then the number of X-ray photons

A

true

489
Q

what is the definition of exposure time?

A

the amount of time that the electrons are flowing through the tube and the x-rays are being created

490
Q

the term of electron production

A

thermionic emission

491
Q

what is the charge of the filament?

A

negative

492
Q

the measurement of tube current

A

mA

493
Q

the controller of X-ray intensity (quantity)

A

mAs

494
Q

the controller of photon penetrability (energy)

A

kVp

495
Q

what condition is required to induce thermionic emission within the cathode filament?

A

high current

496
Q

when imaging an obese patient what technical factor needs to be increased?

A

kVp

497
Q

a chest x-ray demonstrates excessive exposure. How do you decrease the intensity of the beam while maintaining the same beam energy?

A

decrease mA

498
Q

brem radiation is produced

A

by slowing of an incident electron

499
Q

the inner shell of an atom

A

k-shell

500
Q

brem radiation involves

A

an incident electron and the nucleus of an atom

501
Q

a brem photon is the result of

A

energy difference between the incident electron as it passes near the nucleus

502
Q

the closer the incident electron passes to the nucleus

A

the higher the energy of the brem photon

503
Q

how does brems radiation start?

A

high energy electrons interact with the nucleus of the tungsten atom

504
Q

bremsstrahlung radiation is created within the X-ray tube when high-energy electrons interact with

A

electric field of the nucleus

505
Q

the maximum energy of bremsstrahlung photon that can created during an x-ray exposure is equal to

A

the energy of the incident photon

506
Q

the maximum amount of energy of bremsstrahlung photon is controlled by which technical factor

A

tube potential

507
Q

the energy of the bremsstrahlung x-ray photon is equal to the

A

difference between the incoming and outgoing electron energy

508
Q

the closer to the electron is to the nucleus

A

the stronger the binding energy

509
Q

a characteristic X-ray can be defined as

A

total removal of an electron

510
Q

Characteristic X-ray production involves

A

incident electron and inner shell of the electron

511
Q

cascade effect

A

movement of an electron from an outer shell into an inner shell

512
Q

the binding energy and unit of a tungsten atom’s inner shell

A

69 kEV

513
Q

lowest kv setting possible for producing characteristic radiation

A

69 kVp

514
Q

what technical factor is primarily responsible for controlling the energy of the x-ray beam

A

mA

515
Q

what is the definition of attenuation?

A

a reduction in the x-ray beam intensity as a result of absorption and scatter in matter

516
Q

what are the 3 x-ray interactions with matter?

A

transmission

absorbed

scattered

517
Q

what does intensity refer to?

A

the number of x-ray photons

518
Q

after the primary beam has interacted with the patient what is the x-ray beam called?

A

remnant beam

519
Q

what are the 3 attenuation reactions?

A

photoelectric

coherent scattering

compton scattering

520
Q

what does attenuation mean?

A

a reduction in the x-ray beam intensity as a result of absorption and scatter in matter

521
Q

photoelectric absorption

A

then use of ionization to remove an electron in the inner shell and bring a photon in

522
Q

coherent scattering

A

x-ray photon enters then is absorbed by the ENTIRE atom then the energy of photon is released in a different direction

523
Q

Compton scattering

A

x-ray photon enters and is partially absorbed by outer electron and ionization takes place. Then remaining energy of the photon is released in a different direction

524
Q

amount of attenuation is dependent on

A

part thickness

tissue density

atomic number

beam energy

525
Q

an increase in anatomy thickness leads to increased_________________

A

attenuation

526
Q

which radiographic projection results in the highest percentage of x-ray attenuation?

A

pelvis because it has more bone

527
Q

true or false: coherent scattering does have an effect on pt dose?

A

false

no ionization
no biological harm

528
Q

true or false: coherent scattering does have an effect on occupational dose dose?

A

false

scatter is directed toward IR

529
Q

how does coherent scatter affect the image?

A

creates scatter
decreases contrast in the image

530
Q

when does coherent scattering occur?

A

when there is low photon energy

least likely

531
Q

true or false: photoelectric absorption does have an effect on pt dose dose?

A

true

ionization-damaging

532
Q

true or false: photoelectric absorption does have an effect on occupational dose dose?

A

false

no scatter

533
Q

true or false: photoelectric absorption does have an effect on image quality?

A

good effect because it creates contrast

534
Q

what are the two products of PE interaction?

A

free electron

characteristic photon

535
Q

how does increasing kVp affect the proportion of photoelectric absorption events that occur in pt tissues?

A

increasing kvp decreases the proportion of PE absorption

536
Q

what the products of Compton scattering?

A

free electron

scattered photon

537
Q

what is the product of coherent scattering?

A

scattered photon

538
Q

true or false: Compton scattering is a benefit to pt, occupational dose, and image quality

A

false due to the ionization and the end product of scatter leads to an increase in exposure to both the pt and healthcare worker

539
Q

more matter means____________

A

more scatter

540
Q

how to reduce Compton scatter

A

decrease part thickness

use smallest field size

collimate

Use lower kVp

541
Q

when imaging AP toes how much of an angle do you add to view the joint spaces?

A

15 cephalad

542
Q

where do you center for an oblique toe?

A

MTP joint

543
Q

how do you position for a lateral toe?

A

have the pt position like a lateral foot and then use tape to pull the toe in question outwards

544
Q

how do you position tangential view of the toes?

A

wrap tape around pt toes and have them pull toes backwards. CR at first metastarsal

545
Q

what is the recommended collimation for the tangential projection of sesamoids

A

1-2 inches on either side of the foot

546
Q

positioning parameters for plantodorsal view of the calcaneus?

A

40 degree cephalic angle

CR to the base of the third metatarsal

dorsiflex foot

547
Q

why is there a tube angle for AP foot?

A

to be perpendicular to the metatarsal joint space

548
Q

why do we internally rotate 30 degrees for medial oblique foot?

A

to reduce superimposition of the cuboid

549
Q

how much do you angle for AP knee

A

3-5 degrees caudal if ASIS measurement is greater than 19cm

no angulation 19-24cm

3-5 cephalad measurement of 24cm of less

550
Q

what is the CR for lateral knee?

A

1 inch inferior to the lateral epicondyle of the femur

angle tube 15-20 degrees

551
Q

tangential settlegast view Knee

A

patient is positioned like a sunrise tube matches angle of the IR (upwards)

CR at the knee joint

552
Q

for the tunnel view of the knee how much should the knee be flexed?

A

40-60 degrees

553
Q

for AP proximal femur how should the IR be placed?

A

top of the IR at the level of ASIS

554
Q

lateral distal femur how should the IR be placed?

A

bottom of IR 2 inches distal to the patellar apex

555
Q

x-ray photon

A

lots of energy
no mass
no charge
travels at the speed of light

556
Q

what is wavelength?

A

measure of one peak to the next

557
Q

true or false a decreased in wavelength results in an increase in crease frequency with means more energy

A

true

558
Q

what units are used for frequency?

A

hertz

559
Q

the x-ray beam is composed of one singular energy source

A

false because it is polyenergetic

560
Q

what does the term quality refer to

A

average energy of x-rays

561
Q

true or false x-ray beams travel out of the tube in all directions

A

true it is isotropic

562
Q

electromagnetic spectrum

A

full range of photon energies

563
Q

what is frequency

A

number of wave cycles per second

564
Q

tube current refers to

A

flow rate of electrons

565
Q

exposure time refers to

A

total amount of time that electrons are flowing

566
Q

a tech is attempting to increase the x-ray beam intensity without modifying the overall energy of the x-ray beam they should

A

increase mA will increase the the quantity of photons but it won’t affect the overall energy of the x-ray beam

567
Q

a tech is attempting to decrease the beam intensity and decrease the penetrability of the beam they should

A

decrease kVp

568
Q

true or false if distance is increased then the beam quantity decreases

A

false

569
Q

all technical modifications that will increase the beam quantity

A

increase mA
increase time
increase kVp
decrease distance
decrease filtration

570
Q

decreasing SID will result in

A

increased concentration of photons

571
Q

beam energy is measured in

A

Kev

kiloelectron volt

572
Q

beam quality is influenced by

A

kVp
beam filtration

573
Q

which of the following will add to the pt dose but not to diagnostic quality of the image

A

low energy photons

574
Q

In a fluoro exam where is the x-ray tube positioned?

A

behind the pt

575
Q

When using a C-arm when should the backwards R button be used

A

pt is prone looking away from the smiley face indicator

576
Q

true or false pediatric fluoro is a sub category of conventional fluoro

A

true

577
Q

what are the components of the IR in fluroro?

A

input phosphor
photocathode
focusing lenses
electrostatic
anode
output phosphor

578
Q

what is the input phosphor composed of?

A

cesium iodide

579
Q

what is the purpose of cesium iodide

A

helps improve spatial resolution of the image

580
Q

what is the purpose of electrostatic focusing lenses of a fluoro tube?

A

helps funnel the photoelectrons into a concentrated stream

581
Q

what is the output phosphor of the fluoro tube made out of?

A

zinc cadmium sulfide

582
Q

what is flux gain?

A

kinetic energy gained during acceleration from photocathode to output phosphor

583
Q

minification gain

A

concentration of photoelectrons from the input phosphor to the output phosphor

584
Q

what is the flow of energy conversions in fluoro

A

1.digital signal
2. analog signal
3. light photons
4. photo electrons
5. light photons
6.x-rays

585
Q

what happens at the input phosphor?

A

x-ray photons are converted into light photons

586
Q

what happens at the photocathode

A

light photons»»photoelectrons

587
Q

what does the electrostatic lenses do?

A

focus photoelectrons to anode

588
Q

what does the output phosphor do>

A

photoelectrons»>light electrons

589
Q

what is the purpose of the IR in fluoro imaging?

A

brightens the fluoroscopic image so that it can be of diagnostic value

590
Q

what is the role of the anti scatter grid on the IR of the fluoro tube

A

increase image contrast

591
Q

which component collects light photons from the output phosphor and converts them to electrons?

A

charge coupled device

592
Q

what kind of grids does interventional radiology?

A

crossed hatched grid

593
Q

why does fluoro use a lower grid ratio (less space in between)

A

uses higher kVP to penetrate contrast and lower mA to limit overexposure

594
Q

where is the grid located in a fluoro tube?

A

in front of the input phosphor

595
Q

brightness gain

A

measure of the ability of the image intensifier to increase the brightness level of them image

596
Q

conversion factor

A

percentage that measures the efficiency of the image intensifier

597
Q

formula for flux gain

A

output light photons/input x-ray photons

598
Q

minification gain formula

A

D^2i/D^2o

i=input phosphor
o=output phosphor
D=diameter

599
Q

brightness gain formula

A

flux gain x minification gain

600
Q

conversion factor formula

A

intensity of light at the output phosphor/intensity of radiation at the input phosphor

601
Q

during a fluoro exam what is the purpose of automatic brightness control?

A

adjusts exposure factors to deliver constant signal intensity to the image receptor

602
Q

vignetting

A

decrease in image brightness around the edges of the image due to large OID

603
Q

how is vignetting fixed?

A

image processing
adjusting image intensifier
reduce OID

604
Q

pincushioning

A

parts of the image appear curved or bent inward towards the center of the image caused my external magnetic fields

605
Q

how is pin cushioning fixed?

A

post processing

606
Q

the components of flat panel detector

A

scintillation
photodiode
thin film transistor

607
Q

what is RIS

A

radiology information system is like cerner and allows them to generate accession numbers

608
Q

what is HIS

A

hospital information system

manages operational and healthcare data

609
Q

DICOM

A

digital imaging and communications medicine

is universal language to exchange medical information

610
Q

MIMPS

A

medical image management and processing system

functions like PACS

611
Q

components of a CR cassette

A

2 protective layers
photostimuable phosphor
conductive
support
reflective

612
Q

raster pattern

A

related to the processing of CR cassette mirror and image plate

rapid back and fourth pattern

613
Q

components of DR IR

A

photoconductor
Thin film transistor
ADC

614
Q

indirect conversion DR systems

A

x rays
visible light
electronic signals

615
Q

direct conversion DR systems

A

x-rays to electronic signal

616
Q

what is the purpose of a TFT in DR

A

after the light photons are converted to electrical signal from the photodiode the electrical signal is then sent to ADC

617
Q

formula for pixel size

A

field of view/matrix size

618
Q

bit depth

A

total # of possible brightness levels that can be assigned to any given pixel in the digital image

619
Q

quantiziation

A

process of assigning brightness levels

620
Q

modulation transfer function

A

measures accuracy of the image compared to the actual object

621
Q

dynamic range

A

range of exposures that can be captured by an IR

622
Q

exposure latitude

A

range of exposures that produces quality images at an appropriate patient dose

623
Q

detective quantum efficiency

A

a score that describes the ability of the imaging system to convert the remnant x-ray beam into a high quality image

624
Q

capture efficiency

A

percentage of photons that get absorbed by the detector

chin to chest

625
Q

what is the purpose of flexing for the C-spine

A

opens up the space between the spinous process

626
Q

what is the purpose of extension for C-spine

A

closes spaces between the spinous processes

627
Q

true or false when performing flexion of C-spine you do not need the body of the mandible

A

false

628
Q

what is the SID for swimmers view?

A

40

629
Q

what is the CR for swimmers view?

A

C7

630
Q

what SID is used when performing a x-table spine

A

72

631
Q

what is the CR for AP T spine

A

halfway between the jugular notch and the xiphoid process aligned with the midsagittal plane

632
Q

what is the CR for lateral T spine

A

T7-arm pit level

make sure to have 1.5 inches above the shoulder

633
Q

what is the CR for L5S1

A

1.5 inches inferior crest
2 inches posterior to ASIS

634
Q

what is the CR for lateral coccyx

A

3.5 inches posterior from ASIS and 2 inches inferior from ASIS

635
Q

what is CR for SI joints AP

A

2.5 inches inferior to ASIS
30 Cephalad tube angle

636
Q

what is the CR for oblique SI joints

A

At ASIS and go 1 inch medial

637
Q

obliquity for SI joints

A

25-30 degrees

638
Q

CR for oblique L spine

A

1.5 inches superior of crest and 2 inches medial from ASIS

639
Q

stochastic effects

A

Ex: cancer

random and unpredictable

probability increases as the dose increases but not the severity

AKA non threshold dose

640
Q

deterministic effects

A

cataracts, epilation, ,diminished sperm count

only occur when specific dose thresholds are reached

severity of illness increases with the dose

641
Q

dose for decreased sperm count

A

150 mGy

642
Q

dose for epilation

A

3000 mGy

643
Q

true or false? cancer be caused by any dose of radation

A

true

644
Q

what is the chief biological cause of radiation?

A

Ionization

645
Q

target theory

A

adverse radiation effects are only observed when sensitive target molecules in the cells are affected

646
Q

what is direct action?

A

it is when x-ray photon or free electron interacts differently with DNA

RARE

647
Q

what is indirect action?

A

AKA radiolysis

x-ray photon interacts with water which breaks into ions that can cause biological damage

648
Q

double strand breaks

A

are difficult to repair

low probability of completely fixing

649
Q

how are double stand breaks caused

A

indirect action

650
Q

what are the 3 forms of DNA damage

A

base pair lesion

single strand breaks

double strand breaks

651
Q

what is the product of indirect action?

A

free radicals

652
Q

early effects

A

manifests soon after exposure

653
Q

examples of early effects

A

skin burns

hair loss

diminished sperm count

AKA deterministic effects

654
Q

skin erythema occurs

A

2 Gy or more

655
Q

late effects

A

manifests after years of exposure

delayed effects

656
Q

late effects examples

A

cataracts and cancer

657
Q

latency period

A

period of time between exposure and when symptoms start occuring

658
Q

true or false late effects are considered deterministic

A

true

659
Q

why doesn’t ARS occur in diagnostic imaging?

A

the entire body needs to be exposed to a very high dose of radiation

660
Q

hematopoietic syndrome occurs at

A

at least 1 Gy

661
Q

Gi syndrome occurs at

A

at least 10 Gy

662
Q

cerebrovascular syndrome occurs at

A

at least 50 Gy

663
Q

hematopoietic syndrome

A

inadequate blood cell production/destruction of bone marrow

664
Q

GI syndrome

A

destruction of GI tract

pt often die of dehydration and electrolyte balance

665
Q

cerebrovascular syndrome

A

damage to the cerebrovascular structures of the brain

666
Q

prodromal phase

A

body’s initial reaction to high doses of radiation exposure

667
Q

latent phase

A

initial illness appears to resolve

inverse related to the dose

668
Q

manifest illness

A

full onset of systemic illness

directly related to dose

669
Q

what is used to determine how often pt die from ARS

A

LD50/60

lethal dose of radiation that kills 50% of the population within 60 days

670
Q

what are the four stages of disease progression

A

prodromal
latent
manifest
recovery/death

671
Q

law of bergonie and tibondeau

A

the most radiosensitive cells are:

immature
unspecialized
rapidly dividing

672
Q

in the fetal cycle which part of the cycle is the most radiosensitive

A

pre implantation stage

100 mGy

673
Q

physical malformations tend to develop in which part of the fetal cycle

A

organogensis

674
Q

cerebral effects tend to occur in which part of the fetal cycle

A

fetal period

675
Q

variables that affect radiosensitivity

A

age
tissue type
gender
type of radiation
rate of exposure

676
Q

tissue radiosensitivity is important when determining which form of measurement

A

effective dose

677
Q

densely ionizing

A

high LET

deposits energy within a shorter distance

causes more damage

678
Q

oxygen enhancement ratio

A

the difference in biological harm for each radiation type

679
Q

which type of cell is the most radiosensitive?

A

hypoxic cells

680
Q

fractionation

A

tumor is exposed to numerous small doses rather than one large dose

681
Q

what is the OER of x-ray

A

3x

682
Q

LET is commonly measured in units of

A

kiloelectron volts/micrometer

683
Q

relative biological effectiveness

A

radiations ability or effectiveness in causing biological damage

684
Q

What happens if the image is underexposed?

A

Mottle

Grainy image

Increase kVp and mAs

685
Q

Receptor exposure

A

The amount of radiation striking the receptor

686
Q

Exposure indicator

A

Numerical expression of the receptor exposure

687
Q

the process that converts original radiographic histogram to the expected histogram

A

rescaling

688
Q

the process that identifies the values of interest in a radiographic histogram

A

histogram analysis

689
Q

the process of adding brightness and contrast to exposure values within a radiographic range

A

look up table conversion

690
Q

the lowest readings on a histogram represent

A

collimated tissue

691
Q

coincidence testing assess

A

light field accuracy

692
Q

actual exposure time must be within_______of the indicated exposure time

A

5%

693
Q

the actual kVp must be within ___________ of the assigned kVp

A

5%

694
Q

the light field must correspond to the actual exposure field with the tolerance of

A

2%

695
Q

mGy/mAs measurement between adjacent mA stations should not vary by more than `

A

10%

696
Q

x-ray systems must demonstrate consistent exposure reproducibility within a tolerance of

A

2%

697
Q

the CR indicator must align to the actual center of the x-ray field within the tolerance of

A

1%

698
Q

SID range should be

A

2%

699
Q

exposure linearity error range

A

10%

700
Q

positioning parameters for lateral skull

A

anterior oblique

CR: 2 inches above EAM

IPL perpendicular to the edge of the IR

701
Q

what makes a diagnostic lateral skull x-ray

A

superimposition of the orbital roofs and greater sphenoid wings

sella turcica in profile

702
Q

what makes a diagnostic PA skull

A

symmetric petrous ridges

orbits filled by petrous ridges

703
Q

postponing parameters for AP Townes skull

A

30 degrees caudal

2.5 inches above glabella

OML is perpendicular

704
Q

positioning for AP Townes skull if pt can’t bend chin

A

bend chin put 37 tube angle and use IOML

705
Q

diagnostic PA caldwell skull

A

petrous pyramids sitting at the lower 1/3 portion of the orbit

706
Q

positioning parameters for SMV skull

A

IOML is parallel to the IR

CR: 0.75 inches anterior to EAM

707
Q

for SMV skull the CR should enter where?

A

sella turcica

708
Q

positioning parameters for lateral facial bones

A

Anterior oblique

IPL perpendicular to IR

mid sagittal plane is plane to IR

CR: between the EAM and outer canthus

709
Q

diagnostic lateral facial bones

A

superimposed mandibular rami and oribital roofs

sella turcica in profile

710
Q

for waters (pariteocanthial) facial bones how much of angle does the OML make?

A

37 degrees

711
Q

diagnostic lateral facial bones

A

petrous ridges below maxillary sinus

712
Q

for facial bones waters the OML forms what angle to the IR

A

55 degrees

is the only one that has this

713
Q

positioning for lateral nasal bones

A

anterior oblique

IPL is perpendicular

IOML perpendicular to front edge of IR

CR: 0.5 inch inferior to nasion

714
Q

CR for lateral sinus

A

midway between outer canthus and EAM

715
Q

what 2 sinuses are shown on an SMV

A

sphenoid and ethmoid

716
Q

what 2 sinuses are shown on a waters

A

sphenoid and maxillary

717
Q

millamperage formula

A

mA x s= mAs

718
Q

Ma in the x-ray tube is the unit of measure describing

A

tube current

719
Q

exposure time

A

electrons are flowing through the tube

720
Q

in order to decrease motion blur on an image what should you do?

A

decrease mA and increase exposure time

721
Q

SID is defined as the distance from the

A

anode focal spot to the IR

722
Q

mA in the x-ray tube is the measurement of

A

tube current

723
Q

AEC

A

provides x-rays with consistent receptor exposure

automatically adjusts exposure time

reduces the chance of over exposing pts

724
Q

what do ionization chambers do?

A

measure receptor exposure

724
Q

true or false AEC controls the mAs

A

true

725
Q

when using AEC what does the tech need to adjust

A

SID

kVp

mA

726
Q

to change the receptor exposure for the chambers what do you need to do?

A

adjust the density setting

727
Q

if there is motion in the radiograph how do you fix it?

A

increase mA and lower exposure time

728
Q

when using a grid what technical factor needs to be increased?

A

mAs in order to maintain appropriate receptor exposure

729
Q

grid conversion formula

A

mAs2= mAs1 x GCF2/GCF1

GCF2 is the new grid conversion factor

GCF1 is the old grid conversion factor

730
Q

when should grids be used?

A

when the atomic body part exceeds 10cm in thickness

731
Q

grid ratio

A

Height of lead strips (h) divided by distance (D). h/D

732
Q

Increase in grid ratio

A

Increase in image contrast

Increase in needed mAs value

Increase in patient dose

733
Q

Material used for strips in grid

A

Lead (most common)
Tungsten
Platnium

734
Q

using the incorrect SID with a focused grid results in

A

grid cut off because focused grids are designed to be used with specific SID

735
Q

if you angle the tube which type of grid can not be used

A

crossed because the body part must be perfectly positioned

736
Q

off level grid error

A

grid is not perpendicular to CR

lead strips are not in line with path of useful beam

737
Q

off level grid errors affect:

A

focused and non focused grids

738
Q

off center grid error

A

only affects focused grids

grid is not placed directly under the CR

739
Q

off focus grid error

A

SID does not match the design of the focused grid

only affects focused grids

740
Q

off angulation grid error

A

x-ray beam is angled against the direction of the grid lines

affects focused and non focused grids

741
Q

upside down grid error

A

focused grid is placed upside down

only affects focused grids

742
Q

inverse square law defines the relationship between

A

distance and beam intensity

743
Q

off center grid errors result in

A

decreased receptor exposure across the entire radiograph

744
Q

autonomy

A

Patients have the right to make decisions about their healthcare

745
Q

tort

A

A civil wrong that can result in legal liability

746
Q
A

RAD Boards (2 decks)

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