Introduction to Radiologic and Imaging Sciences and Patient Care - E-Book: RADR 12010 - Intro to Radiologic Science Final Exam Review Flashcards

radiograph

ionozation

radiation therapy

Contrast medium

Radiography of the breast

Computed Tomography (CT ) - recording of a predetermined plane in the body using an x-ray beam that is measured, recorded, and them processed by a computer form display on a monitor

Magnetic Resonance Imaging (MRI) - Process of using a magnetic field and radio-frequencies to create sectional images of the body

CT's use a x-ray beam which causes ionization where the MRI uses a magnetic field and radiofrequencies which does not.

Wilhem C. Rongten

November 8, 1895

diagnostic imaging

American Healthcare Radiology Administrators - organized to promote management practice in the administration of imaging services. approx 4000 members/ journal Radiology Management/ offer Certified RAdiology Administrator (CRA) examination

American Registry of Radiologic Technologists - Encouraging the study and elevating the standards of radiologic technology, examining and certifying eligible candidates, and periodically publishing a listing of registrants

American College of Radiology - to advance the science of radiology, improve service to the patient, study the socioeconomic aspects of the proactive of radiology, and encourage continuing education for radiologists and persons practicing in allied professional fields.

• radiography
• nuclear medicine
• radiation thereapy
• cardiovascular interventional technology
• mammography
• CT/MRI
• dosimetry
• QM

Registered Technologist - Radiographer

24 hours

process of doing an action

process of thinking (analysis) of an action

analyzing personal values and feelings and managing ethicl situations

primary radiation

remnant radiation

scatter radiation

attenuation

NOT easily penetrable by x-rays or other forms of radiant energy

Permitting the passage of x-rays or other forms of radiant energy with tittle attenuation

Source-to-Image Distance - distance between the source of x-rays (usually the focal spot of the x-ray tube) and the image receptor

• greater the SID, the better the recorded detail will be.

Object-to-Image Distance

• When the object is moved closer to the image receptor, penumbras decreases and the image sharpness increases.
• The smaller the OID is, the better the recorded detail will be.

Controls the size and shape of the x-ray field coming out of the x-ray tube.

• 2 adjusting knobs adjust length and width of the rectangular x-ray field

(PBL) form of x-ray collimation of field size that ensures the x-ray exposure field is no larger than the receptor size

Influence and determine the quantity and quality of radiation a patient is exposed to

A grid is a device that is designed to remove as many scattered photons exiting the patient as possible before they reach the IR.

bucky tray

• mAs IS A PRIMARY FACTOR OF DENSITY
• mAs represents the quantity of x-ray production
• Direct relationship
• Calculated by simple multiplication of milliamperage (mA) and exposure time (S)
• Regardless of the mA and time combinations, the same mAs value will yield the same exposure (mAs Reciprocity Law).

use rule of ALARA

• Controls x-ray beam penetration
• Direct relationship
• X-ray beam is polyenergetic or heterogeneous
• 15% Rule

The degree of darkening or blackness of exposed and processed photographic or radiographic film

Difference between adjacent densities on a radiographic image

Yes, depending on the type of body tissue irradiated. EX. bone tissue, being more densely packed and made of harder material, attenuates the beam to a greater degree than sof tissue of the same thickness.

Distortion

Control console is the interface between the radiographer and the sophisticated electronics of the x-ray machine

• Most are microprocessor- controlled and use a simple computer interface
• Generator consoles permit selection of kVp, mA, exposure time (S), and mAs
• May be operated in the mAs mode or timer mode
• Technique selection is critical to good radiography

Performs positive beam limitation (PBL) and allows the x-ray unit to detect the size of the image receptor the radiographer is using and automatically collimates to a size not larger than the image receptor.

Part of the rotor-exposure switch which activates the rotor, or prep, and causes the anode to rotor and prepares the x-ray tube for the exposure factors that have been selected. After the tube has been properly prepared, the second switch is activated to begin the exposure.

mobile

Joint Review Committee on Education in Radiologic Technology (JRCERT)

• Concerned with compliance with education standards developed by and for the profession of radiologic technology
• Governed by a Board of Directors known as the Joint Review Committee
• JRCERT accreditation requires demonstrated compliance with minimum requirements known as
• Essentials and Guidelines or Standards
• Established in 1969
• Board members nominated by four professional organizations concerned with radiology education
• Currently accredits approx. 750 programs in:
  
  • Radiography
  • Radiation Therapy Technology
  • Medical Dosimetry
  • Magnetic Resonance Imaging

JCAHO is an abbreviation for Joint Commission on Accreditation of Healthcare Organizations. It is an organization made up of individuals from the private medical sector to develop and maintain standards of quality in medical facilities in the United States. The JCAHO has no official connection to United States government regulatory agencies, and has no legal enforcement power; however, since many medical facilities rely on JCAHO accreditation procedures to indicate to the public that their particular institution meets quality standards, JCAHO and its policies has taken on a real importance in the medical field, despite the lack of official government sanction.

American Society of Radiologic Technologists (ASRT)

• represent indiviudual ppractitioners, educators, managers, and theadministrators, and students in radiography, radiation therapy, and muclear medicine, as well as the many specialties.
• >140,000 memebers
• Goals are to advance the professions of radiologic technology and imaging specialties, to maintain high standars of education, to enhance the quality of patient care, and to further the welfare and socioeconomics of RTS.

The CARE bill is a bill that seeks to protect patients from over exposure to radiation and pursues basic education and certification standards for healthcare workers who administer radiologic procedures. CARE stands for Consistency, Accuracy, Responsibility, and Excellence in Medical Imagining and Radiation Therapy.

The bill was first introduced to the U.S. Senate in 2012 and pressed on the fact that it would save the government large amounts of money as well as improve overall patient care. It would be applicable to every state in the union and limit, if not eliminate, inconsistencies with formal education. The CARE bill is not a licensure bill, so states are not required to license anyone as a result. Once the bill is passed, it will take three years to implement it nationwide.

Dosimeter

• Optically stimulated luminescence dosimeter(OSL)
• film badge
• thermoluninescent dosimeter (TLD)
• Pocket dosimeter

process of placing protection (lead shield) over the reproduction organs during when beam is 4 to 5 cm away. Especially important in children and adults of reproductive age.

minimizes reproductive organ exposure to radiation

Ethics

1. Constitutional Law (system of checks and balances)
2. Legislative/Administrative Law – system of statutes and regulations (local level, state,etc)
3. Case Law – derived from the Common Law of England (case-by-case basis) decisions can be made as to what happened before in such situations.

Constitutional Law

minimize scatter radiation and create a sharper image without the "fog" and creating greater contrast

Medium used to capture the image for the recording, such as x-ray film or a digital imaging plate

• X-ray beam energy is produced using high-voltage electricity.
• X-rays pass through matter and strike an image receptor.
• Image receptor converts the energy of x-rays into an image.

thermionic emission

X-ray beam energy is produced using high-voltage electricity.

as low as reasonably achievable (ALARA)

Radiologic Technologist and those preforming x-rays

Calculated by simple multiplication of milliamperage (mA) and exposure time (S)

• mA x time = mAs

Regardless of the mA and time combinations, the same mAs value will yield the same exposure (mAs Reciprocity Law).

generally defined as a willful and intentional misrepresentation of facts that may cause harm to an individual or result in loss of an individual right or property.

• error by destroying or altering images or records
• altering personnel records, changing patients medical records, incorrect billing, misleading or covering up some form of wrongdoing

• HIPPA violoation
• possible lawsuit, suspension, loss of job
• Rules of ethic violation and possible barring from ARRT

the full range of frequencies of electromagnetic radiation including TV/Radio, infrared, visible light, gamma rays, x-rays, and cosmic rays.

• Consequentialism - evaluates the rightness or wrongness of ethical decision by assessing the consequences of these decisions on the patient, thus producing a good effect or at least avoiding some potential harm (may lie to patient if they believe the lie might benefit the patient)
• Non-consequentialism - belief that actions themselves rather than consequences, determine the worth of actions

studies internal activities,processes, and presents images in "real time". - GI movement and structure, blood vessels, genitorurianry function, and joints

the x-ray tube is located above the patient

developed to see the latent image.

1. Source of electrons
2. Method to accelerate electrons to great speed
3. Method to stop electrons

for optimal production of an x-ray. Vacuum contained in enclosed special heat resistant glass.

Positive and negative terminals?...

Focal spot is the area of the anode surface which receives the beam of electrons from the cathode.

Focal spot is the area of the anode surface which receives the beam of electrons from the cathode.

• Radiography
• CT Scanning
• Medical Sonography
• Radiation Therapy
• MRI Scanning
• Mammography
• DEXA Scanning
• Radiologist Assistant
• Nuclear Medicine Cardiovascular Interventional Technology
• PACS Administrator
• Radiology Administration
• Education
• Research
• Commercial Firms

o Early Years
 >5000 years Egypt and Mesopotamia were using medicine in combination with religious beliefs – deliberate removal of bone and skulls
 Hippocrates (460-370 BC)
• Greek physician considered the father of Western Medicine
• Emphasized the importance of carefully observing the patient and prevention thru diet and exercise
• Responsible for the Hippocratic Oath which is the standard for ethical treatment between a physician and a patient
 Romans recognized the importance of proper sanitation – aqueducts, baths, sewers, etc.
o 17th Century
 Edward Jenner (1749-1832) introduced a vaccine to prevent smallpox in 1796 and was the foundation for the field of immunology
o 19th Century
 Louis Pasteur (1822-1895) developed pasteurization thru his work with bacteria and proving the germ theory of infection
 Robert Koch (1843-1910) receive the Nobel Prize in 1905 for his discovery of a test for tuberculosis
 Florence Nightingale (1820-1910) developed the foundations for modern nursing
 1895 Wilhelm Rontgen discovered x-rays medicine
o 20th Century saw development of the scientific method throughout medicine
 Sir Alexander Fleming (1881-1955) discovered penicillin in 1928 which lead to a better understanding of the immune system.
 Increased use of chemotherapy and a better understanding of the immune system
 Human Genome Project started in 1953 which goals were to identify, determine, store, improve, transfer, and address issues pertaining to and around DNA
• Describe the discovery of the x-rays.
o Wilhelm C. Röngten (Roentgen) (1845-1923)
 began the field of Radiology on November 8th, 1895.
 Stumbled upon the X-Ray working on cathode rays outside of their tubes
 Barium platinocyanide painted screen emitted light (fluorescing)
• Became the first ever radiographic image
• Named “X-Ray” because “X” was the symbol for UNKNOWN
• William Crookes (1832-1919) produced x-rays around 1870 however did not grasp the significance of the image
 December 28th, 1895 Roentgen submitted his first report, titled On a new Kind of Rays, to the Wurzburg Physico-Medical Society
 1901 Roentgen won the first Nobel Prize in Physics

• specialize in the use of x-rays to crate images
• diagnostic procedures - skeletal system, chest, and abdomen
• Administer contrast media to permit visualization of the GI tract

keep it simple and do not diagnosis

Accreditation – voluntary peer process through which an agency grants recognition to an institution for a program of study that meets specified criteria.

Certification - Voluntary process through which an agency grant recognition to an individual on demonstration, usually by examination, of specialized professional skills

Joint Review Committee (JRC)

repeated colds, ulcers, muscle stiffness, elevated cholesterol, excess sleeping, irritability, and headaches

The physiologic reaction to a real or imagined threat arising from emotion of both fear and anger - internal - release of hormones to increase metabolism, increases in fats and sugars for energy, and increase sin heart rate and respiration.

• "I'm stressed out!"
• home, school, daily life

• Review the material soon after it is introduced
• use as many senses as possible
• plan a regular schedule of study
• study in a group
• attitude helps remembering

• Take the day off from study before a comprehensive test to relax and prepare both mentally and physically
• wear bright-colored clothes
• Avoid a diet full of carbohydrates
• get good nights sleep
• get to the test early
• scan the test
• review your test when completed
• put it behind you

Creative action based on professional knowledge and experience involving sound judgement applied with high ethical standards and integrity

Not every case, patient, situation is the same.

1. Identify the problem
2. investigate the problem
3. formulate viable solutions to the problem
4. select the best solution

The purpose of a clinical education is to provide an environment in which the student can transfer learning from the didactic and laboratory settings to real-world, patient-care experiences

improved integration of the didactic, clinical and affctive aspects of the programs

didactic to introductions to "real world" experiences with mentorships and guidance given be RTs and clinical supervisors

• Governance of a hospital begins with the board of directors or governing board.
• The President or Chief Executive Officer (CEO) is accountable to the hospital board.
• The hospital divisions and departments are accountable to the CEO.

• Varies depending on size and scope
• Often consists of sub-departments
• Requires support services
• Led by Administrative Director

Allied health - assist with diagnostic and treatment of the patients - same principles and focus as the hosptial

• managing resources and assets
• coaching and staff development
• analyzing opportunities
• strategic planning

• The Joint Commission (TJC)
• Nuclear Regulatory Commission (NRC)
• Occupational Safety and Health Administration (OSHA)
• Food and Drug Administration (FDA)
• American College of Radiology (ACR)
• State Health Departments
• Internal agencies
  • infection control
  • radiation safety committee
  • etc.

• Film-screen (conventional) system - special film, manufactured to be particularly sensitive to x-radiation and certain colors of light radiation, is used to capture the energy message carried by the remnant beam and to convert it into an image. - Must be processed
• Digital Cassette Systemss - photostimulable phosphor systems, also know as computed radiography (CR) or cassette-based DR, PPS make use of the digital acquisition modality in chich PSP plates are used to produce radiographic images (imaging plates)
• Digital Cassette-less systems - the detectors are permanently enclosed in a rigid protective housing. Both direct capture DR and indirect capture DR detectors are used with these systems - x-ray photons are absorbed by the coating material and immediately converted into an electrical signal.

invisible image created after exposure but before processing

the change on an x-ray film that becomes visible when the latent image undergoes appropriate chemical processing.

• x-ray tube
• collimator
• radiographic table
• control console

radiography/fluoroscopy room (R/F)

o Units of Measurement
 The SI units (Système International d’Unités, or International System of Units) were officially adopted in 1985.
 Roentgen (Coulombs per Kilogram)
• Measures exposure in air and is not used to express absorbed dose to individuals
• A measure of ionization in air as a result of exposure to x-rays or gamma rays
• Being phased out as a unit of exposure since exposure may be expressed directly as coulombs per kilogram
 Radiation absorbed dose (Gray)
• Expressed as rad
• Measures the amount of energy absorbed in any medium, defined as 100 ergs of energy absorbed in 1 g of absorbing material
• The rad has been replaced by the gray (Gy) in the SI system.
o 1 Gy = 100 rad
• When we document patient dose in the medical chart we use this unit – centigray (cGy)
 Radiation equivalent man (Sievert)
• Measured as rem
• Unit of dose equivalence
• Accounts for different types of radiation and their biologic effects
• rem has been replaced by the sievert (Sv).
o 1 Sv = 100 rem
• Expressed as the product of the absorbed dose in rad and a radiation quality factor
o rem = rad × QF
 Curie (Becquerel)
• Measures the activity of a radioactive material (radionuclide)
• Used in nuclear medicine and radiation therapy
• The curie (Ci) is the unit of activity equal to 3.7 × 1010 disintegrations per second (dps).
• SI unit of activity is the becquerel (Bq).
o Defined as one disintegration per second (1 dps)
o 1 Ci = 3.7 × 1010 Bq

X-Ray Interactions with Matter

• Diagnostic Range of energies
  
  • Classic coherent scattering
  • Photoelectric interactions - diagnostic/complete absorption/electron leave atom creating a pair
  • Compton scattering - diagnositc/ majority of occupational worker exposures/ incoming phoon collids with outer-shell creating a recoil
• Therapeutic Range of energies
• Pair production
• Photodisintegration

• Time - minimize length of time patient remains in the path
• Distance - maximize the distance between the radiation source and the patient
• Shielding - shield reproductive areas as well as those not withing the interest area

• Time - minimize length of time patient remains in the path to avoid scatter
• Distance - principle of the inverse square law
• Shielding - shielding garments

"acts in the best interest of the patient"

• identifying the problem - thoroughly look at the problem from every angle
• developing alternative solutions - exhaust all possible pathways to a resolution of the dilemma
• Selecting the best solution - based on moral and ethical resolve
• Defending the selection - you can explain the basis for your ethical decision in terms that you can justify to both colleagues and patients.

faith, beliefs, and differences of behavior....

• patient identification data
• medical history
• examination findings
• diagnostic and therapeutic orders
• observations
• Reports and test
• consent forms
• Conclusions and follow up care

Couple of different ways, treatment and billing

Health Insurance Portability and Accountability Act (HIPAA)

to improve the efficiency and effectiveness of the health care system by mandating confidentiality of health information - privacy, security, and the establishment of standards and requirements for the electronic transmission of certain health information

• Failure to use such care as a reasonably prudent person would use under like or similar circumstances

• For damages to be awarded, 4 elements must be proven
  
  • Duty to the patient by the worker
  • Breach of duty by an act or failure to do act
  • Compensable injury
  • Causal relation between injury and act

A willful and intentional misrepresentation of facts that may cause harm to an individual or result in loss of an individual right of property

Person's agreement ot allow something to happen (such as surgery) that is based on a full disclosure of the facts needed to make the decision intelligently - risks, alternatives, benefits, etc