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What are the two important components of most radiographic exams?
- patient preparation
- contrast media
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What two ways are patients preparation performed?
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External preparation
the removing of clothing, jewelry that may cover the area that xrays will pass through.
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Internal preparation
exams that require cleansing enemas so that structures in the abdomen are not obscured by gas or fecal material
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contrast media
solutions or gases introduced into the body to provide contrast on a radiograph between an organ and its surrounding tissue.
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3 types of contrast media:
- iodine-based media
- barium-based media
- air
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What is an ionic contrast media?
Iodine
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What is a non-ionic contrast media?
- Barium
- it is inert and cannot be absorbed by the body
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What is the medium of choice for gastrointestinal studies?
Barium sulfate
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when surgery is imminent or a perforated stomach is suspected which contrast media is the perfered ?
a water soluble iodine contrast agent would be used.
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What is the primary contrast agent for chest radiography?
Air
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Exams performed by the radiographer on particular regions of the body with the use of x-ray tube?
radiographic studies
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What category are radiographs of the region above the neck?
skull and headwork
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Skull and headwork studies are done primarily by these procedures?
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Exams done to the skull and head region without CT or in junction are:
- skull
- facial bones
- nasal bones
- mandible
- temporomandibular joints (TMJs)
- sinuses
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The mandible and TMJs are primarily imaged using this?
panoramic tomography
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Headwork imaging is usually performed for what reason(s)?
- evaluate possible fractures
- locate foreign bodies
- examine abnormalities
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Areas such as the sella turcica, zygomatic arches, mastiods, and orbits are imaged using?
CT
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What is the most commonly radiographed region of the body?
Thoracic cavity
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Name studies of the thoracic cavity:
- ribs
- sternoclavicular joints (STJs)
- sternum
- lungs
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The extremities category is divided into what regions?
- upper
- lower
- shoulder/pelvic
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Name upper extremity studies:
- fingers
- hands
- wrists
- forearms
- elbows
- humeri
- shoulders
- clavicles
- acromioclavicular joints (ACJs)
- scapulas
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Name lower extremity studies?
- toes
- feet
- heels
- ankles
- lower legs
- knees
- patellae
- femurs
- hips
- pelvis
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How many views are needed for bone studies?
2 at right angles from each other
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Why are radiologic exams on extremities performed?
- evaluate bone fractures
- dislocations
- arthritis
- osteoporosis
- tumors
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The spine category includes these studies:
- cervical spine
- thoracic spine
- lumbar spine
- sacroiliac joints
- sacrum
- coccyx
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A "live" radiological study
fluoroscopic study
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study of the esophagus, requiring the patient to swallow a barium sulfate preparation.
esophagram
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studies of the stomach and performed with the use of barium sulfate.
upper gastrointestinal (GI) series
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Procedure used to evaluate hiatal hernias, peptic ulcers, and other stomach disorders.
upper gastrointestinal series
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procedure involved in radiographing the abdomen every hour to watch the progress of barium through the small intestine?
small bowel examination
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radiographic exams of the colon which introduce a barium solution.
barium enema (BE)
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What is used in air-contrast studies of the colon to reduce cramping and peristalis.
glucagon
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a study where air is added to a barium study for better visualization of abnormaties in the colon.
air-contrast barium enema
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procedure where an iodinated contrast agent is injected into the bloodstream through a vein in the arm.
Intravenous pyelogram (IVP)
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examination of the urinary system
excretory urography
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a fluoroscopic study of the urinary system while it is filled with contrast agent
cystogram
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a procedure where the patient urinates the contrast material while under fluoroscopy
voiding cystourethrogram (VCUG)
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a fluoroscopic exam performed to diagnose anomalies in the biliary system or pancreas
endoscopic retrograde cholangiopancreatography (ERCP)
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List fluoroscopic exams
- esophagram
- upper GI series
- barium enema
- urinary system studies
- ERCP
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study that visualizes the arteries of a particular body regions. done with contrast and fluoro.
arteriogram
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exam used to evaluate the structures in and around a joint space. uses fluoro and MRI
arthogram
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examination of the uterus and fallopian tubes
hysterosalpingogram
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procedure used to destroy stones in the kidney or ureter by using sonic shock waves.
lithotripsy
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a radiographic study of the breast
mammogram
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an examination of the subarachnoid space of the spinal cord.
myelogram
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study of the salivary glands after they have been injected with contrast.
sialogram
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study used to evaluate the veins in a particular area of the body.
venogram
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venography is supplemented with and gradually being replaced by?
sonography
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what components make up a diagnostic radiograph?
- proper positioning
- selects proper exposure factors
- image interpretation
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what is the image recepter in CR?
photostimulable phosphor plate
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what is the IR in direct digital radiography(DR)?
a charged electronic device
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what is radiographic film composed of?
emulsion spread on a thin transparent sheet of polymer plastic
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What is developer?
the chemical solution that causes the crystals in the film that were struck by xrays to become black metallic silver
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elements used in digital radiography?
- cesium iodide
- gadolinium
- oxysulfide
- selenium
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Digital radiography can be produced in two methods:
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indirect method of DR
the xrays are first converted to light then the light is converted to electronic signal
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direct method
xrays interact with selenium creating a n electronic signal
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advantages of digital radiography:
- elimination of film and chemistry
- quicker time for patients
- image manipulation and adjustment
- decreased patient dose
- cautious of exposure creep
- elimination of fog
- image storage
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factors affecting the radiographic image
- geometric factors
- detail/resolution(measured in line pairs permm lp/mm)
- film (10 lp/mm)
- digital does not have the resolving ability of film, but contrast is greater
- photographic properties
- operator console/control panel
- time (sec/msec)
- voltage (kVp)
- amperage (mA)
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Factors that affect quality of radiograph?
- density * most important
- contrast
- distortion
- detail
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What determines the quality of the xray beam?
- kVp
- higher the kVp the higher the energy
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What determines the quantity of xray?
- milliampere (mA)
- greater the mA the greater the amount of radiation
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what is density?
is the amount of blackening
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What are the 5 radiographic densities in order of least to great in the human body:
- gas/air (black)
- fat
- muscle
- bone
- metal (white)
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what is the inverse square law?
I1/I2=(D2)2/(D1)2
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What is fog?
- it is created by scatter radiation.
- it increase the overall density of the radiographic image and it detracts from the overall quality of the image
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Name two devices that reduce exposure field size (beam limiters)?
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What is contrast?
a variation in density
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What are some advantages of beam limiting devices?
- reduce exposure field
- decrease amount of radiation
- decrease scatter radiation
- decrease fog
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Between where is the greatest contrast in the body demonstrated?
bone and air
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What is a grid?
- the device used to reduce scatter radiation.
- placed between subject and IR
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What factors affect distortion?
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How can you reduce magnification?
increase the SID
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Visibility of detail is influenced by:
- contrast
- visual acuity
- density
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What is the focal spot?
- the spot or source from which the xrays originate.
- a large focal spot produces unsharp images
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radiographs obtained at intervals of several minutes during the time that the kidneys, ureters, and bladder are highlighted by contrast material
IVP
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