CAMRT EXAM -with 100% verified solutions 2024-2025, Exams of Nursing

Download CAMRT EXAM -with 100% verified solutions 2024-2025 and more Exams Nursing in PDF only on Docsity! CAMRT EXAM -with 100% verified solutions 2024-2025 833Q&A What is the advantage of line focus principle? It provides the detail of a small focal spot while allowing a large amount of heat dissipation If the pedicles sit too far posterior on vertebral bodies for an oblique L spine, what does this mean? Too much obliquity Remember: PP - too much (posterior pedicles) What is a CVP line? Used for measuring central venous pressure as well as allowing nutrients and fluid to be instilled Best location for a CVP (Central Venous Pressure) Line? Brachiocephalic vein or Superior Vena Cava Where does a Swan-Ganz catheter sit? The right side of the heart and the arteries leading to the lungs What does a Swan-Ganz catheter measure? The heart's function and blood flow pressures in and around the heart What are Plia circularis? The numerous folds of the mucous membrane of the small intestine What are the instruments used for sensitometry? - Sensitometer (step wedge) - Densitometer How often is a sensitometry strip done? Daily What is demonstrated on a 15O degree occipitofrontal view of the sinuses? - Frontal sinuses - Anterior ethmoidal air cells - Sphenoid sinuses Oblique fracture of the base of the first metacarpal? Bennett's fracture An ankle fracture affecting one of the malleoli? Pott's fracture An ankle fracture affecting both of the malleoli? Second degree Pott's fracture (bi-malleolar fracture) An ankle fracture affecting both of the malleoli and the posterior surface of the tib fractured as well? Third degree Pott's fracture (tri-malleolar fracture) What is a Compound fracture? When the bone has broken through the skin Optimal kVp for an abdomen? 65 - 70 kVp Minimum number of people needed for a stretcher transfer (without slider board)? 3 What is the Fowler's position? Patients head elevated above feet What is the Trendelenburg position? Patients head lowered below feet Three anatomical landmarks assessed for perfect scapular Y view? - Coracoid - Acromion angle - Medial scapular angle When inserting an enema tip it should be directed ____ and ____? Anteriorly and Superiorly SID distance for AC joints? 180 SID Why use weights for AC Joints? To show if separation is occuring What is the first sign of anaphylactic shock? Itching and redness of the skin What is the treatment for anaphylactic shock? Epinephrine How does cold barium affect the stomach? Reduces irritation to colon, reduces spasms and cramping To see if a foreign body is in the lungs and not esophagus, you should do what view? PA Expiration What is an insufficient quantity of photons hitting the intensifying screen due to low mAs / time factor? Quantum Mottle Normal blood pressure? 110-140 Systolic and 60-80 Diastolic Mammo kVp? 23 - 28 kVp What is an injection site for a Myelogram? The subarachnoid space by spinal puncture What is a Myelogram? Injecting contrast medium into the subarachnoid space & radiographing (CT / X-Ray) to look for spinal canal problems The breathing for a Soft tissue neck? Slow inspiration On an oblique lumbar spine what is the "neck" of the Scotty Dog? Pars Interarticularis What is the most often used injection site for an abdominal angiogram? Femoral artery (catheter positioned at T12) What vertebral level do the kidneys sit? Air CT # - 1000 Fat CT # - 100 Fat pads of elbow are shown on what view? Lateral What does a Fat pad sign on an elbow X-Ray indicate? An undetectable fracture What is a sac formed by dilation of a blood vessel, usually an artery, and filled with blood? Aneurysm What is demonstrated on an oblique view of a Myelogram? Ruptured intervertebral discs Areas to look for a possible aspirated Foreign Body in a child? Nasopharynx to anal canal The maximum length the enema tip can be inserted is ____ inches or ____ cm 1.5 inches or 3.8 cm Final location for PICC line? SVC (Superior vena cava) Final location for a feeding tube? 1st part of duodenum Final location for an NG tube? Stomach Final location for a Swan Ganz? Right or left pulmonary artery (naturally flips into the right artery) What is the angle of the CR for a Barium Enema sigmoid shot if the patient is prone? 30-40 caudad Which position best demonstrates pleural effusion of the right lung? Right Lateral Decubitus When using a grid, what error causes an overall decreased density? Off level or off centered grid What is enteroclysis? The injection of nutrient or medicinal liquid into the bowel (After the procedure you must tell the patient not to eat or drink for a few hours as spray anesthesia is used to inhibit gag reflex when intubating) The anatomical landmark for SI joints? 1 inch above ASIS The xiphoid tip is at what vertebral level? T10 The sternal angle is at what vertebral level? T4 - T5 The cricoid cartilage is at what vertebral level? C5 65 - 75 kVp What is Tetralogy of Fallot? - Ventricular septal defect (VSD) - Right pulmonary valve stenosis - Displaced aorta - Right ventricular hypertrophy What is agenesis? Absence of an organ What four vessels supply blood to the brain? - Right internal carotid - Left internal carotid - Right vertebral artery - Left vertebral artery CSF CT # 15 Muscle CT # 50 Clotted blood CT # 75 High grid ratio focusing range? Smaller focusing range Low grid ratio focusing range? Larger focusing range Average body temperature? 36 - 37 degrees What rib attaches to the sternal angle? Second rib What sphincter allows food to pass into the duodenum? Pyloric sphincter What procedure is done for pneumothorax? Chest Tube How is the male urethra best demonstrated in a voiding cystogram? Anterior oblique view Where is a vesicovaginal fistula found? Between the bladder and vagina What are the symptoms of a PE (Pulmonary Embolism)? 80 percent of patients have no symptoms Where is the needle inserted in a shoulder arthrogram? 1/2 inch inferior and lateral to the coracoid process into the joint A ring artifact on a CT image could indicate what? Detector malfunction Weight / volume of barium for a single contrast GI ____% and double contrast GI up to ____% 30 - 50% Single contrast GI 250% Double contrast GI What 3 vessels form the celiac axis and where is it located? - Common gastric artery - Left gastric artery - Splenic artery Why include anterior soft tissue on a trauma cross-table lateral of the c- spine? To locate any type of vertebral displacement or swelling that could suggest a disguised fracture What is the purpose of lateral bending for scoliosis imaging? To determine the presence of structural change when bending to the right and left and assess the degree of correction that can be obtained Why is a CT study for PE scanned from from abdomen to just above shoulders? To help reduce artifact of the contrast when the initial injection is given because of the large amount of contrast that will be entering the superior vena cava before the coronary arteries What is Spatial Resolution? The ability to distinguish two small separate objects close together What should you do if a nurse forgets to chart a medication during an Intravenous pyelogram (IVP)? Bring any omissions to their attention - any item that has not been documented on the chart is considered to be "not performed" in a court of law What is a PICC line? Where is it located? A peripherally inserted central catheter which is placed in the brachiocephalic vein at the junction of the SVC or actually within the SVC itself What is the function of a PICC Line? Used for measuring central venous pressure as well as allowing nutrients and fluid to be instilled What is the function of a Swan-ganz catheter? - Wedge pressure - Central venous pressure - Systolic pressure - Diastolic pressure - Mean pressure - Withdraw blood samples - Inject drugs or administer fluids What are the three layers of mater surrounding the brain? From outer to inner: - Dura - Arachnoid - Pia What is the appearance of an Chronic subdural hematoma on a CT? Isodense lesion What is the appearance of an Acute subdural hematoma on a CT? A crescent-shaped peripheral high-density lesion What is a subdural hematoma? Venous bleeding from ruptured veins between the dura and meninges What is the cause of a subdural hematoma? Trauma Why should scoliosis images be performed PA? To reduce radiation exposure to selected radiosensitive organs What is considered the Sterile Corridor? The area in the operating room between the patient drape and the instrument table Name all parts of the Circle of Willis? What is the hip localization method? Imagine a line from the ASIS to symphysis pubis and at midpoint of that line, imagine a perpendicular line, moving 1.5" distally to locate the femoral head What is included on a CT head? = 1.05 What is the minimum length of a mobile x-ray cable? 3m What are the two routine projections/views for mammography imaging? - MLO (Mediolateral Oblique) - CC (Craniocaudal) Which mammography view requires the pectoral muscle on the posterior edge of the breast, retromammary tissue, and the nipple in profile? Craniocaudal View Optimal kVp used in Mammography? 23 - 28 kVp What is the function of Automatic Brightness Control? Maintain the brightness of an image during a fluoroscopic exam by automatically adjusting the exposure factors as necessary What does a recumbent right lateral stomach view demonstrate? Right retro-gastric space, duodenal loop, and duodenojejunal junction What are the 3 arteries off of the aortic arch? - Brachiocephalic artery - Left common carotid artery - Left subclavian artery What does the Brachiocephalic artery branch into? - Right subclavian artery - Common carotid artery What side dot the 3 arteries of the aortic arch branch off? Right side Remember: Right to tri - Right lung 3 lobes After changing the collimator light bulb, what test would you perform? Collimator light field/ x-ray beam congruency test What are the CT numbers for air, lung, fat, water, blood, and bone? Air = -1000 Lung = -200 Fat = -100 Water = 0 Blood = 20 Bone = 1000 You are performing a mobile chest x-ray. You have a distance of 60" and you use 6.3 mAs. How would you adjust your mAs value if you changed the distance to 72"? mAs1 / mAs2 = D1sq / D2sq6.3 / mAs2 = (60 x 60) / (72 x 72) = 3600 / 5184 mAs2 = 9.072 = 9.1 At what vertebral level do the kidneys sit? T12 to the level of the transverse processes of L3 What does the acronym TIPS stand for and what is its purpose? Transjugular Intrahepatic Portosystemic Shunt Its purpose is to decrease portal hypertension and the associated variceal bleeding by allowing the portal venous circulation to bypass its normal course through the liver What is the recommended overall repeat rate? 4 - 6% What is the final location for a feeding tube? First part of the duodenum What is the air gap technique? Increase OID to decrease scatter & therefore increase image contrast From what vessels do the right and left vertebral arteries originate? The right and left subclavian arteries By how much do you need to increase technical factors when imaging through a fiberglass cast? No change required (fiberglass does not attenuate as much as a plaster cast) How do you turn a patient who is on spinal precautions? Log roll What is the outpatient prep for a barium enema? Low residue diet for 2-3 days followed by clear fluids only the day before the exam and a laxative When imaging the cranium, what is the most radiosensitive area? Eyes What is the bifurcation of the trachea called? Carina Where is an ETT (Endotracheal Tube) located? 5cm above the carina What position does the body have to be in to view the fundus of the stomach in fluoroscopy? LPO What is the Hilum of the lung? It is the only site of entrance or exit for structures associated with the lungs In what position can you view the Hilum of the lung? Lateral Chest Why are the greater trochanters required in a scoliosis series? To help measure the degree of spinal curvature What is the reason for doing an AP Axial image of the Clavicle or AC Joints? To rule out subluxation / dislocation If you see the radial tuberosity in profile on a lateral elbow, is the patients palm flat or hand karate chopped? Palm flat On a scapular Y view, how can you tell is a dislocation is anterior or posterior? - Anterior: Humeral head under the Coracoid - Posterior: Humeral head under the Acromion What are the breathing instructions for Upper ribs and Lower ribs? - Upper ribs: Inspiration - Lower ribs: Expiration When doing a C-spine oblique, what side is of interest? The side closest to the tube When would you do a lateral pelvis? If looking for a foreign body or IUD How do you assess rotation on a Caldwell view of the skull? Equal distance from lateral border of skull to lateral border of orbit on both sides What view best demonstrates Osgood Schlatter's disease? Lateral view of the affected knee What is the advantage of slip ring technology in CT? Allows for continuous rotation of the x-ray tube by eliminating the cables between the gantry and the generators What does the term "pitch" refer to in CT? Pitch, is the relationship between the patient couch movement and x-ray beam collimation What is the equation used to calculate Pitch? Pitch = couch movement every 360-degrees / Slice thickness Why is a pitch greater than 1 not ideal for a CT examination? A pitch greater than one means that we are getting a greater amount of space between slices due to the motion of the couch therefore possibly missing pathology A left posterior oblique for a nephrogram will demonstrate the ____ureter and ____ kidney Left ureter and right kidney A right posterior oblique for a nephrogram will demonstrate the ____ureter and ____ kidney Right ureter and left kidney True or False: Osteoporosis is a disease of the elderly population False, osteoporosis can be a potential disease to a person of any age, gender and race What is the location of a boxer's fracture? Neck of the fifth metacarpal How is the x-ray tube in a mammography unit positioned to take advantage of the anode heel effect? The cathode end is closer to the chest wall High grid ratio focusing range smaller or larger? Smaller focusing range Low grid ratio focusing range smaller or larger? Larger focusing range What is atelectasis? Collapsed lung For a patient that has atelectasis and requires a chest x-ray, do you increase or decrease your technical factors? Increase; a collapse of the lung results in airlessness of all or part of the lung tissue, causing lung tissue density to increase What term is used to describe the folds in the stomach? Rugae The warming sleeve of the pressure injector pump is set to maintain contrast temperature at? Body temperature about 37 degrees (it does not heat up contrast it just maintains the heat) Where is the CT beam collimated? There are two collimators: - Pre-patient - Pre-detector Which rib attaches at the sternal angle? 2nd rib What must be included on all projections of the thumb? From distal tip of thumb to trapezium What mechanism allows food to pass into the duodenum? Pyloric Sphincter What sinuses are visualized on a lateral view of the skull? - Frontal - Maxillary - Ethmoid - Sphenoid What is the normal rate of respiration for an adult? 12-20 breaths per minute What carpal bone is susceptible to avascular necrosis and why? Scaphoid, because its blood supply enters from the distal portion and can get cut off when the bone is fractured What projections of the Lumbar spine will demonstrate the intervertebral joint spaces? Both AP and Lateral Which distal ureter is best visualized in LPO position? Left distal ureter In a RPO position which kidney is best demonstrated? Left kidney Patient has arrived in Fluoroscopy for an esophagus study, the clinical information states that they are looking for a perforation. What type of contrast will likely be used? Iodinated contrast, since it is water soluble and can easily be reabsorbed into the body without any adverse effects What is Cholelithiasis? The presence of gallstones What reduces patient dose during a CT without changing the technical factors? Increasing pitch What Chest views could you perform to demonstrate a possible pneumothorax? - PA with inspiration - PA with expiration - Lateral What is the angle and centering for a coned AP bladder shot? 15 degrees caudad directed to a point 1" above ASIS What is the role of the Radiation Protection Officer? - Oversee the program's daily operation and provide for its formal review each year - Developing appropriate radiation safety programs for the facility - Maintaining radiation monitoring records for all personnel What 3 vessels form the celiac trunk and where is it located? - Common Hepatic - Left Gastric - Splenic Arteries Located beneath the diaphragm at approximately T12 How many sacral segments does the sacrum consist of? 5 segments fused together to make the sacrum What is the tube position for an "outlet" pelvis male and female? 20 - 35 degrees Cephalad Males 30 - 45 degrees Cephalad Females What does and "outlet" view of the pelvis show? Superior / inferior rami and pubis of the ischium In what position are the zygapophyseal joints best demonstrated on a thoracic spine? Oblique view When x-raying an AP lumbar spine, why are the knees bent? To reduce the lordotic lumbar curvature in order for intervertebral joints to be well demonstrated What does mA control in regards to the x-ray beam? The amount of electrons that form in the electron cloud surrounding the filament when an exposure is about to be made (higher mA means more electrons are able to cross over to the anode resulting in more x-ray photon production) What does kV control in regards to the x-ray beam? The length of the exposure and goes hand in hand with the mA (this gives us the term mAs since mA multiplied by the time in seconds equals our mAs) What does Time control in regards to the x-ray beam? The intensity and energy of the beam (the higher the kV, the more penetrating power it has) When performing a GI exam of the stomach, what position should the patient be positioned in to demonstrate a possible hiatal hernia? Trendelenburg position In the O.R. where do you want the X-ray tube to reduce the technologist and surgeon's dose? Tube under the table, with the II close to the patient to reduce OID What corrections must be made if the pisiform is more anterior than the scaphoid on a lateral image of the wrist? Rotate hand and wrist internally What is the acceptance criteria value when testing kVp accuracy? Within ±10% of the selected value On a patella skyline image, the patellofemoral joint space is closed. To better superimpose the apex and based of the patella borders, the angle of the central ray can be ____ or the flexion of the knee can be ____? Decreased; decreased What is best demonstrated on the left anterior oblique view of the L- spine? Right zygapophyseal joints What part of the occipital bone articulates to form the atlantooccipital joint? The occipital condyles off of the occipital bone help to create the atlantooccipital joint What is Ketoacidosis? Ketoacidosis (hyperglycemia) usually refers to a diabetic patient that has a high blood sugar level What does the acronym ALARA stand for? As Low As Reasonably Achievable What is a normal adult pulse per minute? 60-90 beats per minute in a rested state for an adult When doing a mammogram exam, what is best demonstrated by the MLO position? Axillary tail and lymph nodes of affected breast What does a low GFR and creatine level mean? Decreased kidney function What kind of contrast would you use for a patient that has a low GFR and creatine level? - Non-ionic - Water soluble - Low osmolality In regards to radiographic contrast, what does the term viscosity refer to? A measure of thickness What is Entrance Skin Exposure (ESE)? Most frequently reported way to specify the amount of radiation received by a patient from a diagnostic imaging procedure What is the inverse square law when the exposure from an x-ray tube operated at 70kVp, 200mAs is 400 mR at 90 cm. What will be the exposure at 180 cm? Intensity1 / Intensity2 = (distance2 / distance1)^2 400 = i2 x (180 / 90)^2 400 = i2 x 4 i2 = 400 / 4 i2 = 100 mR at 180cm You are involved in an O.R case where fluoro is needed for a Lumbar spine. You decide to roll in lead shields for the surgeons who do not have lead aprons on so they can stand behind them during the exposure. Is this barrier considered to be a primary or secondary barrier? This barrier is considered to be a secondary barrier as it is only blocking out the scatter or leaked radiation. The shield is not built to fully withstand the full energy of the primary beam What is the primary factor controlling radiographic contrast? kVp Increase kVp = Decreased contrast Decrease kVp = Increased contrast If you have a complaint about a radiologist, what body would you contact? The College of Physicians and Surgeons The largest occupational dose comes mainly from which two areas of a DI department? Mobiles and fluoroscopy True or False: Estimated calculations have shown that when standing one meter away from the primary beam the energy of the beam will only be 0.01% of the original energy? True What causes the ball bearings to wear in the x-ray tube? Rotor prep time (melts bearings) What is syncope? Temporary loss of consciousness caused by a fall in blood pressure Which trimester of pregnancy is deemed to be the most sensitive to radiation? The first trimester is the most sensitive to radiation, since earlier exposures have more prolonged effects (All or Nothing Effect) What landmark is at the level of C3/C4? Hyoid Bone What is a nephrogram and why is it important? A radiograph of the kidney after an injection of a water-soluble iodinated contrast, if the kidney does not completely fill then we know that there is likely a blockage What is the anatomical term of the ampulla located in the duodenum that is important for ERCP procedures? Ampulla of Vater The tracheal bifurcation is also known as the? Carina What is the location of an ET Tube? To prevent over-inflation of the right bronchus, resulting in collapse of the left lung, the ET tube is placed 5-7 cm above the tracheal bifurcation (carina) At how many minutes does the fluoro timer go off? 5 minutes For an abdominal angiogram, where does the catheter sit when doing the flush? The level of T12 What is the purpose of a flush in an abdominal angiogram? To rule out the presence of aneurysms, congenital anomalies, stenosis, or occlusions True or False: The smaller the target angle the smaller the effective focal spot and the better the resolution? True, think of a mammography machine in comparison to a general x-ray unit. The angle of the target in mammography is smaller to have a smaller effective focal spot and increase the resolution of the tissue being imaged Which stomach position demonstrates the fundus full of barium, and an unobstructed view of the duodenal bulb? LPO Where should be your center of gravity when you are lifting something? Right overtop your base of support A grid's primary function is to improve what? Contrast What is off-focus radiation (extra-focal radiation)? Electrons bounce off the focal spot and land on other areas of the target, causing x-rays to be produced from outside the focal spot or field How is off-focus radiation controlled? - Fixed diaphragm in the tube housing - Metal envelope x-ray tube - Decreased kVp Which drug will relieve pain without loss of consciousness? a. Anesthetic b. Antihistamine c. Anticonvulsant d. Analgesic Analgesic What is cyanosis? Bluish discoloration of the skin due to a lack of oxygen What range of ribs should be visible on an AP Upper rib study? Upper Ribs: 1st - 10th above the diaphragm What range of ribs should be visible on an AP Lower rib study? Lower Ribs: 8th - 12th below the diaphragm What is a TIA (transient ischemic attack)? A build up of plaque at the bifurcation of the carotid artery causing headache, dizziness, drowsiness, and mental confusion (a mini-stroke) True or False: Systolic pressure is the highest point reached during the contraction of the left ventricle True What is the purpose of universal precautions? To prevent the transmission of disease by body fluids and substances by assuming that every patient has an infectious disease and must be handled with the correct PPE and care at all times Epiglottitis typically affects which age group? Children aged 3-6 years old Which vein will most likely be used for an IVP injection? Antecubital If the exposure used at 30 SID is 5 mAs, calculate what the mAs exposure would be used at 40 SID? mAs1 / mAs2 = (distance1 / distance2)^2 5 / x = (30 / 40)^2 5 / x = 0.5625x Which bones form the hard palate? Palatine bones and maxillae What is the location of the catheter tip for a percutaneous nephrostogram? Renal pelvis What type of gas is produced when granules are given during a GI series? Carbon dioxide How often should the MRT assess a trauma patient while they are in an imaging department? Every 5 to 10 minutes Where is the coronoid process located? There are two locations that have a coronoid process: the proximal ulna and the mandible True or False: The technologist has no control over the mA selection when using a falling load generator? True If you are about to start CPR, which artery should be used to assess pulse? Carotid What is Ataxia? Uncoordinated What PPE is required when dealing with a patient who has MRSA? Gloves and gown (Contact precautions) What is a DXA scan? DXA = Bone density testing True or False: Effective radiation doses for DXA are higher than the radiation dose for conventional radiography? False, DXA is a much lower dose How many cranial bones are there and what are they called? 8 cranial bones: - Frontal - Occipital - 2 Parietals - 2 Temporals - Sphenoid - Ethmoid On a 10 degree caudal projection of the coccyx, is the coccyx demonstrated above or below the symphysis pubis? Above What is Sims position? On left side with weight distributed on ileum, humerus, and clavicle What forms the bony nasal septum? - Nasal Spine - Perpendicular Plate - Vomer After a mild allergic reaction to contrast, the doctor wants to administer an antihistamine, which of these would be selected? a. Benadryl b. Adrenalin c. Xylocaine d. Atropine Benadryl During an IVP, the patient has a heart attack. You see that their chart states DNR. What should you do? a. Begin CPR b. Call a code c. call radiologist that injected A patient presents with vertigo. Which cranial bone contains the parts of the body that could be implicated with vertigo? The temporal bone contains all of the bones of the ear which when altered can affect balance What is the most likely radiation induced effect on a fetus in the 1st trimester? CNS damage (if dose exceeds 200 mSv, death) An Inferosuperior projection of the patella should not be done if what pathology is demonstrated on the AP image? Transverse fracture of the patella A satisfactory abdominal image is produced using an 8:1 grid, 35mAs, and 85kVp. A second image is requested using a 12:1 grid. Calculate what mAs is needed to produce a second satisfactory image? 35 / mAs2 = 4 / 5.5 35 / mAs2 = 0.72727273 mAs2 = 48 How is repeat rate calculated? Total # of repeats / total # of images produced What is the safe infusion rate for IV drip for a patient without an order? 15 to 20 drips per minute What is the safe 02 rate for a patient without an order? Oxygen is considered a medication and must be prescribed with an order Is bleach a disinfectant? Yes Is alcohol a disinfectant? Yes Why must the elbow be flexed 90 degrees for a lateral elbow view? The elbow fat pads are least compressed in this position The greatest source of scatter radiation occurs where? a. Tabletop b. Patient c. X-ray tube d. Grid Patient For a PA chest, only the center cell was selected when using the AEC setting. How will the image appear and why? Overexposed (dark) since the radiation was too much for the one single detector What kVp would be used to achieve high contrast? Low kVp (short scale contrast) What kVp would be used to achieve low contrast? High kVp (long scale contrast) What is inherent filtration on an x-ray machine? The window of the x-ray tube and any permanent enclosure for the tube or source that reduces the primary x-ray beam In the image intensifier tube, what is the purpose of the input phosphor? Input phosphor (made of cesium iodide) converts x-rays photons to visible light photons Which of the following components of the II is responsible for focusing the electron beam? Electrostatic Lens What is the purpose of a back-up timer? To terminate the exposure in the event of an AEC failure The medial condyle, it is useful in determining the rotation on a lateral knee when a correction is needed Which area of the body is most susceptible to the formation of decubitus ulcers? - Scapulae - Elbows - Sacrum - Trochanters - Knees - Heels When should a grid be used? If part thickness is over 10cm, and if kvp is over 70 Which two vessels unite to form the main portal vein? - Superior mesenteric vein - Splenic vein Ways to reduce risk to a recently fertilized ovum? - Scheduling (10 day rule) - Patient questionnaire - Posting What is the NCRP Recommended cumulative occupational dose limit? Age x 10 mSv What is the NCRP Recommended annual occupational dose limit? 50 mSv What is the NCRP Recommended occupational dose limit for students? 1 mSv What is the NCRP Recommended occupational dose limit for skin, hands and feet? 500 mSv What is the NCRP Recommended occupational dose limit for the lens of the eye? 150 mSv What is the NCRP Recommended occupational dose limit for an embryo / fetus ? 0.5 mSv (per month) 5.0 mSv (entire gestation) List all personal radiation monitors? - Optically stimulated luminescence (OSL) - Thermoluminescent dosimeter (TLD) - Film badge - Pocket dosimeter - Ion storage device What are SI Units? - Air Kerma (Gya) - Gray (Gyt) - Sievert (Sv) What are Traditional Units? - Roentgen - rad - rem Name all Radiation Weighting Factors? - X or gamma rays (1) - Protons (2) - Neutrons 10 - 100 keV (10) - Neutrons 100 keV - 2 MeV (20) - Alpha particles (20) Name all Tissue Weighting Factors? - Skin (0.01) - Thyroid (0.05) - Breast (0.05) Window level affects what? Brightness Window width affects what? Contrast List the grid conversion factors for the following: No grid 5 : 1 6 : 1 8 : 1 10/12 : 1 16 : 1 No grid - 1 5 : 1 - 2 6 : 1 - 3 8 : 1 - 4 10/12 : 1 - 5 16 : 1 - 6 What is the grid conversion formula? mAs1 / mAs2 = GCF1 / GCF2 What are the advantages of digital fluoroscopy photospots? - Decreased patient dose - Post processing capabilities - "Road mapping" capabilities When should gonadal shielding be used? 1. When the reproductive organs lie in or near a properly collimated beam 2. The clinical objectives of the examination will not be compromised 3. The patient has a reasonable reproductive potential List the safety features of fluoroscopy equipment? - Max 5 mA - At least 30 cm between focal spot and tabletop - Max 100mGy / min tabletop exposure - Dead man switch - 5 minute cumulative timer - Automatic collimation - Bucky slot cover - Protective lead curtain Factors affecting resolution? - OID (Magnification distortion) - SID (Magnification distortion) - Focal spot size (Focal spot blur) - Patient factors (Shape/Structure/Position) - Motion (Motion blur) Reciprocity Law Any combination of mA and time that gives you the same mAs What are primary barriers? Protect from the useful primary beam What are secondary barriers? Protect from the scattered and leakage radiation 3 cardinal rules of radiation protection - Time - Distance - Shielding As grid ratio increases? - Contrast resolution improves - Scatter is cleaned up - Exposure factors must be increased - Positioning latitude decreases What is attenuation? True or False, autotransformers select the amount of voltage sent to the transformer? True Autotransformers require ____ current for operation? AC Autotransformers operate on the principle of ____? Self induction List the characteristics of Tungsten? - High atomic number (Z = 74 Increases x-ray production) - High melting point (3410 degrees resists pitting and cracking) - Thermal conductivity (Heat dissipation) What is the Line Focus Principle? The effective focal spot is always smaller than the actual focal spot What is a normal GFR? Normal results range from 90 to 120 What is a normal creatinine? Normal creatinine clearance is 88-128 mL/min for healthy women and 97- 137 mL/min for healthy men What end has more penetration power, Anode or Cathode? Cathode What are 2 things to watch for on a trauma cervical spine series? - Shifting of the lateral masses of the odontoid - The 3 main lines on the lateral image to look for vertebral shifts to the front or back What are oblique cervical spine views used to assess? - Zygapophyseal joints - Open foramina Name all structural joint types? - Fibrous - Cartilaginous - Synovial Name all functional joint types? - Synarthrosis - Amphiarthrosis - Diarthrosis List the 6 types of Synovial joint movement? - Gliding - Hinge - Pivot - Ellipsoid - Saddle - Ball and socket List the 4 image quality factors of a radiograph? - Density - Contrast - Spatial resolution - Distortion What are 2 landmarks that should NEVER be palpated? - Pubis symphysis - Ischial tuberosity What is the position that demonstrates the apices of the lungs, without superimposition of the clavicles? Lordotic or Apical What is the rationale for positioning the hand in supination for the AP projection of the forearm? This prevents the ulna and radius from crossing Which images might be improved by using a breathing technique? How are the exposure factors manipulated to allow breathing during the exposure? Lateral cervicothoracic projection, mA is lowered and exposure time is lengthened (Reciprocity law) What accommodations are made for patients with cervical trauma? - Patients are in an immobilization device (collar) so the equipment will have to move around the patient instead of us positioning them - A lateral view must be taken first and cleared by a doctor before proceeding with imaging What fractures might be missed if the lateral projection does not demonstrate the top of T1? Clay shoveler's fracture What additional projection is required if T1 is not demonstrated on the C- spine lateral? A lateral projection of the cervicothoracic spine (Swimmers) Which positions are contraindicated if the shoulder joint is suspected to be dislocated? Internal and external rotation What criterion is used to determine if the CR angle was sufficient for an axial projection of the clavicle? Most of the clavicle should be projected above the ribs and scapula, the medial end should be at level of 1st or 2nd rib What is the purpose of the required limb position for the AP projection of the pelvis and upper femora? The internal rotation of the lower limbs places the femoral necks parallel to the IR which reduces foreshortening Which projection will optimally demonstrate an injury to the right anterior ribs? PA so the affected side is closer to the IR Which projections and positions may be used to demonstrate a pneumoperitoneum on a patient who is too ill to stand? AP left lateral decubitus and lateral dorsal decubitus What is the difference between a projection and a position? Give examples. - Projection: AP, PA, Lateral, Oblique - Position: Supine, Upright, Decubitus, Medial/Lateral rotation If the kidneys are of primary interest, would the PA projection be a viable option? Why or why not? No, the kidneys are magnified when imaged PA In acute abdominal cases, why is the left lateral decubitus position preferable to the right lateral decubitus position? Left lateral decubitus allows intraperitoneal gas to rise under the right hemidiaphragm where it wont be superimposed by the gastric gas bubble on the left Why is it imperative to visualize the diaphragm on an acute abdominal series? If there is a pneumoperitoneum, the free air will rise to diaphragm level Why is proper hydration before contrast administration particularly important? Dehydration increases the risk of contrast induced renal failure Which patient populations should be carefully screened for proper hydration before contrast administration? - Multiple myeloma - Sickle cell positive - Diabetes - High uric acid levels You are about to examine a trauma patient who is unable to hyperextend the neck far enough to place the mento-meatal line perpendicular to the plane of the IR. How should the acanthioparietal projection be modified for this patient? Adjust the CR to enter the acanthion with a cephalic angle parallel to the mento-meatal line Left The attenuation of a specific tissue relative to water is the? a. CT number b. Window width c. Echo coefficient d. Positron absorption CT number Which type of contrast medium is preferred for hysterosalpingography? a. Barium sulfate b. CO2 c. Oily viscous d. Water-soluble Water-soluble In computed tomography, if the pitch increases, the dose? a. Pitch and dose are unrelated b. Increases c. Stays the same, as dose is controlled by mAs and kV d. Decreases Decreases Which of the following is NOT part of the Circle of Willis? a. Right and left anterior cerebral arteries b. Right and left internal carotid arteries c. Anterior communicating artery d. Right and left vertebral arteries Right and left vertebral arteries What dose descriptor is used to describe a measurement of the total amount of exposure for a series of scans? a. CTDI volume b. Multi-slice absorbed dose c. DLP d. Total scan dose DLP Which is a true statement in regards to a stroke protocol in the ER department? a. A CT scan of the head must be done as soon as possible b. A unenhanced CT scan will provide sufficient information to diagnose and treat a stroke c. A MRI is required to rule out a stroke d. A Ct scan of the head is only done if a patient has a previous history of a stroke A CT scan of the head must be done as soon as possible Of the following, which gauge allows for the highest rate of injection for an intravenous contrast injection CT procedure? a. 18 gauge b. 25 gauge c. 20 gauge d. 22 gauge 18 gauge What is a typical WL and WW of a lung window? a. WL +50 / WW 350 b. WL +80 / WW 250 c. WL -500 / WW 1600 d. WL + 500 / WW 2000 WL -500 / WW 1600 The ability of the scanner to differentiate small differences in attenuation between closely spaced objects refers to which term? a. Spatial resolution b. Temporal resolution c. Contrast resolution d. Signal to noise ratio Spatial resolution Which vein site is overused and can become scarred or sclerotic? a. Dorsal wrist b. Back of the hand c. Anterior surface of the elbow d. Superficial foot Anterior surface of the elbow Which of the following are moderate reactions to contrast media? a. Nausea, vomiting, or itching b. Respiratory distress c. Sensation of warmth d. Metallic taste, or sneezing Nausea, vomiting, or itching True or False, Retrograde urography differs from excretory (normal flow) in that the contrast medium is injected directly in the kidney by means of a percutaneous injection through the skin? False A technologist is preparing contrast media for an enhanced CT scan of the chest. The patient has a known history of an allergic response to IV contrast media. What medication should be administered prior to having the CT scan? a. Diphenhydramine (Benadryl) b. Hyoscine Butylbromide c. Prednisone (corticosteroid) d. Lorazapan Diphenhydramine (Benadryl) Prednisone ( corticosteroid) If the main tissue of interest is the lung tissue for a CT exam, which would be the most appropriate window level setting? a. 50 b. 0 or the level of water c. - 600 d. 400 - 600 Window width in CT controls? a. Density b. Mid range of densities c. Resolution d. Gray scale Gray scale What is the chief disadvantage of CT colonography over conventional endoscopy? a. Can't biopsy or remove polyps b. Bowel prep c. Cost d. Time consuming procedure Can't biopsy or remove polyps High-resolution CT studies of the chest require a slice thickness to be reduced to? a. 2.5 mm b. 0.625mm c. 1.25 mm d. 5mm 1.25 mm During venipuncture, the technologist places the needle bevel ____ at a ____degree angle to the skin's surface? a. Up, 45 b. Up, 15 c. Down, 15 d. Down, 45 Up, 45 What is the purpose of the use of bowtie filters in CT? a. Increase patient exposure b. Ensure correct patient centering and reduce dose c. Increase kilovoltage d. Shape the intensity of the primary beam Shape the intensity of the primary beam What is the normal range for glomerular filtration rate (GFR)? a. 90 to 120 mL/min b. 0.05 to 1.2 mg/dL c. 10 to 20 mg/dL d. 110-115 mL/min 90 to 120 mL/min Which of the following window settings would be used to visualize abnormalities in the liver? a. WW = 2000, WL = -400 b. WW = 2000,WL = 300 c. WW = 300, WL = 20