Radiographic Imaging Principles and Techniques, Exams of Advanced Education

Download Radiographic Imaging Principles and Techniques and more Exams Advanced Education in PDF only on Docsity!

ARRT RADIOGRAPHY INSTANT ACCESS DETAILED

EXPLANATION 2023

For the cervicothoracic region lateral projection (swimmer's technique), the recommended position of the humeral head closest to the IR is move - anteriorly What two bones are united to form the sternoclavicular joint? -. Clavicle and sternum A radiographic contrast medium that absorbs more radiation than the organ in which it is placed is termed a(n) - Positive agent Which radiographic projection of the shoulder joint will demonstrate the glenoid cavity in profile? - AP oblique (Grashey method) What is the primary factor affecting the brightness of the fluoroscopic image? - Density of the anatomic part Which part(s) of the humerus should be palpated and correctly placed to ensure that the humerus is correctly positioned for AP projections? - Epicondyles Underexposed radiographs produced while using an AEC device might result from: - Having an insufficient backup time set for a very large patient A common group of drugs that are used to promote defecation are termed: - Cathartics How much is the patient rotated from the horizontal position to visualize the zygapophyseal joints of the thoracic vertebrae? - 70 degrees Which of the following radiographic procedures requires an image demonstrating a long scale of contrast? - Chest Select the correct sequence of energy conversions when an indirect flat panel detector is used: - X-ray to light to electrons

The ovaries are least sensitive to radiation at which age? - 20 - 30 years of age What is the active component of the TLD? - lithium fluoride A right lateral decubitus radiograph is taken of a patient with the grid placed behind the patient. This is an example of a(n): - AP Projection During cystography, when ureteral reflux is suspected, it is often necessary to include a __________ radiograph. - Voiding What is the milliampere setting if the desired milliamperage-seconds are 40 and if the time is setting is 50 milliseconds? - 800 mA Which of the following is (are) possible long-term somatic effects of radiation exposure?

1. Nausea & vomiting 2.Carcinogenesis
2. Leukemia - 2 & 3 only Direct action may occur after exposure to any type of radiation, but it is much more likely to happen after exposure to: - high-LET radiation such as alpha particles Which device in the typical x-ray circuit is adjusted to select the kilovoltage? - Autotransformer If all of the other factors remain the same, what effect does excessive filtration have on a radiographic image? - Reduced contrast What does the term "fill factor" refer to? - The percentage of the pixel face that contains the x-ray detector Which of the following would decrease the production of scatter radiation? - A decrease in kilovolts (peak)

The American College of Radiology (ACR) recommends that all available dose data from fluoroscopic examinations be recorded in the patient's medical record. Which of the following are acceptable methods of recording approximate dose?

1. Cumulative Air Kerma or Air Kerma area product data
2. Fluoroscopic exposure time and number of images acquired
3. Exposure factors utilized for the examination - 1 & 2 Medical asepsis can be defined as the __________ of pathogenic microorganisms in the environment? - reduction in number What is the name of the type of skull that is considered to be of average shape and size? - Mesocephalic Radioactive materials are stored and processed in the hospital nuclear medicine department. What types of personal protective equipment should the technologist wear while working with these materials?
4. Disposable nitrile gloves
5. Safety glasses
6. Surgical mask
7. Lab coat
8. Close-toed shoes
9. Sleeve protectors - 1, 2, 4, 5, 6 When walking into a patient's room that has been diagnosed as having TB, what should you wear? - Gloves and a N95 mask This type of DR technology uses silicon semiconductor chips which are tiled together into a matrix array. - CCD How many heat units (HU) are generated when setting a technique of 75 kVp, 400 mA, 250 milliseconds, on a 3-phase, 12-pulse generator? - 10,575 HU When imaging a morbidly obese patient, which of the following should be considered to minimize the radiation dose to the patient? - Use midline body landmarks to ensure accurate positioning.

To better visualize the lateral thoracic spine, the patient should be instructed to: - Breathe quietly Which of the following situations may cause a patient to go through the grieving process?

1. having a fractured clavicle
2. losing a spouse
3. being diagnosed with cancer - 2 & 3 Radiographic contrast is injected into which of the following for a lumbar myelogram? - Subarachnoid space Which radiographic decubitus position is preferred for demonstrating air and fluid levels in the abdomen? - Left lateral decubitus Where is the sternal angle located? - At the junction of manubrium and sternal body If a radiographer sets a technique of 75 kVp and 50 mAs for an AP projection of the abdomen but was asked to reduce the dose to the patient, the radiographer could: - Use a higher speed screen with a comparable change in milliamperage- seconds What is the average pulse rate of an infant? - 115 to 130 beats per minute What is the name of the bony projection that extends superiorly from the cribriform plate of the ethmoid bone? - Crista Galli A patient develops hives several minutes after a radiographic contrast medium is injected. Which type of drug may be given to the patient to counteract this reaction? - Antihistamine Which part of the rib articulates with the transverse process of the thoracic vertebrae? - Tubercle Which of the following methods represents a means of transmitting a disease through insect bites? - Vector

Which body position will demonstrate the left ribs free from superimposition of the cardiac silhouette? - LAO or RPO Which of the following does not represent a responsibility of the radiographer? - Providing patients with complete and accurate information regarding diagnosis and treatment Which of the following groups benefit from the low as reasonably achievable (ALARA) principle as set forth by the NRCP?

1. general public
2. patient
3. radiographers/operators - 1, 2, and 3 What is the minimum suggested schedule for testing lead aprons and gloves for inadequate shielding? - Annually The anatomic organ used for phonation is called the: - Larynx Which anatomy is well demonstrated in a lateral oblique projection of the hand?

1. Joint spaces
2. Distal phalanges
3. Middle phalanges - 1, 2 & 3 Which of the following would affect shape distortion? - Tube angulation In the third trimester, what is the recommended monthly dose-equivalent limit for the fetus? - 0.5 mSv Which of the following radiographic methods are used to demonstrate the intercondylar fossa?
4. Holmblad (PA axial)
5. Danelius-Miller (axiolateral)
6. Camp-Coventry (PA axial) - 1 & 3 Which of the following statements would be most important for a pregnant radiographer? - Don't switch dosimeters between the collar and waist level"

An optimal radiograph of the lumbar vertebrae of a geriatric patient requires a technique of 70 kilovolts (peak) and 40 mAs. To reduce exposure to the patient and maintain adequate radiographic density: - Increase kilovolts by 15 percent with a 50 percent decrease in milliamperage-seconds Which of the following would best demonstrate free air in the abdomen of a 3-yr old child with the least risk to the patient? - Decubitus projection without a grid Which unit of measurement would be most appropriate for stating the quantity of radiation exposure as measured by an ionization chamber? - Air kerma The length of exposure cords on medical imaging equipment is regulated to reduce radiation dose to personnel. Guidelines state that exposure cords: - must be at least 6 feet long on mobile equipment Which of the following does not determine CR resolution? - Laser scan speed To protect both the patient and the radiographer at a distance of 1 meter from the source, leakage radiation should not exceed? - 100 mR/h With a table Bucky device the appearance of grid lines on the radiograph could indicate that: - The exposure time is too short The amount of detail present in any image is known as ______ resolution. - Spatial The axiolateral oblique projection is used to demonstrate the mandible. How is the head positioned to demonstrate the ramus of the mandible? - True lateral A disadvantage of using magnification mode during fluoroscopy is: - the patient receives additional dose Which of the following is a reason why lidocaine (Xylocaine) is often used in the radiology department? - To provide a topical anesthetic for invasive procedures Which of the following organs receives blood from the portal vein? - Liver

What type of contrast medium is acceptable for use with infants who have swallowing disorders and with adults who have suspected bronchoesophageal fistulae? - Water-based barium As the field size is increased with all other factors remaining constant, the scale of radiographic contrast will: - Be lengthened During an ERCP, an endoscope is passed into the duodenum under fluoroscopic control. "Spot" images are usually taken of the _____ duct(s) .1. pancreatic

2. hepatic
3. common bile - 1 & 3 What graphs illustrate the relationship between radiation and the organism's response to it? - Dose-response curves Some local tissues suffer immediate consequences from high radiation doses. Examples of such tissues include: 1.bone marrow 2.male and female reproductive organs 3.skin - 1, 2 & 3 A metastatic bone survey usually involves imaging these bones:
4. Skull
5. Hands
6. Humeri
7. Femora
8. Pelvis
9. Spine
10. Feet - 1, 3, 4, 5, 6 Which of the following positioning methods can reduce radiation dose to sensitive tissues? - Pediatric chest imaging should be performed with posteroanterior projections

A chest radiograph is taken with a patient erect against the bucky with a 12:1 grid using technical factors of 110 kVp and 5 mAs. What factors should be used on a dedicated chest unit with an 8:1 grid? - 110 kVp, 4 mAs What may be demonstrated on a tangential projection of the patella (Settegast method)?

1. transverse fractures of the patella
2. patellofemoral articulations
3. longitudinal fractures of the patella - 2 & 3 In the lateral position, how far posterior does the sacrum lie from the median coronal plane? - 3" If the patient places the dorsal surface of the right hand against the right thigh, the humerus will be in the: - Lateral postiiton Which of the following lines is placed perpendicular to the plane of the image receptor for the AP axial projection of the TMJ articulation? - Orbitomeatal line Which imaging study of the urinary system demonstrates the collecting ducts of the kidneys by injecting a radiographic contrast medium through the ureter? - Retrograde pyelogram To obtain a more uniform image density, the respiration phase for the AP projection of the clavicle should be: - Expiration What is the recommended minimum amount of filtration in a fluoroscopic unit? - 2.5 mm Al equiv What is the name of the process that extends superiorly from the scapula? - Acromion process If a radiographer failed to correctly mark a radiograph that subsequently resulted in faulty diagnosis, he or she may be guilty of a tort under the doctrine res ipsa loquitur, which means: - The thing speaks for itself

Of the basic methods of reducing dose to imaging personnel, using the principle of time can be achieved by: - Limiting the amount of time the radiographer is in the immediate vicinity of a live x-ray beam All of the following are true of oxygen therapy EXCEPT: - oxygen therapy can be prescribed by pharmacists and respiratory therapists The ____ array is divided into square detector elements (DEL). - Thin-film transistor Which of the following x-ray interactions with matter is primarily responsible for radiographic contrast? - Photoelectric effect Grids can cause the moiré effect on digital images if this principle has not been satisfied: - Nyquist criterion When a photostimulable phosphor is irradiated and is in a metastable state, it will emit light _____.

1. Immediately
2. When stimulated by light
3. over time - 1, 2 & 3 The ampulla of vater empties its contents into the duodenum through the structure called the: - Sphincter of Oddi Specific area shielding may be selectively used during some x-ray procedures to protect which of the following?
4. Lens of the eye
5. Breast
6. Extremities - 1 & 2 If the orbitomeatal line is perpendicular to the image receptor for an AP axial (Towne) projection of the skull, how much angulation of the central ray is required? - 30 degrees Computed radiography plates respond to radiation with _____. - photostimulable luminescence

The main property of x-radiation that makes it potentially hazardous is its ability to: - Ionize matter Protective eyeglasses with optically clear lenses should contain a minimal lead equivalent protection of: - 0.35 mm A patient is scheduled for a UGI and small bowel radiological procedures. The patient is suspected of having a perforated colon. Which type of contrast medium is contraindicated for the procedures? - Barium Sulfate Which of the following are functions and/or responsibilities of the U.S. Occupational Safety and Health Administration (OSHA)?

1. Functions as a monitoring agency in places of employment, predominantly in industry
2. Regulates occupational exposure to radiation through Part 1910 of Title 29 of the U.S. Code of Federal Regulations (29 CFR 1910)
3. Responsible for regulations concerning the "right to know" of employees with regard to hazards that may be present in the workplace - 1, 2 & 3 A patient is to be scheduled for a BE, Abdominal US, and UGI. The proper sequence for performing the procedures is: - Abdominal US, BE, UGI If a radiograph demonstrates excessive size distortion, which of the following corrections should be made before repeating the radiograph? - Increase the SID An older x-ray tube that has evaporated tungsten on the tube window may cause which of the following problems: 1) decreased tube output, 2) decreased half- value layer (HVL), 3) arcing of the tube current - 1 & 3 A caliper is a tool used by the radiologic technologist to accurately measure body part thickness. Which method below describes how to properly use this tool? - Place the tool around the body part in such a manner as to measure the central ray entrance and exit positions What is the name of the special imaging procedure or examination of the uterus and fallopian tubes? - Hysterosalpingography

Which of the following articulates with the medial cuneiform bone? - First metatarsal Which of the following methods for obtaining a radiograph of the hip should be performed when a fracture is suspected? - Danelius-Miller method When radiographing the multiple-trauma patient who is incapacitated, what rule of thumb should be observed to provide greatest diagnostic benefit for the patient? - Obtain two views, 90 degrees apart, of all traumatized anatomy How should the patient's hands be positioned for an erect lateral projection of the sternum? - Clasped behind the patient's back What new exposure factors should be used to create a longer scale of contrast without altering image receptor exposure if the original radiograph used exposure factors of 300 mA, 1/10 second, and 60 kVp? - 300 mA, 1/20 second, and 70 kVp Where should the ionization chamber be located if it is to be used as an efficient automatic exposure timer? - Between the patient and the image receptor What is the name of the opening through which the spinal nerves pass after branching from the spinal cord? - Intervertebral foramen In an image intensifier, the squared ratio of the area of the input screen to the output screen is defined as: - Minification gain Which of the following radiographs would benefit most from the use of the anode heel effect? - Dorsoplantar projection of the foot The x-ray interactions with matter that cause ionization of the irradiated material include:

1. photoelectric effect
2. Compton scattering
3. pair production - 1 & 2

What would be the main advantage of using the "last image hold" feature of a fluoroscopy unit? - Effective means of reducing radiation dose to the patient Determination of radiological bone age is most frequently applied to the: - hand and wrist If bone marrow cells have not been destroyed by exposure to ionizing radiation, they can: - repopulate after a period of recovery Identification of radiographic images with the patient name and other required information is primarily an electronic process. Where does this information originate? - Hospital Information System (HIS) database The radiologist requires 60 percent more than the normal 50-cc dose of radiographic contrast medium to be used for a urologic procedure. The amount to be prepared is: - 80 cc A device that acts like a camera in an indirect conversion detector is known as a _________. - charge coupled device When using the c-arm mobile unit, which of these choices will best reduce patient dose? - Placing the intensification tower as close as possible to the patient Which of the following pathologies are well visualized by a double-contrast BE? - polyps Which of the following may be an example of the early somatic effects of ionizing radiation at very high doses? 1. Central nervous system syndrome 2. Hematopoietic syndrome 3. gastrointestinal syndrome - 1, 2 & 3 What is the acronym used in radiology for the genetic load on a population following gonadal exposure? - GSD Which type of cell in the integumentary system is most radiosensitive? - Epithelial

If a patient scheduled for an arthrogram states that he or she has an allergy to an iodinated contrast medium, what other imaging method could demonstrate the anatomy without putting the patient at risk? - Magnetic resonance imaging Grid use for PSP examinations is more critical than in film/screen radiography because CR: - Imaging plates are more sensitive to low energy photons Which type of generator would incorporate a high speed semiconductor voltage regulating switch (DC chopper) in order to convert 60 Hz AC to pulsed DC? - high frequency Dose area product (DAP) is a method of quantifying radiation dose based upon the dose received by local tissue and the volume of tissue irradiated. Which of these statements is/are accurate?

1. DAP may be a better indicator of stochastic risk than effective dose alone
2. DAP increases with increasing field size.
3. Exposing less tissue decreases DAP
4. DAP accounts for primary and leakage radiation - 1, 2 and 3 Which of the following blood pressure readings would indicate shock? - Diastolic pressure lower than 50 mmHg How many degrees and in which direction should the central ray be directed for an AP projection of the sacrum? - 15 degrees cephalic Which of the following radiographic positions will demonstrate the duodenal bulb and loop in profile during an upper gastrointestinal procedure? - RAO During an operative cholangiogram, the surgeon injects the contrast medium directly into the biliary system. Which of the following projections are typically done during this procedure in surgery?
5. AP
6. AP oblique, RPO
7. AP oblique, LPO - 1 & 2 Which of the following is administered during arthrography before the injection of contrast? - Local anesthetic

The radiation produced at very discrete energies of approximately 69 kiloelectron volts (keV) when electrons interact with the k shell of the tungsten target is called: - Characteristic radiation To demonstrate the zygapophyseal joints of the lumbar vertebrae with an AP projection, the patient rotation is: - 45 degrees The higher the number of pixels in a matrix, the: - Higher the image resolution The addition of thorium to the filament: - Increases filament life What radiographic baseline should be parallel to the image receptor for a submentovertex (SMV) projection of the paranasal sinuses? - Infraorbitomeatal line How is the central ray directed to obtain AP axial C-spine? - 15 to 20 degrees cephalad Which radiographic position of the skull should clearly demonstrate all four sets of Paranasal sinuses? - Lateral How should the patient's hand be positioned for a PA projection of the ribs so that the scapulae are rotated away from the rib cage? - Back of the hands against the hips Which of the following anatomic structures articulates with the capitulum of the humerus? - Head of radius During cardiopulmonary resuscitation (CPR) of an adult, the cardiac compression rate should be about: - at least 100 compressions per minute The key to an image in which the anatomy is optimally visualized is determined by the correct image receptor exposure. Which of the following does the radiologic technologist primarily use to achieve optimal IR exposure? - milliampere seconds

Which of the following are considered in the calculation of the monthly dosimetry reading?

1. natural background radiation
2. nuclear fallout
3. occupational dose - 3 only Where is the central ray directed for a lateral projection of the scapula? - Mid- medial border of the scapula "Touching a patient without permission" is the legal definition of: - Battery Which of the following is an accepted method of sterilization? - Dry hat Computed radiography acquires an image through: - the use of a storage phosphor plate When the femur is vertical, the medial condyle is lower than the lateral condyle. How many degrees difference is there between the two? - 5 - 7 degrees Which of the following will be accomplished by the proper use of beam-limiting devices?
4. improved image quality
5. reduced patient dose
6. reduced scatter radiation production - 1, 2 & 3 In which of the following positions would the patient be placed for insertion of an enema tip? - Sim's position The proper medical term for a patient who suddenly turns pale and feels cold and clammy is: - Diaphoretic In keeping with ALARA, select the action that would prevent a technologist from receiving exposure from the primary x-ray beam during one of the following portable examinations: - Wear a 0.5 mm Pb equivalent apron and thyroid shield, use a grid holder for the image receptor, use sponges or other devices as needed to immobilize the patient, use the full six feet of the exposure cord while standing at 90 degrees to the patient.

Which of the following may be used by the radiographer to help compensate for the varying densities of anatomic structures on a routine posteroanterior (PA) projection of the chest? - Trough filter Rescaling the digital image happens during this stage of image processing. - Pre- processing Cells are most sensitive to radiation when they are immature, undifferentiated, and rapidly dividing. This summarizes: - The law of Bergonie & Tribondeau What type of device would increase the diagnostic quality of a radiograph of the dorsoplantar projection of the foot? - Wedge filter Which of the following methods for detecting radiation is the most useful for measuring radiation exposure in air? - Ionization Automatic brightness control (ABC) and Automatic exposure rate control (AERC) are components of fluoroscopic systems whose purpose is to ensure creation of images with appropriate brightness while not exposing the patient to excess radiation. Of the following examples of ABC programming, which one will deliver the lowest dose to the patient? - System will increase kVp to a maximum before increasing mA. For the AP projection of the forearm, the hand is: - Supinated Which of the following is NOT acceptable practice when entering information into a patient's chart? - Use white-out to erase mistakes Many medical professions have developed "Practice Standards" to ensure optimum performance of their members. The radiography "Practice Standards" are developed and maintained by the: - American Society of Radiologic Technologists (ASRT) Which carpal bone has a characteristic hook like process? - Hamate

Which type of pathology would be best demonstrated by a radiograph of the lower leg? - Osgood-Schlatter disease Which of the following imaging procedures would require an informed consent form? - Cardiac catheterization If a radiographer receives a dose of 68mSv/hr while standing at a distance of 40 inches from the radiation source, what would the new exposure be if the radiographer moves to a new distance of 60 inches? - 30 mSv/hr Which type of personal monitoring may be worn for the longest period of time? - TLD The response of tissue to x-radiation is principally a function of which of the following? - Dose What is the central ray centering point for the RAO position of the esophagus? - T5-T The number of grid lines per inch or centimeter defines: - Grid frequency Which of the following radiographic methods would best demonstrate the coronoid process of the ulna? - AP oblique projection with medial rotation of the elbow The Alliance for Radiation Safety in Pediatric Imaging recommends that grids be used on pediatric patients when which of the following criteria are met? - When the body part being imaged is greater than 12 cm water-equivalent thickness Which of the following would demonstrate off-focus grid cutoff? - Both sides of the image are underexposed What degree of central ray angulation should be used for the axial plantodorsal projection of the os calcis? - 40 degrees Which of the following should be considerations when using an AEC device:

1. proper selection of time,

2. proper selection of ionization chamber(s),
3. precise positioning over the desired chamber(s) - 2 & 3 only What is the rounded projection on the anterior proximal surface of the tibia called? - Tibial tuberosity You are called to the trauma center to perform a bedside radiographic procedure on a patient, and you suspect the patient may have hepatitis B. What safety practices should you follow to protect yourself? - Wear gloves Intentional or unintentional acts performed by an individual and based on unreasonable conducts are known as: - Torts What amplifies the visible light released from the photostimulable phosphor (PSP) after it is stimulated? - Photodetector Which of the following test tools would be used to measure FSS? - Star test pattern Select the correct order in which the skin responds to radiation exposure:

1. Epilation
2. Dry desquamation
3. Erythema
4. moist desquamation - 3, 4, 2, 1 For persons with hematopoietic syndrome, survival time shortens as the radiation dose: - Increases These hematopoietic cells are highly sensitive because they live only about 24 hours and it is believed that their numbers drop quickly because large whole-body doses of radiation kill the mature cells first. - Lymphocytes When performing magnification radiography, if the SID is 40 in. (100 cm) and the object-image receptor distance (OID) is 6 in. (15 cm), what is the magnification factor? - x 1.

What can happen if a diabetic patient has taken his or her insulin but has been NPO since midnight? - The patient can go into insulin shock For which type of habitus will the diaphragm be at the highest position? - Hypersthenic The right sacroiliac joint should be clearly demonstrated in which of the following? - LPO An extremity encased in a fiberglass cast requires what modification to exposure factors? - Usually no increase in exposure factors is needed When using pulse progressive fluroscopy, which of the following practices will further lower patient dose? - Pulsing the fluoroscopic x-ray beam at the lowest frame rate The production of heat at the anode is directly proportional to _________. - Tube current Where is the exposure timer located in a typical x-ray circuit? - On the primary side of the step-up transformer Added filtration in a diagnostic x-ray machine is used for the main purpose of reducing radiation dose to the: - Patient's skin The yearly occupational radiation dose-equivalent limit for stochastic effects of the whole body is now determined to be: - 50 mSv Which of the following type of personal monitor measures radiation through a chemical change or reaction? - Film badge A radiologist asks you to administer a radiographic contrast medium. The patient collapses from anaphylactic shock. You may be protected from a lawsuit under the doctrine of respondeat superior, meaning: - Let the master answer What is the most common cause of injury to a health-care worker in the Radiology department? - lifting heavy object

Using the line-focus principle to gain sharper images will enhance a side effect known as: - anode heel effect Where would a "central line" catheter be located? - subclavian vein