chapter 53 x_rays_and_diagnostic_radiology

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

X-rays and Diagnostic RadiologyX-rays and Diagnostic RadiologyPowerPoint® presentation to accompany:

Medical AssistingThird Edition

Booth, Whicker, Wyman, Pugh, Thompson

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Learning Outcomes53.1 Define x-rays and explain how they are

used for diagnostic and therapeutic purposes.

53.2 Compare invasive and noninvasive diagnostic procedures.

53.3 Discuss the medical assistant’s role in x-ray and diagnostic radiology testing.

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Learning Outcomes (cont.)

53.4 Discuss the medical assistant’s duties in preparing a patient for an x-ray.

53.5 Explain the risks and safety precautions associated with radiology work.

53.6 Describe proper procedures for filing and maintaining x-ray films and records.

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Introduction Diagnostic radiology

is a valuable tool Screening Clinical diagnosis

Medical assistant Role in noninvasive

and invasive procedures

Safety issues Proper handling and

storage of films Preparation and

instruction of patients

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Brief History of the X-Ray Discovered in 1895 by

Wilhelm Konrad Roentgen

Electromagnetic wave Travels 186,000 miles/sec Short wavelength Penetrates solid objects Reacts with photographic

film

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Brief History of the X-Ray (cont.)

Diagnostic and therapeutic uses

Radiologist Physician Interprets films

Radiologic technologists

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Diagnostic Radiology Contrast medium

Purpose Makes internal organs denser Blocks passage of x-rays to film Provides a clearer image of

organs and tissues

Types Gases Heavy metal salts Iodine compounds

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Invasive procedures A catheter, wire, or other testing

device is inserted into a blood vessel or organ by a radiologist

Requires surgical aseptic techniques

Patients must be closely monitored, especially if anesthesia is used

Diagnostic Radiology (cont.)

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Noninvasive procedures View internal structures

Standard x-rays Ultrasonagraphy

Do not require inserting devices, breaking the skin, or as great a degree of monitoring as invasive procedures

Uses the conventional x-ray machine or specialized instruments

Diagnostic Radiology (cont.)

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Apply Your Knowledge

2. What is the difference in noninvasive and invasive procedures?

ANSWER: Noninvasive procedures do not require inserting devices, breaking the skin, or special monitoring and use conventional x-ray machines or specialized instruments to visualize internal organs. Invasive procedures require surgical aseptic technique for the insertion of a catheter, wire, or other testing device into an organ or blood vessel.

1. X-rays are __________________ waves that travel at the speed of light and penetrate solid objects

electromagnetic

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Medical Assistant’s Role in Diagnostic Radiology Assist with or perform

procedures Based on scope of practice for

state Pre- and post-procedure patient

care Patient education

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Preprocedure care Schedule appointments Provide preparation

instructions Explain the procedure Ask pertinent questions

Medication history Women – possibility of pregnancy

Medical Assistant’s Role in Diagnostic Radiology (cont.)

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Care during and after a procedure Assist with placing,

removing, and developing film

Tasks listed in Procedure 53-1 “Assisting with an X-ray Examination”

Medical Assistant’s Role in Diagnostic Radiology (cont.)

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Apply Your KnowledgeHow can you find out what role you can take in radiologic testing as a medical assistant?

ANSWER: Check with your state’s scope of practice for medical assistants.

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Common Diagnostic Radiologic Tests Contrast media in

diagnostic tests

Adverse effects Mild to severe Localized to systemic Check for allergy to

fish

Examples Angiography Arthrography Barium swallow or

enema Cystography Myelography Retrograde pyelography Nuclear medicine studies

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Fluoroscopy X-rays cause certain

chemicals to emit visible light

Allows for viewing movement of an organ or passage of substances through organs

Hysterosalpingography Examination of uterus

and fallopian tubes by fluoroscopy

Used to evaluate shape and structure of uterus and patency of fallopian tubes

Common Diagnostic Radiologic Tests (cont.)

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Arthrography Contrast medium and

fluoroscopy Used to diagnose

abnormalities or injuries in cartilage, tendons, or ligaments

Barium enema or swallow Contrast medium –

barium Diagnose and evaluate

obstructions, ulcers, polyps, diverticulosis, tumors, or motility

Patient instructions and compliance important


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Cholecystography – detect gallstones or abnormalities of the gallbladder

Cholangiography – evaluate function of bile duct

Conventional tomography Uses a computerized camera

that moves back and forth over the patient

One view per arc over patient

Computer tomography Camera rotates completely

around the patient Cross-sectional view from

each rotation


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Heart X-ray – shows configuration of the heart and cardiac enlargement or aortic dilation

Intravenous pyelography (IVP) Used to evaluate urinary system Shows contrast medium moving through kidneys,

ureters, and bladder

Retrograde pyelography – Similar to IVP but contrast medium injected through a urethral catheter


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Kidneys, ureters, and bladder (KUB) radiography X-ray of abdomen Assesses the size, shape, and position of urinary organs

Magnetic resonance imaging (MRI) – uses strong magnetic field to examine internal structures and soft tissues

Mammography – x-ray exam of internal breast tissues


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Myelography Fluoroscopy of the

spinal cord used to evaluate spinal abnormalities

Performed less frequently because of new technology

Nuclear medicine Use of radionuclides or

radioisotopes to evaluate internal organs

Types include SPECT PET MUGA


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Stereoscopy – specially designed microscope used to produce 3-D images of abnormalities in the skull

Thermography Infrared camera photographs variations in skin

temperatures Diagnosis of breast tumors, breast abscesses, and

fibrocystic breast disease


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Ultrasound Directs high-frequency sound

waves to produce an echo of the internal organ

Produces image based on echo

Xeroradiography X-rays developed with powdered toner on specialized

paper Less radiation exposure


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Apply Your KnowledgeTrue or False:

___ Fluoroscopy is used for many procedures.

___ Hysterosalpingopraphy is used to evaluate the patency of the colon.

___ Cholangiography is used to detect abnormalities of the gallbladder.

___ For an IVP, the radiologist injects the contrast medium through a catheter.

___ An MRI uses a combination of nonionizing radiation and a strong magnetic field.

___ Mylography is done frequently to evaluate for spinal abnormalities.

___ Thermography uses an infrared camera to record variations in skin temperature.

ANSWER:

less often due to advanced technologies

F

F

F

F

T

T

T

a retrograde pyelography

bile duct

fallopian tubes

Bravo!

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Common Therapeutic Uses of Radiation Radiation therapy – used to treat cancer by preventing

cellular reproduction

Two types: Teletherapy – allows deep penetration; used for deep

tumors Brachytherapy

Places temporary radioactive implants close to or directly into the cancerous tissue

Requires special precautions for radiation safety

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Radiation Safety and Dose Reducing patient exposure

Advances in technology Assessment of benefit-to-risk ratio

NCRP Guidelines for protection from radiation Prevent serious damage from radiation by limiting

radiation dose levels Reduce risk of cancer and genetic effects Individual dose limits set

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Personnel safety Always wear a radiation

exposure badge

Make sure equipment is working properly

Anyone present when equipment is operating should wear lead shield

Radiation Safety and Dose (cont.)

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Apply Your Knowledge1. What are the two types of radiation therapy?

ANSWER: Teletherapy allows for deep penetration and is used for deep tumors. Brachytherapy involves the implantation of temporary radioactive implants close to or directly into cancerous tissue.

2. What should the physician consider before ordering radiologic testing for a patient?

ANSWER: The benefit-to-risk ratio. Super!

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Storing and Filing X-rays Keep fresh film on hand Maintain new and exposed film

in good condition at proper temperature and humidity

Prevent pressure marks Keep expiration dates visible Use oldest film first Open all packages or boxes in darkroom Do not store near acid or ammonia vapors

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Storing and Filing X-rays (cont.) Document x-ray information

Patient record card or record book Verify that film is labeled correctly

File correctly Film-filing envelope Use “out-card” when removing

file

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Electronic Medicine Telemedicine technology

Rapid video Computer-based

communications Stereotaxis – magnetic

neurosurgery technique

Digital imaging Eliminates traditional x-ray

films Decreased exposure to

radiation DICOM – communication

protocol

Advances in radiology 3D/4D ultrasound “live-action” images

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Apply Your Knowledge1. How do you store new and exposed x-ray film?

ANSWER: X-ray film should be stored at proper temperature and humidity. Packages should be stored on end and not stacked.

2. What is DICOM?

ANSWER: DICOM is a communications protocol for handling, storing, printing, and transmitting information in medical imaging.

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In Summary Medical assistant

Assist with patient care before, during, and after a procedure

Provide patient instructions Preparing patients for tests Storing and filing x-rays Understand and follow safety precautions

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End of Chapter

Words can be like X-rays if you use them properly--they'll go through anything. You read and you're pierced.”

~ Aldous Huxley

http://thinkexist.com/quotes/aldous_huxley/

chapter 53 x_rays_and_diagnostic_radiology

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