Ouhsc Advanced Imaging & Critique Final

Front 1

Is there a single CT protocol?

Back 1

No, they vary by facility, radiologist, machine, and/or patient condition

Front 2

What's the most common type of CT exam?

Back 2

Head

Front 3

What are the differences between a diagnostic x-ray tube & a CT x-ray tube?

Back 3

CT has more kVp range & absorbs and eliminates heat more efficiently

Front 4

What does the box represent on a CT scout image?

Back 4

Range of tissues

Front 5

What line should the slices be parallel to on head?

Back 5

Supraorbital meatal line (reduce radiation exposure to eye)

Front 6

What are the only exams that use a Gantry tilt?

Back 6

Head/Brain exams

Front 7

Why is the scout CT scan performed?

Back 7

Better center the patient to Gantry hole

Front 8

What is the "step-and-shoot" method?

Back 8

Tube goes around 1 rotation & makes a full acquisition/ circumference, then table moves

Front 9

Window width controls....

Back 9

The number of shades of gray (contrast)

Front 10

Window level (center) controls...

Back 10

Brightness

Front 11

What exam is the helical mode of a CT machine used for?

Back 11

Studies that require 3D reformations or CT angiography
Neck studies

ex. Circle of Willis studies

Front 12

Intracranial Hemorrhage (ICH)

Back 12

- CT is most frequent initial exam done for this
- appears hyperdense for first 3-10 days
- appears isodense from 11 days - 6 months
- appears hypodense after 6 months

Front 13

What's the pharmacologic treatment for acute ischemic stroke?

Back 13

Tissue plasminogen activator (t-PA)

Must be administered within 3 hours of stroke

Front 14

What kind of stroke should t-PA NOT be used for?

Back 14

Hemorrhagic stroke

Front 15

What type of CT scan is done to differentiate between hemorrhagic & ischemic stroke?

Back 15

Non-contrast Head CT

Front 16

How is a CTA better than traditional angiography for the head & neck?

Back 16

Less invasive, widely available, less expensive, time-saving

Front 17

What is the goal of a CTA exam of the head & neck?

Back 17

- accurately measure stenosis of carotid & vertebral arteries (and branches)
- evaluate circle of Willis

Front 18

Why are CT scans of the sinuses done?

Back 18

- inexpensive, accurate, low radiation dose method for confirming the presence of inflammatory sinonasal disease

Front 19

How is the patient placed for a CT exam of sinuses?

Back 19

Prone to look for fluid levels

Front 20

Pitch

Back 20

- quantity of table movement to rotation
- tells you how spread out the helical acquisition will be

Front 21

A pitch less than 1 indicates...

Back 21

There's an overlap of slices (desirable)

- increases patient dose but increases accuracy of measurements

Front 22

What are beta-blockers used for in CT?

Back 22

- lower the heart rate to make rhythm more regular for cardiac CT
- have to get an order from patient's physician

Front 23

What is multiphasic CT imaging used for?

Back 23

- pancreas, liver, kidneys, some abdominal studies
- images reviewed in 2 or more window settings

Front 24

How is CT used for imaging the musculoskeletal system?

Back 24

- useful for evaluating bone & soft tissue tumors
- useful for evaluating joints (especially w/ contrast)

Front 25

How long has vascular imaging been around?

Back 25

Over 5000 years old

Front 26

Who performed the first cardiac caatheterization on a horse in 1711 AD?

Back 26

Hales

Front 27

Who coined the term "cardiac catheterization"?

Back 27

Claude Bernard

Front 28

Who performed the first human cardiac catheterization in 1929?

Back 28

Dr. Werner Forssman (performed it on himself, used urinary catheter)

Front 29

Who coined the brachial approach for catheterization in 1959?

Back 29

Dr. Mason Sones (used dog hearts)

Front 30

Who came up with the idea of pre-shaped catheters?

Back 30

Dr. Melvin Judkins

Front 31

Who's the grandfather of angioplasty?

Back 31

Dr. Andreas Gruntzig

Front 32

What's the differences between cardiac lab & specials lab?

Back 32

Cardiac Lab --> cardiologist, see cardiac vasculature

Specials Lab --> radiologist, see internal aspects of organs (non-vascular)

Front 33

Which type of catheter almost always has side holes?

Back 33

Pigtail

Front 34

Retrograde Administration

Back 34

Against the flow

Front 35

Antegrade Administration

Back 35

With the flow

Front 36

Intrathecal Administration

Back 36

Into a sheath (ex. Myelogram)

Front 37

Parenteral Administration

Back 37

Into a vessel (anything that's not oral)

Front 38

Difference between Medical & Surgical Asepsis

Back 38

Medical --> microorganisms have been eliminated (normal hand washing)

Surgical --> taken microorganisms & spores and destroy them w/ heat & chemicals (5 mins)

Front 39

Where are the sterile lines?

Back 39

Waistline/Table Height & Gown sleeves/Waistline

Front 40

What's the patient prep & room setup for specials?

Back 40

- ensure correct approach
- palpate pulse/locate anatomy
- trim hair & prep patient (Iodine vs. Cl/OH based)
- drape patient & equipment

Front 41

What does a specials procedure team consist of?

Back 41

Physician, scrub tech, circulator (in charge of equipment), nurse, recorder

Front 42

What 3 medications need to be stopped at some point before a specials/cath lab procedure?

Back 42

Heparin, Kumadin/Warferen, & Aspirin

Front 43

What lab values that relate to kidney function need to be obtained before a specials/cath lab procedure?

Back 43

BUN (blood urea nitrogen)
Creatinine
GFR (Glomerular Filtration Rate)

Front 44

What lab values that relate to blood clotting ability need to be obtained before a specials/cath lab procedure?

Back 44

Prothrombin Time
Partial thromboplastin Time
INR (International Normalized Ratio)

Front 45

What are risk factors for specials/cath lab procedures?

Back 45

- anuria
- history of previous MI
- heart failure
- previous contrast reactions

Front 46

What levels must be monitored before, during, & after the specials/cath lab procedure?

Back 46

EKG, pulse ox, BP, respiratory rate, LOC, continuous IV access, supplemental O2, crash cart

Front 47

What's the difference between the cutdown approach & the percutaneous approach?

Back 47

Cutdown --> old method, cut down skin to expose vessel, slice opening into vessel & slide catheter in

Percutaneous --> cleaner, safer, less blood loss (Seldinger/Modified Seldinger sticking methods)

Front 48

Which artery is most often used in the percutaneous approach?

Back 48

Femoral

Front 49

When are vitals taken after a specials/cath lab procedure?

Back 49

1st Hour: every 15 min

2nd Hour: every 30 min

Next 4 hours: 1 per hour

Front 50

Where do the most common complications from a specials/cath lab procedure occur?

Back 50

At the puncture site

Front 51

What complications can renal arteries cause?

Back 51

Renal arteries vasoconstrict when they have contrast media in them, can become a temporary lesion & cause ischemia to kidneys

Front 52

When was NMR (nuclear magnetic resonance) discovered?

Back 52

1946 by Bloch & Purcell

Front 53

When was NMR fully medically accepted?

Back 53

1967 (Jasper Johns)

Front 54

What is NMR?

Back 54

Interaction between nuclei w/ non-zero magnetic moment (something that has magnetic susceptibility/permeability) & an external magnetic field

Front 55

When is NMR observed?

Back 55

When the nuclei in a system are disturbed by an oscillating magnetic field (a radio frequency pulse) w/ a frequency equal to the procession frequency ω0

Front 56

What does 1 Tesla equal in Gauss?

Back 56

10,000 Gauss

Front 57

What's the magnetic field of Earth?

Back 57

0.31-0.58 Gauss

Front 58

What are the 3 things you need for MRI?

Back 58

Hydrogen Proton
Large static magnetic field
Radio Frequency Signal

Front 59

Why is hydrogen used for the majority of diagnostic MRI imaging?

Back 59

- most numerous element in body
- has large magnetic moment & large angular momentum

Front 60

What are examples of high signal intense areas on T1 & T2?

Back 60

Fat or Blood

Front 61

What are examples of low signal intense areas on T1 & T2?

Back 61

Air (sinuses, lung, bowel) & cortical bone

Can also be indication of fibrous tissue

Front 62

Explanation of what happens to protons in MRI

Back 62

When the nuclei are placed in a magnetic field, the protons will align themselves at discrete energy levels (called Zeeman energy levels) parallel or antiparallel to the magnetic field

Front 63

Where will a slight excess of protons be, the parallel or antiparellel direction?

Back 63

Parallel (lower energy)

Front 64

Precession

Back 64

- compared to rotation of a spinning top tilted on its axis
- top not only spins on its axis, but also rotates in a circular path around the up/down direction

Front 65

Larmor Frequency Equation

Back 65

ωø = γ Bø

γ is the gyromagnetic ratio in MHz/Tesla
Bø Is the magnetic field in Tesla
(1T = 104 Gauss)

Front 66

Resonance (Resonance Frequencies)

Back 66

- tendency of a system of oscillate at a greater amplitude at some frequencies than at others

Front 67

T1 time is...

Back 67

Time taken for the longitudinal magnetism to grow about 63% of its original value

Front 68

T2 time is...

Back 68

Time taken for the transverse magnetization to decay about 37% of its original value

Front 69

Name the cranial nerves in order

Back 69

Olfactory / Optic / Ocular Motor / Trochlear / Trigeminal / Abducens / Facial / Auditory / Glossopharyngeal / Vagus / Accessory Spinal / Hypoglossal