Download Radiology 1 - Westinghouse College Prep

Pearson's Comprehensive
Medical Assisting
Administrative and Clinical Competencies
Second Edition
CHAPTER
48
CHAPTER
Radiology
Lesson 1:
Introduction to Radiology
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Lesson Objectives
Upon completion of this lesson, students
should be able to …
• Define and spell the terms to learn for this
chapter.
• List six X-ray procedures that require
preparations ahead of time. Describe the
preparations.
• List and explain four basic positions used
for taking X-rays.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Critical Thinking Question
1. Is a medical assistant qualified to
perform the general procedures for an
X-ray examination? Explain your answer.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Radiology
• Branch of medicine that uses radioactive
substances or matter that gives off
radiation
• Uses various techniques for visualizing the
internal structures of the body for the
diagnosis and treatment of disease
• Divided into three specialties:
– Diagnostic radiology
– Radiation therapy
– Nuclear medicine
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Radiology Personnel
• Radiologist
– Physician specializing in radiology
• Radiographer or radiologic technologist
– Involved in making diagnostic radiographs or
X-rays
– Requires a 2- to 4-year college program
• Medical assistant in a radiology
department
– Will require additional training in order to
assist with radiologic procedures
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Duties of a Radiologic
Technologist
• Positioning patients for
radiographic
procedures
• Determining the proper
voltage, current,
exposure time for each
X-ray
• Adjusting radiographic
equipment
• Developing the film
• Assisting the radiologist
with special procedures
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Principles of X-rays
• Developed in 1895 by Wilhelm Konrad
Roentgen
• X-rays are produced in a vacuum tube
when electrons collide into a target of
specific material such as tungsten
• Collision produces electromagnetic rays
• X-rays emitted from the tube form a coneshaped X-ray beam
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Principles of X-rays
• Radiation field is the cross section of the
X-ray beam and the point of use
• Patient is placed between the tube that
produces the X-ray beam and the film
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
X-Ray Table
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Characteristics of X-rays
• Penetrate substances of different densities
to varying degrees
• Cause ionization of the substances
through which they pass
• Cause fluorescence of certain substances
• Travel in a straight line
• Can destroy body cells
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Diagnostic Imaging
• Involves the use of
X-rays, ultrasound,
radiopharmaceuticals,
radiopaque media,
and computers
• Produces images of
internal structures
and processes
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Contrast Medium
• Radiopaque substance
• Does not allow the passage of X-rays
• Facilitates radiographic imaging of internal
structures that are difficult to visualize on a
regular X-ray or fluoroscopic screen
• Include liquids (barium), powders, air, and gas
• Administered orally, by injection (parenterally),
or by enema
• Acts to convert an organ or structure into an
opaque area
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Barium Enema
Radiograph of the colon
after a barium enema.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Contrast Medium Materials
• Barium sulfate
– Positive contrast media
– Consists of a chalky compound mixed with water
– Used for fluoroscopic examination of the
gastrointestinal tract
• Iodine contrast compounds
– Used to form radiopaque compounds
– Cannot be used on patients allergic to seafood or
iodine
– Interfere with nuclear medicine
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Contrast Medium Materials
• Negative contrast
– Include air, carbon dioxide, and other gases
– Appear black on X-rays
– Used to visualize the spinal cord
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Role of the Medical Assistant for
Radiology Exams
• Schedule the procedure
• Educate patient about the procedure
• Inform patient about the length of the
procedure
• Explain to patient about any preparation
required
• Ensure patient is provided an ample size
gown and drape
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Role of the Medical Assistant for
Radiology Exams
• Request patient remove all metallic
materials
• Assist the patient during and after the
procedure
• Provide post-procedure instructions
• Inform patient of when to expect test
results
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
X-ray Procedures Requiring
Special Preparations
• Angiogram:
– No breakfast if morning examination or lunch if
afternoon examination
• Barium enema (Lower GI):
– Enemas until the bowel return is clear on the evening
before the examination
– Doctor may order rectal suppository in the morning or
a cathartic such as 2 oz. of castor oil or citrate of
magnesia at 4:00 P.M. the day before the X-ray
– Clear liquids and gelatin for dinner
– Nothing by mouth (NPO) after midnight
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
X-ray Procedures Requiring
Special Preparations
• Barium meal (Upper GI):
– NPO after midnight
• Bronchogram:
– NPO after midnight
• Cholecystogram (GB series):
– Light supper of non-fatty food such as fruit and
vegetables without butter or oil the evening before the
X-ray
– Gallbladder tablets (prescribed by the physician) are
taken with water after supper
– NPO except for water until X-ray the following day
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
X-ray Procedures Requiring
Special Preparations
• Computerized tomography (CT):
– NPO for 4 hours before X-ray if a contrast media is
used
• Intravenous cholangiogram:
– NPO after midnight
• Intravenous pyelogram (IVP):
– Three Dulcolax tablets or 2 oz. castor oil at 4:00 P.M.
the day before the X-ray
– Eat a light supper
– NPO after midnight
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
X-ray Procedures Requiring
Special Preparations
• Myelogram: NPO
• Retrograde pyelogram:
– Enemas or laxatives on the evening before
X-ray
– NPO for 8 hours before the procedure
• Ultrasound:
– May require a full bladder or laxatives
depending on the type of ultrasound
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Steps to Assisting with a
Radiologic Procedure
Step 7: Ask the patient to remove all
jewelry and metals as needed.
Step 6: Instruct the patient to remove all
clothing appropriate for the procedure.
Step 5: Explain procedure to the patient.
Step 4: Determine patient compliance with procedure
preparation requirements.
Step 3: Identify the patient.
Step 2: Check necessary X-ray equipment as needed.
Step 1: Check X-ray examination order.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Positions for Radiology
Procedures
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Anterioposterior (AP)
• X-ray beam is
directed from front to
back
• Patient may be
standing or supine
• Patient’s front will
face the X-ray
equipment and
patient’s back will be
near the film plate
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Posterioanterior (PA)
• X-ray beam is
directed from back to
front
• Patient will be
standing upright
• Patient’s back will
face the X-ray
equipment and his or
her front will be near
the film plate
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Oblique
• Patient is turned at an
angle to the film plate
so the X-ray beam
can be directed at
areas that would be
hidden on an AP, PA,
or lateral X-ray
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Lateral
• X-ray beam is directed
toward one side of the
body
• In the right lateral (RL)
position, the patient’s
right side is near the film
plate and left side is near
the X-ray equipment
• In a left lateral (LL)
position, the patient’s left
side is near the film plate
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Axial
• X-ray tube is angled to direct a ray along
the axis of the body or body part
• Cephalad angulation: the X-ray beam is
directed at an angle from the feet toward
the head
• Caudal angulation: the X-ray beam is
directed from the head toward the feet
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Information Required for Scheduling
a Radiologic Procedure
•
•
•
•
•
Patient’s name
Type of insurance
Pre-certification or approval number
Referring physician’s name
Type of radiologic procedure to be
performed
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Special Dietary Restrictions for
Radiology Procedures
• All-liquid diet on the day before the test
• Nothing by mouth after a specific time
It is up to the physician to decide whether the patient
should or should not take his or her daily medications.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Beverages That the Patient May
Have on an All Liquid Diet
•
•
•
•
•
•
•
•
•
Coffee
Tea
Carbonated beverages
Clear gelatin desserts
Strained fruit juices
Bouillon
Clear broth
Tomato juice
The patient may not have any dairy products
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Guidelines for Sequencing
Multiple Diagnostic Procedures
• Schedule all radiographic exams and tests
that do not require contrast media and
iodine uptake
• Radiographic tests of the urinary tract
• Radiographic tests of the liver and
gallbladder
• CT scans of the abdomen and pelvis
• Procedures requiring barium
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Guidelines for Sequencing
Multiple Diagnostic Procedures
• Lower gastrointestinal series (barium
enema)
• Upper gastrointestinal series
• CT procedures that require IV contrast
media may be done AFTER blood is
drawn for iodine uptake series
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Questions?
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.