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DEPARTMENT OF Diploma . IN MEDICAL TECHNOLOGY INTRODUCTION:Objectives: The training of candidates registering for B.Sc. Medical technology (x-ray) course is aimed at equipping the candidate to carry out the routine and some of the sophisticated diagnostic procedures in a modern hospital. The basis for the training is practical training, supplemented by series of lectures and demonstration on the various theoretical subjects. HOD/Radiodiagnosis shall act as a course coordinator. The students work by rotation, in batches, in various sections in the discipline of Radiodiagnosis. The students are evaluated by a system of internal assessment and 3 annual examinations. His/her final examination at the end of the 3rd year is a comprehensive one. REGULATIONS FOR THE AWARD OF BACHELOR OF SCIENCE IN MEDICAL TECHNOLOGY (X-RAY) DEGREE 1. The Bachelor of Medical Technology (x-ray) Course is proposed to be a 3 years integrated degree course. The course will run on annual basis. 2. It is proposed to admit 12 students annually to the course of B.Sc. Medical technology (x-ray) (including all categories) on self financing basis as per distribution of seats desired by the competent authority. 3. ELIGIBILITY Admission requirement for the course shall be: i) Candidates who have secured 50% marks in 10+2 (Medical/Non-Medical) or 10+2 (Vocational course in Medical Technology x-ray) or 2 years Diploma in xray. ii) Part I of B.Sc. (Medical) course of Punjab University or Any other examination recognized by syndicate equivalent to i) or ii) 4. The syllabi and courses of reading for B.Sc. Medical Technology x-ray course is appendix A shall be as approved by the Faculty of Medical Sciences from time to time. 5. The examination in First/Second/Third year shall be open to a student who has remained on the rolls of the course concerned for full one academic year preceeding the examination and having attended not less than 75% of the full course of lectures and practical separately held for the purpose in each year. The lectures/practical will be counted up to the last day when the classes break up for appearing in the examination. 6. The Director Principal of the Govt. Medical College, Chandigarh on the recommendation of the Coordinator of the course will have the authority to condone deficiency as prescribed in University rules from time to time. 7. During each year, the studentzs will be eligible for leave for 30 days. No other kind of leave or vacations will be admissible. In exceptional circumstances a student may be granted 30 days leave NOT DUE on the condition that he/she shall work for the same number of days after the dfate on which he/she would have otherwise completed the couerse. If any student avails leave of more than 60 days in any year (i.e. 30 days admissible leave 30 days leave due, his/hersession will be shifted by one year. 8. The examination in theory/practical shall be held at the end of the 1st academic year (1st term) and at the end of 2nd academic year (2nd Exam) and third exam at the end of the 3rd academic year with two internal and two external examiners. 9. The students shall submit his/her application for admission to the examination to the Punjab University through the Director Principal of the Govt. Medical College, Chandigarh on the prescribed form, with the required fee and certificates regarding the satisfactory completion of training by the candidate duly signed by the Chairman/head of the Department. 10. The last dates by which admission form fees must reach the controller of Examination without or with late fee as prescribed by the syndicate from time to time shall be fixed by the university. 11. The amount of admission fee for each year to be paid by a candidate shall be prescribed by the syndicate from time to time. 12. The examination conducted at the end of each year will be only in subjects which have been taught i.e 1st year exam at the end of First year, 2nd year exam at the end of Second year and 3rd year exam at the end of Third year. 13. The medium of examination shall be ENGLISH. 14. A student will be deemed to have passed in the subject if he/she obtains as minimum of 50% marks in that subject in theory and practical separately. 15. The question papers for 1st year, 2nd year and 3rd year will be set by two internal and two external examiners only. 16. Evaluation of all papers (Part I, II & III) will be done by two internal and two external examiners. 17. The re-valuation of answer books shall be permissible as per rules laid down by the University for Re-valuation from time to time. 18. The results will be tabulated and declared by the Controller of Examination’s office. 19. The successful candidates shall be classified in to divisions as under: Those who obtain 60% or more but less than 75% marks of the aggregate First division. Those who obtain 50% or more marks but below 60% marks of the aggregate marks second division. 20. The candidate shall be provided with the details marks card of each year after 1st, 2nd & 3rd year. The detail marks card shall indicate the division in which the candidate has passed the examination. The date of entry and leaving the course shall be shown on the certificate of the degree awarded to such candidates. 21. INTERNAL ASSESSMENT: The candidates will be given 50 marks as internal assessment on the basis of their performance during the semester. That a candidate be eligible to appear in the examination provided he/she secured a minimum of 35% marks in internal assessment in theory and practical separately. That the Regulations/Rules, number of seats etc. for Bachelor of Science (Medical Technology X-ray) to be started from the session 2007-2008 be approved with the following changes: 22) Page 5 – Under the Regulations for the award of B.Sc. Medical Technology x-ray course: Points 1 & 2 omitted and substituted with the following: 1. The B.Sc. Medical Technology (x-ray) is three year integrated degree courses. 2. To admit 12 students annually including 2 seats for sponsored/departmental candidates instead of 16 students. 23) Page 7: That a candidate be eligible to appear in the examination provided he/she has secured a minimum of 35% marks in internal assessment in theory and practical. (This is in relation to clause 21 at page 7). NOTE: 1 The fee structure for the course would be the same as for B.Sc. (Ophthalmology techniques) & B.Sc. Medial Lab. Technology. (Syndicate dated 21.01.2006 Para 35) 2. The above may be allowed to be implemented in anticipation of the approval of the Government of India/publication in Government of India Gazette. Rules of Examination for B.Sc. Medical Technology (x-ray) Course. 1. The students will not be allowed to appear in the examination unless he/she attends 75% of the total theory and practical in each subject separately. 2. Date of examination and appointment of examiner will be made by the University. 3. In theory examination essay type or multiple choice/objective type questions will be included at the discretion of the examiner. 4. 50 marks in each subject will be assigned for internal assessment. The marks of internal assessment and final examination of each year will be added together. 5. A student will be deemed to have passed in the subject if he/she obtains a minimum of 50% marks in that subject in the theory and practical separately. 6. A student will be deemed to have passed in the examination if he/she passes in each subject separately. 7. The students who will absent himself/herself from the examination without prior permission of the Dean, will be deemed to have failed in that examination. 8. There will be fresh internal assessment and compulsory attendance for the students for the examination in which he/she has failed at the time of subsequent examination in that subject. 9. A candidate who will obtain 75% or more marks of the total marks in any subject shall be declared to have obtained distinction in that subject provided he/she passed in all the subjects of the courses in all the parts in the first attempt. 10. PART-I Please refer to page no. 5 of Annexure A. d) A candidate who fails in one or more subjects will be given two or more chances at six monthly intervals to pass in those subjects. However, if he/she fails to pass in those subjects in these two extra attempts he/she will be required to repeat the whole examination of Part-I. e) The Candidate will be required to pass in all subjects of Part-I examination at least 6 months before the final examination of Part-II. f) The marks of the examination are given in appendix-II. 11. PART-II Please refer to page no. 6 of Annexure A. d) Rule No. 1 to 9 which applies to both Part I and II examination. e) The candidate will be required to pass in all the subjects of Part-II at least six months before he/she shall be allowed to appear for the final examination of Part-III. f) A candidate who fails in one or more subjects will be given two more chances at six monthly intervals to pass in those subjects. However, if he/she fails to pass in those subjects in these two extra attempts he or she will be required to repeat the whole examination of Part-II. g) Marks of the examination are given in Appendix II. 12. PART -III Please refer to page No. 6 & 7. d) Rules No. 1 to 9 will apply to part I, II and III examinations. e) A candidate who fails in one or more subjects will be given two more chances at six monthly intervals to pass in those subjects. However, if he/she fails to pass in those subjects in these two extra attempts he or she will be required to repeat the whole examination of Part-III. f) Marks of the examination are given in Appendix III. 13. Director Principal of the College is empowered to condone the shortage of attendance of lecturers as prescribed in University Rules in each course of theory and practical. 11A. In case of students joining late owing to the late admission with the approval of the Vice-Chancellor, their lecturers are to be counted from the date of joining. Deficiency in studies should be made up by arranging special classes for them at the level of Head of the Department. 11B. That a candidate is eligible to appear in the examination provided he/she secures a minimum of 35% marks in the internal assessment in theory and practical separately. Appendix II (B.Sc. Medical Technology X-ray Course) Distribution of Marks First Year (each subject) Second Year (each subject) Third Year (each subject) Theory 100 Marks 100 Marks 100 Marks Practical & Viva Voce 100 Marks 100 Marks 100 Marks Internal Assessment 50 Marks 50 Marks 50 Marks Total 250 Marks 1000 Marks 250 Marks 1000 Marks 250 Marks 1000 Marks GOVERNMENT MEDICAL COLLEGE & HOSPITAL CHANDIGARH -160047 B.sc Medical Technology A THREE YEAR PROGRAMME GOVERNMENT MEDICAL COLLEGE & HOSPITAL CHANDIGARH B.SC. MEDICAL TECHNOLOGY ( X-RAY ) (TRANSCRIPT) Transcript for 3 years B.Sc Medical Technology (X-ray) degree course in radio diagnosis Medium of instruction and examination : English Name of the student : Period of training : 3 years SUBJECT TAUGHT PART-I 1) Anatomy , physiology and related pathology of human body Part-I 2) Radiological science for technologist and darkroom Techniques 3) Patient care in Radiography including CPR 4) Basic Radiographic techniques PART-II 1) Anatomy and physiology and related pathology of human body Part-II 2) Equipment for Radio diagnosis Part-I 3) Physics for medical imaging 4) Basic radiographic techniques II and special procedures PART-III 1) Special procedure in Radio diagnosis, Planning & QA in Radio diagnosis 2) Equipment for Radio diagnosis including newer developments 3) Modern Imaging Technology 4) Radiation physics and radiation protection Hours of instruction of theory and clinical training per week 10 hrs of teaching per week [Part-I] 30 hrs of clinical training per week [Part-I] 10 hrs of teaching per week [Part-II] 30 hrs of clinical training per week [Part-II] 10 hrs of teaching per week [Part-III] 30 hrs of clinical training per week [Part-III] Total hrs teaching (theory only) for 3 years Subject Anatomy and physiology and related pathology No. of hrs. 160 hrs Radiological science for technologist & Dark room technique 100 hrs Patient care in Radiography including CPR Film discussions , seminars , journal clubs 100 hrs 120 hrs Radiographic techniques including special procedures 120 hrs Equipment for Radio diagnosis including newer development and quality assurance 120 hrs Physics for medical imaging and radiation physics including radiation protection Planning an Quality control in Radio diagnosis 160 hrs 120 hrs CT-Scan , MRI , PET-Scan ,Ultra sonography , Nuclear Imaging , Mammography , Special procedure , (Modern Imaging Technology) 160 hrs Total 1160 hrs Total hrs of practical training for 3 years Radiodiagnosis Part - I 1200 Hrs Part - II 1200 Hrs Part - III 1200 Hrs Clinical training posting in Radio diagnosis on rotational basis Part - I Patient Registration 2 weeks Dark Room Practice 5 weeks Extremities radiography 6 weeks Chest radiography including ribs 7 weeks Abdomen radiography 6 weeks Patient care 6 weeks CPR 2 weeks Vertebral – column radiography including Pelvic girdle 6 weeks Total 40 weeks Part - II Barium studies (GI tract) 6 weeks IVU 6 weeks Special procedures – HSG , Myelography , Dacrocystography , Arthrography and Cavitography etc . 6 weeks Operation theatre Technique 4 weeks Skull including PNS and facial 6 weeks Ward radiography/including trauma 6 weeks MCU, RGU, and Cystography etc 6 weeks Dental radiography 2 weeks Total 40 weeks PART- III Mammography 6 weeks Interventional procedures ; vascular and nonvascular including ERCP, PTC, PTBD, and PCN etc 6 weeks CT 6 weeks US/Color Doppler 6 weeks MRI 6 weeks DSA 2 weeks Quality assurance and radiation protection 6 weeks Hospital practice and care of patient 2 weeks Total 40 weeks AVAILABILITY OF EQUIPMENT IN DEPARTMENT OF RADIODIAGNOSIS Radiography Machines ranging from 500-800mA with high frequency Generators as well as 6 pulse generators – 05 nos. Radiography and fluoroscopy equipment with IITV system 2 nos. Mobile C – Arm with IITV system – 3 nos. Mammography unit – 1 (one) no. Portable and mobile units (high frequency) – 7 nos. Dental units – 1 no. Spiral CT ( single slice/ dual slice ) – with facilities of 3D, BMD , Fluoro CT, Virtual Endoscopy, CT angiography etc – 1 (one) no. Ultrasound machines fixed and portable type and color Doppler = 8 nos. Multiformat camera , laser cameras and dry camera = 6 nos. Automatic Film Processors (large , medium and table top models) = 4 nos. Quality assurance kit – Complete set. MODE OF EXAMINATION Final examinations is conducted at the end of each year in the following subjects For the Part I, Part II, Part III , during the month of August PART - I Theory papers 1) Anatomy , physiology and related pathology of 100 marks Human body 2) Radiological science for technologist and darkroom 100 marks techniques 3) Patient care in Radiography 100 marks including CPR 4) Basic Radiographic techniques 100 marks Practical and viva voice exam in the entire subjects (100 marks in each subject) Internal assessment in the entire above subjects (50 marks in each subject) Board of examiners comprises of two external and two internal examiners . The coordinator of the course ( Professor & Head of the Dept. of Radio diagnosis ) is the convener cum internal examiner. 2nd internal examiner is tutor of medical technology (X- Ray) One external examiner is Professor of Anatomy , Physiology 2nd external examiner is from Medical Physics . PART - II Theory paper 1) Anatomy , physiology and related pathology of Human body 100 marks 2) Equipment for radio diagnosis Part – I 100 marks 3) Physics for medical imaging 100 marks 4) Basic radiographic techniques II and special procedure 100 marks Practical and viva voice exam in the entire subjects (100 marks in each subject) Internal assessment in the entire above subjects (50 marks in each subject) Board of examiners comprises of two external and two internal examiners . The coordinator of the course ( Professor & Head of the Dept. of Radio diagnosis ) is the convener cum internal examiner. 2nd internal examiner is tutor of medical technology (X- Ray) One external examiner is Professor of Anatomy , Physiology 2nd external examiner is from Medical Physics . PART – III Theory paper 1) Special procedure in Radiographic , Planning & 100 marks QA in Radio diagnosis 2) Equipment for Radio diagnosis including 100 marks newer developments 3) Modern Imaging Technology 100 marks 4) Radiation physics and Radiation protection 100 marks Practical and viva voice exam in the entire subjects (100 marks in each subject) Internal assessment in the entire above subjects (50 marks in each subject) Board of examiners comprises of two external and two internal examiners . The coordinator of the course ( Professor & Head of the Dept.of Radio diagnosis ) is the convener cum internal examiner. 2nd internal examiner is tutor of medical technology (X- Ray) One external examiner is Professor of Anatomy , Physiology 2nd external examiner is tutor of medical technology (X- Ray) During all the annual examinations the candidate shall have to obtain 50 % marks separately in theory plus internal assessment as well as in practical and viva voice examinations The successful candidates shall be as under on the basis of aggregate marks obtained in the Part I , Part II, Part III examination taken together . Those who obtain 60% or more marks - First Division Those who obtain 50% or more marks - Second Division But less than 60% A candidate standing first in the final examination will be eligible for the award of gold medal provided he/she secures a minimum of 75% marks and fulfill the various terms and conditions prescribed by the institute. A candidate standing second in the final examination will be eligible for the award of Silver medal provided he/she secures a minimum of 70% marks and fulfill the various terms and conditions prescribed by the institute. A candidate standing third in the final examination will be eligible for the award of Bronze medal provided he/she secures a minimum of 65% marks and fulfill the various terms and conditions prescribed by the institute. The degree of Bsc. Medical technology (x-ray) will be awarded to the candidate after he /she successfully completes the following : a) Has passed all the three examinations. b) Has satisfactory completed the full period of period of 3 years . c) His /her work and conduct during the period of training has been satisfactory. This degree is awarded on the day of convocation as decided by the institute . INTRODUCTION In the modern concept of medical service , the importance of the support from Para–medical professional cannot be over emphasized. For this reason the Institute attaches great value to these disciplines and organizes the training programme within its fold with provisions to review and update the course outlines and syllabi periodically to keep pace with the newer developments taking place in these fields Bsc. Medical Technology(x-ray) is one such training programme which has an important role to play in the service of suffering humanity . The training of the candidate registering for B.sc. Medical Technology (x-ray) course is aimed at the equipping them adequately to carry out all the routine and some of the modern sophisticated diagnostic and treatment procedures in a modern hospital . The basis for the training is “ in-service training” supplemented by a series of lecture-demonstrations on the theoretical aspects of various subjects. The student work on rotation basis and spend three years on different sections in the discipline of Radio diagnosis . The training , both theoretical and practical, is spilt into two parts on a yearly basis. The student are evaluated by a system of internal assessment and three annual examinations the final examination at the end of the third year is a comprehensive one. TRAINING The training includes both lectures and practical training. For the practical training, the students are posted in various sections, rooms and labs in Radiodiagnosis department and other departments of the hospital and they engage themselves in the day to day work together with the employed technicians, under the control of tutor technicians and supervisors. For this purpose, the students spend three years and are posted for specific period in all the sub-specialities, operation theatres and other areas in each department. FIRST YEAR PAPER-I ANATOMY AND PHYSIOLOGY AND RELATED PATHOLOGY OF HUMAN BODY No. of lecturers and practical demonstantions - 40 Introduction to the body as a whole The cells, tissues of the body The cell: Structure, multiplication Tissue : Types structure, characteristics, functions Epithelium : Squamous, Cuboidal, columnar, ciliated Compound : Stratified, transitional Connective : Areolar, adipose, fibrous, elastic, cartilage, blood and bone Muscle : Striated (voluntary), smooth (involuntary) cardiac, Nervous : Fibrosis : Cell regeneration Membranes : mucous, serous, and synovial Osteology (including whole skeleton, bones and joints) Development of bone (Osteogenesis): Cells involved Types and functions of bone, types of joints and various movements AXIAL Skeleton : Skull : Cranium, face, air sinuses Vertebral column: regions, movements and vertebrae characteristics Sternum Ribs Appendicular skeleton: bones involved- shoulder girdle and upper limb, Pelvic girdle and lower limb. Healing of bones : Cellular activity Factors that delay healing Diseases of bones and joints The Respiratory system Organs : Position and structure and function Nose and nasal cavities Functions: respiratory, Olfactory, Pharynx Larynx – Functions: respiratory, vocal Tracheal, Bronchi, lungs: lobes, lobules, pleura Respiratory function: External and internal respiration common terms relating to diseases and conditions of the system PAPER-II RADIOLOGICAL SCIENCE FOR TECHNOLOGIST The Photographic process, introduction, visible light, images, produced by radiation, light sensitive photographic materials. i) Photographic emulsions, The photographic latent image Positive process. ii) Film materials in X-ray film, History, structure of an X-ray firm single sided films , types of films. iii) Spectral sensitivity of film material, graininess of film material speed and contrast of photographic materials iv) Sensitometry: Photography density, characteristics curves features 65 of characteristic curve. v) Variation in the characteristic curve with the development Comparison of emulsions by their characteristic curves. Information from the characteristic curve. vi) The storage of film materials and radiograph: Storage of Unprocessed film, storing of radiographs. vii) Intensifying screens and cassettes, Luminescence: fluorescence and phosphorescence, Construction of an intensifying screen. viii) The fluorescent materials. Types of intensifying screens, Intensification factor. The influence of KV , scattered radiation, Detail, sharpness and speed, size of the crystals, reciprocity failure, ix) Cassette design, care of cassettes, mounting of intensifying screens. x) Care of intensifying screens, tests to check screen film contract and light leakage. xi) Film processing L Development the nature of development. Manual, automatic, The PH scale. xii) The constitution of developing solutions and properties of developing chemicals. xiii) The development time, factors in the use of a developer. Developers in processing systems. xiv) Film processing: fixing and role of a fixing solution. Constitution of the fixing solutions and properties of the constituent. xv) Fixers used in automatic processors. Factors affecting the use of the fixer. xvi) Regeneration of fixing solution Silver recovery and its various methods. xvii) Rinsing, washing and drying objections of rinsing and washing methods employed. xviii) Methods of drying films. xix) Preparation of solutions and making stock solution. xx) Processing equipment Materials for processing equipment, processors for manual operation, hangers, control of chemical temperature by heating and thermostat, immersion heaters as well as cooling methods. xxi) Maintenance of automatic processors and common faults. xxii) Dark Room: Layout and planning, Dark room construction nature of floor, walls, ceiling and radiation protection. xxiii) Type of entry , door design, Dark room illumination. xxiv) Dark room equipment and its layout, Location of pass through boxes or cassette hatches. xxv) Systems for daylight film handing :daylight systems using cassettes and without cassettes. xxvi) The radiographic image: Components in image quality- density contrast and details. xxvii) Unsharpness in the radiographic image, various factors contributing towards unsharpness. xxviii) The presentation of the Radiograph, Identifications markers and orientation Documentary preparation. xxix) Viewing accessories: Viewing boxes, magnifiers, viewing conditions. xxx) Light, images and their recording, The formation of light images, image formation by mirror, by a lens and aberrations of lenses. xxxi) Fluorography: An optical system for image intensifiers fluorography. xxxii) Cameras for fluorography sensitometer response of fluorography film. xxxiii) Processing equipment and procedures, graininess in fluoro-grams. xxxiv) Some special imaging process, Xero- radiography it meaning technique and application xxxv) Copying radiograph its technique and application. xxxvi) Subtraction its techniques as applied to radiography as well as its applications. xxxvii) Common film faults due to manufacturing as well as due to chemical processing . xxxviii) Management of the quality of the Radiographic image. xxxix) Practical’s: (i) test to check x-ray films and screen contact in the cassette (ii) test to check light leakage in the cassette (iii) to prepare a characteristic curve of a radiographic film (iv) to check the effect of sale light on exposed as well as unexposed x-ray film. PAPER-III PATIENT CARE IN RADIOGRAPHY AND C.P.R No. of lectures and practical demonstation – 30THE RADIOGRAPHER AS A MEMBER OF THE HEALTH CARE SYSTEM/TEAM The Health Care Team Ethical and Medico legal Consideration Code of Ethics Self Care Care of supplies and equipment Patient rights Malpractice ATTITUDES AND COMMUNICATION IN PATIENT CARE The Health illness Continuum Developing professional attitudes Dealing with dying and death Communication with patients Challenges in communication Children and adolescents Geriatric patients Altered states of consciousness Patients who do not speak Hindi Communications with patients “Families” Communications with co-workers The chart as a resource Problems-oriented medical recording Routine communication SAFETY, TRANSFER AND POSITIONING Fire prevention In case of fire Other common hazards Body mechanics Patient transfer Wheel chair transfer Stretcher transfer Positioning for safety comfort Skin care Safety straps and rails Restraints and immobilization methods Accidents and incidents’ reports EVALUATING AND METTING PHYSICAL NEEDS Meeting personal needs Serving as a physician stander Current status Physical signs Vital signs INFECTION CONTROL The cycle of infection Infectious organisms The reservoir of infection The susceptible host Transmission of disease Practical asepsis Handling linen Disposal of contaminated waste Environmental asepsis Isolation technique The isolation patient in radiology deptt. Precaution for the comprised patient Surgical asepsis MEDICATION AND THEIR ADMINSTRATION The role of the radiographer Medication information The topical route The oral route The parenteral route Preparation of injection The intravenous route Charting DEALING WITH ACUTE SITUATIONS Accident victims Head injury Spinal injury Extremities fracture Wounds Burns Oxygen administration Life threatening emergencies Respiratory arrests Heart attacks and cardiac arrests Shocks Other medical emergencies Nausea Epitaxis Postural hypotension and vertigo Seizures Diabetic coma and insulin reaction Asthma Wound dehiscence Multiple emergencies PREPARATION AND EXAMINATION OF THE GASTROINTESTINAL TRACT Preparations for examination Diet Cathartics Enemas Contrast media for gastrointestinal examinations Barium sulphate Iodinated media Air contrast Examination of the lower gastrointestinal tract Barium enemas Double contrast barium enemas Upper gastrointestinal studies Routine upper gastro intestinal studies Double contrast gastrointestinal studies Hypotonic Duodenography Ensuring compliance with preparation orders Follow up care Scheduling sequencing of examination CONTRAST MEDIA AND SPECIAL IMAGING TECHNIQUES Iodinated contrast media Aqueous iodine compounds for intravascular injection Reaction to contrast media Contrast examination of the urinary examination IVU CYSTOGRAPHY Retrograde pyelography Contrast examination of the biliary system Oral cholecystography Intravenous cholangiography IPTC T-TUBE Other common contrast examination Myelography Contrast arthrography Bronchography Angiography Skin preparation Special imaging techniques Computed tomography Diagnostic medicine sonography Nuclear medicine Mammography Thermography BEDSIDE RADIOGRAPHY SPECIAL CONDITION AND ENVIRONMENTS Mobile radiography Orthopaedic traction Orthopaedics bed frames The ICU Tracheostomies Nasogastric tubes Closed chest drainage Swan ganz catheters The neonatal nursery The surgical suite C.P.R. Basics of CPR How to give CPR Precaution during CPR PAPER-IV BASIC RADIOGRAPHIC TECHNIQUE-1 RADIOGRAPHY TECHNIQUES Skeletal system: Radiography techniques for X-ray of: a. Upper limb with special reference to hand wrist joint, and elbow joint, Supplementary techniques for carpal tunnel, scaphoid bone fracture, head of radius and supra-condylar projections. b. Lower limb which includes all the bones with special reference to ankle joints, knee joint, patella, techniques for4 calcaneum bone, supplementary techniques for flat foot, intercondylar notch and femur and metatarsals, etc. c. Shoulder girdle and thorax, d. Vertebral column with special techniques for cervical spine, inter -vertebral joint and foramina, Lumbosacral joint. e. Pelvic girdle and hip region. f. Respiratory system Chest radiography for both the lungs, apical, lordotic and oblique views, lateral views techniques to demonstrate fluid levels, effusion in the thoracic cavity, decubitus AP and of the lower gastrointestinal tract OUTLINES OF SYLLABUS FOR SECOND YEAR. PAPER-I No. of Lectures & Practical Demonstration : 40 1.Anatomy and Physiology and related pathology of human body. Review of Types of Cells , tissues , bones and joints . Introduction to system and cavities of the body. a) Heart and blood vessels (Circulatory System ) Blood vessels arteries, veins, capillaries, sinusoids, structure and functions. Heart Position , structure and functions. Circulation of blood Pulmonary , systemic , portal, main blood vessels, their origins and distribution. Diseases of blood vessels and conditions of the system. b) The lymphatic system The parts of the lymphatic system. Lymph channels : capillaries , vessels , ducts structure , and functions. Lymph nodes : position , structure and functions. Lymphatic tissues tonsils , adenoids , intestinal nodules. Spleen : position ,structure and functions . Diseases and conditions of the system. c) The digestive systems Elementary tract structure : Mouth –Position ,structure and functions Pharynx-- Position ,structure and functions Salivary glands-- Position ,structure and functions. Esophagus-- Position ,structure and functions Stomach -- Position ,structure and functions. Liver -- Position ,structure and functions. Gallbladder -- Position ,structure and functions Small intestine-- Position ,structure and functions. Large intestine -- Position ,structure and functions Digestion and absorption, Metabolism of carbohydrates. Proteins and fats . Diseases and conditions of the digestive systems. d) The Urinary System Parts of urinary systems. Kidneys-- Position ,structure and functions Ureters-- Position ,structure and functions Urinary bladder -- Position ,structure and functions Urethra--- Position ,structure and functions. Formation and composition of urine. Water and composition of urine. Water and electrolyte balance. Diseases and conditions of the system. e) The reproductive system Female reproductive system External genitalia : position ,structures and functions. Perineum. Internal organs : Position ,structure and functions Vagina Uterus Fallopian tubes Ovaries Menstrual cycle : stages , hormone control , ovulation Breasts (mammary glands )- Position ,structure and functions. Changes : puberty , in pregnancy , during lactation. Male reproductive system. Scrotum ,testis ,epididymus : Position ,structure and functions. Spermatogenesis . Spermatic cords, seminal vesicles ,ejaculatory ducts : Position ,structure and functions. Prostate glands -- Position ,structure and functions Urethra and penis --- Position ,structure and functions Functions of male reproductive system. Puberty Disease of female and male reproductive systems Endocrine system Endocrine glands : Pituitary and hypothalamus : Position ,structure and functions Thyroid glands : Position ,structure and functions Adrenal (Supra renal gland ) : Position ,structure and functions Parathyroid glands ; Position ,structure and functions Pancreas : Position ,structure and functions Hormones : secretion , function & control. Pineal gland. Common terms and disease related to the Endocrine system. The organs of sense : Hearing and the ear : external ,middle and inner ear.-- Position ,structure and functions Physiology of hearing and diseases of ear. Sight and the eye : Position ,structure and functions Sclera , cornea ,choroids , ciliary body , iris ,lens ,retina ,optic nerves. Physiology of sight and disease of the eye. Sense of the smell : olfactory nerves----origins ,distribution. Physiology of the smell. Sense of taste.—organs , physiology of the taste. Common disease of the system. The nervous systems. Neurons : Position ,structure and functions Central nervous system : neurons, neuralgia , meninges. Ventricles of the brain, C.S.F. BRAIN, SPINAL CORD : structures ,functions peripheral nervous system.. Spinal and cranial nerves : origin distribution & function. Automatic nervous system : origin, distribution , function. Sympathetic and para sympathetic : origin , distribution , function. Common disease of the system The skin . Structure of the skin. Epidermis , dermis. Function of the skin. Hypothermia, wound healing, primary and secondary disease of the skin. PAER II 2. EQUIPMENT FOR RADIODIAGNOSIS-I No. of lectures & practical demonstration : 40 The following topics will be taken up : a) High Tension Generators: The self rectified high tension circuit. The half wave. rectified circuit. The four valve full wave rectified circuit Three phase full wave rectified circuit. Voltage waveforms in high tension generators. Constant potential circuits Rectifiers—valves and solid state. The high frequency generators, advances and newer development. b) The X-ray Tube: General features of the x-ray tube. The fixed anode-x-ray tube Rotating anode – x-ray tube. Rating of x-ray tube. Focal spot sizes. Methods of heat dissipation of x-ray tubes. Common tube faults . Developments in rotating anode tube. Tube stands and ceiling tube supports. c) Components and control in the x-ray circuits : The high tension transformer The rectification of high tension. The control of kilovoltage,kilovoltage indication . The filament circuit and control of tube current. Exposure timers-electronic, automatic. Main voltage compensation. Mains supply and the x-ray set. d) The Control of Scattered Radiation Significance of scatter, Beam limiting devices-cones, diaphragm (collimators). Beam centering devices. The secondary radiation grid : its types, components of the grid , grid movements. the assement of the grid functions. e) Portable and mobile x-ray units Main requirement, portable x-ray machines and x-ray equipments for operation theatre. f) Fluoroscopic equipment Structure of a fluorescent screen, The fluoroscopic image. The fluoroscopic table ,spot film devices and explorators. The protective measure and physiology of vision. g) Image intensifiers Image intensifiers tube-its design , its application. The television process and the television tube. Recording of the intensified image. T .V. monitors, video tape recording. The radiographic cameras. h) Tomographic equipments Principle of tomography. Various types of tomographic movements Multi section radiography. Transverse axial tomography. Equipments for tomography i) Equipment for rapid serial radiography. The AOT changer. The roll film,cut film changer,rapid cassette changer. j) Equipment for cranial and dental radiography. The skull table, The general dental x-ray equipment. Specialized dental x-ray equipment. PAPER III PHYSICS FOR MEDICAL IMAGING No of Lectures & Practical Demonstration:40 1 . RADIATION PHYSICS:-Structure of atom, electromagnetic radiation, production of x-rays, interaction of x-ray, absorbed dose, filtration 2 . IMAGING WITH X-RAYS:-Attenuation of x-rays by the patient, effect of scattered radiation, secondary radiation grid, magnification and distortion,unsharpness and blurring,tomography.limitation of x rays tube 3 . RADIOGRAPHY WITH FILMS AND GRIDS :- Intensifying Screens ,films, characteristic curve, radiographic contrast, screen blurring, quantum mottle or noice, choice of exposure factor, macroradiography, mammography, xeroradiography 4 . FLUOROGRAPHY,DIGITAL IMAGING AND COMPUTED TOMOGRAPHY:- Fluoroscopy, digital imaging, computed tomography ,PACS 5. GAMMA IMAGING :- Radioactivity, radioactive transformation , gamma imaging, radiopharmaceuticals, dose to the patient, precaution to be taken in the handling of radionuclide’s, tomography with radionuclide’s 6 . IMAGING WITH ULTRASONUD:- Piezoelectric effect, interference, single transducer probe, behavior of a beam at an interface between different materials, attenuation of ultrasound , A-mode, B-mode, Real time imaging, gray scale imaging, resolution, artifacts, M-mode, Doppler methods, safety consideration, quality assurance 7 . MAGNETIC RESONANCE IMAGING :- The spinning proton, the magnetic resonance signal, spin echo sequence, spatial encoding, magnets and coils, other pulse sequence , characteristics of the magnetic resonance image, artifacts, other nuclides, atomic magnetism, quality assurance, and hazards . PAPER – IV 4. BASIC RADIOGRAPHIC TECHNIQUES II and SPECIL PROCEDURES No. of lectures & Practical’s Demonstration :40 1 SKULL:- Radiography of cranial bones, cranium, sell turcica, orbit Optic foramina, superior orbital fissure and inferior orbital fissure . 2 FACIAL BONES :- Para nasal sinuses, Temporal bone 3 DENTAL RADIOGRAPHY:- Radiography of teeth – intra oral, extra oral and occlusal view. 4. ALIMENTARY TRACT :- Preparation of patient. General, acute positioning for fluid and air levels, Plain film examination , Radiography of female abdomen to look for pregnancy : intravenous Pyelography and cystography. 5. MACRORADIOGRAPHY :- Principal, advantage, technique and applications . 6. STEREOGRAPHY :- Procedure , presentation for viewing, stereoscopes, stereo-metery 7. SOFT TISSUE TECHNIQUE :- Mammography , localization of foreign bodies, 8. WARD MOBILE RADIOGRAPHY :- electrical supply, radiation protection equipment and instructions to be followed for portable radiography 9. OPERATION THEATRE TECHNIQUES :- General precautions , Aspects in techniques, checking of mains supply and functions of equipment, selection of exposure factors explosion risks , radiation protection and rapid processing techniques . Radiological procedures pertaining to salivary glands, lacrimal system. Braonchography, arthrography and hystero salpangiography-various requirements trolley set up, indications and contra indications, contract media used. Ventriculography and encephalography- Technique, contrast media used, film sequence, indication and contra indications. Myelograpsy: Technique, contrast media used, injection of contrast media indications and contra indications. Intra venous cholangiography. T.Tube: Cholangiography, peroperative cholangiography, procdure, contrast media, indication and contra indications. Double contrast Barium studies: (small bowel enema, Ba Enema etc.) procedure, requirements, indications, contra indications and contrast media used. Angiography: Cerebal, cardiac, abdominal aortography, general, renal and selective renal. Splenoportoveno graphy Peripheral, arterial and venous angiography, precautions, radiation protection, film changers, manual automatic biplane, film type, - large, miniature, cine contrast media injection procedure and techniqjue. Intraventinal radiological procedures: PTC PTBD, ERCP, fine needle aspiration cytology, percutaneous nephrostomy. Cardiac catherization- embolization, dilation etc. PART - III PAPER – I SPECIAL PROCEDURES IN RADIODIAGNOSIS, PLANNING AND QA IN RADIODIAGNOSIS NO. of Lectures & Practical Demonstration : 40 Radiological procedures pertaining to salivary glands , lachrymals system Bronchography , arthrography and hysterosalpingiography various requirements trolley set up, indications and contra indications, contrast media used . Ventriculography and encephalography :- Technique, contrast media used, film sequence . indications and contra indications , Myelography :- Technique, contrast media used , injection of contrast media indications and contra indications . Intravenous cholangiogrphy , T Tube :- Cholangiography, preoperative cholangiography , procedure , contrast media , indication and contraindications . Double contrast Barium studies :- ( small bowel enema , Ba Enema etc ) Procedure , requirements, indications, contra indications and contrast media used. Angiography :- Cerebral, cardiac , abdominal aortography , general , renal and selective renal. Splenoportovenography , peripheral, arterial and venous angiography, precautions, precautions , radiation protection , film changers , manual automatic biplane, film types- large, miniature, cine contrast media injection procedure and technique. Interventional radiological procedures :- PTC, PTBD, ERCP , fine needle aspiration cytology , percutaneous nephrostomy Cardiac catheterization – emobolization , dilation etc. Quality Assurance in Radiodiagnosis :- Aim of quality assurance in ,medical imaging , Q.A. Programme i.e. phases of development of its radiological facility Q.A. , activities applicable in. i) Equipment selection phase ii) Equipment installation of acceptance phase iii) Operational phase . PLANNING IN RADIO-DIAGNOSIS :Location of the department Adjacent department and areas Basics of the imaging rooms Patient waiting areas Basics infrastructures of the imaging rooms . Etc PAPER-II 2. Equipment for Radio – diagnosis including newer development NO. of lectures & Practical Demonstration :20 1. Computed tomography :- Historical developments , its principle and applications , various generations and definition of terms and cross sectional anatomy 2. Diagnostic Ultrasound :- Its principle, applications and role in medicine. Various types of transducers and definition of terms and cross sectional anatomy 3. Digital Radiography :- Principle , scanned projection radiography , digital subtractions angiography , applications and definition of terms . 4. MRI :- Principle , applications , its advantage over computed tomography or ultra sonography . Its limitations and uses and cross sectional anatomy . 5. NUCLEAR IMAGING 6. PET – SCAN 7. PORTAL IMAGING PAPER – III 3. MODERN IMAGING TECHNOLOGY NO. of Lectures & Practical Demonstration :- 40 1. ULTRA SONOGRAPHY Ultra sonography Doppler ultrasound Doppler flow imaging , principle of ultrasound Types of transducers Basics of Doppler ultrasound system \ 2. CT SCAN Conventional CT Spiral CT Basic principle CT Technique Equipment description CT artifacts Indications Contraindications Contrast media used 3 MRI Basic Principle Equipment description MR Angiography MR artifacts Indications Contraindications Contrast media used 4. NUCLEAR MEDICINE Definition Contrast media / imaging material used Characteristics of radionuclide Commonly used radio nuclides Descriptions of equipments Imaging technology Uses and advantages 5. PET- SCAN Definitions Basic principle of PET-SCAN Equipment description Imaging materials used Imaging technology Advantages PET- SCAN 6. MAMMOGRAPHY Basic principle of mammography Equipment description Imaging technology Importance Uses and advantages 7. PORTAL IMAGING Basic principle of portal imaging Devices Imaging technology Advantages and uses Importance of portal imaging 8. INTERVENTIONAL RADIOLOGY Definitions Procedure of diff. types of procedure Imaging materials Imaging technology Uses and importance 9. COMPUTED RADIOGRAPHY Definitions Basic principle of CR Imaging Plates Imaging Materials Imaging technology Uses and importance PAPER – IV Radiation physics including radiation protection No .of Lectures :- 30 No. of Practical :-10 Atomic structure as applied to generation of X-rays and radioactivity of diagnostic imaging and therapy X-rays . Effects of variation or tube voltage , current . filtration. HT waveform and target material on X- ray production. Law of radioactivity and decay schemes of different alpha ,beta and gamma ray, negatron and positron emitters as used in medicine, especially in radiotherapy . Artificial radionuclide generators employed in medicine in general and radiotherapy sources in particular. Interaction of radiation with matter attenuation absorption and scattering phenomenon . Photoelectric absorption , Compton scattering , pair production and annihilation process, ionization , effects of geometry of thickness of the absorber. Dependence on the nature and Atomic number of the absorber and on radiation quality . transmission of x-ray through body tissue . Linear energy transfer . Range of secondary electrons and electron build up. Relative amounts of scatter from homogeneous and heterogeneous beam during the passage through a patient . Physical requirements of beam during the passage through a patient. Physical requirements of beam defining devices e.g. cones diaphragm , collimator etc. Units of radiation measurement specification of quality and half – valve thickness (HVT) and its measurement filters and filtration . Measurement of radiation and dosimeter procedures . radiation detectors and their principles of working . Definition of Bragg-peak , percentage depth dose , peak scatter factor , tissue air – ratio . tissue , tissue maximum ratio scatter air ration, is dose curves and radiation penumbra of different beams. Wedge filters, wedge angle, hinge angle . Compensators, beam flattening filters, scattering toils . Physical properties of phantoms , phantom materials, bolus and bolus substitutes . Factors used for treatment dose calculations , daily treatment time and monitor units calculation method. Physical aspects of electron and neutron beam therapy. RADIATION PROTECTION :Definition of radiation hazards maximum permissible dose and annual limit of intake (ALI), permissible dose levels on and around sealed source housing and installation principles of radiation protection and APD’s of different IRCP rules , stochastic and non – stochastic effects . Importance of `ALARA’ physical principle of design and planning of radiation installation . Safe work practice in teletherapy and brachytherapy . Shielding materials . Radiation survey and personnel monitoring devices film badges , TLD badges . pocket dosimeters in Head and neck cancer