Download SMU-DDE-Assignments-Scheme of Evaluation PROGRAM Bachelor

SMU-DDE-Assignments-Scheme of Evaluation
PROGRAM
SEMESTER
SUBJECT CODE &
NAME
BK ID
DRIVE
MARKS
Q.
No
1.
A
Bachelor/Diploma in Medical Imaging Technology
III
BMI 302– Radiographic Techniques: Routine Procedures- I
B1976
WINTER 2015
60
Criteria
Marks
Total
Marks
Describe the factors affecting the quality of radiographic image.
The factors affecting the quality of radiographic image are
1. Density
2. Contrast
3. Magnification
4. Distortion
5. Sharpness
Density: It is the degree of blackness on an x-ray film. It depends
primarily on the milliampere second (mAs). When a radiographic
film is exposed to x-rays or light it produces some degree of
blackening depending on the level of exposure on the film. Density
(degree of blackness) increases with the increase in x-ray exposure
on the film. If a radiograph is too light or dark, an accurate
diagnosis becomes difficult or impossible.
Contrast: It is defined as the difference in density. It depends
primarily on the kilovoltage (kVp). You may not see any pattern of
color (image) on a surface painted with the same color. It is
necessary to have pattern of color (difference in color or degree of
darkness) to form a real image. A tissue with different attenuation
value and thickness produces a different density producing image
contrast. Bone attenuates comparatively greater amount of x-rays
than soft tissues and thus the area under bone appears brighter than
the soft tissues with low attenuation value. The brighter bone can
easily be seen over the surrounding darker soft tissue due to the
higher contrast on the image
Magnification: Magnification occurs in a radiographic image as
the x-ray beam continues to diverge as they pass from the object to
the film. The source of the x-rays is the x-ray tube focal spot. For a
given focus to film distance (FFD), the greater the distance
between the object and the film, the greater will be the
magnification of the image. To obtain minimal magnification, the
film to object distance (FOD) should be minimized and focus to
film distance should be maximized
Distortion: If the object and film are not parallel to each other,
there is a difference in magnification of different parts of the
(Unit 1, Page No. 12– 15)
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SMU-DDE-Assignments-Scheme of Evaluation
object, resulting in distortion.
2.
A
3.
A
Sharpness: It refers to the ability to see the sharp margins of object
in the radiograph. Several factors affect the unsharpness. These are
unsharpness due to:
a) geometry
b) movement
c) absorption
d) photographic factors
Discuss the various radiographic views of chest.
(Unit 2, Page No. 42-48)
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The chest x-rays routinely performed in the radiology department
are as follows:
1. Postero-anterior (PA) view
2. Lateral view
3. Antero-posterior (AP) view
4. Lateral decubitus view
5. Anterior and posterior oblique views
6. Apical lordotic view
7. AP view for neonates
Brief explanation of all the above views
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Describe the various antero-posterior and oblique views for elbow joint.
(Unit 6, Page No. 112-113,120-122)
The radiograph of the elbow AP should cover the distal humerus,
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elbow joint space, proximal radius and ulna of the upper
extremities.
Clinical indications: Following are the clinical indications of
elbow AP view
1. In cases of road traffic accident to detect fractures of bones and
dislocations of the joints.
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2. Joint diseases like rheumatoid arthritis, tuberculosis etc.
3. Suspected case of osteomyelitis or bone tumors.
4. For age estimation.
Procedure: The procedure for elbow joint AP radiograph is as
follows.
a) The patient should be made to sit by the side or at the end of the
x-ray table on a stool with the hand over the cassette.
b) The entire posterior aspect of the limb should touch the table and
palm of the hand should be facing up.
c) Cassette is kept under the elbow. Adjust the position of arm to
bring the medial and lateral epicondyles equidistant from the film
d) The limb is immobilized with sand bag over the forearm.
e) Radiographic marker and patient identification marker should be
placed in the radiographic cassette.
SMU-DDE-Assignments-Scheme of Evaluation
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External oblique
The radiograph of the elbow external oblique should cover the
distal humerus, elbow joint space, proximal radius and ulna.
Clinical indications: Fractures, joint effusion, dislocation, radial
head and neck, bone lesions and foreign bodies.
Procedure: The procedure for elbow external oblique view is as
follows.
a) The patient should be made to sit by the side or at the end of
the x-ray table on a stool with the hand over the cassette.
b) The entire posterior aspect of the limb should be touching the
table and palm of the hand should be facing up.
c) Cassette is kept under the elbow. Adjust the position of arm to
bring the medial and lateral epicondyles equidistant from the
film.
d) Rotate the entire arm laterally so the distal humerus and the
anterior surface of the elbow joint is 45° to film (palpate
epicondyles to determine rotation)
e) Radiographic marker and patient identification marker should
be placed in the radiographic cassette.
Internal oblique
Procedure: Now rotate arm until distal humerus and the anterior
surface of elbow are rotated 45° to radiographic cassette (palpate
epicondyles to determine rotation)
4.
A
Discuss the various radiographic views for demonstrating scapula.
(Unit 9;Section 9.2, Page No: 168- 172,178-179)
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Radiographic views to demonstrate scapula
 Scapula AP view
 Scapula lateral view
 Scapular Y shape view
A. Scapula AP view
Scapula AP radiograph should cover the area of scapula free from
superimposition.
Clinical indications: Following are the clinical indications of
scapula AP view:
1. In cases of road traffic accident to detect fractures of bones and
dislocations of the joints.
2. Suspected cases of osteoarthritis, tuberculosis and a
neuropathic joint.
Procedure: The procedure for scapula AP view radiograph is as
follows.
a. The patient lies supine with the center of scapula being
examined in the midline of the table. Unaffected shoulder is
side. The elbow is flexed; arm is partially abducted and
medially rotated to move the scapula laterally
b. The limb is immobilized with sand bag over the forearm.
c. Radiographic marker and patient identification marker should
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SMU-DDE-Assignments-Scheme of Evaluation
be placed in the radiographic cassette.
Radiographic techniques
B. Scapula lateral view
The scapula lateral radiograph should cover the area of scapula free
from superimposition.
Clinical indications: Fractures and dislocations of proximal
humerus and scapula.
Procedure: The procedure for scapula lateral view radiograph is as
follows.
1. The patient stands with the side being examined against a
vertical bucky.
2. The patient’s position is adjusted so that the center of the
scapula is at the level of the center of the cassette
3. The arm is either adducted across the body or abducted with
the elbow flexed to allow the back of the hand to rest on the
hip.
4. Keeping the affected shoulder in contact with the bucky, the
patient’s trunk is rotated forward until the body of the scapula
is at right angles to the cassette. This can be checked by
palpating the medial and lateral borders of the scapula near the
inferior angle.
Radiographic techniques
Scapular Y shape view
The scapular Y shape view radiograph should cover the area of
the proximal humerus, scapula and scapulohumeral joint
Clinical indications: Fractures and dislocations of proximal
humerus and scapula.
Procedure: The procedure for scapular Y view radiograph is as
follows.
a. The patient should be erect and facing towards the upright
Bucky.
b. The patient should be rotated into an anterior oblique position.
c. The average patient will be in a 45° to 60° anterior oblique
position. Palpate the scapula borders to determine the correct
rotation for a true lateral.
d. The arm should be abducted slightly not to superimpose
humerus over ribs.
5.
A
Radiographic techniques
Describe the basic radiographic views of the leg.
Radiographic views of leg
 AP basic view
(Unit 12;Section 12.2, Page No: 223- 231)
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SMU-DDE-Assignments-Scheme of Evaluation
 Lateral basic view
 Proximal tibio-fibular joint - lateral oblique view
 Proximal tibio-fibular joint - AP oblique view
A. AP basic view
Two projections are taken of the full length of the lower leg.
A cassette fitted with standard intensifying screens is chosen
that is large enough to accommodate the entire length of the
tibia and fibula.
Clinical indications: Following are the clinical indications of
leg AP basic view:
a) In cases of RTA to detect fractures
b) To detect foreign bodies in soft tissues
c) Suspected cases of osteomyelitis
d) Bone tumors.
Procedure: The procedure for leg AP basic view radiograph
is as follows.
1. The patient is either supine or seated on the x-ray table,
with both legs extended.
2. The ankle is supported in dorsiflexion by a firm 90degree pad placed against the plantar aspect of the foot.
The limb is rotated medially until the medial and lateral
malleoli are equidistant from the cassette.
3. The lower edge of the cassette is positioned just below
the plantar aspect of the heel.
Radiographic techniques
B. Lateral basic view
The leg lateral view x-ray should cover the entire tibia /
fibula, knee joint proximally and ankle joint distally.
Clinical indications: Following are the clinical indications of
leg lateral basic view
a) In cases of RTA to detect fractures
b) To detect foreign bodies in soft tissues
c) Suspected cases of osteomyelitis
d) Bone tumors.
Procedure: The procedure for leg lateral basic view
radiograph is as follows.
1. From the supine/seated position, the patient rotates onto
the affected side.
2. The leg is rotated further until the malleoli are
superimposed vertically.
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SMU-DDE-Assignments-Scheme of Evaluation
3. The tibia should be parallel to the cassette.
4. A pad is placed under the knee for support.
5. The lower edge of the cassette is positioned just below
the plantar aspect of the heel.
Radiographic techniques
C. Proximal tibio-fibular joint - lateral oblique view
The lateral oblique projection is taken to demonstrate the
tibio-fibular articulation.
Clinical indications: Demonstrate the tibio-fibular
articulation.
Procedure: The procedure for proximal tibio-fibular joint lateral oblique view radiograph is as follows.
1. The patient lies on the affected side, with the knee
slightly flexed.
2. The other limb is brought forward in front of the one
being examined and supported on a sandbag.
3. The head of the fibula and the lateral tibial condyle of the
affected side are palpated and the limb rotated laterally to
project the joint clear of the tibial condyle.
4. The centre of the cassette is positioned at the level of the
head of the fibula.
6.
D. Proximal tibio-fibular joint - AP oblique view
The AP oblique projection is taken to demonstrate the tibiofibular articulation.
Clinical indications: Demonstrate the tibio-fibular
articulation.
Procedure: The procedure for antero-posterior oblique view
radiograph is as follows.
1. The patient is either supine or seated on the x-ray table,
with both legs extended.
2. Palpate the head of the fibula and the lateral tibial
condyle.
3. Rotate the limb medially to project the tibial condyle
clear of the joint.
4. The limb is supported by pads and sandbags.
5. The center of the cassette is positioned at the level of the
head of the fibula.
Radiographic techniques
Explain femur lateral with no injury and lateral after injury views.
(Unit 14;Section 14.2 Page No: 252-257)
SMU-DDE-Assignments-Scheme of Evaluation
A
Lateral with no injury
This radiograph should cover proximal half to two thirds of
the femoral shaft, femoral head, femoral neck, trochanters
and hip joint.
Clinical indications: Fractures, tumors and infection.
Procedure: The procedure for femur lateral view radiograph
is as follows.
a) The patient turns to one side. Hip and knee flexed
slightly. Film positioned against the lateral aspect of the
thigh. Unaffected limb is kept away.
b) Immobilize in the same position with sand bags.
c) Right or left marker and patient identification are placed.
Radiographic techniques
Focus film distance
100 cm
kVp
50-55
mAs
8
Grid
No
Cassette size
14” x 17”
Breathing Instructions
NA
Centering
Central ray perpendicular to the
mid-femur and the center of the
cassette.
Radiation Protection
Lead waist apron is used to
protect the gonads
Collimation
Shutter A: to the full length of
the film.
Shutter B: within 1.25cm (half
an inch) of the skin-line
Note: the position of the
proximal and mid femoral shaft
is nearer the anterior aspect of
the thigh
Vertical central ray to the
cassette
90 degrees
Lateral after injury
This radiograph should cover proximal half to two thirds of
the femoral shaft, femoral head, femoral neck, trochanters
and hip joint.
Clinical indications: Road traffic accident to detect fractures
of bones and dislocations of the joints
Procedure: The procedure for femur lateral view radiograph
is as follows:
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SMU-DDE-Assignments-Scheme of Evaluation
1.
The patient lies supine, limb extended. Rotate the limb
to centralize the patella over the femur. Film positioned
vertically against the lateral side of the thigh, the beam
directed mediolaterally and the opposite limb raised on
a suitable support
2. Immobilize the limb in the same position using sand
bags.
3. Right or left marker and patient identification are
placed.
Radiographic techniques
Focus film distance
100 cm
kVp
50-55
mAs
8
Grid
No
Cassette size
14” x 17”
Breathing Instructions
NA
Centering
Central ray perpendicular to the
mid-femur and the center of the
cassette.
Radiation Protection
Lead waist apron is used to
protect the gonads
Collimation
Shutter A: to the full length of
the film.
Shutter B: within 1.25cm (half
an inch) of the skin-line
Note: the position of the
proximal and mid femoral shaft
is nearer the anterior aspect of
the thigh
Vertical central ray to the
cassette
90 degrees
*A-Answer
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