x-rays and diagnostic...

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

X-rays and Diagnostic RadiologyPowerPoint® presentation to accompany:

Medical AssistingThird Edition

Booth, Whicker, Wyman, Pugh, Thompson

53-2


Learning Outcomes

53.1 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.

53-3


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.

53-4


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

53-5


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

53-6


Brief History of the X-Ray (cont.)

� Diagnostic and therapeutic uses

� Radiologist

� Physician

� Interprets films

� Radiologic technologists

53-7


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

53-8


� 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.)

53-9


� 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.)

53-10


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

53-11


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

53-12


� 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.)

53-13


� 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.)

53-14



How 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.

53-15


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

53-16


� 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.)

53-17


� 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

Common Diagnostic


53-18


� 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

Common Diagnostic


53-19


� 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

Common Diagnostic


53-20


� 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

Common Diagnostic


53-21


� 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

Common Diagnostic


53-22


� 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

Common Diagnostic


53-23


� 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

Common Diagnostic


53-24



True 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!

53-25


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

53-26


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

53-27


� 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.)

53-28



1. 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!

53-29


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

53-30


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

53-31


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

53-32



1. 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.

53-33


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

53-34


End of Chapter

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~ Aldous Huxley~ Aldous Huxley~ Aldous Huxley~ Aldous Huxley

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