x-rays and diagnostic...
TRANSCRIPT
© 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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Brief History of the X-Ray (cont.)
� Diagnostic and therapeutic uses
� Radiologist
� Physician
� Interprets films
� Radiologic technologists
53-7
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Apply Your Knowledge
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
Radiologic Tests (cont.)
53-18
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
Radiologic Tests (cont.)
53-19
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
Radiologic Tests (cont.)
53-20
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
Radiologic Tests (cont.)
53-21
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
Radiologic Tests (cont.)
53-22
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
Radiologic Tests (cont.)
53-23
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
Radiologic Tests (cont.)
53-24
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Apply Your Knowledge
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
� 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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Apply Your Knowledge
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Apply Your Knowledge
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
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
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
End of Chapter
Words can be like XWords can be like XWords can be like XWords can be like X----rays if rays if rays if rays if you use them properlyyou use them properlyyou use them properlyyou use them properly--------they'll go through they'll go through they'll go through they'll go through anything. You read and anything. You read and anything. You read and anything. You read and you're pierced.” you're pierced.” you're pierced.” you're pierced.”
~ Aldous Huxley~ Aldous Huxley~ Aldous Huxley~ Aldous Huxley