Term
| What is the exposure differnce between flouroscopy and cineangiography? |
|
Definition
| Fluoroscopy generates 1/5 the exposure of cineangiography |
|
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Term
| What are the concepts of the lab radiotion safety policy? |
|
Definition
-Routine monitoring of exposure
-Continuing education programs for rad safety
- Program to make personnel aware of the risks associated with rad exposure
- Requirement for personnel to wear protective equipment
- Procedure to check safety of all equipment |
|
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Term
| What is the proper thickness of a lead apron? |
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Definition
|
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Term
| How often should lead aprons be examined under fluoro? |
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Definition
|
|
Term
| What is the proper length of a lead apron? |
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Definition
| Long enough to cover the femur and should extend to the knee or just below the knee |
|
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Term
| A single x ray exposure of ______ to the eyes can produce cataract formation. |
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Definition
|
|
Term
| What should protective eye wear be made of in the cath lab? |
|
Definition
| 0.5-0.75mm lead equivalent glass, optimal if they have a wrap around shield |
|
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Term
| Lead glasses offer how much more protection from radiation than regular glasses? |
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Definition
|
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Term
| The measure of ionization deliverd to a specific point. |
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Definition
|
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Term
| The amount of radiation energy deposited per unit mass of tissue. Depends on tissue type. |
|
Definition
| Radiation absorbed dose (rad) |
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Term
| Used to express the biological impact of given exposure for radiation. |
|
Definition
| Radiation equivalent dose in man (REM) |
|
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Term
| What is the ratio of Roentgen to rad in soft tissue? In bone? |
|
Definition
Skin-1R:1 rad
Bone - 1R:4 rad |
|
|
Term
| What is the ratio of rad to REM? |
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Definition
|
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Term
| What are the components invloved in generation of the x-ray image? |
|
Definition
-Xray generator
-Xray tube
- Image Intensifier |
|
|
Term
| How should the operator stand in order to recieve the least amount of radiation? |
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Definition
| At right angles to the scattering object or image intensifier |
|
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Term
| What are 5 methods used to limit radiation exposure? |
|
Definition
-Wear lead aprons (80% protection)
-Limit exposure Time
-Reduce distance between Xray source and patient
-Maximize distance between xray source and operator
-Limit mA per KV
- Use collimators |
|
|
Term
| What are the 4 principles of radiation exposure? |
|
Definition
- Less exposure, the less chance oof biological interaction
- No known level of radiation is absolutely safe
- Radiation exposure is cumulative
- Voulunarily accepted some radiation exposure |
|
|
Term
| Provides power source necessary to accelerate the electrons through the xray tube |
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Definition
|
|
Term
| Converts electrical energy into an xray beam. |
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Definition
|
|
Term
|
Definition
|
|
Term
| Rapidly rotating disk that converts electrons to xray |
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Definition
|
|
Term
| Converts the invisible xray image into a visual image after it passes through the body. Each xray hit a phosphorus covered plate resulting in a light particle being detected. |
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Definition
|
|
Term
| Number of photons generated per unit of time? |
|
Definition
|
|
Term
| Increase in mA causes what effects? |
|
Definition
- Improved resolution
- Reduced mottling (spotty appearance)
- Increased rad exposure and scatterto patient and staff |
|
|
Term
| What is the mA limited by? |
|
Definition
| Heat capacity of xray tube |
|
|
Term
| The enrgy spectrum or wavelenghts of the xray beam? |
|
Definition
|
|
Term
|
Definition
Greater penetration
Shorter wavelenght
Lower Resolution
Higher dose of radiation and scatter |
|
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Term
| What is the correct method to set up for administration of contrast? |
|
Definition
-Ensure warmed to body temp
-Check if patient is aware of contrast or iodine/seafood allergies
-Warn patient they may feel a hot flushing sensation |
|
|
Term
| What are some side effects associated with contrast? |
|
Definition
Anaphylatic reations
Cutaneous/Mucosal
Smooth Muscle
Cardiovascular
Renal Failure |
|
|
Term
| What are the cutaneous/mucosal reactions to contrast? |
|
Definition
Angioedema
Flushing
Laryngeal edema
Uticaria
Hives |
|
|
Term
| What are the Smooth muscle reactions to contrast? |
|
Definition
Bronchospasm
Laryngeal edema
GI spasm
Uterine Contraction |
|
|
Term
| What are the cardiovascular reactions to contrast? |
|
Definition
Arrythmia
hypotension
Vasodilation |
|
|
Term
| What are the indications for low osmolar/non-ionic contrast? |
|
Definition
Unstable ischemic syndromes
CHF
Diabetes
Renal insufficiency
Hypotension
Severe Bradycardia
Hx of contrast allergy
Severe valvular heart disease
Use of IMA and peripheral vascular injections |
|
|
Term
| What is the reason for coughing after contrast media injections? |
|
Definition
| Maintains arterial pressure,cerebral blood flow and influences vagal tone |
|
|
Term
| What is the best catheter position for an LV gram? |
|
Definition
| Place near the mid cavity in a position that aviods contact with the papilary muscles or positioning to close to the MV |
|
|
Term
| What grade of MR is described as mild LA opacification tht clears rapidly |
|
Definition
|
|
Term
| What grade of MR is described as moderate LA opacification, < LV |
|
Definition
|
|
Term
| What grade of MR is described as diffuse contrast regurgitant and LA opacification equals LV: LA significantly enlarged |
|
Definition
|
|
Term
| What grade of MR is described as LA opacification is > LV, persistnet: systolic pulmonary vein opacification may occur: often marked LV enlargement |
|
Definition
|
|
Term
| What grade of AR is described as small regurgitant jet; LV ejects contrast with each systole? |
|
Definition
|
|
Term
| What grade of AR is described as regurgitant jet faintly opacifies LV cavity; not cleared each systole? |
|
Definition
|
|
Term
| Persistent LV opacification equal to aortic root density; LV enlargement |
|
Definition
|
|
Term
| Persistent LV opacification > AO root density; often marked LV enlargement |
|
Definition
|
|
Term
| What are the indications to perform an LV gram? |
|
Definition
- ID of LV function for patients with CAD, myopathy, or valvular heart disease
- ID of VSDs
-Quantify degree of MR
-Quantify the mass of myocardium for regression of hypertrophy |
|
|
Term
| What are two adverse events that can occur during LV gram? |
|
Definition
Cardiac arrythmias (VF/VT)
Intramyocardial staining
Embolism form thrombi or air |
|
|
Term
| What wall segments are seen in 30 RAO |
|
Definition
| High lateral, anterior, apical, inferior LV walls |
|
|
Term
| What wall segments are seen in 60 LAO with 20 cranial angulation |
|
Definition
| posterior-lateral, septal LV walls and VSDs |
|
|
Term
| Uniform, alomost concentric inward motion of all points along the ventricular inner surface during systole? |
|
Definition
|
|
Term
| Uncoordinated contractions in the pattern of wall motion contraction? |
|
Definition
|
|
Term
| What are the three types of asynchronis motion? |
|
Definition
Hypokinesia
Akinesia
Dyskinesia |
|
|
Term
| A diminished, but not absent, motion of one part of the LV wall (also called weak or poor contraction) |
|
Definition
|
|
Term
| Total lack of motion of a portion of the LV wall |
|
Definition
|
|
Term
| Paradoxical systolic motion or expansion of one part of the LV wall ( i.e., an abnormal outward bulging during systole) |
|
Definition
|
|
Term
| What are the four problems in the interpretation of angiograms? |
|
Definition
-Vessel Overlap
-Poor Artery Opacification
-Total Coronary Occlusion may be suspected in catheter injection site is sub-selective
-Coronary Spasm may appear as a fixed stenosis |
|
|
Term
| What can be done to prevent vessel overlap? |
|
Definition
| use steeper angles or AP cranial or caudal views |
|
|
Term
| What principles should the cath lab staff be aware of in order to obtain optimun cineangiographic views? |
|
Definition
-Image Intensifier as close to patiens as possible
- The patient should be instructe to take deep breaths and hold before the start of each cine
- Ensure all wires and metal objects on the patient are out of the field
- Use shutters to focus on the area |
|
|
Term
| Whhich views is best to view the left main |
|
Definition
AP
LAO Cranial
LAO Cuadal (horizontal Hearts) |
|
|
Term
| Which views are best to view the Proximal LAD? |
|
Definition
|
|
Term
| Which views are the best to view the Mid LAD? |
|
Definition
LAO cranial
RAO cranial
Lateral |
|
|
Term
| Which views are the best to view the Distal LAD? |
|
Definition
|
|
Term
| Which views are best to view the Diagnol braches? |
|
Definition
|
|
Term
| What views are best to view the proximal Circumflex? |
|
Definition
RAO cranial
RAO caudal
LAO caudal |
|
|
Term
| What views are best to view the Intermediate? |
|
Definition
|
|
Term
| What views are best to view the Obtuse Marginals |
|
Definition
|
|
Term
| What views are best to view the Proximal RCA? |
|
Definition
|
|
Term
| What views are best to view the mid RCA? |
|
Definition
|
|
Term
| What views are best to view the distal RCA? |
|
Definition
|
|
Term
| What views are best to view the PDA? |
|
Definition
|
|
Term
| What views are best to view the posterior lateral? |
|
Definition
|
|
Term
| What is used for qualitative grading of coronary blood flow? |
|
Definition
| -TIMI or Thrombolysis in Myocardial Infarction |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is improtant for an operator to note when viewing collateral circulation. |
|
Definition
- Ipsilateral - same side filling
- Contralateral - opposite side filling
- Region affected
- Stenoses in the artery feeding the collateral |
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