2. © 2009 The McGraw-Hill Companies, Inc. All rights reserved X-rays and Diagnostic Radiology PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

3. 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.

4. 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.

5. 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

6. 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

7. 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

8. 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

9. 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.)

10. 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.)

11. 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

12. 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

13. 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.)

14. 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.)

15. 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.

16. 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

17. 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.)

18. 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.)

19. 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.)

20. 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.)

21. 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.)

22. 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.)

23. 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.)

24. 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.)

25. 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!

26. 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

27. 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

28. 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.)

29. 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!

30. 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

31. 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

32. 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

33. 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.

34. 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

35. 53-34 © 2009 The McGraw-Hill Companies, Inc. All rights reserved End of Chapter Words can be like X-rays if you use them properly-- they'll go through anything. You read and you're pierced.” ~ Aldous Huxley