Radiologic Technology in Surgery

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the most important skill that a radiologic technologist must develop in the operating room?

Understanding reliable exposure factors

Ability to problem-solve unforeseen situations (correct)

Knowledge of surgical procedures

Mastery of imaging equipment

Why must a radiologic technologist be kept under the direct supervision of an experienced technician initially?

To monitor their technical skill with imaging equipment

To expose them to a variety of surgical procedures

To ensure they can handle routine tasks independently

To help them develop confidence in the surgical environment (correct)

What type of equipment must the technologist be proficient in operating?

Both conventional and digital imaging equipment (correct)

Only digital imaging equipment

Only C-arm equipment

Only conventional imaging equipment

What challenge might a radiologic technologist face during surgery?

Sudden malfunction of imaging equipment Signup and view all the answers

In developing their skills, radiography students should focus on:

Transferring newly acquired skills from one procedure to another Signup and view all the answers

What may happen if reliable exposure factors fail to produce a diagnostic image?

An alternative imaging method must be considered Signup and view all the answers

Which of the following best describes the role of experience in the surgical environment for a radiologic technologist?

Experience helps in developing quick solution-finding skills Signup and view all the answers

How should the radiologic technologist approach different surgical procedures?

By adapting abilities learned from previous procedures Signup and view all the answers

What is the primary purpose of the modified acanthioparietal (modified reverse Waters) projection?

To demonstrate the floor of the orbits and the entire orbital rims Signup and view all the answers

How should the central ray (CR) be angled in the modified acanthioparietal projection?

Cephalad to align CR parallel to the LML Signup and view all the answers

What key consideration should be taken for radiation safety in a surgical environment?

Communicate concerns about radiation safety with the team Signup and view all the answers

What should be done to reduce radiation exposure to radiosensitive tissues?

Shield tissues outside the area of interest Signup and view all the answers

What is the significance of suspending respiration during radiographic exposure?

It prevents patient movement and blurriness in images Signup and view all the answers

What role does a radiologic technologist play during surgical procedures?

They must perform procedures without error and delay Signup and view all the answers

What should be optimized according to the ALARA principle?

Exposure time and radiation doses Signup and view all the answers

Which anatomical area is highlighted as the best showcased by the modified acanthioparietal projection?

Floor of the orbits Signup and view all the answers

What is the main purpose of angling the CR and IR in relation to the foot during the AP projection?

To maintain true CR-part-IR alignment Signup and view all the answers

When should only one projection be taken during trauma radiography?

When unavoidable obstructions prevent standard projections Signup and view all the answers

What should be included in the patient's record when standard CR-part-IR relationships cannot be maintained?

A note explaining the reason for variance in routine Signup and view all the answers

Which situation can potentially allow for distortion in the CR-part-IR alignment?

When the patient is placed supine with the IR flat on the table Signup and view all the answers

What is the first principle of trauma radiography regarding the image receptor?

Ensure the entire structure or trauma area is included on the IR Signup and view all the answers

What does the term 'CR-part-IR relationship' refer to in radiographic imaging?

The positioning of the central ray to the patient and image receptor Signup and view all the answers

Why is patient positioning important in trauma radiography?

To ensure accurate angling of the CR Signup and view all the answers

What principle may require the use of larger image receptors in trauma radiography?

Entire structures or trauma areas should be included on the image Signup and view all the answers

False Signup and view all the answers

Study Notes

Trauma and Mobile Imaging

Trauma is defined as a serious injury or shock to the body, often requiring alterations in positioning for radiographic procedures.
Mobile x-ray units are frequently used in emergency departments (EDs) or at the patient's bedside to accommodate patients in various states of immobilization (e.g., splints, backboards).
Radiographers must adapt CR angles and image receptor (IR) placement for accurate diagnosis in challenging circumstances.
Fracture and dislocation terminology is crucial for understanding patient histories and examination requisitions, enabling radiographers to avoid potentially harmful positioning.

Skeletal Trauma and Fracture Terminology

Dislocation: Displacement of a bone from its normal articulation. Detectable by abnormal shape or alignment. Avoid any movement of displaced body parts. Requires imaging in two perpendicular planes to assess displacement. Common dislocations include shoulder, fingers/thumb, patella, and hip. If a bone has relocated following injury, further assessment for damage is necessary.
Subluxation: A partial dislocation, as seen in posterior displacement of a vertebra, or nursemaid's elbow (a partial dislocation of the radial head in children).
Sprain: A forced injury to a joint, resulting in partial ligament rupture without dislocation. Characterized by significant swelling or discoloration (hemorrhage) and requires careful positioning during examination. Clinically similar to fractures, and radiographs differentiate them.
Contusion: A bruise-type injury with possible avulsion fracture, such as a hip pointer.
Fracture (fx): A disruption of bone caused by mechanical force. The radiographer must be extremely cautious in handling the patient, to avoid further injury. Never force a limb into position if obvious pain or any sign of movement is present.
Fracture Alignment Terminology:
- Alignment: Relationship between fracture fragment long axes; aligned fragments are parallel.
- Apposition: Describes contact between fractured bone ends.
  - Anatomic apposition: Ends make end-to-end contact.
  - Lack of apposition (distraction): Ends are separated and don't touch.
  - Bayonet apposition: Fracture fragments overlap.
- Angulation: Loss of alignment, described by the direction of apex (opposite the distal fragment).
  - Apex angulation: Describes the direction of the fracture apex (e.g., medial or lateral).
  - Varus deformity: Distal fragments angled towards the body midline, apex pointed away.
  - Valgus deformity: Distal fragments angled away from the body midline, apex pointed towards.

Types of Fractures

Simple (closed): Fracture where the bone does not break the skin.
Compound (open): Fracture where a bone fragment protrudes through the skin.
Incomplete (partial): Fracture that does not traverse the entire bone. Common in children.
- Torus fx: Buckle of the cortex; localized expansion or torus of the cortex, possible minimal displacement.
- Greenstick fx: Fracture on one side only; one side of the bone breaks, other side bends.
Complete: Fracture that extends completely through the bone.
- Transverse fx: Fracture is across the long axis of the bone at a near-right angle.
- Oblique fx: Fracture line is at an oblique angle.
- Spiral fx: Fracture spirals around the long axis of the bone.
Comminuted fx: Bone is splintered or crushed; results in two or more fragments.
- Segmental fx: Two fracture lines isolate a segment of bone.
- Butterfly fx: Two fragments on each side of a wedge-shaped fragment.
- Splintered fx: Splintered into thin, sharp fragments.
Impacted fx: One fragment driven into the other. Occurs frequently at distal or proximal ends of long bones (femur, humerus, radius).

Specific Named Fractures

Barton Fracture: Intra-articular fracture of the distal radius, often with dislocation or subluxation of the radiocarpal joint.
Baseball (Mallet) Fracture: Distal phalanx fracture caused by a blow to an extended finger; frequently with avulsion fracture at the base.
Bennett Fracture: Longitudinal fracture of the base of the first metacarpal, often with posterior dislocation or subluxation.
Boxer Fracture: Distal fifth metacarpal fracture with posterior angulation (best seen on lateral view). Result of punching.
Colles Fracture: Distal radius fracture with posterior displacement of the distal fragment, often from a fall on an outstretched arm.
Smith (Reverse Colles) Fracture: Distal radius fracture with anterior displacement of the distal fragment, commonly from a backward fall on an outstretched arm.
Hangman Fracture: Fracture through the pedicles of the axis (C2).
Hutchinson (Chauffeur) Fracture: Intra-articular fracture of the radial styloid process.
Monteggia Fracture: Fracture of the proximal ulna with radial head dislocation, commonly from defending against blows with the forearm raised.
Pott Fracture: Complete fracture of the distal fibula with ankle joint injury, often with distal tibia or medial malleolus fracture.
Avulsion Fracture: Bone fragment separated from surrounding tissue due to severe stress on tendons or ligaments.
Blowout and/or Tripod Fracture: Skull fracture caused by a direct blow to the orbit or maxilla and zygoma.
Chip Fracture: Isolated bone fragment.
Compression Fracture: Vertebrae collapses or is compressed from compressive-type injury.
Stellate Fracture: Fracture lines radiate from a central injury point, often seen in the patella.
Stress/fatigue Fracture ("March" fracture): Result of repetitive stress.
Trimalleolar Fracture: Ankle fracture involving medial and lateral malleoli, as well as posterior lip of the distal tibia.
Tuft (Burst) Fracture: Comminuted distal phalanx fracture from a crushing blow.

Mobile X-Ray Equipment

Mobile x-ray units often used in trauma, bedside, or surgical settings. Includes battery-driven units and standard power units (capacitor discharge).
Digital imaging well-suited for trauma and mobile procedures.

Positioning Principles for Trauma and Mobile Radiography

Obtain at least two orthogonal projections (90° to each other).
Ensure entire anatomy in question is included. This requires adaptation as necessary in trauma.
Prioritize patient and health care worker safety. Maintain all safety regulations.

Alternative Modalities

CT: High-speed, used for emergency imaging of skeletal trauma and other trauma.
Sonography: Noninvasive detection of blood or fluid in the abdominal area or the female reproductive system.
Nuclear Medicine: Useful for evaluating specific trauma conditions like pulmonary embolus or gastrointestinal bleeding
Angiography/Interventional Procedures: Can be used for studies of the aortic arch or transcatheter embolization to stop hemorrhaging vessels

Additional Information

Clinical Indications: Specific reasons for the order in trauma or surgical contexts.
Technical Factors: Equipment requirements and settings to obtain diagnostic images in a timely fashion.
Patient Positioning: Specific positioning techniques for different procedures.
Surgical Asepsis: Critical for maintaining a sterile environment.
Surgical Equipment: Detailed descriptions and operations of common equipment.
Radiation Protection: Emphasizing measures to protect patients and personnel.

Surgical Radiography

Confidence and Communication: Key attributes of competent surgical radiographers.
Problem-solving Skills: Necessary for addressing unexpected issues.
Mastery: Comprehensive understanding of all aspects of radiography and procedures.
Surgical Team: Roles of the surgeon, anesthesiologist, surgical assistants, CST, circulator, and scrub.
Surgical Imaging Equipment (C-arm and Mobile Units).
Radiation exposure and personnel safety procedures.
Biliary Tract Procedures (operative cholangiography and laparoscopic cholecystectomy).
Urinary Tract Procedures (retrograde urography).
Orthopedic Procedures (closed reduction, open reduction, internal fixation, external fixation, intramedullary fixation) , including hip fractures.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Explore the essential skills and knowledge required for radiologic technologists in the operating room. This quiz covers supervision, equipment proficiency, challenges, and radiation safety considerations that are crucial for success in a surgical environment. Answer questions to refine your understanding of radiography practices in surgery.