X-Ray Protocols and Lab Rules UON

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Questions and Answers

What should you do if you need to expose radiation during your first lab session?

Make exposure without consultation to avoid delays.

Ask the lab tutor to check before proceeding. (correct)

Consult with a fellow classmate for their opinion.

Wait until the end of the session to review the protocols.

What immediate action should you take before making an exposure in the lab?

Ensure the lab supervisor is out of the room.

Check that protective clothing is worn by all present.

Conduct a quick briefing with classmates.

Verify that the lab door is closed. (correct)

Which rule is NOT mentioned as part of the lab safety regulations?

Enclosed footwear with sturdy upper must be worn.

TLD badges must be worn while attending labs.

No unauthorised person is allowed in the lab.

Students can consume food in reserved areas. (correct)

What is the intended purpose of wearing TLD badges in the lab?

To track radiation exposure levels. Signup and view all the answers

Why is imaging another classmate in the lab prohibited?

There could be legal liability and safety concerns. Signup and view all the answers

What is the central ray positioning for a lateral chest x-ray?

Mid-coronal plane at level of T7 Signup and view all the answers

What is the required tube angle for both lateral chest and AP abdomen x-rays?

Straight tube, perpendicular to anatomy Signup and view all the answers

What is the optimal distance for performing a lateral chest x-ray?

180 cm Signup and view all the answers

Which of the following is essential during patient preparation for a lateral chest x-ray?

Remove artifacts in the field of view Signup and view all the answers

What kVp range should be used for adult AP abdomen imaging?

75-80 kVp Signup and view all the answers

What anatomical structures should be displayed clearly in a lateral chest x-ray?

Lungs, trachea, heart, and diaphragm Signup and view all the answers

What is the required angle for the thumb side of the hand when positioning for a PA oblique hand x-ray?

45 degrees Signup and view all the answers

Which positioning detail is specific to the lateral hand x-ray technique?

Thumb is parallel to the image receptor Signup and view all the answers

What is a recommended instruction to give the patient during a lateral chest x-ray?

Breath in and hold your breath Signup and view all the answers

What is the primary reason for using a left lateral position in a lateral chest x-ray?

To reduce cardiac magnification Signup and view all the answers

What is the central ray location for the PA oblique hand x-ray?

3rd MCP joint Signup and view all the answers

What is the appropriate collimation requirement for both PA oblique and lateral hand x-rays?

Include all of required anatomy including skin edges Signup and view all the answers

What is the recommended mAs setting for the lateral hand x-ray?

2.5 mAs Signup and view all the answers

During a PA oblique hand x-ray, which part of the hand should not overlap as much?

Midshafts of third, fourth and fifth metacarpals Signup and view all the answers

Which is NOT a key anatomical feature to visualize in the criteria for lateral hand x-ray?

Proximal ulna Signup and view all the answers

What is the required distance for the PA Hand imaging?

100-110 cm Signup and view all the answers

What main factor distinguishes the kVp settings between PA oblique and lateral hand x-rays?

Thickness of the hand Signup and view all the answers

Which of the following factors is critical for ensuring appropriate density in abdominal imaging?

Use of contrast agents Signup and view all the answers

In the context of an PA Hand imaging, what is specifically required for proper alignment?

Symmetry of the metacarpals Signup and view all the answers

What anatomical areas should an abdominal X-ray adequately demonstrate?

Diaphragm to inferior pubic rami including bony anatomy Signup and view all the answers

What should be included in the collimation for PA Hand imaging?

All required anatomy including skin edges Signup and view all the answers

During abdominal imaging, what is a sign that could indicate the need for a repeat image?

Blurring of bowel gas Signup and view all the answers

What is the typical kVp setting for a PA Hand imaging procedure?

50 kVp Signup and view all the answers

Which instruction is vital for achieving the correct posture while taking a PA Hand image?

Seating the patient at the end of the x-ray table Signup and view all the answers

What is the correct tube angle for a PA Oblique Thumb positioning?

Straight tube perpendicular to anatomy Signup and view all the answers

Which of the following is NOT part of the criteria for the AP Thumb imaging?

The angle of the tube should be 45 degrees Signup and view all the answers

What is the correct central ray location for both AP and PA Oblique Thumb images?

1st MCP Joint Signup and view all the answers

What distance should be maintained from the tube to the image receptor for Thumb imaging?

100-110 cm Signup and view all the answers

Which of the following is crucial for ensuring that joint spaces are open in Thumb imaging?

Keeping the thumb parallel to the image detector Signup and view all the answers

Which density characteristic should be demonstrated in the final image of the Thumb?

Cortical outline and bony trabecular pattern adequately demonstrated Signup and view all the answers

What preparation should be done on the patient before Thumb imaging?

Remove artifacts in the field of view, such as jewelry Signup and view all the answers

What is the maximum kVp recommended for Thumb imaging?

50 kVp Signup and view all the answers

Study Notes

Introduction

The text is a guide for x-ray protocols at the University of Newcastle (UON), the guidelines may vary depending on the site.
The UON laboratory has a Philips DigitalDiagnost C90 digital radiography system
The UON laboratory uses a Philips 35x43cm IR (Image Receptor)
Body habitus, patient presentations and equipment will affect exposures

Lab Rules

Students must wear TLD badges while attending labs, failure to do so will result in limitations, including lab exclusion.
UON placement uniform, enclosed footwear, must be worn
Eating, drinking, or smoking is not permitted in the diagnostic radiography laboratory
Unauthorised people cannot be in the lab
School of Health Science OH&S regulations must always be adhered to

Radiation Rules

Students should confirm with a tutor before using radiation in a lab for the first time.
Imaging classmates is prohibited.
The door must be closed before taking an exposure.
Students must ensure there are no other people in the room.
The guidance of a supervisor must be followed.

Lateral Chest

Positioning: Left side to upright bucky, hands on head
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: Mid-coronal plane at level of T7 (inferior angle of scapulae)
Distance: 180cm
Collimation: Include lung apices to costophrenic angles, laterally to skin border.
IR (Receptor): 35x43cm Portrait
kVp: 90-110 kVp
mAs: Central cell of AEC Estimate: 4 mAs
Grid: Yes
Breathing: Suspended (inspiration)
Notes: Remove any artifacts before taking an image, patient should wear a gown.

Lateral Chest Criteria

Collimation: From the apices to costophrenic angles. Include the anterior and posterior soft tissues
Alignment: No rotation. Posterior ribs superimposed
Anatomy: Lungs, trachea, heart, great vessels, diaphragm, posterior costophrenic angles, bony thorax
Density: Vertebral bodies of thoracic spine just visible through cardiac shadow
Contrast: Lung detail clearly visualised. Soft tissue borders should be seen
Markers: Side marker evident
Identity: Image has appropriate identification or deliberately anonymised
Hints: Left lateral position reduces cardiac magnification as the heart is close to the image receptor.

AP Abdomen

Posture: Supine
Positioning: Patient on back, on xray table or trolley. No rotation, with shoulders and hips equidistant from table/trolley.
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: Mid-sagittal plane at level of iliac crests
Distance: 100-110cm
Collimation: Include lung apices to costophrenic angles, laterally to skin border.
IR (Receptor): 35x43cm Portrait (landscape may be required in bariatric patients to include all relevant anatomy)
kVp: Adult 75-80 kVp
mAs: Lateral cells of AEC Estimate: 30-35+ mAs
Grid: Yes
Breathing: Suspended (expiration)
Notes: Remove any artifacts before taking an image, patient should wear a gown.

AP Abdomen Criteria

Collimation: Superior to the diaphragm, inferiorly to the inferior pubic rami, laterally to the abdominal skin edge
Alignment: No rotation. Ribs, crests and obturator foramen symmetrical
Anatomy: Abdomen from diaphragm to inferior pubic rami. Liver, spleen, kidneys, gastric bubble, bowel gas, bladder, bony anatomy of the lumbar spine and pelvis
Density: Gas, soft tissue and bone adequately demonstrated.
Contrast: Soft tissue and bony contrast visualised.
Markers: Side marker evident
Identity: Image has appropriate identification or deliberately anonymised
Hints: Carefully observe the patient to catch full breathing expiration. Blurring of bowel gas indicates respiratory movement (repeat may be required)

PA Hand

Posture: Seated
Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: 3rd MCP joint
Distance: 100-110cm
Collimation: Four sides of collimation seen to include skin edges of hand
kVp: 50kVp
mAs: 2mAs
Grid: No
Breathing: N/A
Notes: Remove any artifacts before taking an image (watch, jewellery)

PA Hand Criteria

Collimation: Include all of required anatomy including skin edges
Alignment: No rotation. Symmetry of phalanges and metacarpals
Anatomy: Tips of digits to distal radius and ulna
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualised.
Markers: Side marker evident
Identity: Image has appropriate identification or deliberately anonymised
Hints: Ensure all fingers are in contact with the image detector to ensure joint spaces are open.

PA Oblique Hand

Posture: Seated
Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor. Thumb side of hand raised 45 degrees.
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: 3rd MCP joint
Distance: 100-110cm
Collimation: Four sides of collimation seen to include skin edges of hand
kVp: 50kVp
mAs: 2mAs
Grid: No
Breathing: N/A
Notes: Remove any artifacts before taking an image (watch, jewellery)

PA Oblique Hand Criteria

Collimation: Include all of required anatomy including skin edges
Alignment: 45 degrees rotation with elevation of radial aspect of hand elevated (thumb up). Midshafts of third, fourth and fifth metacarpals should not overlap, however some overlap of distal metacarpal heads
Anatomy: Tips of digits to distal radius and ulna
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualised.
Markers: Side marker evident
Identity: Image has appropriate identification or deliberately anonymised
Hints: Ensure all fingers are in parallel with the image detector to ensure joint spaces are open.

Lateral Hand

Posture: Seated
Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor. From oblique position, rotate hand to 90 degrees. Thumb is parallel to image receptor. Fingers can be superimposed or fanned to see each digit.
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: Level of MCP joint
Distance: 100-110cm
Collimation: Four sides of collimation seen to include skin edges of hand
kVp: 55kVp
mAs: 2.5mAs
Grid: No
Breathing: N/A
Notes: Remove any artifacts before taking an image (watch, jewellery)

Lateral Hand Criteria

Collimation: Include all of required anatomy including skin edges
Anatomy: Tips of digits to distal radius and ulna
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualised. Internal rotation of hand so that thumb is AP and in contact with the image receptor.

AP Thumb

Posture: Seated
Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor. Rotate hand to 90 degrees. Fingers are superimposed or fanned to see each digit.
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: 1st MCP Joint
Distance: 100-110cm
Collimation: Four sides of collimation seen to include skin edges of thumb
kVp: 50kVp
mAs: 2mAs
Grid: No
Breathing: N/A
Notes: Remove any artifacts before taking an image (jewellery)

AP Thumb Criteria

Collimation: Include all of digit of interest including skin edges
Anatomy: Tip of thumb to trapezium
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualised.
Markers: Side marker evident
Identity: Image has appropriate identification or deliberately anonymised
Hints: Ensure finger is parallel to the image detector to ensure joint spaces are open. Hand is free of motion artifact.

PA Oblique Thumb

Posture: Seated
Positioning: Patient seated at end of xray table. Hand flat on image receptor, thumb slightly abducted.
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: 1st MCP Joint
Distance: 100-110cm
Collimation: Four sides of collimation seen to include skin edges of thumb
kVp: 50kVp
mAs: 2mAs
Grid: No
Breathing: N/A
Notes: Remove any artifacts before taking an image (jewellery)

PA Oblique Thumb Criteria

Collimation: Include all of digit of interest including skin edges
Anatomy: Tip of thumb to trapezium
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualised.
Markers: Side marker evident
Identity: Image has appropriate identification or deliberately anonymised
Hints: Ensure finger is parallel to the image detector to ensure joint spaces are open. Hand is free of motion artifact.

Lateral Thumb

Posture: Seated
Positioning: Patient seated at end of xray table.
Tube Angle: Straight tube (perpendicular to anatomy)
Central Ray: 1st MCP Joint
Distance: 100-110cm
Collimation: Four sides of collimation seen to include skin edges of thumb
kVp: 50kVp
mAs: 2mAs
Grid: No
Breathing: N/A
Notes: Remove any artifacts before taking an image (jewellery)

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Description

This quiz covers the essential x-ray protocols and laboratory rules at the University of Newcastle. It includes safety regulations, equipment usage, and the importance of following procedures to ensure a safe learning environment. Test your understanding of these crucial guidelines.