Lecture Clinical procedures for medical assisting (4/e): Chapter 22 – Booth, Whicker, Wyman

CHAPTER

22
X-rays and
Diagnostic
Radiology
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­2

Learning Outcomes
22.1 Explain how x-rays are used for
diagnostic and therapeutic purposes.
22.2 Compare invasive and noninvasive
diagnostic procedures.
22.3 Carry out the medical assistant’s role in
x-ray and diagnostic radiology testing.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­3

Learning Outcomes (cont.)
22.4 Demonstrate the medical assistant’s
duties when preparing a patient for an
x-ray.
22.5 Explain the risks and safety
precautions associated with radiology
work.

22.6 Describe proper procedures for filing
and maintaining x-ray films and
records.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­4

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

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­5

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
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­6

Brief History of the X-Ray (cont.)
• Diagnostic and therapeutic uses
• Radiologist
– Physician
– Interprets films

• Radiologic technologists

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­7

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

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­8

Diagnostic Radiology (cont.)
• 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

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­9

Diagnostic Radiology (cont.)
• Noninvasive procedures
– View internal structures
• Standard x-rays
• Ultrasonography

– 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
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­10

Apply Your Knowledge
1.

2.

electromagnetic
X-rays are __________________
waves that travel at the
speed of light and penetrate solid objects

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.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Medical Assistant’s Role in Diagnostic
Radiology

22­11

• Assist with or perform
procedures
– Based on scope of
practice for state
– Pre- and
postprocedure patient
care
– Patient education

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

Medical Assistant’s Role in Diagnostic
Radiology (cont.)

22­12

• Preprocedure care
– Schedule appointments
– Provide preparation
instructions
– Explain the procedure
– Ask pertinent questions
• Medication history
• Women – possibility of pregnancy

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Medical Assistant’s Role in Diagnostic
Radiology (cont.)

22­13

• Care during and after a
procedure
– Assist with placing,
removing, and
developing film
– Tasks listed in
Procedure 22-1

“Assisting with an X-ray
Examination”
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­14

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.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­15

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

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Common Diagnostic Radiologic Tests

22­16

(cont.)

• Fluoroscopy

• Hysterosalpingography

– X-rays cause certain
chemicals to emit
visible light

– Examination of uterus
and fallopian tubes by
fluoroscopy

– Allows for viewing
movement of an organ
or passage of
substances through
organs

– Used to evaluate shape
and structure of uterus
and patency of fallopian
tubes

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Common Diagnostic Radiologic Tests

22­17

(cont.)

• 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
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Common Diagnostic Radiologic Tests

22­18

(cont.)

• 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

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Common Diagnostic Radiologic Tests

22­19

(cont.)

• 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
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

Common Diagnostic Radiologic Tests

22­20

(cont.)

• 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
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Common Diagnostic Radiologic Tests

22­21

(cont.)

• 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

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Common Diagnostic Radiologic Tests

22­22

(cont.)

• 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
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


Common Diagnostic Radiologic Tests

22­23

(cont.)

• 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
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­24

Apply Your Knowledge
True or False:

ANSWER:

T Fluoroscopy is used for many procedures.
___

Bravo!
fallopian tubes

F Hysterosalpingography is used to evaluate the patency of the colon.
___
F Cholangiography is used to detect abnormalities of the gallbladder.
___

bile duct

F For an IVP, the radiologist injects the contrast medium through a catheter.
___
a retrograde pyelography

T An MRI uses a combination of nonionizing radiation and a strong magnetic
___
field.
less often due to advanced technologies
F Myelography is done frequently to evaluate for spinal abnormalities.
___
T Thermography uses an infrared camera to record variations in skin
___
temperature.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


22­25

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

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.