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published by: Florida Department of Health
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DOH 5/0011000
BASIC X-RAY MACHINE OPERA TOR STUDY GUIDE
State of Florida
Department of Health
December 1986
Acknowledgments
From Nursing Skills for Allied Health Services, by Lucille A. Wood and
Beverly J. Rambo. 0 1977 by The Regents of the University of California.
Used with permission.
Portions of this study guide have as their source the publication Medical
Service: Radiologic Technology, Departments of the Air Force, the Army,
and the Navy (Washington, D.C., 1974).
The Department also thanks the following individuals who prepared the
first draft of the study guide: Gary L. Tomaszewski; Vala Wagie; Nancy
Delgado, formerly with the Center for Instructional Development and
Services (CIDS) at Florida State University (FSU); and Linda Cornelious,
CIDS, FSU. The Department thanks the following for their time and efforts
in reviewing the guide: Gary L. Tomaszewski, Richard Leverone, Vala
Wagie, Louise M. Tomaszewski, Janice Leifer, Susan Bridis, William
Passetti, Simon Growick, Mason Cox, Don Steiner, Danny Smock,
Roxanne McCarthy, Betsy Fulford, Marvin Patterson, Rusin Van Dyke,
and the entire staff of the Bureau of Radiation Control. DOH would also
like to express its appreciation to the applicants who reviewed the guide
and took the certification examination for a pilot study: Eileen Andreu,
Cheryl Bowie, Mary Bradshaw, Mary Cairns, Ladonna Greene, Mary
Guinan, Julie Hall, Michele Knisley, Geraldine
iii
Labrecque, Mary Lamb, Sharon Lancaster, Diane Lutzen, Jane Muse,
Brenda Relstab, Brenda Reynolds, Catherine Richardson, Aimee Sallas,
and Susan Shephard.
Finally, the Department would like to acknowledge the project staff at the
Center for Instructional Development and Services of Florida State
University: Hyoja Lee, project manager and instructional designer; Frances
Brock and Peggy Barlow, editors; Susan Maxwell and Betty Willard, word
processors; Dan Haskin, graphic designer; Alice Fisher and Bob McCann,
proofreaders; Mary Sommer, illustrator; Roberta Carpenter, copyright
specialist; and Linda Cornelious, Young-Sun Yang, and Mike Lado,
graduate assistants.
iv
Preface
Chapter 468, Florida Statutes, provides legal authority for the State
Radiologic Technologist certification program and Chapter 64E-3,
Florida Administrative Code, establishes necessary criteria and
procedures to carry out provisions of the statute.
It is declared to be the policy of the state that the health and safety of the
people must be protected against the harmful effects of excessive and
improper exposure to ionizing radiation. Such protection can in some
major measure be accomplished by requiring adequate training and
experience of persons who use radiation and radiation-emitting equipment
in each particular case under the specific direction of licensed
practitioners. It is the purpose of this part to establish standards of
education, training, and experience and to require the examination and
certification of users of radiation and radiationemitting equipment.
v
equipment operation and maintenance, (3) image production and evaluation,
(4) radiographic procedures and positioning, and (5) patient care and
management.
vi
Table of Contents
Preface/v
A: Introduction to X Rays/2
B: Biological Effects of Radiation/12
C: Protection of X-Ray Operators and Patients/21 D:
Radiation Monitoring/56
Posttest/327
User-Response Sheet/373
vii
Orientation to the Study Guide
ix
The Text contains information you need to know in order to achieve the
objectives. Definitions of technical terms are presented either in the text or
in the footnotes (terms defined in the footnotes are printed in bold face with
a footnote number). The text also includes illustrations to enhance the text.
The practice Questions allow you to see how well you have learned the
material. After completing the Practice Questions, check your answers with
the correct answers provided in the Answers to Practice Questions at the
back of this guide. If you miss questions, review those parts of the text that
cover the items missed. If you still have trouble understanding the material,
you need to seek further instruction.
The Posttest includes 140 multiple-choice items covering all five units:
items 1-40 on Unit 1, 41-55 on Unit II, 56-90 on Unit III, 91-100 on Unit V,
101-120 on the chest section of Unit IV, and 121-140 on the extremity
section of Unit IV. This posttest enables you to practice before you take the
140-item certification examination. Since you will be allowed three hours
for the certification examination, allow yourself three hours to complete this
posttest.
After you have completed the posttest, check your answers in the Answers
to the Posttest at the back of this guide. If you made mistakes, review the
appropriate parts of the guide. If you still need explanation on the items
answered incorrectly, you should seek further instruction or training.
Remember, the items in the practice exercises and the posttest are not the
same test items that appear in the certification examination.
The Answer Keys to the practice questions and to the posttest are provided
at the back of this guide. For the purpose of clarification and review,
"Notes" are included in the answer keys.
Reference
It is recommended that you read The Handbook for State Licensing
Examinees which candidates for the Basic X-ray Machine Operator
Examination that you will receive from the ARRT.
x
UNIT I: RADIATION PROTBC'l10N
A: Introduction to X Rays/2
B: Biological Effects of Radiation/12
1
Section A: Introduction to X Rays
Introduction
The discovery of x rays has had a major impact in the field of medicine. With
the growing use and sophistication of radiographic procedures, the need for
well-trained operators has increased. The more knowledge about radiation that
you as an x-ray machine operator have, the greater your ability will be to
make proper job-related decisions. Such information will also help you to
minimize radiation exposure to the patient and yourself, while achieving an
optimum diagnostic radiograph.
Objectives
c. Given values of the absorbed dose, the quality factor, and the modi-
fying factors, calculate the dose equivalent.
Discovery of X Rays
Properties of X Rays
Because x rays have such short wavelengths, they can penetrate matter, whereas
other types of electromagnetic radiation, such as visible light, are absorbed or
reflected. When x rays are produced, they travel in straight lines at an extremely
fast speed-186,000 miles per second, the speed of light. Although invisible, they
can cause certain substances to fluoresce, or glow. They produce an image on a
photographic film that can be made visible by processing. X rays are electrically
neutral; in other words, they are neither positive nor negative.
X rays:
I: Radiation Protection 3
a.
into•an make
electron and achemicals
certain positive electron (or(fluorescence)
emit light positron). The positron loses energy by
• can ionize matter, including living tissue it, producing two characterisic
ionization until it finds an electron and annihilates
annihilation
NOTE: This photons.
property of x rays can produce biological changes and cause
damage to the human body.
• cannot be seen, heard, or felt
X-Ray Production • travel in a straight line from their source, though they may be de-
flected by atoms they meet
X rays
• used
obey for
thediagnostic purposes
inverse square are produced
law (This when fast-moving
law is discussed in Section electrons*
C of this
strike a positively charged target* (the anode) in the radiographic tube and
unit.)
interact with the atoms of the target. Electrons are produced by heating a filament
(the•cathode),
cannot which
be reflected
is a coil of tungsten wire. When a high voltage is applied,
the negatively charged electrons are accelerated toward the positively charged
target. (According to a rule of physics, like charges repel and unlike charges
Ionizing Radiation and Its Sources
attract.)
Radiation is the emission of radiant energy in the form of waves or particles.
When radiation interacts
The production of x rays with atoms, the atoms
in a radiographic tube are transformed
occurs into electrically
in three stages, as
charged particles,
illustrated called
in Figure ions. This conversion of atoms to ions is called
I-A-1.
ionization. Since some forms of radiation ionize and some don't, the radiation
(such
Stage as1. x-radiation)
The filamentthat
in aconverts atomstube
radiographic of materials
is heatedto
byions is calledcurrent,*
an electric ionizinga
radiation. process that causes the filament to emit electrons.
•
Interaction of X Rays with Matter
When x rays enter an object, some of the x-ray photons interact with the object's
atoms and some do not. When they do, radiant energy is transferred from the x
rays to the atoms. This transfer of energy is called absorption. The remaining x-
ray photons, those that do not interact with atoms, travel in straight lines and can
produce an image on a film showing the size, shape, and internal composition of
the object. When the object is the human body, this image on a radiographic film
is used for diagnosis.
In stage 2, the acceleration of the electrons controls the quality-that is, the
penetrating power-of the x rays. The higher the voltage, the greater the speed of
the electrons. The greater the speed, the higher the energy range of the photons.
The higher the energy range of the photons, the greater the penetrating power of
the x rays. In other words, by varying the peak kilovoltage (k Vp), we can vary
the quality of the x rays.
In the third stage, the rapid deceleration of the electrons produces the x rays.
Types of Radiation
As the electrons interact with the atoms of the target, photons of various energies
emerge from the target. Most of these photons are directed toward the object
being radiographed, and a few of them are not. Those photons directed toward the
object are called primary radiation, and those which are not are called leakage
radiation. The primary radiation is then divided into remnant and attenuated
radiation. The primary photons that pass through the object being radiographed
and reach the film are the useful x-ray beam, and they are called remnant radia-
tion. The primary photons that interact with atoms of the object are called
attenuated radiation (see Figure I-A-2). When it interacts with the object, the
attenuated radiation is divided into scatter radiation and absorption. Since scatter
radiation and leakage radiation are not useful for radiographic procedures, they
are categorized as secondary radiation. These different types of radiation can be
depicted as follows:
••
Figure I-A-l
Production of X-Radiation Inside a Radio-
graphic Tube
I: Radiation Protection 5
Scatter
radiation
Attenuated
radiation
_Film
RadilgraPhic
tube Remnant
radiation (useful x-ray beam)
Figure I-A-2
Types of Radiation
The exposure rate is the number of roentgens produced by the x-ray machine per
second, per minute, or per hour. In other words, it is the intensity of radiation.
Exposure rate can be expressed, for example, as R/min (roentgens per minute) or
R/hr (roentgens per hour).
Rem-Unit of Dose Equivalent (10 . The dose equivalent, known as H, takes into
account the fact that the biological effects of ionizing radiation on human body
tissue are dependent not only on the absorbed dose, but also on other factors. The
rem is the unit used to measure dose equivalent.
The quality factor (Q) takes into account the different degrees of biological
effect that can result following exposure to the same absorbed dose of different
types of radiation. The quality factor for diagnostic x rays is 1, for neutrons 10,
and for alpha 20. This means that neutrons can cause ten times more damage
than diagnostic x rays.
The modifying factor (N) is the product of all other factors. For practical
purposes, N is assigned a value of 1 for all irradiations by external sources.
The dose equivalent (H) is the product of the absorbed dose (D), the quality
factor (Q), and any other necessary modifying factors (N). Since the quality
factor (Q) of diagnostic x rays is 1, and an absorbed dose (D) of 50 rads has been
received, the dose equivalent (in rems) is calculated as follows:
H= DQN
H = 50 rads x 1 x 1
H = 50 rems
I: Radiation Protection 7
Another example: If an x-ray machine operator exposed to an x-ray beam
received an absorbed dose of 200 rads, the dose equivalent for this operator is
200 rems because
H = DQN
H = 200 x 1 x 1
H = 200 rems
The following table lists the ionizing radiation quantities with their units of
measure, the media, and the effects measured.
UNIT OF EFFECT
QUANTITY MEASURE MEDIUM MEASURE
D
exposure roentgen (R) air ionization of
air
Summar
y
X rays are a form of electromagnetic radiation (like gamma radiation) that can
penetrate and ionize matter, including human tissue. Ionizing radiation has both
natural and man-made sources. X rays, a type of ionizing radiation, are
produced when electrons are made to strike a positively charged target in the
radiographic tube and to interact with the atoms of the target. Radiation can be
categorized into two main types: primary radiation and secondary radiation.
Primary radiation is the useful x-ray beam, and secondary radiation consists of
leakage and scatter radiation. Three units of measurement are used in
determining the amount of ionizing radiation: roentgen for radiation exposure,
rad for absorbed dose, and rem for dose equivalent.
Directions
d. Curie
e. Rothernburg
f. Roentgen
g. Ohms
r. ionization
s. photons
t. deflection
u. refraction
I: Radiation Protection 9
6. Which of the following are sources of natural radiation?
z. outer space
aa. the earth
bb. food
ll. When x rays interact with matter, all of the following can happen
EXCEPT:
ccc.Which of the following is the useful x-ray beam that contributes to the
formation of the radiographic image?
ddd.scatter radiation
eee.remnant radiation
fff. absorbed radiation
ggg.leakage radiation
qqq.roentgen
rrr. rad
sss. rem
ttt. quality factor
uuu.roentgen
vvv.rad
www.rem
xxx.quality factor
17. What is the unit that takes into account the biological effects?
yyy.quality factor
zzz.roentgen
aaaa.rad
bbbb.rem
cccc.absorbed dose
dddd.quality factor
eeee.ionizing factor
ffff.modifying factor
gggg.When the absorbed dose is 100, the quality factor is 2, and the
modifying factor is 1, what is the dose equivalent?
hhhh.50 rems
iiii. 100 rems
jjjj. 200 rems
kkkk.400 rems
Now check your answers with the correct ones provided in the Answers to
Practice Questions (I-A) at the back of this Guide.
I: Radiation Protection 1
1
Section B: Biological Effects of Radiation
Introduction
In Section A, we discussed the fact that x rays ionize when they interact with
atoms. Human body tissues are composed of atoms. Therefore, when x rays
penetrate body tissue, ionization occurs. This ionization can result in molecular
change, which can cause cellular damage. Cellular damage can result in the
abnormal functioning or the loss of cells, which may result in organic damage.
When organic damage occurs, biological effects of radiation, such as cataracts or
leukemia, appear in the living organism. In other words, biological effects occur
at three levels: molecular, cellular, and organic.
This section deals with the effects of radiation at these three levels and in the two
categories, genetic and somatic.
Objectives
The human body is composed of various types of cells that perform many
different functions. Every mature human cell is highly specialized, having a
specific function to perform. The cell's specialized function is determined by the
structure of the cell's molecules. Most of these cells can be damaged by ionizing
radiation, because ionization can change the structure and chemical balance of
the cell's constituent molecules. This molecular change, then, changes the cellular
functions.
Immature cells, which are nonspecialized and which undergo rapid cell
division, are more radiosensitive than mature cells, which are specialized in
function and which divide slowly or have ceased to divide.
Lymphocytes (white blood cells) are among the most radiosensitive of the
blood cells. Female and male reproductive cells (ova and spermatogonia) are
very radiosensitive. The cells that become the linings and covers of body organs
(epithelial cells) have moderately high sensitivity. Muscle and nerve cells, which
are highly specialized and do not divide, have low sensitivity.
The biological effects of radiation occur at three levels: the molecular, the
cellular, and the organic.
Cells are composed mainly of water and biologic macromolecules such as DNA
(deoxyribonucleic acid) which, as the genetically active part of the genes,
transmits the hereditary pattern. So, when ionizing radiation interacts with a cell,
the radiation interacts directly with macromolecules such as DNA or with water.
When the interaction occurs directly with DNA, the resulting ions may break a
chemical bond and change the DN A molecular structure. This is called the
direct-hit theory because the damage to the DNA molecules occurs directly.
When the radiation interacts with water and ionizes it, water molecules break
down into ions and free radicals. These free radicals can then cause damage to
biologic macromolecules such as DNA. This is called the indirect-hit theory
because the damage to the DNA molecules takes place indirectly.
I: Radiation Protection 1
3
Cellular Effects of Radiation. The effects of radiation at the cellular level can
result in the following:
Genetic Effects. Molecular damage to DNA molecules in the sperm or ova can
cause biological damage in offspring. Though these effects may not show up for
years or for generations after the exposure is received, they may be passed on
from one generation to another. Because the radiation dose at the gonads (ovaries
and testes-where egg and sperm, respectively, are manufactured and stored) is
genetically significant, it is called the genetically significant dose (GSD).
Gonadal shielding (discussed in the next section) is important to minimize the
amount of radiation received by the male or female gonads.
NOTE: Symptoms of genetic effects are also called genetic dose indicators.
Somatic Effects. Forms of biological damage that affect the individual but that
are not passed on to the offspring are called somatic effects. These effects can be
either short-term or long-term depending upon the length of time between the
exposure and the appearance of symptoms of the damage.
pppp.The initial stage, which begins within 48 hours after radiation expo -
sure, includes nausea, fatigue, loss of appetite, and other symptoms.
qqqq.The latent stage occurs next and lasts about a week. During this
latent period, the early symptoms disappear and the person feels
better. However, changes are taking place within the blood-forming
and other organs; symptoms of these changes will not show up until
the next stage.
rrrr.During the manifest illness stage the patient exhibits fever, infec -
tion, diarrhea, hemorrhage, nausea, vomiting, disorientation, shock,
and other symptoms resulting from the damage. Death may follow
these symptoms.
ssss.If the dose was not lethal, body tissue starts to heal and the
recovery stage begins. Full recovery may take many weeks.
There are three types of acute radiation syndrome in most mammals: central
nervous system syndrome, gastrointestinal syndrome, and hema topoietic
syndrome.
I: Radiation Protection 1
5
dence of life-span shortening. This effect has been confined mainly to
those who practiced during the early years of x-ray use, when
occupational exposure among radiologists was much higher than
today •
• Carcinogenesis, the production of cancer, is a greater risk
following radiation exposure. Such cancers as leukemia (of the
blood) and breast cancer can be caused by radiation. Evidence
indicating that radiation is a carcinogen comes from radium-dial
painters who in gested radioactive material, early radiologists and
dentists, and uranium miners •
Radiation sensitivity decreases during the second and third trimes ters.
Even at these stages, however, abnormalities and disorders can result
from radiation exposure.
w w
(j (j)
)
z z
2 2
f f
B B THRESHOLD
a: a:
DOSE DOSE
Ionizing radiation can result in biological damage to the human body at the
molecular, cellular, and organic levels. The damage can be either genetic or
somatic. Genetic effects damage the offspring of an individual exposed to
radiation, whereas somatic effects damage only the individual exposed.
I: Radiation Protection 1
7
Practice Questions (I-B)
Directions
uuuu.biological level
vvvv.molecular level
wwww. cellular level
xxxx.organic level
yyyy.blood-forming cells
zzzz.nerve cells
aaaaa. reproductive cells
bbbbb. muscle cells
lllll.organic damage
mmmmm. molecular effects
nnnnn. genetic death
ooooo. reproductive death
xxxxx.ionizing radiation
yyyyy.genetically significant dose
zzzzz.somatically significant dose
aaaaaa.gonadal dose
cccccc.cataracts
dddddd.nausea
eeeeee.vomiting
ffffff.fever
I: Radiation Protection 1
9
bbbbbbb.A dose-response curve is a graph representing which of
the following?
Now check your answers with the correct ones provided in the Answers to
Practice Questions (I-B) in the back of this Guide.
Introduction
This section focuses on how these factors can reduce secondary radiation and
how you can protect patients and yourself during radiographic procedures.
Objectives
qqqqqqq.Explain the 10-day rule and the reason female patients of child-
bearing age must be protected from radiation.
I: Radiation Protection 21
Protection of X-Ray Machine Operators (I-C-l)
100 R/hr
= (40)2
x (20)2
100 R/hr 4
=
x 1
(Invert and
multiply)
100 R/hr x = 25 R/hr
--
4x
As Figure I-C-1 and this example show, when the original distance (0 1) is
doubled (0 2), the radiation is spread over an area four times larger, but the
exposure rate, or radiation intensity, is reduced, to 1/4 of the original
exposure.
D2
Figure l-C-l
Inverse Square Law
NOTE:The distance from the source of radiation to the film is called target
to rum distance (TFO), source to image detector (SID), or focal r u m
distance (FFD). These three terms are used interchangeably.
I: Radiation Protection 23
Other
c. Radiation Protection Sbiel@!g
Methods Accessories. Use protective shielding routinely. Shielding refers
to radiopaque* materials inserted between the source of radiation and the
In addition to
individual. those protective
Shielding measures
accessories forprotective
such as which the barriers,
x-ray machine operator
aprons, and
is responsible,
gloves protection
are generally madeis afforded
of lead. both operator and patient through built-
in features wherever an x-ray machine is in use.
While activating radiographic equipment, you should stand behind the
protective lead
Radiographic barrier
Room or wear
Design . Aaradiographic
protective lead
roomapron or gloves,
and the aspa
adjoining shown
tient
in Figure
rooms are I-C-2.
designed in such a way that the placement of the x-ray machine
will direct as little radiation as possible toward the adjoining areas (see
Figure I-C-3).
Bucky
slot
cover
Pigure I-C-2
Protecting Yourself from Radiation Using
Shielding
NOTE: The Bucky tray receives the cassette during radiographic procedures.
The slot (see Figure I-C-3) has a protective cover to minimize the radiation
that would otherwise be directed through this opening.
Overhead
radiographic
tube ----
Figure I-C-3
Examples of Radiographic Room and Protective
Devices
I: Radiation Protection 25
primary barrier 1.5 mm Pb (1/16 inch lead) .75
secondary barrier mm Pb (1/32 inch lead)
lead glass in
control booth control 1.5 mm Pb (1/16 inch lead)
panel (behind
secondary
barrier) 1. 5 m m Pb (1/16 inch lead)
Summary
The basic measures that the x-ray machine operator can take to protect against
occupational exposure to radiation involve three factors: time, distance, and
shielding. Even with the proper exposure time, TFD, shielding accessories, and
protective barriers, you and other persons can be exposed to radiation
unnecessarily if you are not careful.
The following state what you should and should not do when making an
exposure:
• Make sure to remove all unnecessary persons from the area where
they can be exposed to radiation.
Directions
xxxxxxx.short
yyyyyyy.close
zzzzzzz.medium
aaaaaaaa.long
gggggggg.double
hhhhhhhh.be the same
iiiiiiii.triple
jjjjjjjj.decrease
llllllll.400 R/hr
mmmmmmmm.200 R/hr
nnnnnnnn.50 R/hr
oooooooo.25 R/hr
I: Radiation Protection 27
pppppppp.If the exposure rate is 90 R/hr at a distance of 20 inches from
the source of radiation, what will be the exposure rate at a new dis-
tance of 60 inches?
qqqqqqqq.10 R/hr
rrrrrrrr.25 R/hr
ssssssss.50 R/hr
tttttttt.200 R/hr
vvvvvvvv.white gown
wwwwwwww.rubber gloves
xxxxxxxx.lead apron
yyyyyyyy.a lot
aaaaaaaaa.0.25 mm
bbbbbbbbb.0.5 mm
ccccccccc.2.5 mm
ddddddddd.5.0 mm
fffffffff.first barrier
ggggggggg.primary barrier
hhhhhhhhh.secondary barrier
iiiiiiiii.scatter barrier
kkkkkkkkk.1/4 inch
lllllllll.1/8 inch
mmmmmmmmm.1/16 inch
nnnnnnnnn.1/32 inch
Now check your answers with the correct ones provided in the Answers to
Practice Questions U-C-l) at the back of this Guide.
Beam Restriction
Simple lead
diaphragm
with aperture
Cone SIde view Cylinder
TISide view
of cone of cylinder
Figure 1-C-4
Nonadjustable Beam Restriction Devices:
Diaphragm, Cylinder, and Cone
I: Radiation Protection 2
9
X-ray tube
window
(port)
Radiation field
(light source projectio
on film)
Film carrier
Figure I-C-S
Exterior (A) and Interior (B) of Collimator
One set of shutters is adjusted to reduce the amount of off-focus radia tion
coming from the primary beam and exiting from the radiographic tube
housing. The other set of shutters is adjusted to confine the radio graphic
beam to the body part radiographed. For protection against exposure, the
surface of the patient's skin should be at least 15 centi meters below the
collimator. Most x-ray machines manufactured be fore August 1974 had
manually adjusted collimators. By manually adjusting the collimator, an x-
ray machine operator can use a radiation field smaller than the size of the
cassette, thus reducing unnecessary radiation to the patient.
Figure I-C-S
Proper (A) and Improper (B) Collimation
Collimators are equipped with a light and mirror assembly, known as the light
localizer, which projects a light field through the collimator opening onto the
patient's body and shows the size and location of the x-ray beam. Because the
light localizer enables the machine operator to see the actual location of the x-
ray beam prior to making the exposure, the operator can project the light
source onto the film and accurately place the radiation field (see Figure I-C-
5).
Filtration
I: Radiation Protection 31
receives. Tbe NCRP recommends 2.5 millimeters of aluminum
equivalent filtration.
Techniques for testicular shielding are better established than for ovarian
shielding. The anatomical location of the testes is such that covering them
with a shield usually does not obscure needed clinical information. On the
other hand, the location of the ovaries often interferes with the visualization
of other structures.
Two basic kinds of gonadal shields are available today: the shadow
shield and the contact shield.
Figure 1-C-7
Shadow Shield
Courtesy Nuclear ASSOCiates, Carle Place, New York.
Another type of contact shield is the shaped contact shield. These radiopaque
shields surround the testes. Shaped contact shields are contained within
various carriers such as disposable or washable athletic supporters and
jockey-style briefs. The carrier, which has a pouch into which the shield is
inserted, is designed to hold the shield comfortably in position over the
scrotum and penis, whether the patient is recumbent or upright. Since the
patient can put on this garment by himself, effective shielding can be
provided with a minimum of embarrassment to the patient (see Figure I-C-8).
Figure I-C-l
Shaped Contact Shields
Courtesy Nuclear ASSOCiates. Carle Place, New York.
ExpOSlU'e
Factors
Other techniques for exposure reduction are related to technical factors,
which fall into two groups: exposure factors and radiographic accessories.
I: Radiation Protection 3
3
e.
o o o o
Three Prim~ ~ure Faetors. The factors that control
Signalthe quantity and
quality {ienetra ting power) o·f the radiation produced
-tight are called primary
-
the radiographic tube at its peak value. The Line
amount of kVp selected
voltage
affects radiation exposure by determining the energy of the x-ray
photons, which in turn determines the penetrating
compensation
control knob
power of the x-ray
beam. That is, the amount of kVp selected determines the amount of
0G]
force that will be used to accelerate the electrons from the filament to
the target. With a higher kVp, the force with which the electrons
strike the target will be greater. The greater the force, the more
~
penetrating the energy of the x rays will be. In other words, the higher
the kVp, the higher the quality of the beam.
Phototimer
• The amount of mi11iamperage (rnA)selected controls the rate at
which electrons are emitted from the heated filament. The higher the
rnA, the hotter the filament and the more electrons emitted.
Therefore, the amount of rnA selected controls the quantity of radia-
tion produced.
• The length of exposure time (s) selected also affects the quantity of
radiation. The longer the exposure time, the higher the quantity of
radiation produced. The combination of these two exposure factors,
exposure time and rnA, is known as milliamperes per second
(mAs).
With all other factors remaining constant, an increase in the TFD will result
in a decrease in the quantity of x rays striking the film, while a decrease in
the TFD will result in an increase in quantity. As discussed in the previous
section, this is the principle of the inverse square law.
Selection of Exposure Factors. Since each patient is different in size and
condition and since different body parts are of different sizes, the operator
must be able to adjust exposure factors on the machine to produce the
appropriate radiographic beam for every situation. In accomplishing this
purpose, you should use the three basic controls (kVp, rnA, and exposure
time) on the x-ray machine control panel (see Figure I-C-9).
To select the appropriate rnA, adjust the rnA control knob or buttons for the
particular radiographic examination, as shown on the technique chart you are
using. (The use of technique charts is discussed in Unit m .) By doubling the
rnA, you double the amount of x rays produced.
0
Main
_power
kVp meter mA meter switch
Figure I-C-S
The X-ray Control Panel
Since a high kVp produces a more penetrating x-ray beam and a high mAs
produces more radiation, a combination of higher kVp and lower mAs
reduces the patient's radiation dose. For the proper selection of these
exposure factors, use the standardized technique charts.
To determine bow long x-ray production will take place, set the timer on the
control panel. Through the selection of time and rnA (rnAs), you can control the
quantity of x rays, and you can select the fastest time possible without changing
the quantity.
For example:
• If you use 100 rnA for 1 second, you are using 100 mAs, because 100
rnA x 1 second = 100 mAs.
• If you use 200 rnA for 1/2 second, you are still using 100 mAs, be-
cause 200 rnA x 1/2 second = 100 mAs.
I: Radiation Protection 35
• Use aeoUimator to restrict the beam to the area to be radiographed.
(Remember, the smaller the field size, the less scatter radiation
produeed.)
• Adjust filter.
• Select the appropriate kVp and rn As, using technique charts. Gener-
ally, a combination of higher kVp and lower mAs reduces the patient's
radiation dose.
aaaaaaaaaaa.
ttttttttt.All to reduce provide
of the following radiationprotection
exposure to patient's
from radiation EXCEPT:
skin
uuuuuuuuu.filtration
bbbbbbbbbbb. to reduce radiation exposure to
patient's gonads (beam restriction)
vvvvvvvvv.collimation
ccccccccccc. to increase the quality of radiation
wwwwwwwww.ionization
ddddddddddd.
8. Onxxxxxxxxx.shielding
which to increase
of the following the gonadal
should quantityshields
of radiation
be used?
eeeeeeeeeee.patient
yyyyyyyyy.The pregnantandpatients only
the x-ray machine operator receive
fffffffffff. allradiation
unnecessary female patients
exposure from which of the following?
ggggggggggg. all male patients
hhhhhhhhhhh.
zzzzzzzzz.a all patients
limited with reproductive
radiographic examinationpotential
aaaaaaaaaa.a repeat radiographic examination due to technical error
9. Which of the following would you use for male patients?
or carelessness
bbbbbbbbbb.beam limitation and filtration techniques used when
iiiiiiiiiii.anshadow
making exposureshield
jjjjjjjjjjj. flat high-quality
cccccccccc.a contact shieldradiograph produced on the first exposure
kkkkkkkkkkk. shaped contact shield
lllllllllll. lead x-ray
dddddddddd.The shieldbeam should be collimated so that which of the
following is true?
10. Which of the following does not require special shielding?
eeeeeeeeee.The radiation field size is larger than the film holder.
ffffffffff.The
mmmmmmmmmmm. beam is restricted
the eyesto the body part being radiographed.
nnnnnnnnnnn. the
gggggggggg.The thyroid
beam is no larger than the film.
ooooooooooo. the gonads
ppppppppppp.and
hhhhhhhhhh.1 the 2femur
only
iiiiiiiiii.1 and 3 only
11. Alljjjjjjjjjj.2
of the following are primary exposure factors EXCEPT:
and 3 only
kkkkkkkkkk.1, 2, and 3
qqqqqqqqqqq. kVp
llllllllll.What
rrrrrrrrrrr. does
rnA an automatic collimator allow the x-ray machine
sssssssssss.
operator to do? shielding
ttttttttttt. exposure time
mmmmmmmmmm.use a film holder larger than the radiation field
nnnnnnnnnn.adjust
uuuuuuuuuuu. When you theincrease
amounttheof kVp
radiation produced
and then forthe
decrease a mAs
accordingly, what happensexamination
specific radiographic to skin exposure?
oooooooooo.remove the low-energy photons of x rays
pppppppppp.place
vvvvvvvvvvv. It isthe film accurately and consistently
increased.
wwwwwwwwwww. It is decreased.
xxxxxxxxxxx.
qqqqqqqqqq.An It is unchanged.
improperly collimated radiographic beam will do
yyyyyyyyyyy.
which of the following? It is multiplied.
38
I: Radiation Protection I-C: Protection of X-Ray Machine Operators and Patients 37