Basic Radiographic Procedures Syllabus for 2011-2012
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Course

RADR-1411-002 Basic Radiographic Procedures

Prerequisites

Course Description

An introduction to radiographic positioning terminology; the proper manipulation of equipment; positioning and alignment of the anatomical structure and equipment; and evaluation of images for proper demonstration of basic anatomy.

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Department Expectations

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Hours

(4 sem hrs; 3 lec, 3 lab)

Class Type

On Campus Course

Syllabus Information

Textbooks

\ REQUIRED TEXTBOOKS
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1. \ Textbook of Radiographic Positioning and Related Anatomy,   Seventh edition, by Bontrager/Lampignano
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2. \ Radiographic Anatomy and Positioning workbook units 1-13, by Bontrager
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3. \ Radiographic Anatomy and Positioning workbook units 14-24, by Bontrager
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\ (Recommended)-Pocket Atlas-Handbook of Radiographic Positioning and Techniques by Bontrager

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Supplies

\ Students will need a wax marking pencil for all labs.
\ During the course of the semester the student may be required to purchase a box of x-ray film from the campus bookstore.

Student Performance

Radiographic Procedures I

RADR 1411

 Course Objectives

Final Course Competencies

Given the course textbook, personal notes, handouts, and other course materials, the should should be able to do each of the following on a written examination as evaluated by the course instructor with and accuracy of not less than 75%

End-of-Course Outcomes: Define radiographic positioning terms; manipulate equipment; perform basic level procedures in positioning; align anatomical structures and equipment; and evaluate images.

CHAPTER 1 Basic Principles,Terminology

1. Explain the structural organization of the body from the simplest to the most complex level.

2. List the ten body systems and describe the functions of each system.

3. Identify the two divisions of the skeletal system and list the total number of bones in the average adult human body.

4. Describe the three bone classifications and list examples of each classification.

5. Describe the ossification process and the primary and secondary bone formation centers.

6. Classify joints by their functional and structural characteristics, describe the three classes and subclasses of joints, and give examples of the six types of synovial joints.

7. Define and use basic positioning terminology to include general terminology, body planes, body surfaces, specific body positions, relationship terms, and terminology related to movement.

8. Explain the similarities and differences for these terms: positions, projections, and views.

9. Describe the process of evaluating a radiograph for positioning accuracy and image quality.

10. Explain the importance of anatomical side markers and proper radiograph identification.

11. Describe the four image quality factors to include density, contrast, recorded detail, and distortion and their controlling factors.

12. Describe the positioning steps that should be followed when performing a radiographic position and identify and explain the positioning icons used in the text.

13. Explain the two general rules of determining positioning routines and apply these principles to specific structure’s of the body.

14. Identify the major positioning landmarks of the body.

15. Define the four classifications of body habitus.

16. Describe the proper way of displaying radiographs.

CHAPTER 3 - Chest

1. On drawings, list and describe the structures constituting the airway through which oxygen will pass as it travels from the nose and mouth to the terminal aspects of the lungs.

2. Identify the topographical landmarks used for placement of the central ray on PA and AP chest projections and describe specific central ray location techniques on average male and female patients utilizing these landmarks.

3. List the skeletal landmarks associated with organs of the respiratory system.

4. On drawings, identify specific structures of the bony thorax, larynx, trachea, bronchi, lungs and mediastinum.

5. Describe the technical and positioning qualities that should be seen on erect PA and lateral chest radiographs.

6. Describe three reasons for taking chest radiographs in the erect position whenever possible.

7. On a model, position for PA, AP and lateral chest projections/positions.

8. Using a chest phantom, perform routine PA, AP and lateral chest projections/positions producing satisfactory radiographs (if equipment is available).

9. List the patient dose ranges for skin, midline, thyroid and breast for each projection of the chest and upper airway.

Using Chest Radiographs:

11. Determine if rotation is present on PA and lateral chest radiographs.

12. Identify specific radiographic anatomy of the lungs and thorax.

13. Critique and evaluate chest radiographs based on evaluation criteria.

14. Distinguish between acceptable and unacceptable chest radiographs due to exposure factors, motion, collimation, positioning or other errors.

CHAPTER 4 - Abdomen

1. List and describe the location of the three muscles of the abdomen important in abdominal radiography.

2. Using drawings and/or radiographs, identify the principal structures of the digestive system, biliary system, urinary system and accessory organs for digestion.

3. Identify the correct quadrant or region of the abdomen where specific organs are located.

4. Identify and describe the specific bony positioning landmarks that may be used for positioning of the abdomen.

5. Using drawings, identify the major bony and soft-tissue structures of the abdomen.

6. List specific types of pathology that are clinical indications for an acute abdominal series.

7. Describe the appropriate technical factors required for abdominal radiography to include film markers, gonadal shielding, collimation, and exposure factors.

8. Using a phantom and/or model, perform supine, erect, and lateral decubitus abdominal positions.

Given specific abdominal radiographs:

9. Critique and evaluate each radiograph based on evaluation criteria for that position.

10. Identify specific bony and soft-tissue structures seen radiographically.

11. Discriminate between acceptable and unacceptable radiographs of the abdomen regarding centering, positioning, motion, definition or exposure factor errors.

14. Discriminate between those radiographs that were taken in supine, erect or lateral decubitus positions.

CHAPTER 14 - Upper Gastrointestinal System

1. List and describe the organs of the upper gastrointestinal system and other accessory organs.

2. List the three primary functions of the digestive system.

3.List three divisions of the pharynx and describe their relative location.

4. Describe the anatomic location, function, and features of the esophagus, stomach, and duodenum.

5. Describe the effect of body position on stomach contents.

6. Describe the variations of stomach positions due to varying body habitus.

7. Using drawings and radiographs, identify specific anatomy of the upper gastrointestinal system.

8. Describe and differentiate between mechanical digestion and chemical digestion.

9. List and describe the common radiolucent and radiopaque contrast media utilized for studies of the upper gastrointestinal system.

10. Describe the patient preparation, room preparation, and the fluoroscopic procedure for an esophagram and an upper gastrointestinal series.

11. List the general duties of the radiographer during any fluoroscopic procedure.

12. List and define the common clinical indications and contraindications for an esophagram and upper GI serles.

13. Describe various breathing maneuvers and positioning exercises sometimes utilized during fluoroscopy of the esophagus and stomach.

14. List and describe the basic and special positions or projections for the esophagram and upper gastrointestinal (GI) series to include, size and type of film holder, central ray location, direction and angulation of the central ray.

15. Describe which anatomy is best demonstrated with specific projections of an esophagram and upper GI series.

17. Critique esophagram and upper Gl radiographs based on evaluation criteria provided in the textbook.

18. Discriminate between those radiographs that are acceptable and those that are unacceptable due to exposure factors, collimation, or positioning errors.

 Biliary system

1. Identify and describe the anatomy and function of the liver.

2. Describe the production, storage, release, and function of bile.

3. List the major components of the biliary ductal system.

4. List the three aspects of the gallbladder.

5. Describe the location of the gallbladder according to body habitus.

6. On drawings and radiographs, identify specific anatomy of the biliary system

7. Describe the purpose and related positioning for operative (immediate) and T-tube (delayed or postoperative) cholangiography.

8. Describe briefly laparoscopic procedures of the biliary system and the advantages of it over conventional surgical procedures of the biliary system.

9. Explain the purpose, procedure, and risks related to percutaneous cholangiography (PTC).

10. Define and describe the purpose, procedure, and radiographer responsibilities related to the endoscopic retrograde cholangiopancreatography (ERCP).

CHAPTER 15 - Lower Gastrointestinal System

1. List and describe three divisions of the small intestine and the major parts of the large intestine.

3. Describe the function, location, and pertinent anatomy of the small and large bowel.

4. Differentiate between the terms colon and large intestine.

5. Identify on drawings and radiographs, all anatomy of the lower gastrointestinal canal from duodenum through anus.

6. Describe the characteristics that differentiate the large intestine from the small intestine.

7. Describe the peritoneum, mesentery, and omentum and distinguish between intra-, retro- and infraperitoneal structures.

8. List and describe common clinical indications and contraindications for a small bowel series and for a barium enema examination.

9. Describe patient preparation for a small bowel series and for a barium enema.1

10. Describe the radiographic procedure and sequence for a small bowel series.

11. List the basic positions or projections, size and type of film holder, central ray location, direction and angulation of central ray, and anatomy best demonstrated for a small bowel series and for a barium enema examination.

12. Describe the purpose, clinical indications and the methodology for the enteroclysis and the intubation method procedures.

13. Describe room preparation and the fluoroscopic procedure for a barium enema.

14. Explain the correct procedure for inserting a rectal tube.

15. Describe the general duties of the radiographer during the fluoroscopic portion of a barium enema.

16. Explain the advantages, procedure, and positioning for an air contrast barium enema.

17. Describe the purpose, clinical indications and methodology for a defecogram.

18. List five safety concerns that should be followed during a barium enema procedure.

19. Critique radiographs of the small bowel and barium enema based on evaluation criteria provided in the textbook.

20. Discriminate between those radiographs that are acceptable and those that are unacceptable due to exposure factors, collimation, or positioning errors.

CHAPTER 16 - Urinary System

1. Describe the location and pertinent anatomy of the adrenal glands, kidneys, ureters, urinary bladder and urethra.

2. Describe the macroscopic and microscopic anatomy and physiology of the kidneys.

3. Describe the orientation of the kidneys, ureters and urinary bladder with respect to the peritoneum.

4. Define terms such as nephroptosis, micturition, urination, incontinence, extravasation, vasovagal, urticaria and tachycardia.

5. Describe three points of constriction along the course of each ureter.

6. Describe the location of the male and female urethra and the male prostate gland.

7. On drawings and radiographs, identify specific anatomy of the urinary system

8. List the primary function of the urinary system.

9. Describe the basic preparations necessary prior to any injection of contrast medium.

10. Differentiate between mild, moderate, and severe side effects from reactions to injected contrast media; and list several examples of each.

11. List seven basic questions to ask each patient prior to injection of an iodinated contrast medium.

12. Define excretory (intravenous) urography and list an alternate term commonly used for this procedure.

13. Describe the purpose of excretory urography.

14. List clinical indications for excretory urography.

15. List contraindications to excretory urography and six high-risk patient conditions to excretory urography.

16. Describe two methods utilized to enhance pelvicalyceal filling during excretory urography.

17. Define and explain the nephrogram and nephrotomogram.

18. Describe the procedure, site, and type of physician involved in a retrograde urogram.

19. Describe the correct method for instillation of contrast medium during a cystogram and list its indication.

20. Describe the retrograde urethrogram and the use of a Brodney clamp.

21. Explain the basic positions and special projections for urography to include size and type of film holder, central ray location, direction and angulation of central ray and anatomy best visualized for excretory urography, retrograde urography, cystography, urethrography, and voiding cystourethrography.

22. Critique urogram radiographs based on evaluation criteria provided in the textbook and discriminate between those radiographs that are acceptable and those that are unacceptable due to exposure factors, collimation, or positioning errors.

CHAPTER 9 - Cervical and Thoracic Spine

1. Using drawings and radiographs, identify specific anatomy of the cervical and thoracic spine.

2. Identify those features of the cervical and thoracic vertebrae that distinguish them from other aspects of the vertebral column.

3. Describe the location, classification, and type of movement for specific joints of the cervical and thoracic spine.

4. List additional terms for the first, second, and seventh cervical vertebra.

5. Describe topographical landmarks that can be palpated to locate specific thoracic and cervical vertebra.

6. Describe which structures are best demonstrated with each position of the cervical and thoracic spine.

7. Identify basic and special projections of the cervical and thoracic spine and describe the correct size and type of film holder, central ray location, direction and angulation of the central ray for each position.

8. Using a radiographic phantom (if available), produce diagnostic radiographs for basic projections of the cervical and thoracic spine.

Using radiographs of phantom or actualpatients:

9. Critique each radiograph based on evaluation criteria provided in the textbook.

10. Discriminate between those radiographs that are acceptable and those that are unacceptable because of exposure factors, collimation or positioning errors.

CHAPTER 10 - Lumbar Spine, Sacrum and Coccyx

1. Describe the structures and function of the lumbar spine, sacrum and coccyx.

2. Define and describe spina bifida and spondylolisthesis.

3. Using drawings, identify specific anatomy of the lumbar spine, sacrum and coccyx.

4. Using radiographs, identify specific anatomy of the lumbar spine, sacrum, and coccyx.

5. Identify and describe the anatomy that is seen with the "Scotty dog" sign.

6. Describe the classification of the joints found in the lumbar spine.

7. Describe topographical landmarks that can be palpated to locate specific aspects of the lumbar spine,

sacrum, and coccyx.

8. Identify basic and special projections of the lumbar spine, sacrum, and coccyx and describe the correct

size and type of film holder, central ray location, direction and angulation of the central ray for each

projection.

9. Describe which structures are best seen with specific projections of the lumbar spine.

10. Identity the approximate difference in patient doses on AP vs. PA projections, and anterior vs. posterior

oblique positions of the lumbar spine.

11. Using a model, perform specific basic and special projections of the lumbar spine, sacrum and coccyx.

13. Using a radiographic phantom, produce diagnostic radiographs for basic projections of the lumbar spine,

sacrum, and coccyx.

Using radiographs of phantom and actual patients:

14. Critique each radiograph based on evaluation criteria provided in the textbook.

15. Discriminate between those radiographs that are acceptable and those that are unacceptable because of

exposure factors, collimation or positioning errors.

CHAPTER 11 - Bony Thorax

1. Using drawings and radiographs, identify specific anatomy of the sternum and ribs.

2. Classify ribs as either true, false, or floating ribs.

3. Classify specific joints in the bony thorax according to their structural classification, mobility classification and movement type.

4. Identify basic and special projections of the ribs and sternum and describe the correct size and type of film holder, central ray location, direction and angulation of the central ray for each position.

5. Describe which structures are best seen with specific projections of the ribs and sternum.

6. Describe the technical considerations important in radiography of the ribs and sternum to include breathing instructions, general body position, kVp range, and other imaging options.

7. Identify and/or recognize patient dose ranges for skin, midline, thyroid and breast doses for each projection of the ribs and sternum.

8. Identify the difference in thyroid and breast dose ranges between anterior and posterior obliques of the ribs.

9. Using a model, perform specific basic and special projections of the ribs and sternum.

10. Using a radiographic phantom, produce diagnostic radiographs for basic projections of the upper and lower ribs and sternum.

Using radiographs of phantom and actual patients:

11. Critique each radiograph based on evaluation criteria provided in the textbook.

12. Discriminate between those radiographs that are acceptable and those that are unacceptable because of exposure factors, collimation or positioning errors.

Students Rights and Responsibilities

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Expected Student Behavior

CLASSROOM ETHICS

Dishonesty during a quiz or examination is simply the wrong thing to do.  To say the least, for any student, but especially for a student pursuing a career in a health occupation, test dishonest is a reliable predictor of unacceptable job performance following graduation.  If a student makes poor choices to "cheat" on test, will that student also make poor choices relative to quality patient care?  Probably so.  This instructor takes the position that a dishonest student is probable also unethical in other ways and may pose a threat to the safety of any patient who comes in contact with that student.  Employers take a similar position.  The health care industry will not tolerate such conduct.

At Amarillo College there are grave academic penalties for any unethical conduct on the part of the student. The policy and penalty for such conduct is provided in the General Catalog. It can be concluded from this policy statement tht unethical course conduct is absolutly prohibited at Amarillo College.To be more specific, in this course Plagiarism, dishonesty, or any other unethical course conduct, is cause for a final course grade of "F" regardless of other grades earned to-date in the course.  If in doubt about a particular assignment or testing practice, discuss the matter in advance with the course instructor.

Grievance Policy

If a student has a concern with the course instructor, the following due process protocol will apply. The student will follow the protocol steps in the order shown.

   1. Make every effort to resolve the concern directly with the course instructor. The instructor should be contacted by the student before the conclusion of the course.

   2. If the concern cannot be resolved to the satisfaction of the student after meeting with the course instructor, the student should seek satisfaction from the director of radiography within one week of the student instructor meeting.

   3. If the concern cannot be resolved to the satisfaction of the student after meeting with the director of radiography, the student should seek satisfaction from the Dean of Health Sciences within one week of the student supervisor meeting.

  4. If the concern cannot be resolved to the satisfaction of the student after meeting with the Dean of Health Sciences, the student should seek satisfaction from the Vice-President and Dean of Instruction within one week of the student - Dean meeting.

  5. If the concern cannot be resolved to the satisfaction of the student after meeting with the Vice-President and Dean of Instruction, the student should seek satisfaction from the college President within one week of the student-Vice-President meeting.

   6. If the concern cannot be resolved to the satisfaction of the student after meeting with the President, the student should seek satisfaction from the college Board of Regents at the next regular meeting of the Regents. The decision of the Regents will be final.

CLASSROOM RULES

No disruptive behavior will be tolerated.

You will be responsible for cleaning up any mess created by your drinks being spilled.

No electronic communications devices ie: telephones, pagers, etc. without prior permission of the instructor. Five points will be deducted from next pop quiz or 1 points from Major Exam scores for disruptions caused by electronic communications devices during class.

STUDENTS WITH DISABILITIES

Any Student who, because of a disabling condition, may require some special arrangements in order to meet course requirements should contact ACcessibility Services(SSC 125, Phone: 371-5436) as soon as possible.

Grading Criteria

\ GRADING POLICY
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\ This course will consist of four types of activities that will be graded and receive course credit:

\             1. LECTURE QUIZ- A ten to fifteen minute examination consisting of 10 to 20 questions(usually unannounced).

\             2. LAB QUIZ-A ten to fifteen minute examination consisting of 10 to 20 questions(usually unannounced).

\             3. MAJOR EXAMINATION- A examination consisting of 25 to 100 questions (announced in advance).

\             4. COMPREHENSIVE FINAL

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\ Lecture quizzes = 20% of final grade

\ Lab quizzes       = 20% of final grade

\ Major exams     = 40% of final grade

\ Final                  = 20% of final grade

\ Grades are posted through this learning management system.  If the student suspects a discrepancy on the report, he or she must contact the instructor immediately.  The student must be prepared to substantiate any grade challenge made to the written report by providing the instructor with the actual activity paper(s).  It is wise to save all of your graded papers in this, or any other course.

\ The following grade scale shall apply during this course:

\ A= 91.5 - 1      B= 82.5 - 91           C= 74.5 - 82        F=     -  74.4

\ A grade of “D” is not possible in this course!

\ It is not possible to raise a failing grade at the end of the course by asking for extra work to raise your failing grade.  I encourage each student to put forth extra effort from the start of any course.

\ MAKE-UP WORK POLICY
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\ Pop quizzes can not be made up, however, Major examinations not taken at their scheduled time may be completed for partial* credit if done so within one school day immediately following the original deadline and scheduled in advance of the original testing time.*Partial credit refers to 80% of the original maximum point value.

\ e.g.  Jane doe has taken a 100 point major examination late due to an absence.  She scores 90 points.  However, since the work is late, she will only receive 80% of that score or 72 points. (90x.80=72)

\ Note: Students who are present for a class must be prepared to submit any scored activities required during the class period.  This includes a “pop quiz” or out-of-class assignment.  Students should come to all classes prepared to fully participate in the scheduled activities.

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