Chapter 20 Radiation Therapy

CT imaging

Most common means of data capture. Three dimensional ionizing radiation-based technique image x-rays interact with detectors after attenuation to body tissues. CT scan and combines x-ray principles in advance computer technologies. The x-ray source moves in an ark around the body part being scan continually sent out beams of radiation. As to being passed through the body, the tissue absorbed small amount of radiation, depending on their densities. The beans are converted to signals they are projected onto a computer screen. These images look like radiographs of slices through the body. They are typically perpendicular to the long axis of the patient's body.

Who do you report a medical event to

NRC (nuclear regulatory commission)

Anterior

Near to the front of the body

Proximal

Near to the point of origin or attachment

Posterior

Near two or at the back of the body

Superficial

On or near the body surface

How often should the door interlock be checked

Once a day

How often do you check the camera and audio video

Once daily

How often should the treatment chart be checked

Once daily

Tonsils

Or a series of lymphatic knowledgeable in bedded in mucous membrans. Protect against foreign body infiltrated by producing lymphocytes.

OAR

Organs at risk

Efferent lymphatic vessels

Overall are smaller in diameter than the afferent vessels their valves open away from the node facilitating one way flow.

Fowler's position

Patient sitting in a semi sitting up position

Horizontal or transverse plane

Perpendicular to the mid sagittal, parasagittal, and coronal planes. Divides the human body to superior and inferior parts

Coronal or frontal plane

Perpendicular to the sagittal plane and vertically divides the body into anterior and posterior sections

Posterior

Posterior= dorsal = back

radiograph

Provide a two dimensional image of the interior of the body

Surface and sectional anatomy

Provide the foundation that the radiation therapist need to be effective in simulation, treatment planning, in the daily administration of therapy treatment.

PET/CT

Provides anatomic and is a logic information. This is commonly used because it can direct the radiation oncology team to ensure that the treatment field covers all diseased areas.

Maxillary sinus

Pyramid shaped cavity that is enclosed in the maxilla. is the largest of the paranasal sinuses

Ipsilateral

Refers to a body component on the same side of the body

Contralateral

Refers to the opposite side of the body

Hypersthenic Habitus

Represent about 5% of the population. Short, wide trunk, great body weight, and a heavy skeletal framework.

Hyposthenic habitus

Represents approximate 35% of the population. Do you abdominal cavity falls between the synthetic in the asthenic

What is the manubrim depression called

SSN

Scattering beams

Scatter the x-ray foil electrons

Vertebral column

Seven cervical, 12 thoracic, five lumbar, five sacral, and for coccygeal

nuclear medicine imaging

Short lived isotopes are injected into the body

What the largest mass of lymphatic tissue

Spleen

Anterior cavity contains

Sub divided by the muscle called the diaphragm. The two part or at the thoracic cavity in the abdominal pelvic cavity

SCF

Supraclavicular fossa is commonly treated (prophylactic treatment)

Where is the scapula located?

T1 - T4

Carina

T4 and T5

Thoracic cavity subdivided into

The Pericardial cavity and the two pleural cavities

immunity

The ability of the body to defend itself against infectious organisms in foreign bodies. Specifically, lymphocytes and macrophages protect the body by recognizing responding to the foreign matter

Nuclear medicine

The branch of medicine that you just radioisotopes in the diagnosis and treatment of disease uses ionizing radiation to provide information about physiology and anatomical structures

Lymph

The excessive tissue fluid consisting mostly of water and plasma proteins from capillaries

Breast lymphatics

The exhilarate, trans pectoral, and internal memory pathways

Image deformation

The process of shifting or contouring images to ensure the anatomic features are properly matching or register. The deformation of the image can help to account for anatomic changes between two town points they are turning the anatomy on one image into the exact location of another

Body cavities

The space within the body that contains internal organs The two main cavities are the posterior or dorsal and anterior or ventral cavities

Dorsal cavity contains

The spinal or vertebral cavity and the cranial cavity

Anatomic position

The subject stands upright, with feet together flat on the floor, toes pointed forward, arms straight down by the sides of the body with the palms facing board, fingers extended, and thumbs pointing away from the body.

efferent lymphatic vessels

Their valves open away from the node facilitating a one-way flow

MRI disadvantages

They are expensive magnetic shooting requirements, lower thorough put (less patients an hour), increase cost in comparison with CTs

Seperation

Thickness of someone's body

Where is the xiphoid process located?

Thoracic, T10

Where is the supersternal notch located

Thoracic, T2

What are the 3 cardinal principles to keep exposure low

Time, distance, shielding

TD5/5 (tolerance dose)

Total dosage over 5 years

Lateral

Toward one side or the other

Medial

Toward the midline of the body

Inferior

Towards the feet

Superior

Towards the head

Facial bones

Two maxillary bones, two zygomatic bones, two nasal bones, Two lacrimal bones, to Palentine bones, to inferior conchae, One foamer, and one mandible

Floating ribs

Two pairs of ribs that are only attached posterior

What quadrant is the spleen located

Upper left

Breast quadrants

Upper outer, upper inner, lower outer, and lower inner

Positron Emission Tomography (PET)

Use a short-lived a radio isotope such as carbon 11, nitrogen 13, fluorine 18, and oxygen 15 in a solution, he injected into a patient. The radio isotope circulate through the body in a middle part of a charger like giant called possess Jones. These positions Collabs conventional electrons in body tissues and cause a release of cameras. These razor detected and record it. The computer create a colored PET scan that shows functions rather than structure. It can't detect blood flow through organ such as the brain and heart. Diagnosed coronary artery disease, and identify the extent of a stroke or heart attack damage

Non-ionizing imaging

Use alternative means of imaging the body, such as magnetic fields in magnetic resonance imaging MRI echoed Sandwave in ultrasound scanning.

Ultrasound

Use high frequency sound waves that are not heard by the human ear. These waves travel forward and continue to move until they make contact with an object; at that point, a certain amount of the sound bounces back. uses a transducer The image that is produced is called a sonogram no exposure to ionizing radiation

Lipowitz metals

Used for blocks lead, Tin, cadmium, bismuth, eutectic alloy

Ionizing imaging

Uses ionizing radiation to produce images that primarily show anatomy. examples: -conventional radiography -computed tomography (CT) -nuclear medicine imaging -particularly possess John and mission tomography (PET) -Fusion of PET and CT (PET/CT)

What is the best way to ensure the isocenter is correct

Verification films

XY jaws

X makes the jaws go wider y makes the jaws go longer jaws of a collimator

What three axis evolve around the isocenter

X,y, and z Or table, gantry, collimator

Table axis

Y- up and down x- left and right z- in and out

ASIS

anterior superior iliac spine

Four sutures of the skull

coronal, lambdoid, squamous, sagittal

skull sutures

coronal, sagittal, squamous, lambdoid

DRR

digitally reconstructed radiograph

EPID

electronic portal imaging device

Edema

excessive accumulation of fluid in a tissue that produces swelling

EOP

external occipital protuberance bottom of head back of neck

external beam radiation therapy

gamma radiation generated from cobalt-60 is aimed at a tumor, destroying the tissue

trendeleburg position

lying on back with body tilted so that the head is lower than the feet

Lim Fattic system consist of

lymphatic vessels, lymphatic organs, and the fluid that circulates through it called lymph

PSIS

posterior superior iliac spine

Where is the sella turcica located?

sphenoid bone T4

SSN

suprasternal notch

Edema

swelling

Ionization

the process of adding or removing electrons from an atom or molecule, which gives the atom or molecule a net charge

chemotherapy

the use of drugs to treat a disease

Brachytherapy

the use of radioactive materials in contact with or implanted into the tissues to be treated

Photon beam

this type of beam deposits energy in small packets all along their path through tissue.

Orthogonal films

two images taken 90 degrees apart. They may be required for treatment planning purposes to define the location and relationship of various anatomic structures relative to the field's isocenter

adjuvant therapy

used after the primary treatments have been completed to decrease the chance that a cancer will recur

False ribs are called

vertebrochondral ribs

True ribs are called

vertebrosternal ribs

parasagittal plane

vertical plane that is parallel to the median sagittal plane and divides the body into unequal components, both right and left

Flattening Filter

*as x-rays emerge after hitting the target there are more in the center vs edge ---metal absorber that flattens the beam out by absorbing more photons at center of the beam --- dual E linacs have separate flattening filters for each energy --->constructed of metals: tungsten, steel, lead, uranium or aluminum flattening protons

palliation treatment

-symptom control -makes advanced stages more comfortable -pain relief

Three main functions of the lymphatic system

1) Lim Fattic vessels drain tissue space of interesting you will fluid that escapes from body capillaries and loose connective tissue, filtered it, and returned it to the bloodstream overall maintains the fluid levels in the body 2) lymphatic system absorbs fats and transports them into the bloodstream 3) The intricate System plays a major role in the body's defense and immunity

How does cancer cells spread

1) Lymphatic system 2) blood 3) seeding

Correct order of steps

1) diagnosis 2) concaltation 3) simulation 4) RT planning 5) physics check 6) final chart check 7) start treatment 8) end treatment

What is the most common field size

10x10

How many pairs of ribs

12 pairs

Common wedge angles

15, 30, 45, 60

To treat posteriorly

180 degrees

Parallel beams

180 degrees also called POP

What year was x-rays discovered

1895

14 bones of the face

2 maxillary 2 zygomatic 2 nasal 2 lacrimal 2 palatine 2 inferior conchae 1 mandible 1 vomer

How many bones in the skull

29

How many pairs of spinal nerve

31 pairs

How many bones in an adult vertebral colum

33

What is a vaclock

A immobilization device, complex.

Lymphabgiography

A specialized technique that use injected as to help visualize it lymphatic system

lymphangiography

A specialized technique that uses injected dyes to help visualize the lymphatic sustem

What agency developed professional practice standards

ASRT (American society of radiologic technologist)

Paranasal sinuses

Air spaces lined with mucous membranes to reduce the weight at the school and give a resonant to sound to the voice

Four dimensional images

Allow for movement

ARRT

American Registry of Radiologic Technologists

Anterior

Anterior= ventral= front

Skull

Approximately has 22 bones: A true cranial bones and 14 considered facial bones

ALARA

As Low As Reasonably Achievable

Deep

Away from the body surface

Distal

Away from the point of origin or attachment

Umbilus

Belly button located in the lumbar region L4

What mimics tissue and brings does closer to skin?

Bolus

Cranial cavity

Brain and pituitary gland

Ionizing images

CT PET

CT images show

CT images show bone detail well. CTs also show: 1) air (black) 2) water (dark/grey) 3) fat/blood (gray/light) 4) bone/metal (white)

Physique or body habitus

Can be Divided into four groups: 1) hypersthenic habitus 2) Sthenic habitus 3) huposthenic habitus 4) asthenic habitus

what does metastasize mean

Cancer grows or spreads

Asthenic habitus

Center for seek, light body weight, and a lighter skeletal framework. Makes up about 10% of the population

Types of spinal curvature

Cervical curvature, thoracic curvature, lumbar curvature, sacral curvature

Connection between sternum

Clavical

Larnxy

Connect the lower portion of the furnace above it into the trachea below it. It extends from the tip of the epiglottis at the level of the junction of C3 and C4 to the lower portion of the carotid Cartlidge at the level of C6 vertebra. It is subdivided into three anatomic regions the supraglottis, Glottis, subaglottis

afferent lymphatic vessels

Contain one-way valves that open into the node bringing the limp into it

MRIs record

Data that is based on the magnetic properties of the hydrogen nuclei, which can be thought of as tiny magnet spinning in random directions. These magnets interact with neighboring atoms it was all applied magnetic fields. In this imaging modality a strong uniform magnetic energy is applied to small magnetic fields that live parallel to the direction to the direction of the external magnet. The patient is ports with radio waves, which causes nuclei to send out a week radio signal that is detected and rework into a plan or image of body

Compensatory Vertible curves or secondary vertebral curves

Develop after birth as a child learns to sit up and walk

Primary vertebral curves

Develop in utero as a fetus develops in the sea shaped fetal position and they are present at birth

Sensitive radiation detection devices

Display images of radioactive drugs taken through the body in their uptake in tissue areas of increased uptake or the dark spots demonstrate high activity areas that correspond to pathologic change

median sagittal plane also called mid sagittal plane

Divides the body into two symmetric right and left sides

Sagittal plane

Divides the body vertically into right and left sides

Virtual simulation

Done on the computer without the patient being present

Afferent lymphatic vessels

Enter the lymph node several points along to come back service. They contain one-way valves open open into the node brain to limp into it

lymph

Excessive tissue fluid that consist mostly of water and plasma proteins from capillaries

Lithtomy position

Flat on back with knee and legs upp

lymphatic system

Flows in one direction

Mediastinum

Heart, aorta, trachea, esophagus, thymus, bronchial tubes, lymphatics

Sthenic habitus

Heavy scale to framework, elementary track is high but with the stomach located slightly lower in the trunk

What is the vertex

Highest point of the skull

Planes

Imaginary flat surfaces that pass through the body

Pharynx

In brainiest to that extends from the base of the skull to the esophagus. It connects the nasal and oral cavity's with the Lenix and esophagus. It is divided into the nasopharynx, ortho Phoenix, and larnygopharynx

sterum

Is a flat bone

Four dimensional computer tomography (4D CT)

Is able to track the movement of a moving tumor throughout the entire breathing cycle, so physicians can fall exactly where the tumor is located at all points of the cycle.

Thymus

Is larger and children and shrinks as we age helps with immunity

Spleen

Is the largest mass of lymphatic tissue in the body at roughly 12 cm in length. It is located posterior into the left of the stomach any of Domino cavity between the fundus of the stomach and the diaphragm. The spleen actively filters blood, removes old red blood cells, manufactures lymphocytes, and stores Blood

Image fusion

Is when you combine PET and CT OR Or MRI and CT

Lymphatic capillaries join to form

Larger lymphatic vessels

Where is the iliac crest located

Lumbar, L4

Pleural cavity

Lungs

Prone

Lying face down

Supine

Lying face up

Non ionizing images

MRI ULTRA SOUND

MRI Advantage's

MRI has a diagnostic advantage over CT and that it provides information about chemicals in an organ or tissue. Does MRI can be used in a non-invasive biopsy on tumors

What is the largest parineal sinuse

Maxillary

What do you do if the ODI is out

Mechanical distance indocator