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INTRODUCTION
X-rays were discovered by Roentgen in 1895 while studying the cathode
rays (streams of electrons) in a tube.
This new radiation could penetrate opaque substance, produce
flourescence, blacken a photographic plate, and ionize gas. It is a form
of electromagnetic radiation.
Wilhelm Conrad Roentgen (1845-1923) the radiograph of Mrs. Roentgen's hand
BASIC X-RAY PHYSICS
X-rays: a form of electromagnetic energy
Travel at the speed of light
Electromagnetic spectrum
Gamma Rays X-rays
Visible light Infrared light
Microwaves Radar
Radio waves
THREE THINGS CAN HAPPEN
X-rays can:
Pass all the way through the body
Be deflected or scattered
Be absorbed

Where on this image
have x-rays passed
through the body
to the greatest degree?

An x ray machine is a complex device used in variety of
circumstances around the world. With the ability to
penetrate hard objects, they are used for purposes such as
air port security check points to see into backs, or in the
medical community to look for broken bones or problems
within the body.


Background
A German physicist William
Rontgen is usually credited as the
discoverer of x- rays because he
was the first to systematically
study them, though he is not the
first to have observed their effects.
He is also the one who got them
the name x-ray .though many
referred to this as Rontgen rays
(x-ray radiographs or Rontgen
grams).After their discovery and to
this day in some language
including Rontgen native Germany
though x-ray overtook popular
usage.

SCOPE OF STUDY
The scope is to provide
information for common
procedures involved in
diagnosis or repairing the
problems. Most of these
procedures are applicable
to all of fault diagnosis and
repairs of medical device.

X-RAY MACHINE
PRINCIPLES OF OPERATIONS
An x-ray machine is essentially a camera. Instead of visible light,
however, it uses X-rays to expose the film. X-rays are like light
in that they are electromagnetic waves, but they are more
energetic so they can penetrate many materials to varying
degrees. When the X-rays hit the film, they expose it just as light
would. Since bone, fat, muscle, tumors and other masses all
absorb X-rays at different levels, the image on the film lets you
see different (distinct) structures inside the body because of the
different levels of exposure on the film.

X-RAY FILM
Photographic film is a strip or sheet of transparent plastic film base coated
on one side with a gelatin emulsion containing microscopically small light-
sensitive silver halide crystals. The sizes and other characteristics of the
crystals determine the sensitivity, contrast and resolution of the film.[1]

The emulsion will gradually darken if left exposed to light, but the process is
too slow and incomplete to be of any practical use. Instead, a very short
exposure to the image formed by a camera lens is used to produce only a
very slight chemical change, proportional to the amount of light absorbed by
each crystal. This creates an invisible latent image in the emulsion, which
can be chemically developed into a visible photograph.
PARTS OF X-RAY MACHINE
X-Ray Generator: High voltage generator: modifies incoming
voltage and current to provide an x-ray tube with the power
needed to produce an x-ray beam of the desired peak-kilo-voltage
(k V p) and current (mA) and duration (Time).
Control panel: Permits the selection of technique factors and
initiation of radiographic exposures mA, kV, Time
Transformer: Transformers modify the voltage of incoming
alternating-current (AC) electrical signals to increase or decrease
the voltage in a circuit.


CONT
Step-up transformer: Supplies the high voltage to the x-ray tube
(voltage increases and current decreases)
Step-down transformer: Supplies power to heat the filament of
the x-ray tube (voltage decreases and current increases)
Autotransformer: Supplies the voltage for the two circuits and
provide a location for the K v p meter (indicates the voltage
applied across the x-ray tube)
Rectifiers: Convert AC into the direct current (DC) required by
the x-ray tube. A rectifier restricts current flow in an x-ray tube to
one direction (from cathode to anode), thereby preventing damage
to the x-ray tube filament. Two types: Half wave and Full wave.

CONT
X-RAY TUBE: It is an expensive wearing element in
medical radiological equipment. It consists of
Anode,
Expansion bellows (provide space for oil to expand),
Cathode (and heating-coil),
Tube envelope (evacuated) ,
Tube housing,
Cooling dielectric oil,
Rotor,


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THE X-RAY TUBE
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3.1 THE X-RAY TUBE (CONTD)
The main components of an x-ray tube are the cathode and the anode,
sealed opposite to each other in a highly evacuated vacuum tube.
The cathode is a tungsten filament which when heated emits electrons.
The anode consists of a copper rod and a piece of tungsten target (for
producing the x-rays).
The x-ray beam emerges through a thin glass window in the tube
envelope.
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3.1 THE X-RAY TUBE (THE ANODE)
Tungsten is used as target because of its high Z (74) and high
melting point (3370C).
Copper is used for its high heat conduction, heat is removed
by oil (which also serves as an insulator to the tube housing
from high voltage applied to the tube), water or air from
outside the tube. Sometimes, a rotating anode is used to
reduce the temperature of the target at any one spot.
Anode hood is used to shield unwanted stray radiation.
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3.1 THE X-RAY TUBE (THE
ANODE, CONTD)
CONT

High Tension Cable: Special highly insulated cables
Considered are the cable capacitance (130-230 pF/m)
because it affects the average value of the voltage and
current across the x-ray tube (increases the power
delivered to the tube.
Collimators : They are used to increase the image
contrast and to reduce the dose to the patient by mean
limiting the x-ray beam to the area of interest.

CONT
Grid: It is inserted between the patient and the film
cassette in order to reduce the loss of contrast due to
scattered radiation
X-ray film: X-ray film is a sensitive material (sheet)
for the x-ray. A film that has been exposed to x-rays
shows an image of the x-ray intensity.
SCHEMATIC DIAGRAM
11) cassette holder 12) Cable 13) Imaging hand switch 14) Control panel 15)
Generator 16) Display screen 17) Stretcher 18) X-ray tube 19) Collimator
20) Cassette 21) Interface cable 22) trolley 46) Hand grip 66)tube

Basic Chest X-Ray Interpretation
X-rays- describe radiation which is part of the
spectrum which includes visible light, gamma
rays and cosmic radiation.

Unlike visible light, radiation passes through
stuff.

When you shine a beam of X-Ray at a person
and put a film on the other side of them a
shadow is produced of the inside of their body.


Different tissues in our body absorb X-rays at
different extents:


Bone- high absorption (white)


Tissue- somewhere in the middle absorption (grey)


Air- low absorption (black)


GENERAL PRINCIPLES
OF RADIOGRAPHY
Top view of developed film
X-ray film
The part is placed between the radiation source
and a piece of film. The part will stop some of the
radiation. Thicker and more dense area will stop
more of the radiation.
= more exposure
= less exposure
The film darkness (density) will
vary with the amount of
radiation reaching the film
through the test object.
GENERAL PRINCIPLES
OF RADIOGRAPHY
The energy of the radiation affects its penetrating
power. Higher energy radiation can penetrate thicker
and more dense materials.
The radiation energy and/or exposure time must be
controlled to properly image the region of interest.
Thin Walled Area
Low Energy Radiation
High energy Radiation
Be
systematic

:


1) Check the quality of the film
FILM QUALITY
First determine is the film a PA or AP view.

PA- the x-rays penetrate through the back of the patient
on to the film

AP-the x-rays penetrate through the front of the patient
on to the film.


FILM QUALITY (CONT)
Was film taken under full inspiration?
-10 posterior ribs should be visible.

Why do I say posterior here?


When X-ray beams pass through the anterior chest on to the film
Under the patient, the ribs closer to the film (posterior) are most
apparent.
A really good film will show anterior ribs too, there should
Be 6 to qualify as a good inspiratory film.
QUALITY (CONT.)
Is the film over or
under penetrated if
under penetrated you
will not be able to see
the thoracic vertebrae.
OPTIMAL VIEWING
Dedicated light source
Darkened environment (like a movie theater)
Limit distraction
SUMMARY: HOW DO X-RAYS CREATE
AN IMAGE OF INTERNAL BODY
STRUCTURES?

X-rays pass through the body to varying degrees
Higher atomic number structures block x-rays better, example
bone.
Lower atomic number structures allow x-rays to pass through,
example: air in the lungs.
Question: If x-rays were blocked to the same degree by all body
structures, could we see the internal parts of the body?
5 BASIC RADIOGRAPHIC
DENSITIES
Air
Fat
Soft tissue/fluid
Mineral
Metal
1.
2.
3.
4.
5.
Name these radiographic densities.
History: I think my dog swallowed a rock
Diagnosis: Yes, he did.
QUALITY (CONT)
Check for rotation

Does the thoracic
spine align in the
center of the sternum
and between the
clavicles?
Are the clavicles level?
VERIFY RIGHT AND LEFT SIDES
Gastric bubble should be on the left

NOW YOU ARE READY
Look at the diaphram:
for tenting
free air
abnormal elevation
Margins should be sharp
(the right hemidiaphram is
usually slightly higher than
the left)
CHECK THE HEART
Size
Shape
Silhouette-margins should be sharp
Diameter (>1/2 thoracic diameter is enlarged heart)

Remember: AP views make heart appear larger than it
actually is.


Cardiac Silhouette
1. R Atrium
2. R Ventricle
3. Apex of L Ventricle
4. Superior Vena Cava
5. Inferior Vena Cava
6. Tricuspid Valve
7. Pulmonary Valve
8. Pulmonary Trunk
9. R PA 10. L PA
CHECK THE COSTOPHRENIC
ANGLES
Margins should
be sharp
Loss of Sharp Costophrenic Angles
CHECK THE HILAR REGION
The hilar the large
blood vessels going to
and from the lung at the
root of each lung where
it meets the heart.
Check for size and
shape of aorta,
nodes,enlarged vessels
FINALLY, CHECK THE LUNG
FIELDS
Infiltrates
Increased interstitial markings
Masses
Absence of normal margins
Air bronchograms
Increased vascularity

HEMOTHORAX