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81 Cards in this Set

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What is an arthrogram? What is the purpose?

Study of Synovial Joints to look for soft tissue pathology, impingement, tears, etc.

What kind of joints does an arthrogram observe? Name 7 specific joints.

Synovial - ankle, knee, hip, shoulder, wrist, elbow, and tmj

What type of sterile tray do we use for an arthrogram?

A standard myelogram tray w/ any additional sterile items specified by the radiologist.

Briefly explain the 5 steps of the process for an arthrogram.

1. take multiple scout images


2. inject the contrast


3. exercise the joint to move contrast around


4. radiologist does spot images


5. post contrals images (same as the scouts)

What is the purpose of exercising the joint during an arthrogram?

to move the contrast around the joint which helps to visualize any tears, etc.

How is a hip injection different than an arthrogram?

In the hip injection you are injecting pain medication, steroid, and contrast.

Why do we use contrast during a hip injection?

To make sure the needle is located in the joint capsule before injecting the pain medication and steroids.

What type of sterile tray do you use for a hip injection?

Standard Myelogram Tray

What are the general steps in a hip injection?

1. Patient into the room


2. Get patient consent


3. Clean skin surface


4. Fluoro


5. Mark the patient's skin


6. Numb the skin, Numb deeper.


7. Insert spinal needle


8. Contrast


9. Spot the patient


10. Inject steroids and pain medication.


11. Clean the patient, Place Bandaid.

If pain is still persistent after a hip injection, what does this indicate?

There is referred pain from somewhere else, and that joint is not causing the pain.

What is the post procedure care for a hip injection?

Be careful walking b/c hip is numb.


Limit activity for next 24 hours.


Follow up with physician.


Resume blood thinners next day.


Resume normal diet.

How is a hip aspiration different than a hip injection?

- drawing fluid out


- no contrast is being injected


- no medication is being injected

During a hip injection, some radiologist prefer buffered lidocaine. How does this differ from regular lidocaine?

buffered lidocaine has added saline, which creates less of a burning sensation when injected, as well as less tissue damage.

What is a potential issue with using buffered lidocaine?

It is made in the pharmacy, which means there is a chance for cross contamination.

How much contrast is used for a hip injection?

Only a very small amount just to confirm the placement of the spinal needle into the joint capsule.

What kind of steroids are usually used for hip injections?

Kenalog, Depo

Synovial joints are also classified as what other type of joints?

Diarthrodial

The knee and elbow are ______ or ________ joints.

Hinge or Ginglymus

The hip and shoulder are _______ or _________ joints.

Ball in Socket or Spheroidal

The wrist is a ___________ or ________ joint.

Ellipsoidal or Condylar

The TMJ is a _______ joint, which means the movement is in _______ direction(s).

Bicondylar; One

Where is the synovial fluid aspirated from?

Joint Capsule

A patient sticker must be placed on the test tubes containing aspirated fluid from the patient. What information must be included on these stickers?

Patient's Name, DOB, Time the sample is taken, Date, Body Part and R/L, Technologists' initals

After obtaining the aspirated fluid, and labeling the test tubes, you place them in the ________ bag and take them to the ______.

Biohazard, Lab

Where does the spinal cord start?

Below or at the medulla oblongata.

Where does the spinal cord end?

Ends at the conus medullaris.

Nerves at the spinal cord ending are called ______ _______ which means "_____ _____".

Cauda Equine; Horse's Tail

How many ventricles are there in the brain?

4

What are the specific ventricles in the brain?

2 Lateral Ventricles


3rd Ventricle


4th Ventricle

There is a hole between the 2 lateral ventricles that leads to the 3rd ventricle. What is this called?

Interventricular Foramen

There is a hole between the 3rd ventricle that leads to the 4th ventricle. What is this called?

Cerebral Aquaduct

The lateral ventricles are lined by ______ _____ which is full of ________ beds. This is where _______ _______ ________ is made.

Choroid Plexus; Capillary; Cerebral Spinal Fluid

What is the purpose of CSF?

protection, nutrients for the ventricles and the spinal cord.

How much CSF is made daily in the body?

500 mL

How much CSF is present at any given time within the body?

140 mL

What are the three coverings of the brain in order from outermost, to the most internal?

Dura Mater, Arachnoid, Pia Mater

The space between the skull and the dura mater is called the ________ space.

epidural

The space between the dura mater and the arachnoid is called the _______ space.

Subdural

The space between the arachnoid and the pia mater is called the _________ space.

Subarachnoid

During a lumbar puncture the spinal needle is inserted into what space?

Subarachnoid Space

Where is CSF located?

Subarachnoid Space

What is the purpose of a hysterosalpingogram (HSG)?

therapeutic and diagnostic for infertility


check for clip placement (tubal ligation)


uterine pathology (fibroid tumors)

What is a zui catheter? When do we use it?

Catheter that plugs the cervix to allow radiologist to fill uterus with contrast. We use it for women who haven't had children and are tighter. Used in place of acorn catheter.

When performing an HSG what are some questions you should always ask?

LMP (days 7-10). Sexually Active? Any discharge?

When doing an HSG what must you make sure is on the sterile tray?

Speculum to open vagina, uteran sound (probe), betadine, 4x4 guaze pads

Do you always take a scout image for an HSG?

No

What is the scout image for an HSG?

Bladder shot on a 10x12 crosswise, 2" superior to the pubic symphysis.

What are important things to tell the patient after having an HSG?

Discharge may be sticky, red, or brown (blood/betadine). Monitor temperature and cramping that persists for more than 24 hours. If you are trying to conceive, this is the optimum time to have sex.

Patient should take ________ prior to the exam.

motrin

In general what is a USG and HSG?

a study of the uterus and fallopian tubes

What does USG stand for?

Uterinsalpingogram

What is a contraindication for performing a USG or HSG?

Pregnancy

What type of sterile tray is used for an HSG?

HSG tray

How much contrast is injected during a HSG?

5-10 cc

What is the purpose of an acorn catheter?

goes through the cervical os, used to plug hole to keep contrast in uterus

What is a tenaculum?

Looks like skinny pliers, used to pinch the uterus and pull it down.

What is the purpose of a myelogram?

Study of the spinal cord and nerve root branches that uses xray contrast. Can detect tumors, stenosis, etc.

What type of sterile tray is used for a myelogram?

Myelogram Tray plus the contrast (Omnipaque).

Ominpaque is a ________. It comes in ______ variations. Name these variations.

Contrast; 180, 240, 360

The different numbers on xray contrast indicate the __________. The lower the number the ______ the contrast. Like wise; the higher the number the _______ it is.

viscosity; thicker; thinner.

The number on contrast represents the number of __________ molecules in the specific contrast.

Iodine

What vertebral level is the needle most likely inserted into during a myelogram?

L3-L4

Where is the needle inserted into during a myelogram?

L3-L4 Subarachnoid Space


OR


C1-C2 (called cisternal puncture)

How much xray contrast is usually injected into the spine during a myelogram?

9-15 mL

What overhead is usually taken after a myelogram?

cross table lateral

After care for a myelogram requires that the patient must keep there head _________ at ___ degrees.

elevated; 30

What is other post procedure care for a patient after a myelogram?

Drink fluids; if you get headache tell nurse; move as one unit (allows csf to evenly distribute).

What are 4 requirements a patient must reach before the myelogram can be performed?

1. take no anticoagulants


2. no puncture 14 days prior


3. no allergies to contrast/iodine


4. no signs of infection

How does a lumbar puncture differ from a myelogram?

instead of injected contrast, you are extracting csf to test for possible infection and other pathogens.

What type of tray is used for a lumbar puncture?

can use a myelogram tray with an added manometer, or you can use a standard LP tray

What is a syphgmomanometer?

Measure intercranial pressure.

What is the normal range for intercranial pressure?

80-160

What is the post procedure care after having a lumbar puncture?

Supine position for 24hours.


Increase fluid intake.


Tell nurse if headache.

When doing a myelogram of the lumbar spine, what contrast would you use?

180 - thin

When doing a myelogram of the thoracic spine, what contrast would you use?

240 - medium viscosity

When doing a myelogram of the cervical spine, what contrast would you use?

360 - thick and do NOT want contrast to go towards the brain.

What is the scout for a lumbar puncture?

PA L-Spine

What is the scout for a myelogram?

PA L-Spine and a cross table lateral of the area of interest

What does #9 represent? What does #10 represent?

What does #9 represent? What does #10 represent?









#9 is the the tip where the acorn catheter attaches. #10 is the acorn catheter.

What does the blue arrow represent?

What does the blue arrow represent?

This is where the glass syringe would go.

What is this whole device called?
What does #5 do?

What is this whole device called?


What does #5 do?

Cannula


#5 adjusts the tension of the ring (#4).