Contrast Radiography 4

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kris10leejmu
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172258
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Contrast Radiography 4
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2012-09-20 19:13:20
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Clinical Practice ll
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Clinical Practice ll
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  1. Define myelography.
    contrast radiology of spinal canal
  2. What can a myelography detect?
    • spinal cord compression
    • masses in or around the spinal cord
  3. What could cause a spinal cord compression?
    • protruding disc
    • vertebral abnormalities
    • spinal cord swelling
  4. Are myelographys common in an average veterinary practice?
    no
  5. Which veterinary practices usually do myelographs and why?
    • teaching hospitals and referral surgery practices
    • strongly considering for surgery
  6. What is the most common reason we do a myelograph?
    IVD (intervertebral disc disease)
  7. What are some indications for doing a myelograph?
    • neurological deficits of limbs
    • localize spinal lesion for surgery
  8. What are some neurological deficits of limbs?
    • paralysis
    • paresis
    • sensory deficits
    • spinal pain
    • proprioceptive deficits
  9. What is proprioceptive deficits?
    animal does not know where its feet are
  10. What is proprioception?
    the sense of movement and position
  11. Is myelography dangerous?
    yes
  12. Why is a myelograph so dangerous?
    can cause seizures and death
  13. What are the contraindications for myelography?
    • not for minor problems
    • not for confirmation of diagnostic lesions on survey radiograph
    • recent myelography
    • history of seizures
    • presence of infection or blood in spinal cord
  14. What procedure should you do before a myelography?
    CSF analysis
  15. What does CSF stand for?
    cerebrospinal fluid
  16. What do we need to do a CSF tap for a myelograph?
    to place contrast material around the spinal cord
  17. Where is CSF located?
    in the subarachnoid space between arachnoid and pia mater
  18. What do we analyze when we do a CSF analysis?
    • color
    • clarity
    • protein
    • WBC count
    • differential
    • C & S
  19. What kind of contrast agents can we use for a myelograph?
    water-soluble iodine compounds (metrizamide, iohexol)
  20. What kind of anesthesia is required for a myelograph?
    deep anesthesia because there can be no movement of the patient
  21. What kind of premedications should we use for a myelograph and which one should we avoid?
    • we should use diazepam or any other medication with anticonvulsants
    • we should avoid acepromazine because it lowers the seizure threshold
  22. Where do we do the surgical prep for a myelograph?
    • where spinal tap is to be done
    • cervical - cisterna magna, lumbar area
  23. Why is it important to minimize the risk of infection when doing a myelograph?
    because patients are often given corticosteroids which can increase risk of infection
  24. Who does the spinal tap?
    surgeon
  25. What do we need to closely watch for when we are recovering a patient from a myelograph?
    seizures
  26. What is arthrography?
    contrast study of joint space - shows articular surface
  27. What are some indications for doing a arthrograph?
    • joint pain unidentified by other methods
    • ruptured joint capsule
    • cartilage flap (osteochondritis)
    • meniscus injury in stifle
  28. What is better an arthrography or a arthroscopy?
    arthroscopy
  29. What are some contraindications for doing a arthrograph?
    • infection of joint
    • infection of tissue around the joint that the needle must go through
  30. What contrast agent do we use for an arthrography?
    iodine - diluted to 20 mg iodine/ml
  31. Do we ansethetize the patient when doing an arthrograph?
    yes, painful
  32. After we inject the contrast agent with a needle into the joint what should we do?
    flex joint to distribute contrast material
  33. What is pneumoperitoneography?
    injection of gas into peritoneal cavity to outline abdominal viscera
  34. What are some indications for doing a pneumoperitonegraphy?
    • determine size
    • shape
    • positions
    • contours of organs
  35. What are some contraindications for doing a pneumoperitonegraphy?
    • diaphragmatic hernia
    • peritonitis
    • abdominal abscess
    • abdominal fluid accumulation
  36. What contrast agents do we use for pneumoperitonegraphy?
    • CO2
    • N2O
    • room air
  37. How long does it take for the body to absorb the CO2 or N2O after a pneumoperitoneograph?  Room air?
    • a few hours
    • 2 weeks
  38. What can using room air for a pneumoperitoneography cause?
    air embolism
  39. How do we prep a patient for a pneumoperitoneography?
    same as for an upper GI series
  40. Do we anesthetize the patient for a pneumoperitoneography?
    yes
  41. Where is the injection site for a pneumoperitonegraphy?
    halfway between umbilicus and pubis
  42. Where do we do the surgical prep for a pneumoperitonegraphy?
    halfway between umbilicus and pubis
  43. How do we know when to stop injecting the contrast agent for a pneumoperitonegraph?
    infuse gas until dull thud or bongo drum sound is produced on percussion
  44. Why do we need to monitor a patient more carefully when doing a pneumoperitonegraph?
    pressure of gas will make breaking more difficult so we need to watch respiratory rate and color of the patient
  45. What are some other contrast procedures that are less commonly done in veterinary practices?
    • angiography
    • cholecystography
    • bronchography
    • dacryocystorhinography
    • sialography
    • fistulography
  46. What is an angiography?
    injection of iodine into blood vessel
  47. What is an angiocardiography?
    injection of iodine through the heart
  48. What is cholecystography?
    IV contrast material is excreted by liver
  49. What does a cholecystography examine?
    • liver
    • gall bladder
    • bile ducts
  50. What is a bronchography?
    infuse positive contrast material into airways to evaluate trachea and bronchial tree
  51. What is a dacryocystorhinography?
    injection of positive contrast material into nasolacrimal (tear) duct
  52. What does a dacryocystorhinograph evaluate?
    • continuity
    • patency
    • rupture
  53. What is a sialography?
    retrograde injection of positive contrast material into salivary duct to check salivary glands and duct
  54. What are fistulographys and sinus tract infections?
    positive contrast material may be injected into fistulous tract or sinus cavity
  55. What is a fistula?
    abnormal connection between two parts of the body
  56. What are air bronchograms?
    pathological lung densities outline bronchi
  57. What is emphysema?
    pathological accumulation of air in tissue or organs
  58. What can emphysema be due to?
    • wounds
    • lacerations
    • tracheal ruptures
  59. What is pneumothorax due to?
    penetrating wounds, lung rupture
  60. What is pneumomediastinum?
    due to penetrating wounds
  61. What is pneumoperitoneum due to?
    penetrating wounds, bladder rupture
  62. What is gastric dilatation and volvulus?  What causes this?
    • accumulation of gas in stomach
    • torsion, pyloric problems, neoplasia, fermentation of food
  63. What is ileus?
    gas accumulation in intestines after peristalsis has stopped
  64. What does ileus do to the bowel loops?
    distends them

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