RAD-146 FINAL PT.2

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anatomy12
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277259
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RAD-146 FINAL PT.2
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2014-06-23 18:32:34
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  1. What are the breathing instructions for a UGI/BE?
    where is CR for a PA and/or AP BE
    • Suspend respiration and expose on expiration
    • iliac crest
  2. List the routine positions/projections for a single contrast BE.
    • pa and/or ap
    • RAO and LAO
    • LPO and/or RPO
    • LAt. rectum
    • PA
    • post evac
  3. List the routine positions/projections for a double-contrast BE.
    • pa and/or ap
    • RAO and LAO
    • LPO and RPO
    • LAt. rectum
    • R and L lat. decubs (double contrast study)
    • PA post evac
  4. What is the kVp range for a single contrast study?
    What is the kVp range for a double contrast study?
    What positions best demonstrates the hepatic flexure?(2)
    100-125 single contrast

    80-90 kvp for a double contrast

    RAO or LPO
  5. What positions best demonstrate the splenic flexure? (2)
    How does the CR change for each?
    LAO or RPO

    • RPO = 1-2in above crests and 1in to the left of MSP (cr is high because of splenic flexure)
    • LAO = 1-2in above crests and 1in to the right of MSP (cr is high because of splenic flexure)
  6. What is the CR for a lateral rectum and ventral decub. rectum?
    lat. rectum = CR to level of ASIS and midcoronal plane (midway between asis and posterior sacrum)

    same for decub rectum (2 inches up from greater trochanter)
  7. What is best demonstrated on a right lateral decubitus radiograph?
    entire colon and an air filled splenic flexure and descending colon
  8. Why is a post evac. film taken?
    Why are butterfly (axial) positions taken?
    • to see residual contrast
    • to elongate the rectosigmoid region b/c it is very squished
  9. which position in a double contrast study visualizes the an air filled hepatic flexure and ascending colon and cecum
    where is the CR for this position
    left lateral decub BE

    at level of crests
  10. what size cassette is needed for a ap axial or ap axial oblique (LPO) Butterfly positions
    what is the tube angle ap axial
    where is the CR for the ap axial and ap axial oblique
    what is the obliquity of the LPO
    • 11x14
    • 30-40 deg cephalad
    • AP axial: 2" inferior to ASIS at MSP
    • LPO:2'' inferior and 2in medial to right ASIS
    • 30-40
  11. what size cassette is needed for a pa axial or pa axial oblique (RAO) Butterfly positions
    what is the tube angle for pa axial
    where is the CR for the pa axial and pa axial oblique
    what is the obliquity of the RAO
    • 11x14 lengthwise
    • angle cr 30-40 caudal
    • PA: at ASIS at MSP
    • RAO:cr at level of asis and 2in to left of spinous process
    • 35-45 deg
  12. what are polyps?
    What is volvulus?
    What is a neoplasm?
    sac like projection similar to diverticula except they project inward

    a loop of bowel twisting upon itself

    • "new growth" and is another word for tumor
    • they are malignant or benign
    • it is most common cancer of large intestine in sigmoid and rectum
    • it commonly encircles the lumen of the colon and causes "apple core" or napkin ring lesions
  13. a pa post evac use what IR and where is the cr
    do we need more or less penetration
    • 14x17
    • cr at the crests
    • less penetration because there is less barium
  14. Bile is formed in the liver and travels by the right and left _______ ducts to the _____ ducts. Bile is either carried to the ______ via the ______ duct for temporary storage or pour directly into the duodenum by way of the _____ duct  which is joined by the main ______ duct
    • hepatic
    • common hepatic
    • GB
    • cystic
    • common bile
    • main pancreatic
  15. the ______ duct is 3-4 cm long containing several membranous folds along its length. These folds are termed the _____ which functions to prevent distention or collapse of the cystic duct
    • cystic duct
    • spiral valve
  16. What are the three primary function of the gallbladder?
    what are the three main parts of the gallbladder
    which portion is most distal and broader
    storage: if bile is not needed for digestive purposes it is stored for future use in the GB

    concentration: bile is concentrated in the GB due to hydrolysis

    contraction:the GB normally contracts when foods such as fats or fatty acids are in the duodenum

    • fundus neck body
    • fundus
  17. In 60% of individuals the ________ duct joins the pancreatic duct to form an enlarged chamber just proximal to the terminal opening termed the ____ ampulla or ampulla of _______near the terminal opening the duct walls contain circular muscle fiber termed the ______ sphincter or the sphincter of ______the sphincter relaxes when there are increased levels of ______ in the bloodstream
    • common bile
    • hepatopancreatic
    • vater

    • hepatopancreatic sphincter
    • Oddi
    • CCK
  18. the presence of the ring muscle causes a protrusion into the lumen of the duodenum this protrusion is termed the ______ which is the narrowest part of the passageway and therefore a common site for impaction of gallstones
    duodenal papilla (papilla of vater)
  19. What is another name for gallstone?
    choleliths
  20. cholecystectomy
    cholelithiasis
    cholecystitis
    • surgical removal of gallbladder
    • condition of having gallstones
    • inflammation of the galbladder
  21. cholangiogram
    cholecystocholangiogram
    choleliths
    • radiographic examination of biliary ducts
    • study of both the gallbladder and the biliary ducts
    • gallstones
  22. What is a operative cholangiogram done for? (4things)
    • to find undetected choleliths
    • to see if biliary ducts are open and clear no blockage
    • function of the hepatopancreatic ampulla locate small lesions or strictures in biliary ducts
  23. what is a post operative t-tube cholangiogram done for
    to keep place just in case there is an obstruction and can go into it later
  24. what is PTC,why would it be used (3 things)
    percutaneous transhepatic cholangiography an xray of the biliary ducts

    for people who cannot handle anesthesia

    obstructed jaundice: if patient biliary ducts are suspected to be dilated  or obstruction to biliary ducts cause by a stone or stenosis

    stone extraction and biliary drainage
  25. what does ERCP stand for
    is anesthesia used for a PTC
    endoscopic retrograde cholangiopancreatography

    • no because it is an outpatient test
    • it is less invasive and cost less
  26. Explain body habitus variation when referring to the GB?
    what are the four advantages of medical sonography over an conventional OCG (operative cholangiogram)
    • hypersthenic pt = GB will be higher and more transverse
    • asthenic = GB will much lower on top of the spine

    • no ionizing radiation
    • no contrast media administered
    • detects small calculi
    • less pt prep (less time consuming)
  27. What position demonstrates the stratification
    of possible choleliths?
    rt. lateral decub or pa erect
  28. What is a biliary calculi
    gallstones
  29. the _____ kidney is slightly lower due to the presence of the liver
    right
  30. what is the latin designation for kidney

    Most of each ______ lies anterior to its respective kidney

    The ______ muscles on either side of the vertebral column cause the
    longitudinal plane of the kidneys to form a vertical angle of about 20
    deg with the midsagittal plane
    ren

    ureter

    psoas
  31. these large muscles also cause the kidneys to rotate backward approx. ____ degrees
    a 30 degree RPO will cause the ______ kidney to be parallel to the film
    • 30
    • left
  32. Each kidney is surrounded by a mass of fatty tissue called the
    The kidneys normally lie halfway betweenthe xiphoid process and the _______
    • adipose capsule or perirenal fat
    • iliac crests
  33. What are the functions of the urinary system?(3)
    is the production of urine and its elimination from the body

    • removes nitrogenous wastes
    • regulates water levels in the body
    • regulates acid base balance and electrolyte levels
  34. Along the medial border of each kidney is a centrally located, longitudinal fissure termed the _____
    hilum
  35. From the large amount of blood flowing through the kidneys daily, about 1.5 liters of _______ cc’s of urine are formed.
    1500
  36. The structural and functional unit of the kidney
    is the microscopic
    The major calyces unite to form the
    The term ________ is a general term used to describe the total functional portions of the kidneys.
    • nephron
    • renal pelvis
    • renal parenchyma
  37. Directly under the fibrous capsule surrounding each kidney is the

    There are three constricted points along the course of each ureter (where stones get stuck). They are…

    The triangular portion of the bladder along the inner, posterior surface is termed the
    renal cortex

    • ureteropelvic junction (UP)
    • pelvic brim
    • uereterovesical junction (UV)

    trigone
  38. Involuntary urination is termed
    The act of voiding is called urination or
    incontinence

    micturation or voiding
  39. What questions should be asked when taking a pt. history for urography?
    • Have you ever had hay fever, asthma or hives?
    • Are you allergic to any drugs or medication?
    • Are you allergic to iodine?
    • Are you allergic to any foods?
    • Are you currently taking Glucophage?
    • Have you ever have an xray exam that required an
    • injection into an artery or vein?
  40. List examples of mild, moderate and severe reactions of contrast media.
    • mild = hives, itching sneezing
    • moderate = excessive urticaria, giant hives, excessive vomiting
    • severe = low bp, cyanosis, laryngeal edema, profound shock, cardiac arrest
  41. What is the pt. prep for an IVP?
    • light evening meal prior to procedure
    • bowel cleansing cathartic
    • npo after midnight
    • enema morning of examination
    • void prior to procedure
  42. Why use ureteric compression?
    enhances the filling of contrast in the kidneys and pelvicalyceal system
  43. What are contraindications to ureteric compression?
    where are the uteric compression pads placed when in use
    • possible uteric stones
    • abdominal mass
    • abdominal aortic aneurysm
    • recent abdominal surgery
    • severe abdominal pain
    • acute abdominal trauma

    over the pelvic brim just medial to ASIS
  44. What is the basic filming routine for an IVP?
    • Ap scout
    • nehprogram (at injection time)
    • ap 5 min
    • ap 15 min
    • 20 min RPO LPO
    • PA
    • Post void (pa or erect)
  45. Nephrogram vs. nephrotomogram.
    Nephrograms are the early radiographs taken after injection during an ivp

    nephrotomogram is a tomographical image and is a slice as to where the kidneys
  46. What is the purpose of retrograde urography? (2)
    radiographic examination of the urinary system

    • visualizes the collecting portion of the urinary system
    • assess the functional ability of the kidneys (timed procedure)
  47. What is the purpose of retrograde cystography?
    radiographic study of the bladder after instillation of an iodinated contrast medium via a urethral catheter
  48. What is the purpose of voiding cystourethrography?
    What is the kVp range during IVP’s? Why?
    what two studies involve the function of the kidneys
    Which studies are non functional of the urinary system
    provides a study of the urethra and evaluates the patients ability to urinate

    70-75kv, to not burn through a stone

    IVP/VCUG

    Retrograde urogram/cystogram
  49. What structure is best demonstrated on
    a RPO radiograph during an IVP?
    • left kidney
    • right downside ureter
  50. What position will demonstrate nephroptosis?
    erect
  51. What will a PA projection during an IVP best demonstrate?
    it shows filled mid-distal ureters
  52. What are the routine projections/positions for
    cystography?
    what is the routine for a vcug male and female
    • ap
    • rpo
    • lat (optional)

    • male rpo
    • female ap
  53. what cassette do you need for a cystogram
    what is the breathing
    where is the cr for an ap
    what is the tube angle
    • 11x14 crosswise
    • on expiration
    • 2in above pubic symphysis
    • 10-15deg caudad angle
  54. What are the contraindications for contrast media for an IVP?
    • if pt is taking gluocophage metformin
    • has had a history of allergies hives hay fever
    • and all the rest of pt history questions
  55. What is anuria?
    What is a diuretic?
    • complete cessation of urinary secretion by the kidneys
    • an agent that increases excretion of urine
  56. What is uremia?
    What is urinary reflux?
    renal agenesis?
    the abscence of a functioning kidney

    a backward return or flow of urine from the bladder into the ureter and kidney

    an excess in the blood of urea creatinine and other nitrogenous waste of protein and amino acids metabolties

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