FINALS Flashcards
(157 cards)
1
Q
rad. study of the biliary system (Liver, gallbladder and biliary ducts)
A
CHOLEGRAPHY
2
Q
Procedures included in cholegraphy
A
- Cholecystography
- Cholangiography
- Cholecystangiography/ Cholecystocholangiography
3
Q
Routes in cholegraphy
A
- Mouth
- Injection to vein
- Direct injection to ducts
4
Q
Indications of cholegraphy
A
- FX of the liver
- Patency & condition of the biliary ducts
- Concentrating and emptying power of the gallbladder
- R/O calculi or stones formed in the biliary tract
5
Q
Different types of body habitus
A
- Hypersthenic
- Sthenic
- Hyposthenic
- Asthenic
6
Q
rad. examination of the gallbladder through the oral admin of contrast media
A
ORAL CHOLECYSTOGRAM
7
Q
Contraindications of cholecystogram
A
- Vomiting or diarrhea
- Pyloric obstruction
- Malabsorption syndrome
- Severe jaundice
- Liver dysfunction
- Hepatocellular disease
- Hypersensitivity to iodinated contrast media
8
Q
When should laxatives be given to a patient having OCG
A
24 hrs before injestion/injection of CM
9
Q
What kind of meal should be given to a patient having OCG
A
fat free meal
10
Q
On a OCG procedure, CM is given in a _____ dose approx. _______ hrs after _______ meal on the _______ before exam
A
single, 2-3, evening, night
11
Q
The usual single dose form given to patients who will have an OCG
A
3 g in form of 4-12 tablets
12
Q
Clinical indications of OCG
A
Biliary calculi
CHolecystitis
Neoplasms
Biliary stenosis
13
Q
stones in biliary ducts
A
Choledocholithiasis
14
Q
– abnormal calcifications in gallbladder
A
Cholelithiasis
15
Q
Procedures in OCG
A
A. Recumbent PA Proj. (Scout
B. Upright PA Proj
C. PA Oblique (LAO)
D. R. Lat.
E. AP Proj (R. Lat Decub)
16
Q
Answer the following:
Recumbent Pa Projection (scout)
IP
BP
MSP
RP
CR
RESP
SS
A
A. Recumbent PA Proj. (Scout)
IR: 10x12 LW
BP: Prone Position
MSP: R. side of abdomen centered on midline of grid/table
RP: Last rib
CR: Perpendicular to RP
RESP: Suspended expiration
SS: Somewhat opacified gallbladder
17
Q
Answer the following:
Upright PA Proj
IP
BP
MSP
RP
CR
RESP
SS
A
IR: 8x10 LW
BP: Upright Position, anterior side of body resting against IR
MSP: R. side of the abdomen centered on midline of grid/table
RP: 2-4 inches below last rib
CR: Horizontally directed to RP
RESP: Suspended expiration
SS: Axial representation of the opacified gallbladder
18
Q
Answer the following:
PA OBLIQUE (LAO)
IP
BP
MSP
RP
CR
RESP
SS
A
IR: 8x10 LW
BP: Recumbent position
MSP: With px in the prone posi, elevate R side to the desired degree of obliquity (15° - 40°).
RP: At the level of the last rib
CR: Perpendicular to RP
RESP: Suspended expiration
SS: Shows opacified gallbladder free from self-superimposition
19
Q
Answer the following:
R LAT
IP
BP
MSP
RP
CR
RESP
SS
A
IR: 8x10 LW
BP: Recumbent position
MSP: Px lies on the R side
RP: level of the last rib
CR: Perpendicular to RP
RESP: Suspended expiration
SS: Differentiate gallstones from renal stones and separate superimposition of gallbladder and the vertebrae in exceptionally thin px
20
Q
Answer the following:
AP PROJECTION (R. LAT DECUBITUS)
IP
BP
MSP
RP
CR
RESP
SS
A
IR: 8x10 or 10x12 LW
BP: Lat. recum. position
MSP: Place px on the R side w/ body elevated 2 to 3 Inches
RP: Level of the last rib
CR: Horizontally directed to RP
RESP: Suspended expiration
SS: Demo stones that are heavier than bile and that are too small to be visible
21
Q
Procedure where its indications include:
- Investigate biliary ducts of cholecystectomized pxs
- Investigate biliary ducts & gallbladder of non-cholecystectomized pxs when these structures are not visualized by OCG
- Severe vomiting & diarrhea
A
Intravenous cholangiography
22
Q
Contraindications of intravenous cholangiography
A
- Px who have liver disease
- Non-intact biliary ducts
- Obstructive jaundice
23
Q
Employed for pre-op rad exam of biliary tract
A
PERCUATENOUS TRANSHEPATIC CHOLANGIOGRAPHY (PTC)
24
Q
what kind of needle is used in PTC
A
CHIBA “SKINNY” NEEDLE
25
- performed during surgery to
Demo anatomy of the biliary ductal system, drainage into the duodenum, and any residual stones in the biliary ducts.
- may be performed before or following surgical removal of the gallbladder.
OPERATIVE CHOLANGIOGRAPHY
26
Biliary tract examination that is performed by way of the T shaped tube left in the common bile duct
POST-OPERATIVE CHOLANGIOGRAPHY
27
Another name for post-operative cholangiography
DELAYED/T-TUBE CHOLANGIOGRAPHY
28
Indications for post-op cholangiography
- Demo caliber & patency of ducts
- Status of sphincter of HPA
- Presence of residual/previously undetected stones
29
diagnose biliary and pancreatic pathologic conditions
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)
30
What is sprayed on the patients throat during ERCP
local anesthesia
31
How long should the patient be not allowed to drink/eat on ercp
1 hr before exam
32
cm used depends on gastroentero/radiologists
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)
33
rad demo of nasopharynx ff. the instillation of contrast media
NASOPHARYNGOGRAPHY
34
Indications of nasopharyngography
- Carcinoma
- Lymphosarcoma & angiofibroma
35
malignant neoplastic disorders of lymphoid tissue
Lymphosarcoma
36
small, reddish brown or even flesh-colored,
smooth, shiny papules present over the sides of the nose and medial portions of the cheeks.
Angiofibroma
37
WAYS TO STUDY NASOPHARYNX
+/- CM
38
How is +CM introduced during nasopharyngography
continuous breathing technique & modified valsalva maneuver
39
How is -CM introduced during nasopharyngography
introduced through nostril
40
What is the premed for nasopharyngography and when is it given?
ATROPINE – given 30 minutes before exam
41
What is the rationale behind the use of atropine during nasopharyngography?
suppress nasopharyngeal and buccal secretions
42
Cm used in nasopharyngography
Dianosil Aqueous (8-10ml)
43
Topical anesthetic used in nasopharyngography
Lignocaine 4%
44
Positioning for nasopharyngography
SMV PROJECTION
45
Answer the following:
SMV Projection (nasopharyngography)
BP
PP
OML
RP
CR
BP: Supine
PP: Shoulder elevated to extend neck
OML: 40-45° to the horizontal plane
RP: Midway between mandibular angles
CR: 15-20° cephalad
46
Post procedural care for nasopharyngography
Upon completion, let px sit up and blow the nose (For evacuation of CM)
47
rad exam of pharynx using either barium mixture/air
PHARYNGYOGRAPHY
48
Clinical indications of pharyngography
- demo tumor
- demo abscess
- demo presence of foreign body
49
WAYS TO STUDY PHARYNX
- Continuous quiet breathing & valsalva method
- Use of paste barium mixture (4:1)
50
Answer the following
AP PROJECTION (PHARYNX)
BP
PP
MSP
RP
CR
BP: Recumbent supine/erect
PP: Chin up (prevent mandibular shadow from obscuring the contrast filled pharynx)
MSP: Centered on the film
RP: Laryngeal prominence (Adam’s Apple)
CR: Horizontally directed or perpendicular
51
Answer the following
LAT PROJECTION (PHARYNX)
BP
IPL
MSP
RP
CR
FFD
BP: Lat posi Erect/Recumbent
PP: Extend chin to clear space bet. mandible & cervical spine
IPL: ┴ IR
MSP: // to IR
RP: Laryngeal prominence (Adam’s Apple)
CR: Horizontally directed or perpendicular
FFD: 72” (Erect position)
52
- synchronizing the exposure with the height of the swallowing act in deglutition studies
Gunson's method
53
consists of tying a dark-colored shoestring (metal tips removed) snugly around the patient's throat above the thyroid cartilage.
Gunson's method
54
rad exam of larynx
Laryngography
55
Clinical indications of laryngography
- demo paresis
- demo edema/fibrosis
56
(weakening of a muscle or group of muscles)
paresis
57
Most useful view to visualize the larynx is soft tissue
LATERAL VIEW
58
Procedure for laryngography
px prep
premed
cm
* PX PREP: NPO 5 hours
* PremED: Atropine 30 minutes before exam
* CM: Dianosil 10-15ml
59
During AP Projection, what can you see on a laryngography procedure
Larynx is filled w/ air and trachea is overlying the cervical spine of the median plane of the body
60
During Lateral Projection, what can you see on a laryngography procedure
voice box is filled and free of bony superimposition
61
exam of lower respiratory tract; gives excellent demo of bronchial tree
BRONCHOGRAPHY
62
These indications are for what procedure?
- Bronchiectasis
- Other obstructions of lower bronchial tree
- Recurrent hemoptysis
Bronchography
63
Contraindications for bronchography
- Impairment of pulmonary fx
- Recent pneumonia
- Active tuberculosis
- Known allergies
64
What are the 2 contrast used in bronchography?
omnipaque and dianosil
65
Contrast media that is
- Low osmolaric water based contrast medium
- Rapidly absorbed from bronchi and causes less irritation to mucosal lining than other CM
Omnipaque
66
Contrast media that is
- Oil-based compounds
- Viscosity and inability to mix with bronchial secretions sometimes prohibit good coverage
- Residual oily CM can sometimes cause fever
Dianosil
67
Prelim film for bronchography
Chest PA
68
Positioning for bronchography
AP, oblique and lateral projections. Sometimes Trendelenburg
69
How is CM expelled out after a bronchography exam?
* After exam, CM is expelled out by asking px to cough
70
Post procedure care for bronchography
Bronchospasm and impaired respiratory function should be checked by observation up to 4 hours post-examination.
71
– rad exam of ventricle
Ventriculography
72
type of cm used in ventriculography
negative CM
73
What kind of frame is used in ventriculography
stereotactic frame
74
rad exam of spinal cord by using CM injected into the intrathecal space
myelography
75
These indications are for
- Herniated nucleus pulposus
Lesion that may be present w/in spinal canal or may protrude into the canal
- Cancerous or benign tumors
- Cysts
- Possible bone fragments
Myelography
76
Contraindications for myelography
- Blood in the cerebrospinal fluid (CSF)
- Arachnoiditis
- Increased intracranial pressure
- Recent lumbar puncture
77
Contrast media used in myelography
Omnipaque and Isovist
78
Measurement of omnipaque for myelography
9-15 ml
79
During myelography, Injectable sedative or muscle relaxant usually is administered _______hour before the examination.
one
80
Method of needle placement for myelography
1. Lumbar Puncture (l3-l4)
2. CISTERNAL PUNCTURE (C1-C2)
81
Position for lumbar puncture
left lat position
82
Position for cisternal puncture
Px may be seated in an erect/prone, with head flexed to open interspinous spine
83
What are the POSITIONING: CERVICAL REGION during myelography?
- Horizontal beam lat
- Swimmers lat horizontal beam
84
What are the POSITIONING THORACIC REGION during myelography?
- R. Lat Decub. – AP/PA Projection w/ horizontal beam
- L. Lat Decub – AP/PA Projection w/ horizontal beam
- R/L Lateral – vertical beam
85
What are the positioning for lumbar region during myelography?
Semierect Lat – horizontal beam
86
rad exam of individual intervertebral disks
discography
87
another term for discography
nucleography
88
indications for nucleography?
- Investigate internal disk lesions
- px only given local anesthetic to remain fully conscious
89
contrast media for nucleography?
- performed with a small quantity of one of the water-soluble, iodinated media injected into the center of the disk by way of a double-needle entry.
90
rad exam of fallopian tubes & uterus
HYSTEROSALPINOGRAPHY
91
A procedure that can both be diagnostic & therapeutic
Hysterosalpinography
92
indications of hysterosalpinography
- study infertility
- Abnormal gynecological conditions
93
These contraindications are for what procedure?
- Pelvic inflammation
- Vaginal/cervical infection accompanied by purulent discharge
- Immediate premenstrual/ postmenstrual phase
- Active uterine bleeding
- Pregnancy
Hysterosalpinography
94
Contrast media used in hysterosalpinography?
-Ethiodol
- Hypaque
- Lipiodol
- Sinografin
- Renografin
95
For a hysterosalpingography procedure, when should the exam take place/be scheduled?
The exam should be scheduled between the 4th and 10th day following the onset of menstruation
96
What position should a scout film for hysterosalpingography be in?
AP
97
What are the projections for Hysterosalpingography?
AP, PA, oblique and lateral
98
What is the reference point for hysterosalpingography?
2 inches above symphysis pubis for frontal projections
99
rad exam of female pelvic organs by intraperitoneal gas
Pelvic pneumography
100
another term for pelvic pneumography
gynecograpy/ pangynecography;
101
CM into vaginal canal
VAGINOGRAPHY
102
indications for a vaginography?
- Congenital malformations
- Vesicovaginal fistulas
- Enterovaginal fistulas
103
They indicated that the use of a thin barium sulfate mixture for investigation of fistulous communications w/ intestine
Lambie, Rubie, Dann
104
rad exam of the prostate gland
prostatography
105
PROSTATOGRAPHY: AP PROJECTION
IR
BP
PP
RP
CR
IR: 8x10 LW
BP: Prone
PP: MSP aligned to center of the table
RP: 2” superior to SP
CR: Directed 20-25 degrees cranially
106
– rad exam of seminal ducts
EPIDIDYMOVESICULOGRAPHY
107
Another term for epididymovesiculography
vesiculography & epididymography
108
The following are the indications for what?
- Investigation of selected abnormalities such as:
Cysts
Abscesses
Tumors
Inflammation
Sterility
Epididymovesiculography
109
CM used in epididymovesiculography
- Water soluble, iodinated
CM
- Gaseous CM – for improvement of contrast in the exam of extrapelvic structures
110
rad exam of lacrimal system
DACRYOCYSTOGRAPHY
111
composed of 2 lacrimal glands & ducts w/c tears pass through nose
Lacrimal system
112
small oval shaped gland located at each lat. Side of rood of orbits of the eyes
Lacrimal glands
113
minute orifices w/r tears pass from the gland
Puncta Lacimalia
114
Indications for dacryocystography
- Defective development
- Stenosis
- Chronic Mucosal thickening
- Obstructive epiphora (watery eyes)
115
CM used in dacryocystography
- 0.5 to 2 mL Lipiodol fluid
- Oil based, iodinated CM
(Ethiodized oil)
116
What are the 5 procedures/positioning done in dacryocystography?
Water's method
Caldwell's method
Lateral projection
Straight AP Projection
Rhese's Method
117
Answer: DACRYOCYSTOGRAPHY: WATERS M
BP
MSP
OML
RP
CR
BP: Prone or seated upright
MSP: Centered to midline of IR
OML: 37° to IR (Nose 3⁄4” away from the IR)
RP: Lower orbital margin
CR: Directed to RP
118
Answer: DACRYOCYSTOGRAPHY: CALDWELLS
BP
MSP
OML
CR
BP: Prone or seated upright
MSP: Centered to midline of IR
OML: Perpendicular to IR
CR: 15° caudally at Nasion
119
Answer: DACRYOCYSTOGRAPHY: LAT. PROJ
BP
MSP & IOML
CR
IPL
BP: Prone or seated upright
MSP & IOML: // to the IR
CR: 15° caudally at Nasion
IPL: Perpendicular to IR
120
What is the degree of rotation of the head for it to be separated from the shadows of bilaterally opacified ducts in lateral projection
10-15 deg
121
Answer: DACRYOCYSTOGRAPHY: STRAIGHT AP PROJECTION
FS
BP
MSP
IOML
RP
CR
FS: 8x10 LW
BP: Supine
MSP: centered midline Of table
IOML: perpendicular to table
RP: Nasion
CR: Perpendicular to RP
*Directed at RP 15-23° caudally
FFD: 36-40”
122
ANSWER: DACRYOCYSTOGRAPHY: RHESE METHOD (3 POINT LOWER LANDING)
FS
BP
PP
MSP
AML
RP
CR
FFD
FS: 8x10 LW
BP: Prone recumbent
PP: Head resting on nose, chin and cheek
MSP: forms an angle of 53° to the horizontal
AML: perpendicular to table
RP: Centered to the orbit
CR: Perpendicular to RP
FFD: 36-40”
123
rad exam of salivary glands
SIALOGRAPHY
124
another term for sialography
ptyalography
125
Per day, how many liters of saliva are produced per day?
approx. 1-1.5 L/day
126
abnormal connection bet. 2 organs
fistula
127
Ways of studying the glands?
- Right after injection
- Post motor
128
What should be sucked/eaten 2-3 minutes before a sialography?
fresh wedge of lemon
129
During a tangential projection of a parotid gland (sialography), where is the head resting?
Head is resting on occiput.
130
What projection of sialography has the head resting on the occiput?
AP projection
131
Which projection has the head resting on the chin (sialography)
PA Projection
132
This projection clears the space between the cervical spine and the mandibular rami
Lateral projection of parotid gland
133
During the lateral projection of the parotid gland, what is the MSP?
15° toward the IR from a true lateral position
134
Procedure in which the film placement is at the center occlusal w/in the mouth
Axial projection intraoral method submandibular and sublingual gland
135
*This is the only projection that gives an unobstructed image of the sublingual gland regions.
AXIAL PROJECTION
INTRAORAL METHOD
SUBMANDIBULAR& SUBLINGUAL GLAND
136
rad exam of paranasal sinuses
anthrography
137
what are the different sinuses?
(frontal, maxillary, ethmoidal, sphenoid)
138
Sinus below sella turcica
sphenoid
139
w/in lateral mass of ethmoid bone
ethmoid sinus
140
another term for ethmoid sinus
labyrinth sinuses
141
largest sinus and is present at birth
maxillary sinus
142
another term for maxillary sinuses
ANTRUM OF HIGHMORE
143
sinus posterior to glabella, larger in men than in women
frontal
144
CM for anthrography
LIPIODOL FLUID OF HYPAQUE 85
145
indication for anthrography
Chronic Sinusitis
146
What are the positionings for anthrography?
Straight ap upright
Water's method
lateral projection
caldwell's method
147
this positioning for anthrography demonstrates fluid level
STRIAGHT AP UPRIGHT
148
another name for water's method
Mahoney’s Method
149
best positioning for anthrography
lateral projection
150
- Best positioning for frontal & ethmoidal sinuses
CALDWELL
151
What is the ff for STRAIGHT AP UPRIGHT ON ANTHROGRAPHY
MSP
RP
CR
SS
MSP: Centered to the VCH
RP: Nasion
CR: Directed horizontally
SS: Height of maxillary antrum & air is demonstrated
152
What is the ff for WATERS ON ANTHROGRAPHY
MSP
OML
RP
CR
SS
MSP: Centered to the VCH
OML: forms an angle of 37°
RP: Acanthion
CR: Directed horizontally
SS: Filling of the posterior aspect of the maxillary sinus
153
What is the ff for LATERAL PROJECTION ON ANTHROGRAPHY
MSP
IOML
RP
CR
SS
MSP: // to film
IOML: Perpendicular to the film
RP: Zygomatic bone or outer canthus of the eye
CR: Directed horizontally
SS: There will be filling of posterior aspect of the maxillary sinus
154
What is the ff for CALDWELL ON ANTHROGRAPHY
MSP
RP
CR
MSP: Centered to the midline of the VCH
RP: Nasion
CR: Directed 12-15° caudally
155
Rad exam of synovial joints
arthrography
156
CM used in arthrography
- radiolucent –CM
-radiopaque +CM
- combination of CM which is the most common
157
positioning for arthrography
ap, lat
