Unit 3: Reproductive System and Pediatrics

Hysterosalpingiograpy

What is the radiographic imaging of the female reproductive system by the installation of a contrast agent?

Ovaries, uterine/fallopian tubes, uterus, vagina

What anatomy does a hysterosalpingiogram visualize?

- structural or functional

- masses

- post. op

- infertility

- tubal litigation

Diagnostic Indications for Hysterosalpingiography

- ____________ or ____________ defects

- Evaluation of _____________

- _____________ evaluation

- _______________ problems

- Done to image female anatomy after procedure of ______________

__________________

- infertility

- open

- kinks

- adhesions

- dilates

Therapeutic Indications for Hysterosalpingiography

- Can cure _______________

- ___________ tubes

- Straighten ___________

- Stretches ________________

- ______________ narrowed tubes

- Acute inflammation

- Active bleeding

- Pregnancy

What are the contraindications of a hysterosalpingiography?

Oily and water-soluable (most common)

What types of iodinated contrast media are used for a hysterosalpingiogram?

- bowel

- empty bladder

- stirrups / draped

- r and f / department / surgery

Patient Prep

- _____________ cleansing

- Before procedure have patient ___________ _____________

- Patient placed in _______________, prepped and _____________

- Done on regular x-rays (____ and ____) table in _______________ or in ______________ on a cysto-type table

- Speculum

- Catheter / cannula

- Contrast

- Radiographs

Hysterosalpingiogram Procedure

- ______________ is introduced into cervix

- _____________ or _______________ is fixed in place

- _____________ injected

- __________________ taken

- Pelvimetry

- AP and Lateral Pelvis

- Colcher-Sussman

- What was the historical exam that has been replaced by ultrasound, and is a type of imaging done to assess the birth canal?

- What views were obtained?

- What tool was used with this exam to measure the pelvic outlet?

Fetogram

What was the historical exam replaced by ultrasound that was used to image the fetus in utero, check the position of the fetus, look for multiple births, and look for other abnormalities?

- technique / high

- repeats

- projection / view / technical

- double

X-Raying Pregnant Females

- Use great care when setting _____________ (Use _______ kVp)

- Avoid __________

- Write down _________________/____________ and ________________ factors

- _____________ shield on exams when possible

- communication / verbal and nonverbal

- create trust

- explain / yourself / toy

- comfortable

- choices

- quickly

- talking / singing / laughing

- limit

- patience

Patient Rapport With Pediatrics

- ____________________ is very important (_____________ and __________)

- ___________ _____________ - Be honest

- "_______________ _____________" - some children like to hold something

- ________________ in their terms - use __________ or a ___________ as a demonstration

- Try to make them ____________________

- Givem them _____________, where possible

- Work ____________

- Keep _____________, ______________, _____________ to distract them

- ______________ people in the room

- Have ______________

- Hospital protocol

- They will improve the situation, not make it worse

- observer / helper

- LMP / shield

- If a parent is in the room during a pediatric what must be followed?

- What should you ensure if a parent is in the room during a pediatric exam?

- If the parent is in the room, they are either an ______________ or a _______________

- If the parent in the room holds their child during the exam, ensure to ask ______ and __________ them

Thymus gland

What anatomy will be enlarged on a pediatric chest radiograph, but is normal for them?

Ingested and aspirated non-food items

What is specific pathology seen on most pediatric chest radiographs?

- Tape, sandbags, sheets, pigg-o-stat

- Pigg-o-stat

- What are some restriants used on pediatrics?

- What restraint device is good for upright chest x-rays and reduced the chances of repeats?

- Bilateral hands and wrists in one exposure

- Knee

- In a pediatric bone age study what is done?

- What is an optional exam done during a pediatric bone age study?

- "Baby Fat"

- Low technique (low kvp and short exposure time)

- Small

- Shield them

- To part size

- 10 / grid

Pediatric Technique Adjustments

- What is the extra layer of fat under a child's skin that is present from 3 months to 3-4 years, is easy to penetrate, and has an increased tissue density?

- What kind of technique do you use for pediatric patients?

- What kind of film size should you use?

- What should you always do with pediatric patients?

- How should you collimate for a pediatric patient?

- If the pediatric patient's thickness is under ____cm, use no _______

- Mottle

- Set a manual technique

- Because there are fewer photons in pediatric digital imaging, what is the result?

- If the body part size of a pediatric patient is smaller than the AEC detector cell, what needs to be done?

Foreign body chest truama

What causes 300 deaths per year in pediatric patients?

- Square

- Rectangular

- Thin and less muscular

Pediatric Abdominal Truama

- What is the shape of a young child's abdomen?

- How does a child's abdomen look as they mature?

- What is a child's abdominal wall like during their first 2 years of life compared to an adult's abdomen?

- They are larger and more surface area is exposed

- Lower fat content and more elastic attachments

- It's not fully attached within the peritoneal cavity

Pediatric Abdominal Trauma

- Why are the solid organs (liver and spleen) in a child more at risk for injury?

- In a child, what is typical of their intra-abdominal organs?

- In a young child, why is the intestine more vunerable to injury due to sudden deceleration and/or abdominal compression?

- Immature bones / Plastic (bowing), Torus (buckle), Greenstick

- Salter Harris fracture

20%

- What can bow rather than break in response to force in pediatric patients? What type of fractures does this result in?

- What type of fracture causes damage to the epiphysis and can disrupt future growth at the fracture site?

- What percent of fractures are responsible for skeletal injuries in children?

- Battered Child Syndrome

- Report to radiologist or supervisor

- multiple / age / delayed / rib/multiple / two

- 4 / 2,000

Non-Accidental Trauma

- What is a collection of injuries sustained by a child as a result of repeated mistreatment or beating?

- If non-accidental truama is suspected, what should you do?

- Non-accidental trauma can include ______________ injuries, various _________ of injuries, _____________ reporting, ______/__________fractures, and _______ black eyes with no broken nose

- In the U.S. it's estimated that _____ million children are abused in some mannner and as least _________ children die as a result

- Bucket / corner

- ribs

- Acromion

- Spinous

- Occipital

Fractures Specific To Child Abuse

- _____________ handle or _____________ fractures

- Posterior _______

- __________________ of scapula

- ________________ processes

- ________________ impression fractures

- Shaken Baby Syndrome

- Chest compression

- Corner or bucket handle fractures

- What refers to an intercranial injury that occurs as a result of severe angular acceleration and direct impact as the head strikes a solid object?

- How does a child sustain rib fractures?

- What type of fractures occur when the arms and legs move but in a whiplash movement?

- Exposure parameters

- Minimize

- When doing a CT on a pediatric patient what should be adjusted for each specific child?

- You should ________________ multiple scans

- motion / repeats

- careful

- minimal

- vital signs

Pediatric Sedation

- Can reduce ____________ and reduce ____________

- Be extra ____________

- Conscious Sedation = ______________ sedation

- Have someone in the room monitor the __________ ____________

Their body weight

How much contrast media given to a pediatric patient is determined by what?

- 3

- 4

- 6

- 4 / clear / 1

Pediatric Barium Prep

- Under 3 months = NPO for _____ hrs

- 3 months - 5 years = NPO for _____ hrs

- Over 5 years = NPO for ____ hrs

Pediatric IVU Prep

- No food ____ hours before exam and drink lots of ________ fluids until _____ hours before the exam

- Sticker or glove ballons

- Candy

- What can be given as rewards for pediatric patients at the end of their exam?

- What should not be given as a reward?

- Image Gently

- Alliance for Radiation Safety in Pediatric Imaging

- What campaign was launched in Janurary 2008 that encouraged radiologic technologist technologist to maniupulate protocols to reduce pediatric patients exposure to radiation?

- Who launched this campaign?