RADI-108 Exam 2 (Urinary System, tomography, venipuncture)

what is the urinary system sometimes called

excretory system

what is the primary function of the urinary system

production of urine and elimination from the body

what does the urinary system consist of

2 kidneys, 2 ureters, urinary bladder, urethra

what is the average urine output per day

1.5 liters (1500 mL)

what two important substances do the suprarenal glands furnish

epinephrine & cortical hormones

where do the kidneys lie

posterior to lower liver on right and the other ones lies posterior to the lower spleen on left.

why is the right kidney usually lower

due to liver

what is breathing for all kidney views

expiration

why is it important to have the same breathing for all kidney views

they move up and down with movements of the diaphragm

during the production of urine what three things do they kidneys do

1. remove nitrogenous waste

2. regulate water levels in the body

3. regulate acid- base balance and electrolyte levels of the blood

along the each border of each kidney is a centrally located longitudinal fissure termed the _______

hilum

what does the hilum transmit

renal artery, vein, lymphatics, nerves and ureter

each kidney is divided into an upper part called the _____ _____ and a Lower part called the _____ _____

upper pole ; lower pole

what do the ureters sit on top of

psoas muscles

Where do the ureters enter the bladder?

on posterior lateral bladder

where is the three sports kidney stones may get stuck

1. ureteropelvic junction (UPJ)

2. brim of the pelvis

3. ureterovesical junction (UVJ)

what is another name for kidney stones

renal calculi

what are kidney stones

calcifications that occur in the luminal aspect of the urinary tract

what is the trigone formed by

the entrance of two ureters from behind and the exit site of the urethra.

what is the total capacity of the bladder

350-500 mL

How long is the female urethra?

how long is the male?

1 1/2 in long (female)

7-8 in long (male)

what are the two ways contrast medium can be introduced

1. intravenous injection (needle)

2. catheterization

what are the two major types of iodinated contrast media used in urology

1. ionic

2. non-ionic

what is the difference between ionic and non ionic contrast media

ionic has higher osmolality (causing an increase in blood plasma osmolality)

T or F the ionic contrast media has a greater chance of an allergic reaction

true

most hospitals use the ____- ____ contrast

non-ionic

why is iodine contrast media used?

it has a high atomic number

what does a cation do

separates to form 2 different things

what are the two most common side effects of contrast media

1. temporary hot flash

2. Metallic taste in the mouth.

what is an important medication to know your pt. is on before administering contrast media

Glucophage

T or F if a pt. is on glucophage it is recommended they withhold taking medication prior to injection and 48 hrs after the exam

True

what is a normal BUN level

8 to 25 mg/100 mL

what is a normal creatine level

between .6 and 1.5 mg

what is a normal estimated GFR

60 mL/min or greater

If a pt. is known to be allergic to contrast media what do they do

take Benadryl and prednisone

what is a common drug used when pt. is having reaction

epinephrine

what three ways are reactions classified

mild, moderate and severe.

what are the 4 general categories of contrast media reactions

1. vasomotor effect/ mild

2. anaphylactic reaction/ moderate

3. vasovagal reaction/ severe

4. acute renal failure/organ specific (kidneys shut down)

What do the mild (vasomotor) reactions include

nausea

vomiting

hives

itching

extravasation

what is extravasation

when contrast leaks out of the vein and into the skin (redness)

what do the moderate reactions (anaphylactic) include

excessive urticaria (hives)

tachycardia

bronchospasms

hypotension

what do the severe reactions (vasovagal or organ specific) include

very low blood pressure

cardiac or respiratory arrest

loss of consciousness

convulsions

etc.

what is a hypertensive IVU done for

done on pts. with high blood pressure.

what are the three purposes of an IVU

1. visualize the collection portion of urinary system

2. asses the functional ability of kidneys

3. evaluate system for any abnormalities

what does ureteric compression do

compresses ureters to keep contrast in kidneys longer.

what do you collimate to for kidney views

11 x 14 crosswise

what do you collimate to for bladder views

10x12

what is the 1 min. kidney (AP) called

nephrogram

what is your CR for full length IVU

same as AP abdomen (Crest)

where is CR for kidney films

half way between the diploid process and the crest.

In the RPO IVU what is shown

-downside shows ureter free of superimposition (right ureter)

-upside shows left kidney in profile

what is a boules injection

injection done all at one thru syringe

T or F retrograde urethrography is done on males only

True

what is tomography?

a radiographic technique that is designed to bring into focus only that anatomy lying in plane of interest while blurring structures on either side of the plane

what are the other things tomography has been called

planigraphy

stratigraphy

laminography

body-section radiography

in tomography, the tube and IR move in opposite directions around a stationary _________(pivot point) during the exposure

fulcrum

an object placed in the fulcrum will appear ________ while objects outside the focal plane will appear ________

sharp ; blurred

the greater the distance from the fulcrum the _________ the blurring

greater

What is tomographic amplitude?

total distance the tube travels

what is exposure amplitude?

distance the tube travels during exposure

what is the Grossman principle?

the fulcrum is fixed and table moves

What is the planigraphic principle

fulcrum is adjustable, pt. is stationary

what is the most common type of principle

planigraphic principle

what is the section thickness controlled by

exposure angle

the greater the angle the ________ the slice

thinner

what is the tube movement for IVU

linear

the total tomographic arc is limited to _____ degrees for linear

48 degrees

what movements have the maximum tomographic amplitude and thinnest cut

trispiral and hypocycloidal

what is used to located lesions when the exact location is unknown (tomography)

zonography

T or F zonography gives you large slice thickness

true

what line is parallel to floor when doing a panoramic view

IOML

Where do you apply a tourniquet?

3-4 inches above the site

what angle do you put needle in (WITH BEVEL UP)

20-45 degrees

what do you record on your exam req. after venipuncture

time, type, amount of contrast, site of injection, sign name

what is the most common veins used for venipuncture

median cubital, cephalic and basilic veins

What is the first thing you should do before withdrawing any contents from the contrast bottle?

confirm what's in bottle and it hasn't expired, also read it 3 times.