MOD 2 - Extra Lines, Tubes & Pacemakers – Radiographic & Clinical Essentials

28 question-and-answer flashcards summarizing indications, placement, imaging criteria, and complications of central venous catheters, PACs, NG/OG tubes, chest tubes, and pacemakers.

What are four key purposes of central venous catheters (CVCs)?

Provide long-term venous access; deliver chemotherapy, dialysis, blood, or IV medications; avoid peripheral-vein damage; allow frequent blood sampling.

Where are non-tunneled catheters (NTCs) inserted and how long are they intended to remain?

Placed in the internal jugular or subclavian vein (usually right side) for short-term, acute care use.

Which type of CVC is designed for long-term outpatient therapy and lowers infection risk?

Tunneled catheters such as Hickman or Broviac lines.

What is a Port-a-Cath and how is it accessed?

A totally implanted CVC with no external tubing, accessed transcutaneously with a special non-coring needle.

Which vein is typically used to insert a PICC line?

The basilic vein of the upper arm.

List two benefits of a PICC line.

Lower infection risk and easy maintenance while supporting either short- or long-term therapy in stable patients.

What are the MRT’s responsibilities when imaging a CVC?

Acquire a quality image, confirm catheter-tip position, and promptly report any malposition to the care team.

When can a newly inserted CVC be used?

Only after imaging confirms correct tip placement.

Where is the ideal tip location for a CVC delivering general fluids or medications?

In the superior vena cava about 2 cm above the carina (T4–T5 level).

Where should the catheter tip lie when infusing chemotherapy or other irritating medications?

At the cavo-atrial junction, roughly two vertebral bodies below the carina.

Why might a dialysis catheter be positioned in the right atrium and what is the risk?

To achieve high flow rates for hemodialysis; atrial placement increases complication risk and is used only when specifically indicated.

What is the primary purpose of a pulmonary artery catheter (PAC/Swan-Ganz)?

To measure cardiac output, intracardiac pressures, and provide continuous heart-function monitoring.

How is a PAC inserted and where should its tip end?

Introduced via the jugular, subclavian, or femoral vein and balloon-floated through the right heart into the pulmonary artery.

Describe the radiographic appearance of a correctly positioned PAC.

It makes a large U-turn within the cardiac silhouette with the tip at or just below the carina in the main pulmonary artery/trunk.

Name three potential complications associated with PACs.

Malposition or coiling, vascular/cardiac perforation, arrhythmias, and infection.

Give three indications for insertion of a nasogastric or orogastric (NG/OG) tube.

Enteral feeding, gastric decompression, and medication delivery or gastric lavage.

What is the ideal tip location for an NG tube?

At least 10 cm below the gastro-esophageal junction within the gastric bubble.

What is the expected radiographic path of a properly sited NG tube?

Descends midline, parallels the spine, then deviates left into the stomach.

List three malpositions of NG/OG tubes that can be seen on imaging.

Insertion into the right main bronchus, looping in the esophagus, or a U-turn back into the pharynx.

Identify two major complications of NG tube placement.

Aspiration and visceral perforation or bleeding (pneumothorax is rare).

For what purposes are chest tubes inserted?

To remove air (pneumothorax) or fluid (pleural effusion) from the pleural space—often life-saving.

Where is the ‘safe zone’ for chest tube insertion?

The 5th intercostal space just anterior to the mid-axillary line.

How should a chest tube be directed for a pneumothorax versus a pleural effusion?

Toward the apex/anteriorly for air; toward the base/posteriorly for fluid.

What are the MRT’s responsibilities when imaging a chest tube?

Confirm tube position, ensure the tip is appropriately located, and keep the drainage system below insertion site.

Name some complications that can arise from chest tube insertion.

New or worsened pneumothorax, hemothorax, surgical emphysema, infection, or abdominal misplacement.

What is the principal function of a pacemaker (PM)?

To maintain an adequate heart rate when the sinoatrial node fails or cardiac conduction is blocked.

Which symptoms can pacemaker therapy help prevent?

Bradycardia-related syncope, dizziness, and fatigue.

How does a temporary pacemaker differ from a permanent one?

A temporary pacemaker is an external, short-term device used after MI or surgery; a permanent pacemaker is surgically implanted for long-term arrhythmia management.