RADI 442 EXAM 2

What is the purpose of IV/IA lines?

To administer drugs and fluids; to collect samples of blood

What method of injection is an injection with hand-held syringe or automatic injection over short time period?

bolus

What method of injection is a bag of solution connected to tubing and needle?

gravity infusion

What method of injection has electronic control of rate & volume of injection?

infusion pump

What do you immediately plug in and call a radiology nurse if starts beeping?

infusion pump alarm

Can we fix a kinked infusion pump line?

yes

What are the parenteral solutions?

saline, 5% dextrose, total parenteral nutrition, and vitamins (administered through GI tract)

What is the standard height for an IV?

18”-20” above injection site

What should the drip rate be for an IV?

the rate should follow order of MD/pharmacy per specific drug—amount of drug over period of time (we have nothing to do with drip rate, it’s up to nurse/doctor)

What problem with an IV happens when the solution is leaking out somehow and causing symptoms like pain at injection site, swelling at site, cool to touch, and pale skin?

Extravasation

What IV problem causes inflammation in tissues and blood back-up line due to poor infusion?

Phlebitis

What IV problem means that something is obstructing? (clot in vein)

Thrombosis

something that moved from another area within the vascular system and is now causing a blockage

Embolus

What is it called when anyone can legal document these things they want done in certain situations? (including who makes the decisions; do they want a feeding tube, ventilator, etc.?)

Advanced Directive

Can you sterilize ottoclate?

no

What involves inserting a catheter into the bladder to drain urine, often when patients cannot urinate on their own?

urinary catheterization

foley catheter

What oxygen device is not common, overdistension of stomach, and drying of mucus membranes?

Nasal catheter

What oxygen device is temporary, secured over head with elastic strap, may be connected to a portable type of humidifier?

Face mask

What oxygen device is most common especially for those traveling to the department?

Nasal cannula

What oxygen device is through trachesotomy?

ETT tubes

Oxygen use and tips:

1. measured in liters per minute (LPM)

2. check level before turning off/unplugging

3. connect patients tubing to wall unit in room

4. be sure no tubing becomes kinked or compressed in bed rails or by patient

5. if possible, confirm with patient that they are continuing to feel the oxygen

6. secure all tanks

What is sound?

a form of energy that is produced when a vibrating source causes molecules within a medium to move back and forth

What allows waves of sound energy to travel?

the back and forth motion

What kind of waves are sound waves?

longitudinal

What is the scientific study of sound referred to as?

acoustics

Who identified the PEBBLE THEORY, which visualizes sound waves traveling like the waves created by a pebble dropped in water?

Boethius

Who recognized there must be a medium through which sound can travel in order for it to propagate, leading his research to lay the groundwork for the use of COUPLING GEL?

Robert Boyle

Who is the “FATHER OF ULTRASOUND?” Studied how bats use sound waves to detect their victims and to guide their flight? Also helps us understand the PULSE-ECHO technique

Abbe Lazzaro Spallanzani

Who discovered that the pitch of a sound wave varies if the source of the sound was moving? (Doppler effect)

Christian Johann Doppler

What causes an increase in frequency of the returning echo due to the Doppler effect?

red blood cells

Who recognized the piezoelectric effect? (crystals in the transducrer produce ultrasound waves)

Currie brothers

When was the first application of ultrasound in medical diagnosis?

1941

Floyd Firestone developed this to use ultrasound to detect flaws in metal. This was the first technique used in medicine.

reflectoscope

This represents the depth of the returning echo on the x-axis and the strength of the reflector on the y-axis. Represents depth and amplitude and is used in echocardiography and ophthalmic ultrasound.

A-mode (amplitude mode)

This displays the returning ultrasound signal as a dot on the monitor. The dot has varying degrees of brightness, based on the strength of the returning echo. The stronger the returning echo, the brighter the dot. (grayscale sonography)

B-mode (brightness mode)

This documents the movement of structures in the body along a single scan line. The y-axis shows depth, the x-axis shows time. Used to demonstrate fetal heart rate and in echocardiography as a critical part of standard protocols.

M-mode (motion mode)

What is triplex imaging?

the combination of B-mode, spectral, and color doppler

What is the ultrasound technique that uses the Doppler effect to detect and measure the movement of blood or other moving structures? It shows the DIRECTION and SPEED of blood flow by measuring changes in the frequency of reflected sound waves.

Doppler

What is a doppler ultrasound mode that uses color to display the DIRECTION and relative VELOCITY of blood flow superimposed on a grayscale (B-mode) image?

Color Doppler

On a color doppler, red blood flow represents its flowing ____ the transducer

toward

On a color doppler, blue blood flow shows its flowing ____ the transducer

away from

What doppler ultrasound mode displays the STRENGTH (amplitude) of the doppler signal to detect blood flow? It is more sensitive than color doppler. especially for slow or small-vessel blood flow, but does not show the direction or velocity of flow.

Power Doppler

An ultrasound technique that combines B-mode (grayscale) imaging with Doppler ultrasound to show both the anatomy of structures and the blood flow within them at the same time.

Duplex imaging

What is the basic principle of ultrasound imaging in which the transducer sends out short pulses of sound waves and receives the echoes that return from tissues to CREATE an image? (specific depth, limited aliasing)

Pulse-echo ultrasound

What is the doppler ultrasound that continuously transmits and receives ultrasound waves, allowing it to measure very high blood flow velocities without aliasing? THOUGH, it cannot determine the exact depth (location) of the blood flow. (high velocities, no depth)

Continuous wave doppler

What is it called when the blood is moving too fast for the machine to measure correctly?

aliasing

What is the aorta protocol?

1. SAG Prox AO (with and without measurement) (SMA is anterior superior to the aorta)

2. Sag Mid AO (with and without measurement)

3. SAG Dis AO (with and without measurement)

4. SAG Bif AO Bifurcation (with and without measurement)

What is the TRV protocol for aorta?

1. TRV Prox AO (with and without AP & width measurement)

2. TRV Mid AO (with and without AP & width measurement)

3. TRS Dis AO (with and without AP & width measurement)

4. TRV Bif AO (with and without AP & width measurement)

5. TRV Bif AO (color)

abdominal aorta

SAG AO PROX

SAG AO MID

SAG AO DIS

SAG AO Bifurcation

SAG RT ILIAC

SAG LT ILIAC

TRV AO PROX

TRV AO MID

TRV AO DIS

TRV AO BIF

What is the most common area of work-related injury for sonographers?

shoulder

What is Ergonomics?

the scientific study of creating tools and equipment that help the human body adapt to the work environment

Where is a person’s center of gravity located?

pelvis

What is neutral posture?

balancing of the body to include joints, muscles, and spine

What is the max length you should adduct your arm?

30 cm

What does WRMSD stand for?

Work-related Musculoskeletal Disorder

What are the common locations for a pinched nerve on a sonographer?

elbow, wrist, and neck

What does ALARA stand for?

As low as reasonably achievable

What is the principle of keeping ultrasound exposure to the lowest level possible while still obtaining the necessary diagnostic information?

ALARA

What are patient rights?

the legal rights of the patient, the protection of individual rights, and the rights of the healthcare employee. an underlying theme is that of consent. (informed and implied)

What does HIPPA stand for?

Health insurance portability and accountability act

What are the policies on EPIC for US Student?

1. you do not have access to epic

2. you can only use epic when given permission, even when just looking at the schedule

3. only use it under the sign on of the person who gave you permission

4. must accept the information you are given if not in the position to ask more questions

What does DNR stand for?

do not resuscitate

What does a DNR mean?

a medical order stating that CPR and other resuscitation efforts should not be performed if a patient’s heart stops or they stop breathing.

Where do you place the folry catheter bag?

below the level of the bladder

Who was the first to apply ultrasound findings

dussik

What advanced technology measures the stiffness of tissue?

Elastography imaging

What are the first lateral branches of abdominal aorta seen by ultrasound?

renal arteries

What is the measurement criteria for proximal, mid, and distal aorta

up to 3 cm

What is the measurement criteria for iliac arteries?

up to 1.5 cm

What courses posterior to SMA and anterior to aorta?

left renal vein

What courses posterior to IVC, originating from aorta?

right renal artery

superior mesenteric artery in transverse scan plane

IVC in transverse scan plane

celiac artery in transverse scan plane

What is the pertinent anatomy for prox sag aorta?

1. proximal aorta

2. celiac artery

3. eg junction

4. SMA

5. liver

Pertinent anatomy for sag mid aorta

1. mid ao

2. possibly SMA if still in same plane as AO

3. bowel

Pertinent anatomy for prox trans aorta

1. prox AO

2. CA (if visualized)

3. common hepatic artery (if visualized)

4. splenic artery (if visualized)

5. liver

6. IVC

Pertinent anatomy for mid trans AO

1. mid AO

2. IVC

3. SMA

4. pancreas

5. splenic vein

6. right renal vein (if visualized)

What are the 3 layers of the aorta?

1. tunica adventitia

2. tunica media

3. tunica intima

ventricles contract and blood is sent into AO is…

systole

aortic valve closes and arterial vessels push blood through the system is…

diastole

Is the aorta retroperitoneal?

YES

what is the first anterior branch of the aorta?

celiac artery

What is the second anterior branch?

superior mesenteric artery (SMA)

What is the third anterior branch?

inferior mesenteric artery

What is the seagull sign on the celiac axis?

AO, CA, splenic, and hepatic

GDA (gastroduodenal artery)

branches off common hepatic artery and is the head of the pancreas

Proper HA branch

at porta hepatis; proper HA bifurcates into right and left hepatic arteries in the liver; cystic artery arises from the right hepatic artery

Splenic artery

courses from the celiac artery to the spleen; often tortuous; blood supply to the spleen