II Lecture Chapter 13 Diagnostic Imaging pp 298

What type of examination is necessary to identify an atelectasis (collapsed lung)?

plain chest film; x-ray

Identify six purposes of radiographic exams in the operating room (OR).

1. Identify the location of abnormalities or foreign bodies (such as bullets, ingested items or calculi)

2. Locate retained foreign objects such as sponges, sharps, or instruments

3. Discover fluid or air within body cavities

4. Verify the correct location for an operative procedure (scout film)

5. Diagnose bone fractures and aid in bone realignment (reduction) and prosthesis placement (internal fixation)

6. Verify placement of indwelling catheters, tubes and drains

During a portable X-ray of the surgical site, what is the duty of the surgical technician in the scrub role?

to protect the sterile field from contamination

What piece of radiographic equipment is shown in figure 13-1?

C-arm with monitor; portable image intensifier; fluoroscope

What is the advantage of fluoroscopy?

The images may be viewed during movement and projected in "real time"; allowing the movement of joints and organs to be viewed directly.

*Allows a physician to see a live image of the body's internal organs in order to observe their size, shape and movement.

*Provide dynamic and functional information.

*Readily available.

*Inexpensive.

*Good for visualized bony structure.

List intraoperative applications for fluoroscopy.

1. Angiography (including cardiac catherization)

2. Cholangiography

3. Retrograde urography

4. Aid in bone realignment and prosthesis placement

5. Verification of catheter placement (epidural/central venous pressure) and lead (pacemaker) introduction

6. To direct instrumentation (neurosurgery/orthopedics)

List the steps, in order, for percutaneous placement of a femoral artery catheter using the Seldinger technique.

1. a catheter is introduction into the femoral artery

2. it is positioned into the ostia of the left coronary system under fluoroscopy

3. contrast medium is injected with the aid of computerized digital subtraction

4. cinefluograms (x-ray motion films) are taken

5. any lesions of the left coronary system are clearly outlined

6. catheters are exchanged and the technique is repeated for the right coronary system

Seldinger technique

Use of a guidewire for placement of any catheter into vessels, ducts, or other anatomical spaces

Box 13-1

Identify the structures shown in figure 13-2

a. common bile duct

b. hepatic ducts

c. cholangiogram catheter

d. ligating clips

e. obstruction

What type of radiography can be used to visualize the structures of the biliary tract?

choleangiography

describe the process of shooting an intraoperative cholangiograph (IOC).

1. a sterile cholangiogram catheter is inserted through a tiny incision in the cystic duct, which connect the gallbladder to the common bile duct

2. a contrast medium is injected into the biliary system to outline calculi or other obstructions on plain x-ray or under fluoroscopy

What pathological conditions are detected with detected with the use of cholangiography?

calculi or other obstructions

A bone scan is an example of what type of scan? The term "hot spot" refers to what aspect of the scan, and what condition might be indicated by its presence?

isotope scanning, a nuclear medicine study or radionuclide imaging

a "hot spot" is a collection of isotopes in a certain area and can indicate the presence of a pathological condition

A six month old is scheduled to undergo a CT scan with general anesthesia. What is the most likely reason that general anesthesia will be administered?

children may become frightened since the patient must enter the tube for a length of time and remain still

The patient is suspected to have a spinal cord tumor. Will an MRI or a CT scan be more useful in visualizing the soft tissue tumor?

MRI is especially good for imaging soft tissue; slices may be taken from any direction

Why is ultrasonography ideal for examination of a fetus?

it does not use ionizing radiation