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Hannah RAD III > Alternative Procedure and Medical Devices Review > Flashcards

Alternative Procedure and Medical Devices Review Flashcards

1
Q

What are the terms used for the radiographic study of the biliary system, gallbladder and biliary ducts?

A
  • Cholegraphy – biliary system
  • Cholecystography – gallbladder
  • Cholangiography – biliary ducts
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2
Q

***What does PTC stand for?

A

Percutaneous Transhepatic Cholangiography

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3
Q

***What does ERCP stand for?

A

Endoscopic Retrograde Cholangiopancreatography

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4
Q

PTC Procedure:

A
  • Right side of patient is prepped with local anesthetic
  • Chiba needle is inserted through right lateral intercostal space and advanced to liver hilum
  • Stylet is removed and syringe with contrast is attached to needle
  • After filling of ducts needle is withdrawn
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5
Q

PTC Procedure:

A
  • If dilated biliary ducts are identified, a drainage catheter is placed into biliary duct
  • Guidewire is passed through needle lumen & needle is removed
  • Catheter is passed over guidewire and wire is removed
  • Left in place for prolonged drainage
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6
Q

***Explain the postoperative t-tube cholangiograpm:

A

-Exams the biliary tract using a T-shaped or pigtail shaped catheter

-Follows a cholecystectomy
Left in common hepatic & common bile ducts for postoperative drainage

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7
Q

***What type of procedure is used to place a T-tube and pigtail catheter?

A
  • T-tube is placed during a surgical procedure

- Pigtail catheter is placed during a laparoscopic biliary procedure

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8
Q

***What is the purpose of the postoperative T-tube cholangiogram?

A
  • Demonstrates caliber & patency
  • Status of sphincter of hepatopancreatic ampulla
  • Presence of stones or other pathologic conditions such as strictures
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9
Q

Why is the drainage tube clamped the day before the procedure?

A

Allows tube to fill with bile to prevent air bubbles within the duct from mimicking stones (preventive measure)

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10
Q

***What is the purpose for an ERCP?

A
  • It is used to diagnose biliary and pancreatic pathology
  • It is useful when biliary ducts are not dilated and no obstruction exist @ ampulla
  • Therapeutic procedure
    - Removal of choleliths or small lesions
    - Repair a stenosis of a duct
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11
Q

***ERCP Procedure:

A
  • Endoscope is placed through mouth into duodenum
  • A small cannula is passed into the hepatopancreatic ampulla
  • Contrast is then injected into common bile duct (retrograde injection)
  • Contrast drains from ducts within 5 minutes of injection
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12
Q

What is another name for a chest tube?

A

Thoracostomy or intrapleural tube

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13
Q

Where is a chest tube inserted?

A
  • Fluid accumulates near lung base
    • 5th to 6th intercostal space @ midaxillary
  • Air rises to upper pleural space
    • 2nd to 3rd intercostal @ midclavicle
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14
Q

***A chest tube is inserted to reestablish intrapleural pressure that may be caused by what various conditions?

A
  • Pneumothorax
  • Hemothorax
  • Pleural effusion
  • Empyema
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15
Q

What is the purpose of an endotracheal tube (ETT)?

A
  • Patient has need for mechanical ventilation or oxygen delivery
  • Patient has upper airway obstruction
  • Possibility of gastric acid reflux or aspiration
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16
Q

***Where is the proper placement of the endotracheal tube?

A

5 to 7 cm superior to tracheal bifurcation (halfway between clavicles and carina {T5-T7}

17
Q

***Malpositioning of the endotracheal tube:

A
  • If tube is inserted too far – enters the right bronchus causing a collapse of left lung or atelectasis
  • If tube is too high – air enters the stomach and regurgitation leads to aspiration pneumonia
18
Q

***What is the name of the catheter that is inserted into a large vein and has a variety of uses?

A
  • Central venous catheter
  • Venous access device
  • Hickman/Groshong (developer)
19
Q

What are some of the uses for the catheter mentioned in the previous question?

A
  • Administer chemotherapeutic and other drugs
  • Parenteral nutrition
  • Manage fluid volume
  • Blood analysis and transfusion
  • Monitor cardiac pressure
20
Q

***Where is the preferred location for a central venous line?

A

SVC approximately 2 to 3 cm above the right atrial junction

21
Q

***What are some of the common insertion sites for central venous lines?

A
  • Subclavian vein
  • Internal jugular vein
  • Femoral vein
  • Antecubital area (PICC lines)
    • Basilic vein
    • Cephalic vein
22
Q

***What type of line is a Swan-Ganz catheter?

A

Pulmonary arterial or PA line

23
Q

What is a pulmonary arterial line?

A
  • Single or multilumen CV line that contains a small electrode at distal end which is used to monitor pulmonary arterial pressure
  • It enters through right internal jugular and ends in the right pulmonary artery
24
Q

***Who performs the insertion of a PICC line?

A

Radiologist
Nurse
Specially trained technologist

25
Q

***What are some of the uses of a PICC line?

A
  • Prolonged antibiotic treatment
  • Home health care for extended treatment
  • Chemotherapy
  • Nutrition
26
Q

What is an implanted access device?

A
  • A device surgically implanted under patient’s skin in the chest wall or patient’s arm.
  • Tip lies in SVC
  • Used for drawing blood or administering medications/contrast
27
Q

***What type of needle is used to access an implanted access device (port)?

A

Huber needle

28
Q

What are the primary uses for a nasogastric tube?

A
  • Administration of medications
  • Gastric decompression
  • Removal of fluids from stomach after obstruction or trauma
29
Q

What is the most common NG tube?

A

Levin tube

-Single lumen with several holes near its tip

30
Q

What are some uses for the nasoenteric feeding tube?

A
  • Feeding and hydration of patient
  • Contrast administration
  • Nasoenteric feeding tubes are thinner and more flexible than NG tubes.
  • NE tubes can stay in for a longer period of time
  • NE tubes are positioned @ the level of 3rd portion of duodenum
31
Q

What is a PEG tube?

A

-Gastric feeding tube
-Percutaneous Endoscopic Gastrostomy
– most common type
-Inserted through a small incision into stomach/jejunum using surgery or endoscopy
-Used for long term nutrition

Hannah RAD III (25 decks)

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