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Rad III > Alternative Procedures and Medical Devices > Flashcards

Alternative Procedures and Medical Devices 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 Cholangioraphy

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3
Q

What does ERCP stand for?

A

Endoscopic Retrograde Cholangiopancreatography

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4
Q

PTC procdure:

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  • After filling of ducts needle is withdrawn
  • If dilated biliary ducts are identified, a drainage catheter is placed into biliary duct
  • Guidewire is passed through needle lumen and needle is removed
  • Catheter is passed over guidewire and wire is removed
  • Left in place for prolonged drainage
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5
Q

Explain the postoperative t-tube cholangiogram:

A
  • Exams the biliary tract using a t-shaped or pigtail shaped catheter
  • Follows a cholecystectomy
  • Left in common hepatic and common bile ducts for postoperative drainage
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6
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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7
Q

What is the purpose of the postoperative t-tube cholangiogram?

A
  • Demonstrates caliber and patency
  • Status of sphincter of hepatopancreatic ampulla
  • Presence of stones or other pathologic conditions such as strictures
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8
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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9
Q

What is the purpose for an ERCP?

A
  • It is used to diagnose biliary and pancreatic pathology
  • It is used when biliary ducts are not dilated and no obstruction exist at ampulla
  • Therapeutic procedure for removal of choletihs or small lesion/ repair a stenosis of a duct
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10
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 mins of injection
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11
Q

What is another name for a chest tube?

A

Thorocostomy or intrapleural tube

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12
Q

Where is a chest tube inserted?

A
  • Fluid accumulates near lung base (5th to 6th intercostal space at midaxillary)
  • Air rises to upper pleural space (2nd to 3rd intercostal at midclavicle)
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13
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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14
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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15
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})

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16
Q

Malpositioning of the endotracheal tube:

A
  • If tube is inserted too far - enters the right bronchus causing a collapes of left lung or atelectasis
  • If tube is too high - air enters the stomach and regurgitation leads to aspiration pneumonia
17
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)

18
Q

What are some of the uses for the central venous catheter?

A
  • Administer chemotherapeutic and other drugs
  • Parenteral nutrition
  • Manage fluid volume
  • Blood analysis and transfusion
  • Monitor cardiac pressure
19
Q

Where is the preferred location of a central venous line?

A

SVC approx. 2 to 3 cm above the right atrial junction

20
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)

21
Q

What type of line is a Swan-Ganz catheter?

A

Pulmonary arterial or PA line

22
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
23
Q

Who performs the insertion of a PICC line?

A

Radiologist, nurse, specially trained technologist

24
Q

What are some of the uses of a PICC line?

A

Prolonged antibiotic treatment, home health care for extended treatment, chemotherapy, nutrition

25
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
26
Q

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

A

Huber needle

27
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
28
Q

What is the most common NG tube?

A

Levin tube - single lumen with several holes near its tip

29
Q

What are some uses for the nasoenteric feeding tube?

A

Contrast administration, feeding and hydration of patient

30
Q

Facts about nasoenteric tubes (NE tubes)

A
  • 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 at 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

Rad III (5 decks)

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