Chapter 13 Flashcards
diagnostics
sources of pt data
history and physical
diagnostic imaging
sources of medical history
medical (family) social (religion) and physiological (family) information
how do you get medical history
personal interview process
what is a physical
to verify the symptoms + looks for additional signs
methods for getting a physical
direct (look)
indirect (mirror)
enhanced (scope)
palpitation (touch)
auscultation (stethoscope)
what word means listening, usually with a stethoscope
auscultation
what is a scout film for
verify correct location of procedures (spine) (form of radiography)
most common exposures for portable machines
AP (anterior posterior)- front to back
lateral- side to side
who reads X-rays
radiologist or surgeon
STSR job with radiography
protect sterile field
drape machines and put screen if needed
what is radiolucent
penetrate by xray
what is contrast
solution introduced into body that stands out in X-ray (cholangiogram)
methods of contrast media
injected vessels ducts subarachnoid
swallowed
instilled
what method of contrast media can you usually not use
rectally, can cause paralysis of peristalsis
use radiopaque powered instead for barium rectally
contrast medium characteristics
water soluble w/ iodine
hypertonic viscid solution
- may be diluted
contrast medium brand names
reflects specific concentration
- hypaque
- renografin
- cystografin
- gastrografin
CT scan
“computer axial”
produces sliced 3d image
adjustable thickness slices
what can you do to enhance CT scan
give the patient IV contrast media
which scan is faster and less expense
CT scan, not MRI
what do CT scans detect
masses, tumors, infection, fresh bleeding, bone spurs, disc pathology
what does fluoroscopy do
projects an image onto a monitor
- image intensifier can amplify
- allows removal of background images
what is another name for fluoroscopy
C- arm
- can be foot pedal activated
- mini, large, XL
considerations with C-arm
specialty drapes
PPE (lead)requires radiolucent table
uses for flousocopy
angiogram
cholangiogram
retrograde
bone alignment
prosthesis placement
catheter placement
what is myelograph
form of xray or cat scan
clearly outlines bone tissue
evaluation of spine, back, leg pain
used with contrast medium
MRI mostly used now
what is angiography
form of xray or fluoroscopy
invasive sterile procedure
visualization of veins and arteries
done in Cath lab
selective angiography
morediregct path to Dx
require less concentrated contrast
specialty catheters
nonselective angiography
diagnostic exam
requires larger volumes of higher concentrated contrast
cardiac catheterization
(with fluoroscopy)
evaluation of heart functions
- visualization of arteries + chambers
diagnose
- CAD
- pulmonary + valve disease
- congenital heart failure
what is a coronary artery arteriogram
Cath inserted into the coronary system to check for coronary artery disease
left ventriculogram
for ventricular pressure
multi holes in tip to measure chamber pressure + injecting lots of contrast media
ejection fraction
% of blood pumped out of ventricle with each heart beat
55-75% is normal
measures with left ventriculogram
low: indicates cardiomyopathy
what kind of catheter do you use for right ventriculogram
swan-ganz catheter
what do you measure with the swan Ganz catheter
pulmonary capillary wedge pressure
indirectly measure left side of the heart
also indicate pulmonary edema
5 common catheter placement locations
femoral - most common
brachial
subclavian
internal jugular
radial
there main placement supplies
needle/ cannula combination
guidewires - J most common
specialty catheters
seldinger technique
easiest entrance to most vessels of the body
most common is femoral
supplies needed for seldinger technique
xylocaine
11 blade
needle/ cannula set
guidewire
catheter
contrast medium
what case is cholangiogram used
cholecystectomy of common bile duct
what clamp secures catheters in ducts
Olsen clamp
what is a urogram
used to outline the structures of the urinary system
outliner renal pelvis of kidney
what is another name for intravenous pyelogram (IVP)
antegrade pyelogram
contrast given into vessel in urogram
what is retrograde pyelogram
contrast injected in the distal ureter
what is radioisotope imaging
uses radioactive medications to assist
locates tumors
2 types of radioisotope imaging
PET (positron emission tomography)
- 3D
scintigraphy
- 2D
how does a PET scan work
combines specialized CT and radioisotopic scanning
highlights chemical activity in the brain or body with radioactive medications
reasons not to do a PET scan
lengthy and expensive
what is a scintigrapy
2D version of PET scan
injects of radioactive isotope metabolized by tissue type
the more active a cell is, the more it takes up an isotope creating “hot spots” in an image
what is the thing to remember about MRI
no metal can be in the room
uses no ionized radiation
2 forms of energy used to create MRI image
magnetic feild
radio waves
how can MRIs be sliced
any direction
what kind of contrast medium does an MRI use
non iodine based contrast medium
what scan do you use to see bleeding
CT
what is ultrasonography
electrically stimulated crystal transducer that creates and recipes ultrasound waves
what frequency of sound waves does ultrasonography go at
1-10 million Hz
what is ultrasonography used for
noninvasively examine the heart, blood flow, and abdopelvic cavity
what is the benefit of ultrasonography
no radiation- safe for fetus
what does doppler ultrasonography do
measures blood flow by transmitting sound of moving RBC
what is the doppler ultrasonography used to check for the tech
patency of arterial anastomosis by checking blood flow to limbs
what part of the doppler ultrasonography is draped
probe
echocardiogram (ECG)
2D image of heart through chest wall
maps blood flow
form of ultrasonography
what is an echocardiogram called when its dont through an esophageal probe
TEE
what does plethysmography do
measures changes in volume in parts of the body
- measures volume of air passing through the air
- measure volume of blood in vessels
what machine is used conjunction with plethysmography
doppler ultrasonography
phleborheography
notes changes in venous volume associated with respiration
- measures DVT
electrodiagnostic studies
ECG
EEG
EMG
ECG (EKG)
deals with heart
help detect forms of heart disease
measures dysrhythmia
three types of ECG
placing electrodes
holter monitor -disruptions in rhythm
stress test (grade exercise testing)
EEG
see electrical activity of brain
more leads= more info
what does EEG diagnose
seizure
tumors
epilepsy
EMG
electrical activity of skeletal muscle
inserted through skin to muscle
-diagnose ALS and carpal tunnel
interop neuro monitoring
provides immediate electrical nerve velocity feedback from electrons applied to pt extremities
during cranial and spine procedures
what is spirometry in pulmonary assessment
obtains info on lung capacity and pressure
tells if you have leak in ventilator system, COPD, ARDS
blood gasses
drawn from pt and visually examined in lab
arterial saturation range (blood gasses)
96-100%
venous saturation range (blood gasses)
60-85%
capnography
part of pulmonary assessment
what is your arterial level of Co2 during mechanical ventilation
what is the measure of exhaled Co2 called in capnography
end tidal Co2
RBC high and low indicates
high: bone marrow disease
low: anemia
hemoglobin high and low indicates
high: dehydration
low: anemia
hematocrit high and low indicates
high: dehydration
low: anemia, bleeding, malignancy
platelets high and low Indicates
high: too thick
low: DIC
WBC high and low indicates
high: leukemia
low: immunosuppressed
international normalized ratio high and low indicates
high: increased bleeding
low: increased clotting
what do you test on the hematologic studies (blood panel)
RBC
hemoglobin
hematocrit
platelets
luekocytes
international normalized ratio
prothrombin time
partial thromboplastin time
what Is the hematocrit range for adult preggo women
30-34%
hematocrit ranges for adult male and female
male: 42-54%
female: 38-46%
whole blood arterial saturation should be his much capacity
96-100% of capacity
collection method of urinalysis
simple void
clean catch
sterile
what do you take with bacteriologic test
gram stain
what does gram stain do
identifies bacteria
quick method to determine initial course of treatment
gram positive stain
retains purple- blue stain
what do you use in gram stain
crystal violet, iodine, then alcohol, then safranin
gram negative stain
fades to pink red
culture and sensitivity test
take a “culture” of tissue to identify pathology
determines form of treatment
what are aerobic bacteria
found in oxygen
what are anaerobic bacteria
live in the absence oxygen
what is a culture test
test to find germs that cause infection
what is a sensitivity test
checks to see what type of antibiotic test will treat the best
what is thoracentesis
needle placed in pleural space for analysis of pleura
diagnose cancer or inflammation
- or to remove fluid
surgical biopsy
pieces of tissue taken out to diagnose
specimen sent to pathology
what is a histological exam
study of tissue
what is a cytological exam
study of cells (aspirated fluids)
needle biopsy
removal of fluid through a needle with syringe attached
cysts, joints, body cavities, nodes
washing and brushing specimens
collection of fluid with cells
washing + brush biopsy
wiping to grab specimen
difference between incision and excision biopsy
incision = removing a part of lesion
excision= removing entire lesion
what do you do with permanent sections in biopsy
placed in preservative
what are frozen section biopsy for
immediate diagnosis
not 100% accurate
centesis and fluid analysis
needle into body cavity for removal or fluid for diagnostic and therapeutic purposes
4 types of centesis and fluid analysis
paracentesis - peritoneal cavity
thoracentesis - pleural space
amniocentesis - abd for pregnancy
pericardiocentesis - pericardial sac
what do you do if you lose specimen
do it again
Ionizing radiation READ
R- radioactivity
E- exposure
A- absorbed dose
D- dose equivalent
