Chapter 13 Flashcards
diagnostics
1
Q
sources of pt data
A
history and physical
diagnostic imaging
2
Q
sources of medical history
A
medical (family) social (religion) and physiological (family) information
3
Q
how do you get medical history
A
personal interview process
4
Q
what is a physical
A
to verify the symptoms + looks for additional signs
5
Q
methods for getting a physical
A
direct (look)
indirect (mirror)
enhanced (scope)
palpitation (touch)
auscultation (stethoscope)
6
Q
what word means listening, usually with a stethoscope
A
auscultation
7
Q
what is a scout film for
A
verify correct location of procedures (spine) (form of radiography)
8
Q
most common exposures for portable machines
A
AP (anterior posterior)- front to back
lateral- side to side
9
Q
who reads X-rays
A
radiologist or surgeon
10
Q
STSR job with radiography
A
protect sterile field
drape machines and put screen if needed
11
Q
what is radiolucent
A
penetrate by xray
12
Q
what is contrast
A
solution introduced into body that stands out in X-ray (cholangiogram)
13
Q
methods of contrast media
A
injected vessels ducts subarachnoid
swallowed
instilled
14
Q
what method of contrast media can you usually not use
A
rectally, can cause paralysis of peristalsis
use radiopaque powered instead for barium rectally
15
Q
contrast medium characteristics
A
water soluble w/ iodine
hypertonic viscid solution
- may be diluted
16
Q
contrast medium brand names
A
reflects specific concentration
- hypaque
- renografin
- cystografin
- gastrografin
17
Q
CT scan
A
“computer axial”
produces sliced 3d image
adjustable thickness slices
18
Q
what can you do to enhance CT scan
A
give the patient IV contrast media
19
Q
which scan is faster and less expense
A
CT scan, not MRI
20
Q
what do CT scans detect
A
masses, tumors, infection, fresh bleeding, bone spurs, disc pathology
21
Q
what does fluoroscopy do
A
projects an image onto a monitor
- image intensifier can amplify
- allows removal of background images
22
Q
what is another name for fluoroscopy
A
C- arm
- can be foot pedal activated
- mini, large, XL
23
Q
considerations with C-arm
A
specialty drapes
PPE (lead)requires radiolucent table
24
Q
uses for flousocopy
A
angiogram
cholangiogram
retrograde
bone alignment
prosthesis placement
catheter placement
25
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
26
what is angiography
form of xray or fluoroscopy
invasive sterile procedure
visualization of veins and arteries
done in Cath lab
27
selective angiography
morediregct path to Dx
require less concentrated contrast
specialty catheters
28
nonselective angiography
diagnostic exam
requires larger volumes of higher concentrated contrast
29
cardiac catheterization
(with fluoroscopy)
evaluation of heart functions
- visualization of arteries + chambers
diagnose
- CAD
- pulmonary + valve disease
- congenital heart failure
30
what is a coronary artery arteriogram
Cath inserted into the coronary system to check for coronary artery disease
31
left ventriculogram
for ventricular pressure
multi holes in tip to measure chamber pressure + injecting lots of contrast media
32
*ejection fraction*
*% of blood pumped out of ventricle with each heart beat*
55-75% is normal
measures with left ventriculogram
low: indicates cardiomyopathy
33
*what kind of catheter do you use for right ventriculogram*
*swan-ganz catheter*
34
*what do you measure with the swan Ganz catheter*
*pulmonary capillary wedge pressure*
indirectly measure left side of the heart
also indicate pulmonary edema
35
5 common catheter placement locations
femoral - most common
brachial
subclavian
internal jugular
radial
36
there main placement supplies
needle/ cannula combination
guidewires - J most common
specialty catheters
37
*seldinger technique*
easiest entrance to most vessels of the body
*most common is femoral*
38
supplies needed for seldinger technique
xylocaine
11 blade
needle/ cannula set
guidewire
catheter
contrast medium
39
*what case is cholangiogram used*
*cholecystectomy of common bile duct*
40
what clamp secures catheters in ducts
Olsen clamp
41
what is a urogram
used to outline the structures of the urinary system
outliner renal pelvis of kidney
42
*what is another name for intravenous pyelogram (IVP)*
*antegrade pyelogram*
contrast given into vessel in urogram
43
*what is retrograde pyelogram*
*contrast injected in the distal ureter*
44
what is radioisotope imaging
uses radioactive medications to assist
locates tumors
45
2 types of radioisotope imaging
PET (positron emission tomography)
- 3D
scintigraphy
- 2D
46
how does a PET scan work
combines specialized CT and radioisotopic scanning
highlights chemical activity in the brain or body with radioactive medications
47
reasons not to do a PET scan
lengthy and expensive
48
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
49
what is the thing to remember about MRI
*no metal can be in the room*
*uses no ionized radiation*
50
2 forms of energy used to create MRI image
magnetic feild
radio waves
51
how can MRIs be sliced
any direction
52
what kind of contrast medium does an MRI use
non iodine based contrast medium
53
what scan do you use to see bleeding
CT
54
what is ultrasonography
electrically stimulated crystal transducer that creates and recipes ultrasound waves
55
*what frequency of sound waves does ultrasonography go at*
*1-10 million Hz*
56
what is ultrasonography used for
noninvasively examine the heart, blood flow, and abdopelvic cavity
57
what is the benefit of ultrasonography
no radiation- safe for fetus
58
what does doppler ultrasonography do
measures blood flow by transmitting sound of moving RBC
59
*what is the doppler ultrasonography used to check for the tech*
*patency of arterial anastomosis by checking blood flow to limbs*
60
*what part of the doppler ultrasonography is draped*
*probe*
61
echocardiogram (ECG)
2D image of heart through chest wall
maps blood flow
form of ultrasonography
62
what is an echocardiogram called when its dont through an esophageal probe
TEE
63
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
64
what machine is used conjunction with plethysmography
doppler ultrasonography
65
phleborheography
notes changes in venous volume associated with respiration
- measures DVT
66
electrodiagnostic studies
ECG
EEG
EMG
67
ECG (EKG)
deals with heart
help detect forms of heart disease
measures dysrhythmia
68
three types of ECG
placing electrodes
holter monitor -disruptions in rhythm
stress test (grade exercise testing)
69
EEG
see electrical activity of brain
more leads= more info
70
what does EEG diagnose
seizure
tumors
epilepsy
71
EMG
electrical activity of skeletal muscle
inserted through skin to muscle
-diagnose ALS and carpal tunnel
72
interop neuro monitoring
provides immediate electrical nerve velocity feedback from electrons applied to pt extremities
during cranial and spine procedures
73
what is spirometry in pulmonary assessment
obtains info on lung capacity and pressure
tells if you have leak in ventilator system, COPD, ARDS
74
blood gasses
drawn from pt and visually examined in lab
75
*arterial saturation range* (blood gasses)
*96-100%*
76
*venous saturation range* (blood gasses)
*60-85%*
77
*capnography*
part of pulmonary assessment
*what is your arterial level of Co2 during mechanical ventilation*
78
*what is the measure of exhaled Co2 called in capnography*
*end tidal Co2*
79
RBC high and low indicates
high: bone marrow disease
low: anemia
80
hemoglobin high and low indicates
high: dehydration
low: anemia
81
hematocrit high and low indicates
high: dehydration
low: anemia, bleeding, malignancy
82
platelets high and low Indicates
high: too thick
low: DIC
83
WBC high and low indicates
high: leukemia
low: immunosuppressed
84
international normalized ratio high and low indicates
high: increased bleeding
low: increased clotting
85
what do you test on the hematologic studies (blood panel)
RBC
hemoglobin
hematocrit
platelets
luekocytes
international normalized ratio
prothrombin time
partial thromboplastin time
86
*what Is the hematocrit range for adult preggo women*
*30-34%*
87
hematocrit ranges for adult male and female
male: 42-54%
female: 38-46%
88
*whole blood arterial saturation should be his much capacity*
*96-100% of capacity*
89
collection method of urinalysis
simple void
clean catch
sterile
90
what do you take with bacteriologic test
gram stain
91
what does gram stain do
identifies bacteria
quick method to determine initial course of treatment
92
*gram positive stain*
*retains purple- blue stain*
93
*what do you use in gram stain*
*crystal violet, iodine, then alcohol, then safranin*
94
*gram negative stain*
*fades to pink red*
95
culture and sensitivity test
take a "culture" of tissue to identify pathology
determines form of treatment
96
what are aerobic bacteria
found in oxygen
97
what are anaerobic bacteria
live in the absence oxygen
98
*what is a culture test*
*test to find germs that cause infection*
99
*what is a sensitivity test*
*checks to see what type of antibiotic test will treat the best*
100
what is thoracentesis
needle placed in pleural space for analysis of pleura
diagnose cancer or inflammation
- or to remove fluid
101
surgical biopsy
pieces of tissue taken out to diagnose
specimen sent to pathology
102
what is a histological exam
study of tissue
103
what is a cytological exam
study of cells (aspirated fluids)
104
needle biopsy
removal of fluid through a needle with syringe attached
cysts, joints, body cavities, nodes
105
washing and brushing specimens
collection of fluid with cells
washing + brush biopsy
wiping to grab specimen
106
difference between incision and excision biopsy
incision = removing a part of lesion
excision= removing entire lesion
107
*what do you do with permanent sections in biopsy*
*placed in preservative*
108
*what are frozen section biopsy for*
*immediate diagnosis*
not 100% accurate
109
centesis and fluid analysis
needle into body cavity for removal or fluid for diagnostic and therapeutic purposes
110
4 types of centesis and fluid analysis
paracentesis - peritoneal cavity
thoracentesis - pleural space
amniocentesis - abd for pregnancy
pericardiocentesis - pericardial sac
111
what do you do if you lose specimen
do it again
112
Ionizing radiation READ
R- radioactivity
E- exposure
A- absorbed dose
D- dose equivalent
