Chapter 15 Trauma, mobile, surgical radiography Flashcards
ACL
Anterior cruciate ligament
Arthrodesis
Stiffening of a joint by operative means
Arthropathy
Any disease that affects a joint
Arthroplasty
creation of an artificial joint to correct ankylosis
Asepsis
state of sterility
condition in which living pathogens are absent
Cancellous screw
Orthopedic screw designed to enter and fix porous and spongy bone
Cannulated screw
large screw used for internal fixation of non-displaced fractures of proximal femur
Cardiac pacemaker
an artificial regulator for cardiac rate and rhythm
Cerclage wire
orthopedic wire that tightens around fracture site to reduce shortening of limb
Cesium implants
used of radioactive cesium in the treatment of certain malignancies including prostate cancer
Cholecystectomy
surgical removal of gallbladder
Closed reduction
procedure in which bone fragments are reduced manually without surgical intervention
Cortical screw
narrow orthopedic screw designed to enter and fix cortical bone
CR
closed reduction (cast or traction)
Cystoscope
lighted tubular endoscope used for examination of urinary bladder
DHS
dynamic hip screw
Dynamic compression plate
screw and plate combination used to apply forces through the fracture site;
used commonly for long bone shaft fractures in which stress may be great
ESWL
extracorporeal shock wave lithotripsy
electrohydraulic shock waves used to break apart calcifications in the urinary system
Ex-fix
External fixation
Fracture (orthopedic) table
special OR table used for hip pinnings and other orthopedic procedures to provide traction to the involved limb and allow fluoroscopy to be performed during the procedure
Hip pinning
surgical procedure designed to reduce proximal femoral fractures through the use of various internal fixation devices
HTO
High tibial osteotomy
Illizarov technique
procedure in which a special external fixator is used to lengthen long bones as treatment for severe fracture or congenital deformity
IM nail
intramedullary nail
Interbody bone fusion device
titanium or other alloy cage filled with bone and inserted between the vertebral bodies to maintain disk space height and permit fusion of the intervertebral joint
Intramedullary rod
a flexible or rigid device placed within the medullary cavity to reduce a fracture or stabilize a diseased long bone
Kirschner wire K-wire
unthreaded (smooth) or threaded metallic wire used to reduce fractures of the wrist (carpals) and individual bones of the hands and feet;
also may be used for skeletal traction
Laminectomy
surgical procedure performed to alleviate pain caused by neural impingement by removing an aspect of the lamina in the vertebral arch
Laminectomy can be performed on cervical in an anterior approach (pt is supine) or lumbar regions in a posterior approach (pt is prone).
Laminotomy
surgical opening into one or more laminae of the vertebral arch
Laparoscopic cholecystectomy
use of a special endoscopic device to visualize and assist with surgical removal of the gallbladder
Lithotripsy
crushing of calcification in the renal pelvis, ureter, or urinary bladder by mechanical force or sound waves
Microdiskectomy
microsurgical procedure performed on the spine to remove bony fragments or disk material that may be causing neural impingement
Neural impingement
condition in which bony changes or a herniated disk produces impingement of the spinal nerves that pass through the vertebral arch of the vertebrae
Open reduction
reduction of fracture fragments through surgical intervention
Operative (immediate) cholangiography
Radiographic procedure performed during surgery to visualize and locate undetected stones or obstructions within the biliary ducts
ORIF
Open reduction with internal fixation
PCL
Posterior cruciate ligament
Prosthesis
Fabricated (artificial) substitute for a diseased or missing anatomic part
Reduce
To align two bone fragments in the correct position as treatment for a fracture, as applied in orthopedic medicine
Retrograde urography
a nonfunctional examination of the urinary system during which contrast media is introduced directly retrograde (backward, against the flow) into the pelvicalyceal system via catherization by a urologist during a minor surgical procedure. At least 3 images are obtained. First a scout film. Second is a pyelogram. Third radiograph is a ureterogram.
Semitubular plate
flexible and thin orthopedic plate used to fix and connect fractures
Shower Curtain
an isolation drape that seperates the sterile field from the nonsterile environment; often used to permit the use of C arm fluoroscopy during a hip pinning procedure
Spinal fusion
surgical fusion of one vertebra to another, which stabilizes them following laminectomy or as treatment for a degenerative condition or fracture
Spinal Stenosis
condition caused by degenerative changes that result in enlargement of the facet joints, which often leads to impingement of the spinal nerves that pass by them.
Strike-through
soaking of moisture through a sterile or nonsterile drape, cover, or protective barrier, permitting bacteria to reach sterile areas
THR, THA
Total hip replacement, total hip appliance
TKR, TKA
Total knee replacement, total knee appliance
Total Joint Arthroplasty
the use of artificial joint implants to restore motion and function of a joint-
for example, total hip replacement is common orthopedic procedure performed on patients with degenerative joint disease (e.g. avascular necrosis or proximal femur)
Traction
process of putting a limb, bone, or group of muscles under tension with the use of weights and pulleys to align or immobilize the part
Computer Radiography
well suited for trauma
wide exposure lattitudes
ability to transfer images electronically
Close collimation & accurate centering in trauma
eliminates primary beam interaction w/ artifacts
reduce scatter radiation
Trauma Radiography
performed with conventional overhead tube
mobile (portable units
Types of mobile systems
battery driven, batter operated
standard power, non-motor driven
mobile c arm digital fluoroscopy
common procedures w/ c arm
cholangiography
open/closed fx reduction
hip pinning
C arm image orientation
required each time it is set up for use
Vertical Posteroanterior projection c arm
if patient is supine tube located under patient w/image intensifier on top
minimizes exposure to neck and face
Which C arm position poses up to 100 times more dose to eyes of operator?
Vertical AP Projection C arm
What is the primary source of exposure to fluoroscopy staff?
scatter radiation frompatient
Trauma Horizontal beam w/ questionable spinal injury
Head and neck cannot be moved or elevated
no supportive sponge use
place IR below level of tabletop and move patient to edge of table to avoid cut off of posterior skull from beam divergence
Safety in trauma situations
always raise patient bed rails even if they were not originally up
all equipment returned to original location
no exposure should ever be taken with an unshielded person in the vicinity of primary beam
Alternative Imaging Modalities
Computed Tomography
increase speed
three dimensional reconstruction (useful in assessing skull trauma)
Sonography
Early assessment trauma patients experienced blunt abdominal injury
detect free fluid or blood in abdomen
modality of choice in trauma of female reproductive system
Nuclear Medicine
pulmonary embolus, testicular tortion, and gastrointestinal bleeding
blood flow assessed through radionuclide injection
Angiography
used when study indicates aortic arch trauma
Blowout/tripod fx
Direct blow to the orbit, maxilla, and or zygoma creates fx of orbital floor
Epiphyseal fx
Fracture through epiphyseal plate. Most easily fx sites of long bones in children.
Tuft/burst fx
Comminuted fx if distal phalanx caused by crushing blow to distal finger or thumb.
C arm placement with tube in vertical AP position
can increase OID
Cine Loop images
images recorded in rapid succession while contrast medium is injected and displayed as a moving (cine) image.
snapshot/digital spot mode
activates a digital spot which results in a higher quality computer-enhanced image as compared to held fluoro images.
Digital spot film
acquires a single static radiographic image w/low radiation dose.
.5 mm lead apron
reduces exposure by a factor of 50 or more over the diagnostic x ray energy range
Boost Feature Fluoroscopy
provides brighter image for patient with large body habitus. Also increases radiation (mA) exposure to pt. and surgical team 3-4 x’s that of standard fluoro
Which method is preferred with C arm use AEC or Manual?
AEC
Operative Cholangiography
2-3 images are obtained in slightly different positions. AP, slight RPO, and slight LPO
Three principals when performing trauma or mobile radiography
Two projections 90 degrees to each other
Entire structure or trauma are on IR
Maintain safety of patient, health care providers, and public
