CNS, Endocrine and reproductive system Flashcards
Myelogram: Purpose and Contrast
Purpose:
To visualize and examine the spinal cord and its nerve root branches
Contrast is injected into the subarachnoid space
(intrathecal); iodinated, water-soluble contrast
Myelogram: indications and contraindications
Indications *Suspected lesion Herniated disc (most common lesion) Neoplasm Arm or leg numbness, weakness, or pain. Spinal stenosis Infection Inflammation of meninges
Contraindications Increased intracranial pressure Bleeding disorders Contrast allergy Seizures Meningitis Blood in CSF Recent lumbar puncture (within 2 weeks)
Myelogram: procedure
Procedure:
Preliminary films of the spine are done if the patient has not had recent ones.
The radiologist explains the exam to the patient and has the patient sign a consent form for the procedure.
The myelogram tray is prepared
The pt. is prone on the table with pillows under the abdomen
Put a small sponge under the pt’s head (prevents contrast from entering cranium).
The radiologist inserts the needle under fluoro
CSF may be collected and sent to the lab (allowed to drain from connecting tube into vial, never withdrawn)
Contrast is injected, spinal needle removed & images are taken.
Myelogram: supplies
SUPPLIES: Isovue 200- 20 ml (lower osmolality to avoid osmolarity) Disposable myelogram tray Surgical gloves Steri-stat / betadine Syringes Spinal needle 25g
Consent form
Lab requisitions (if samples taken)
Shoulder braces, foot rest/ankle restraints
Grid/cassettes for HRLs
Myelogram: post procedure
The patient is instructed to keep head at least 300 upright for 24-48 hours
Adverse reactions: Mild reactions which may occur during or shortly after injection are: Nausea Vomiting Feeling of warmth Metallic taste Faintness Sweats Headache Dizziness Fever
May have severe headache lasting up to 48 hours.
Lumbar Myelogram
Prone
Puncture at L3-L4
Imaging: PA HRL (may be semi-erect) Also may do AP and/or obliques Correct markers
Cervical Myelogram
Shoulder braces
Pt.’s neck hyper-extended
Puncture: L3-L4 (or at C1-C2 if necessary)
Imaging
HRL/ Swimmer’s HRL
Also may do obliques
Post Myelogram CT
Shows the size, shape and position of the spinal cord and nerve roots
Beneficial for compression injuries, dural tears and leaking CSF.
Parathyroid Gland
Four glands on the posterior thyroid
Regulates calcium level; causes calcium to be drawn from bones if blood levels require it
Pathology
Hyperparathyroidism
Radiographs to check for calcium loss, KUB to demonstrate any renal stones
radiographic presentation: salt and pepper skull, subperiosteal resorption, or brown tumors?
Thymus
Primary organ of lymphatic system
Located in mediastinum between lower border of thyroid and 4th costal cartilage; anterior to trachea and great vessels
Largest at age 2
Atrophies into fat tissue after puberty
Pathology
Abnormal enlargement
Hodgkin’s disease