Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Rad Pro 3 > Interventional radiography > Flashcards

Interventional radiography Flashcards

1
Q

What is this describing?

General term referring to radiologic examination of vascular structures after the introduction of a contrast medium

A

Angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Arteriography?

A

Imaging of the arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Venography?

A

Imaging of the veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who are the people present on the angiography team?

A

-Interventional Radiologist
-Scrub Technologist, Nurse, or Certified Surgical Technologist (CST)
-Circulating Technologist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the technologists’ responsibilities in angiography?

A

-Equipment Operation
-Inventory Management
-Patient Prep
-Scrub Tech!!
-Circulating Tech!!
-Documentation
-Sterile Tray Preparation
-Adding catheters and wires to tray as requested

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What equipment is present in an angiography suite?

A

1.Digital Flouro (Single or Biplane)
2.Anaesthesia Equipment (O2, Blood Pressure, HR, ECG)
3.Monitor: Over sedation, Hemorrhage, Anaphylaxis
4.Ultrasound
5.Infusion Devices – IVAC pump or IV poles (heparinized saline)
6.Power Injector

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why do we have a kettle in the angiography suite?

A

Have to shave catheter and will have to put it under the steam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 2 types of digital fluoro equipment?

A
  1. Single Plane
  2. Biplane Fluoro
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T/F

Most angio suites have single plane flouro equipment

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of detector does a single plane flouro machine have?

A

Flat panel detector

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the advantages of using Biplane Fluoro?

A

-Acquire AP and lateral images simultaneously
-Safer for patient because less contrast needed

-Doesn’t save dose but saves time
-Multiple runs with just one contrast injection-Better for the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of flouro machine do most neuro suites have?

A

Bi-plane flouro machines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long is a single plane flouro machine?

A

16”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F

A single plane flouro machine has everything other than the head.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F

A single plane flouro machine can go around 360 degrees

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What machine is this showing?

A

An automatic injector

-Has to be primed
A: 100% contrast
B: Why is there two?: Cannot use 100% so we can mix the contrast
-i.e. half contrast half saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most Diagnostic Angiography has been replaced with what?

A

CTA
-An example is a GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does CTA and angiography work together? (don’t memorize, just understand)

A

Once the pathology has been found using CTA, the patient is brought to the angio suite for intervention (embolization to stop the bleed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the benefits of interventional angiography?

A

-Less expensive than traditional surgical procedures
-Less invasive than traditional surgical procedures
-Shorter hospital stays
-Shorter recovery time
-Alternative for nonsurgical candidates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the indications for interventional angiography?

A

-Identify anatomy (anomalies) or pathology of the blood vessels
-Stenosis
-Occlusion
-Aneurysm
-AVM = Arterial Venous Malformation
-Bleeds
-Tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is stenosis?

A

narrowing of a vessel; usually due to atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an occlusion?

A

blockage of a vessel; often caused by atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is Right renal stenosis more common?

A

More common because it is longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the treatments for tumours within the vessels?

A
  1. Chemoembolization
  2. Pre-op surgical removal of tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is Chemoembolization?

A

Catheter right to a tumour filled with chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What equipment is needed for sugeries of the cerebrovascular system?

A

Needles
Sheaths
Wires
Catheters
Dilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

T/F

The smaller the gauge, the bigger the needle

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What percentage of an inch is an 18g needle?

A

18g = 1/18 of an inch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

For vascular structures, what gauge is used?

A

18-19g typically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What needle method is used for venous access?

A

Single wall for venous access

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What needle method is used for arterial access?

A

Double walled for arterial access (inner stylet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a Micro puncture?

A

A 21 gauge or less needle injected which reduces the vessel trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the types of non vascular needles:

A

Chiba
Spinal needle
Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describe a chiba needle:

A

Thin walled with inner stylet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the gauge used for a chiba needle?

A

18-25g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How long is a chiba needle?

A

10-20 cm long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Describe a Spinal Needle:

A

Thicker wall and smaller inner lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe a Biopsy needle:

A

Has a loaded gun, increased capability of cutting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How many millimeters are the sheath’s inner diameter?

A

0.33 mm=1 FR (inner diameter)

40
Q

When are sheaths used?

A

Used when multiple catheter exchanges are expected to protect the tissue and clot formation

41
Q

What is the size of a sheath determined by?

A

Determined by the inner diameter (5 French sheath is used with a 5 French catheter)

42
Q

How long is a sheath in cm?

A

10-90 cm in length

43
Q

What is the purpose of the backbleed valve in a sheath?

A

To prevent blood loss during catheter or wire manipulation

44
Q

What is used in the back bleed to prevent clot formation?

A

Herborized saline in the back bleed valve-to prevent clots

45
Q

How many drips per minute of saline is given into the back bleed?

A

15-20 drips per minute

46
Q

What structure is positioned before the catheter is inserted? Why?

A

Guide wire positioned first-reduces possibility of complications

47
Q

What structure is inserted over the guide wire?

A

Catheter inserted over guidewire

48
Q

How long should the guide wire be?

A

Should be at least 10 cm longer than catheter for exchanges

49
Q

What are the three types of guide wires?

A

-Steerable
-non-steerable
-hydrophilic (slippery)

50
Q

How do you know you are in the femoral artery?

A

If the blood is spurting out quickly (pulsatile)

51
Q

How do we get the J wire to go through the guide wire?

A

Push the blue to the tip and it straightens the J

52
Q

Once you are in right femoral artery, what happens when the J wire gets through the needle?

A

It becomes a J again and will bounce off the wall and not puncture

53
Q

What happens if the straight needle goes through the femoral wall?

A

Creates a dissection

54
Q

What are the four Puncture methods into the femoral artery?

A

1.Seldinger (Percutaneous)
2.Modified Seldinger
3.Cut Down Method
4.Translumbar

55
Q

What puncture method is used currently?

A

Modified seldinger

56
Q

When is the cut down method used?

A

Used by vascular surgeons for the abdomen aneurysm-EVARs (endovascular aneurysm repair)

Should not see this method unless you are in the OR

57
Q

T/F

The translumbar method is not commonly done

A

True

58
Q

Describe the Seldinger Technique

A

1.Vertical needle and puncture through both the anterior and posterior wall of the femoral artery
2.Pull back until they get blood squirting out

59
Q

T/F

The Femoral artery or vein can be used with the Modified Seldinger Technique

A

True
(Easily palpated and accessible. Relatively large and compressible-femoral head below puncture site)

60
Q

What type of approach is most common when using the Modified Seldinger Technique?

A

Retrograde approach most common for artery

61
Q

Where is the femoral vein located in relation to the femoral artery?

A

Femoral vein is 0.5 cm medial to the femoral artery

62
Q

Where do you palpate for the femoral vein and artery?

A

Both are found by palpating at the crease of the hip

63
Q

What artery is becoming the norm for cardiac catheterization?

A

Radial artery

64
Q

What happens if you let go of the guide wire with the femoral artery?

A

It pushes back out

65
Q

What happens if you let go of the guide wire with the femoral vein?

A

It goes to the right side of the heart and is pulled inwards

66
Q

Watch the following video:

A

https://www.youtube.com/watch?v=LChKL2E95jE

67
Q

Describe the Procedure for the Modified Seldinger technique:

A

1.Groin is prepped and draped
2.Modified Seldinger technique with needle (puncture femoral artery)
3.Stylet of the needle is removed
4.J-wire is pushed through needle into vessel-Wipe the wire
5.Needle pulled out leaving wire in vessel
6.Sheath inserted over wire to protect vessel during multiple catheter exchanges
7.Sheath connected to heparinized saline
8.J-wire removed and replaced with specific wire to get into desired structure or leave that one in
9.Catheter placed over wire
10.Wire removed
11.Injection performed of vessel

68
Q

Who preps the patient’s groin in a modified Seldinger technique?

A

Done by the dirty tech

69
Q

Who preforms the iodine and chlorohexidine rub in a modified Seldinger technique?

A

Clean tech

70
Q

What degree of insertion is the needle at for a modified seldinger technique?

A

–Needle on 45 degree angle

71
Q

T/F

The J wire should be able to flow free inside a good distance initially.

A

True

72
Q

What happens to the vessel after the cut down method?

A

Vessel is sutured after

73
Q

What other modality is used for the modified seldinger?

A

Ultrasound guidance with the Modified Seldinger

74
Q

What room preparation is done prior to the patient’s arrival for an interventional proceedure?

A

1.Enter patient demographics
2.Check crash cart supplies / O2 and suction
3.Set exposure technique
4.Load injector if needed
5.Obtain and setup sterile procedure tray /catheters, guidewires, and sheath

75
Q

What is the patient prep starting the night prior for an interventional procedure?

A

NPO

76
Q

What is the patient prep prior to an interventional procedure?

A

1.History taken
2.Procedure explained in detail
3.Consent signed with knowledge of risks
4.Patient connected to ECG, O2, SAT
5.Shave groin area before prepping skin
6.Iodine and Chlorhexidine wash
7.Drape patient and equipment
8.CLEAN TECH > scrub in, prep & drape site
9.DIRTY TECH > ready to image / assist as needed (get supplies)

77
Q

What history needs to be taken from the patient prior to an interventional procedure?

A

Meds, allergies, renal function, clotting Creatinine, INR(international normalized ratio), PTT (Partial thromboplastin time)

78
Q

T/F

In an interventional procedure, we may image all phases (arterial, capillary, venous)

A

True

79
Q

What phase; arterial or venous phase, requires a faster frame rate?

A

Arterial phase requires faster frame rate

80
Q

How long is the frame rate for an arterial phase in cerebral imaging?

A

Typically requires 7-10 seconds for cerebral imaging (mask before contrast + all 3 phases)

81
Q

What are the branches that come off the aortic arch?

A

BCT, then LCC then L SC

82
Q

What are the complications of angiography in interventional radiography?

A

1.Infection at site
2.Anaphylactic Shock
3.Dissection of vessel
4.Hemorrhage
5.Thrombus
6.Contrast Induced Nephropathy (CIN)
7.DEATH !!

83
Q

What is a dissection of a vessel?

A

–False aneurysm-blood runs through the wall of the vessel instead of the center
–Could cause death

84
Q

T/F

Vasospasm increases transit time in angiography

A

True

85
Q

T/F

AVM increases transit time in angiography.

A

False; AVM decreases transit time in angiography

86
Q

T/F. Why or why not?

Imaging starts prior to contrast injection in angiography.

A

True; so that mask can be applied for DSA

87
Q

What is the Transit time?

A

Time it takes to get from arterial to venous circulation

88
Q

What is the procedure for post angiogram-Femoral access?

A

1.Pressure on site (min 20 minutes for femoral art.)
2.Check for pedal pulses
3. PACU or day surgery
4.Lie flat at least 4 hours to ensure clot/seal
5.Vascular closure devices

89
Q

Why we check pedal pulse after a femoral artery procedure?

A

To make sure the vessel is not compromised

90
Q

T/F

If you don’t compress the femoral artery properly it can bruise and take longer

A

True

91
Q

How do you demonstrate the aortic arch?

A

-45° LAO or RPO
-C-arm obliqued rather than patient

92
Q

What is the top left phase showing?

A

Phase 1: Arterial phase

93
Q

What is the top right phase showing?

A

Phase 2: Capillary phase

94
Q

How long is the exposure for an angiogram?

A

Exposure for 7-10 seconds

95
Q

What is the bottom left phase showing?

A

Phase 3: Venous stage

96
Q

What are the vascular suture devices?

A
  1. Reduce compression time and allow patient to ambulate faster
  2. Collagen plug, sealant gel, suture

Rad Pro 3 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions