IVP Unit Flashcards
What word describes a kidney?
filter
What does a kidney filter?
blood
What is it called when something goes against normal flow?
retrograde
What does IVP stand for?
intravenous pyelogram
During an IVP, does the contrast flow with normal flow or against normal flow?
with
What is an x-ray of the bladder called?
cystogram
What is the tube called that drains urine from the kidney to the bladder?
ureter
If someone has a urinary tract infection, they have an infection of what?
any or all part(s) of the urinary system (kidney, bladder, ureters, urethra)
For an LPO position, which side of the body is elevated?
right side
How many degrees is the body rotated for an oblique view of the kidney?
30°
Which portion of the kidneys is located more posteriorly?
superior portion
Are the kidneys located inside the peritoneum?
no (they are retroperitoneal)
Which kidney is lower in the body?
right (because of liver)
What body part(s) are demonstrated on an IVP?
urinary system
Why might we do an IVP exam?
view structures or look for a stone
Why would we not go ahead with an IVP?
allergy to contrast
renal failure (BUN 8-25 or Creatinine 0.6-1.5)
What are the steps to performing an IVP?
Have pt. empty bladder
Ask pt. about kidney problems/allergies & check labs
Take scout
Start IV
Inject contrast
Take images per protocol
Tomography
Post Void image(s)
What are the steps to performing a cystogram in the x-ray department?
Have pt. empty bladder
Put sheets/towels on table/take supine scout
Have nurse insert catheter into bladder (maintain sterile environment)
Hook up contrast & run it through catheter
Take AP KUB after pt. complains of full bladder (CR is on MSP, 2” below ASIS @ level of the hip)
Any additional images use 10”x12” IR
How is a retrograde cystogram done in the OR?
Urologist inserts a cytoscope through urethra to help him/her catheterize the ureter.
What are standard views for an IVP?
Abdomen KUB
OBL Kidneys @ 30° (CR is 2” lateral from midline toward elevated side @ level of crests)
Bladder Shot (CR is 2” below ASIS on MSP)
What type of organs are kidneys?
glandular
What are 2 functions of the kidneys?
remove waste from blood
maintain fluid/electrolyte balance
secrete substances to regulate blood pressure
What is the “cortex” portion of a kidney?
the outside portion
What is the “medullary” portion of a kidney?
the inside portion
Are the kidneys included in the peritoneum?
no
Which kidney is slightly longer & narrower?
left kidney
When the body is rotated 30° for an LPO of RPO, which kidney lies perpendicular to the IR and which lies parallel to the IR?
lower kidney is perpendicular to IR
upper kidney is parallel to IR
Which portion of the kidney is located more anteriorly?
lower portion
Where do the ureters enter the bladder?
on the sides of the bladder
Where is the hilum of a kidney located?
medial border
What is the hilum (exhilum region)?
general area that is open for entry of blood vessels/nerves/ureters
Calyces are designed to do what?
act as collecting systems for kidney waste
Where is the bladder located?
immediately posterior & superior to pubic symphysis
Where is prostate gland located?
posterior to lower portion of pubic symphysis
What are some indications for an IVP/IVU?
Abdominal masses, renal cysts, renal tumors
urolithiasis (kidney stone)
pyelonephritis (inflammation)
hydronephrosis (fluid build-up)
trauma
pre-operative evaluation
renal hypertension (high BP)
What does retrograde mean?
against the flow
What does antegrade mean?
with the flow
Which cystogram uses a higher concentration of contrast media, retrograde or antegrade?
antegrade
Why do IVP scouts?
visualize kidney positions/size/shape
localize calcifications
assure proper positioning/technique
check GI tract is prepped (no poop)
Why is a PA KUB better than an AP KUB for an IPV?
PA puts ureters closer to IR
In tomography, each “cut” is assigned a number. Which portion of the kidney would have the higher number, the upper pole or lower pole?
lower pole
When giving a child contrast for an IVP, how is the amount of contrast determined?
1cc per 10 lbs of body weight
When doing a double contrast on a child for an IVP, what is used instead of gas crystals?
carbonated soft drink
What are the side effects of IV contrast?
feeling warm/flushed
hives
nausea/vomiting
edema of respiratory membranes
Nearly all life threatening reactions to contrast media occur when?
immediately or within 20 minutes of being injected
What is the initial contrast “blush” of the kidney called?
nephrogram phase
When will the greatest concentration of contrast media be seen?
15-20 minutes after injection
What does the prone position do after contrast has been injected?
helps to fill ureters
What are the breathing instructions for all IVP images?
all exposures are done at the end of expiration
What is another word for post-void?
micturition
What does a post-void IVP/Cystogram image show?
small tumor masses
prostate enlargement
If a patient has a catheter bag, what must be done before starting IVP/Cystograms?
bag must be clamped
How much contrast media concentration is used for a cystogram?
30%
How much contrast media concentration is used for a retrograde IVP?
30%
How much contrast media concentration is used for an antegrade IVP?
50-70%
What does nosocomial mean?
originating in a hospital
How is an Oblique image done for a cystogram?
rotate pt. 40°-60°
CR is 2” superior to pubic symphysis & 2” medial to upper ASIS
extend and abduct uppermost thigh so it doesn’t superimpose on bladder
How is a Lateral done for a cystogram?
True lateral - flex knees
CR is 2” superior to pubic symohysis @ MCP
density may need to be increased if photo-timing or can use an L-5/S-1 spot technique
How is a Voiding Cystogram image done?
Upright or supine
Fluoro or overheads
Rotate pt. 35°-40° degrees
males may use urinal/Females use towels
