IVP Unit

Question 1

What word describes a kidney?

Answer 1

filter

Question 2

What does a kidney filter?

Answer 2

blood

Question 3

What is it called when something goes against normal flow?

Answer 3

retrograde

Question 4

What does IVP stand for?

Answer 4

intravenous pyelogram

Question 5

During an IVP, does the contrast flow with normal flow or against normal flow?

Answer 5

with

Question 6

What is an x-ray of the bladder called?

Answer 6

cystogram

Question 7

What is the tube called that drains urine from the kidney to the bladder?

Answer 7

ureter

Question 8

If someone has a urinary tract infection, they have an infection of what?

Answer 8

any or all part(s) of the urinary system (kidney, bladder, ureters, urethra)

Question 9

For an LPO position, which side of the body is elevated?

Answer 9

right side

Question 10

How many degrees is the body rotated for an oblique view of the kidney?

Answer 10

30°

Question 11

Which portion of the kidneys is located more posteriorly?

Answer 11

superior portion

Question 12

Are the kidneys located inside the peritoneum?

Answer 12

no (they are retroperitoneal)

Question 13

Which kidney is lower in the body?

Answer 13

right (because of liver)

Question 14

What body part(s) are demonstrated on an IVP?

Answer 14

urinary system

Question 15

Why might we do an IVP exam?

Answer 15

view structures or look for a stone

Question 16

Why would we not go ahead with an IVP?

Answer 16

allergy to contrast

renal failure (BUN 8-25 or Creatinine 0.6-1.5)

Question 17

What are the steps to performing an IVP?

Answer 17

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)

Question 18

What are the steps to performing a cystogram in the x-ray department?

Answer 18

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

Question 19

How is a retrograde cystogram done in the OR?

Answer 19

Urologist inserts a cytoscope through urethra to help him/her catheterize the ureter.

Question 20

What are standard views for an IVP?

Answer 20

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)

Question 21

What type of organs are kidneys?

Answer 21

glandular

Question 22

What are 2 functions of the kidneys?

Answer 22

remove waste from blood

maintain fluid/electrolyte balance

secrete substances to regulate blood pressure

Question 23

What is the “cortex” portion of a kidney?

Answer 23

the outside portion

Question 24

What is the “medullary” portion of a kidney?

Answer 24

the inside portion

Question 25

Are the kidneys included in the peritoneum?

Answer 25

no

Question 26

Which kidney is slightly longer & narrower?

Answer 26

left kidney

Question 27

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?

Answer 27

lower kidney is perpendicular to IR upper kidney is parallel to IR

Question 28

Which portion of the kidney is located more anteriorly?

Answer 28

lower portion

Question 29

Where do the ureters enter the bladder?

Answer 29

on the sides of the bladder

Question 30

Where is the hilum of a kidney located?

Answer 30

medial border

Question 31

What is the hilum (exhilum region)?

Answer 31

general area that is open for entry of blood vessels/nerves/ureters

Question 32

Calyces are designed to do what?

Answer 32

act as collecting systems for kidney waste

Question 33

Where is the bladder located?

Answer 33

immediately posterior & superior to pubic symphysis

Question 34

Where is prostate gland located?

Answer 34

posterior to lower portion of pubic symphysis

Question 35

What are some indications for an IVP/IVU?

Answer 35

Abdominal masses, renal cysts, renal tumors urolithiasis (kidney stone) pyelonephritis (inflammation) hydronephrosis (fluid build-up) trauma pre-operative evaluation renal hypertension (high BP)

Question 36

What does retrograde mean?

Answer 36

against the flow

Question 37

What does antegrade mean?

Answer 37

with the flow

Question 38

Which cystogram uses a higher concentration of contrast media, retrograde or antegrade?

Answer 38

antegrade

Question 39

Why do IVP scouts?

Answer 39

visualize kidney positions/size/shape localize calcifications assure proper positioning/technique check GI tract is prepped (no poop)

Question 40

Why is a PA KUB better than an AP KUB for an IPV?

Answer 40

PA puts ureters closer to IR

Question 41

In tomography, each "cut" is assigned a number. Which portion of the kidney would have the higher number, the upper pole or lower pole?

Answer 41

lower pole

Question 42

When giving a child contrast for an IVP, how is the amount of contrast determined?

Answer 42

1cc per 10 lbs of body weight

Question 43

When doing a double contrast on a child for an IVP, what is used instead of gas crystals?

Answer 43

carbonated soft drink

Question 44

What are the side effects of IV contrast?

Answer 44

feeling warm/flushed hives nausea/vomiting edema of respiratory membranes

Question 45

Nearly all life threatening reactions to contrast media occur when?

Answer 45

immediately or within 20 minutes of being injected

Question 46

What is the initial contrast "blush" of the kidney called?

Answer 46

nephrogram phase

Question 47

When will the greatest concentration of contrast media be seen?

Answer 47

15-20 minutes after injection

Question 48

What does the prone position do after contrast has been injected?

Answer 48

helps to fill ureters

Question 49

What are the breathing instructions for all IVP images?

Answer 49

all exposures are done at the end of expiration

Question 50

What is another word for post-void?

Answer 50

micturition

Question 51

What does a post-void IVP/Cystogram image show?

Answer 51

small tumor masses prostate enlargement

Question 52

If a patient has a catheter bag, what must be done before starting IVP/Cystograms?

Answer 52

bag must be clamped

Question 53

How much contrast media concentration is used for a cystogram?

Answer 53

30%

Question 54

How much contrast media concentration is used for a retrograde IVP?

Answer 54

30%

Question 55

How much contrast media concentration is used for an antegrade IVP?

Answer 55

50-70%

Question 56

What does nosocomial mean?

Answer 56

originating in a hospital

Question 57

How is an Oblique image done for a cystogram?

Answer 57

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

Question 58

How is a Lateral done for a cystogram?

Answer 58

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

Question 59

How is a Voiding Cystogram image done?

Answer 59

Upright or supine Fluoro or overheads Rotate pt. 35°-40° degrees males may use urinal/Females use towels