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ACUTE CARE MODULE 2 > Neuro Imaging > Flashcards

Neuro Imaging Flashcards

1
Q

what is the standard slice orientation for neuro imaging

A

transaxial or axial where the L is shown as R as if you’re standing at the patient’s feet

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2
Q

what is an xray

A

short-wavelength EM vibrations that can produce a 2D image

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3
Q

what are x rays used for

A

bony changes, stenosis, and subluxation of the spine

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4
Q

what are the three advantages of an xray

A
  1. inexpensive
  2. readily available
  3. quick to obtain
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5
Q

what are the 2 disadvantages of xray

A
  1. ionizing radiation

2. nonsensitive with many pathologies missing on plain film

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6
Q

what is CT

A

commuted tomography is multiple x rays collected by a computer

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7
Q

what are cardinal signs of an abnormal head CT (3)

A
  1. abnormal tissue density
  2. mass effect from edema/hemorrhage/tumor
  3. ventricular enlargement
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8
Q

what are the two BIGGEST indications for CT

A

highly sensitive for intracranial hemorrhage and acute head trauma/skull fracture

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9
Q

how does a hemorrhage show up on a CT

A

white due to Hb

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10
Q

what is another, but lesser indication for a CT

A

certain brain tumors (meningiomas and gliomas) and cysts

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11
Q

what are the four major advantages of CT

A
  1. more accurate visualization than xray
  2. widely available at low cost
  3. critical care monitoring devices are allowed
  4. excellent bone imaging
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12
Q

what are the three major disadvantages of CT

A
  1. ionizing radiation
  2. acute phase head injuries may be negative for diffuse axonal injury and ischemic CVA
  3. poor resolution and contrast compared to MRI
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13
Q

what can CT not image?

A

diffuse axonal injury and ischemic CVA, especially during acute phase head injury

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14
Q

how can the CT disadvantages apply to PT

A

PT can educate family on inconclusivity of a negative CT result

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15
Q

what is the most commonly evaluated element in MRI

A

hydrogen

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16
Q

what does a T1 weighted MRI tell you

A

anatomic detail typically used to identify lesions (gray matter is gray and white matter is white)

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17
Q

when is a T2 MRI typically used

A

typically used to identify contusions, brain bleeds, changes in CSF, and ventricular volume

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18
Q

how does fluid show up on a T2 MRI

A

bright white

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19
Q

what are the two advantages of MRI

A
  1. no ionizing radiation

2. excellent soft tissue contrast and high resolution

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20
Q

what are the four disadvantages of MRI

A
  1. longer scan times
  2. susceptible to patient movement
  3. will dislodge implants
  4. limited availability and higher cost
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21
Q

what is cerebral angiography (CTA) used for

A

used to detect blockages or narrowing or arteries/veins in the brain, head, or neck with the best visualization of the vascular system

22
Q

how long does a CTA take

A

takes up to 3 hours

23
Q

how does CTA work

A

small capsule containing radiopaque dye released into cerebrum followed by a series of xrays in order to note any obstruction

24
Q

how can a CTA be applied to a patient’s condition

A

it is used to determine stroke extent, size of a tumor, presence of aneurysms, AVMs, and blood flow

25
Q

what are the PT implications for CTA (2)

A
  1. bedrest for approximately 8 hours to ensure proper healing of catheter site
  2. no movement of the catheter site, usually femoral artery
26
Q

what is magnetic resonance angiography (MRA)

A

used to asses vascular anatomy in medium to large vessels without the use of a contrast agent

27
Q

what is an EEG

A

recording of brain activity using electrodes fixed to the scalp

28
Q

where does the electrical activity come from for EEG?

A

inhibitory and excitatory postsynaptic potential of pyramidal cells

29
Q

what are the advantages of an EEG

A

noninvasive, painless, and inexpensive

30
Q

what four things can an EEG assist in diagnosing

A
  1. seizure disorders involving tumors and head injury
  2. psych and sleep disorders
  3. metabolic/degenerative disorders of the brain
  4. CONFIRM DEATH
31
Q

what is the sole PT implication for EEGs

A

activity may be withheld or performed based on orders

32
Q

what is myelography

A

injection of contrast into subarachnoid to enhance dx of spinal nerve injury, vertebral displacement, herniation, cord compression, or cord tumor

33
Q

what are the PT implications for myelography

A

complaint of headache, back spasm, and N/V

34
Q

what does nuclear imaging do

A

images the spatial distribution of radioactive isotopes

35
Q

what are types of nuclear imaging

A

bone scan, PET, SPECT scans

36
Q

what are examples of things that will elicit an image on nuclear imaging

A

cell swelling, edema, and tumor growth

37
Q

what does a PET scan tell you

A

brain hemodynamics and metabolic activity

also the most common nuclear imaging device for neuro patients

38
Q

T/F: a PET scan can tell if a tumor is benign or malignant

A

true

39
Q

what is PET mainly used for

A

dx, staging, and evaluation of treatment of brain tumors

40
Q

what is the advantage of a PET scan

A

can perform hemodynamic, chemical, and thus functional imaging of cerebral blood flow and glucose metabolism

41
Q

what are the three disadvantages of a PET scan

A
  1. high cost
  2. radiation
  3. limited access
42
Q

what does ultrasound imaging do

A

assesses blood flow direction, velocity, and magnitude using the doppler effect against RBCs

43
Q

what are the advantages of ultrasound doppler

A

noninvasive, portable, cheap, and high intrinsic spatial resolution

44
Q

what is the disadvantage of ultrasound doppler

A

poor soft tissue contrast

45
Q

what are the two types of ultrasound doppler

A
  1. transcranial doppler sonography

2. carotid noninvasives

46
Q

what is transcranial doppler sonography

A

determines velocity of blood in cerebral or basilar arteries - over thin cranial bones or their gaps

47
Q

what is carotid noninvasives

A

assesses severity of carotid occlusion and stenosis - over the common, internal, and external carotids

48
Q

what is the order of imaging for a spinal trauma

A
  1. plain film x ray
  2. CT if fracture is suspected
  3. MRI if ligamentous/disc/soft tissue involvement suspicion
49
Q

what imaging is best for progressive loss of neuro function

A

MRI has the greatest ability to differentiate spinal cord primary disorder and extradural defect - but we may also see spinal myelography

50
Q

what is the best imaging for brain/skull trauma

A

non contrast CT or MRI in the first 24 hours, but CT is imaging of choice due to compatibility with medical equipment and sensitivity for skull fractures

51
Q

what is the best imaging for a CVA

A
  1. CT very sensitive for acute ICH

2. MRI is more accurate for acute ischemic infarct

52
Q

what is the best imaging for a brain tumor

A
  1. MRI
  2. CT with contrast (if MRI not available/indicated)
  3. PET scan

ACUTE CARE MODULE 2 (9 decks)

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