OR Flashcards
surgical asepsis
separation between sterile and non-sterile areas
several methods to drape the C-arm
plastic drape w/adhesive
snap covers
shower curtain cover
describe the “rainbow position”
c arm is above the patient (like a rainbow)
causes more radiation exposure to the field
for lateral position typically (such as laminectomy)
is it acceptable to have the tube on the top when imaging?
No
radiation safety - when on the bottom - keeps the radiation low to the floor, directed at extremities/feet
What area is of the most concern when considering c-arm position in the OR?
non-shielded areas such as head and neck (cuz of thyroid and brain tissue)
mag mode
pulse mode
intermittent radiation delivered at intervals
snapshot
computer enhanced images
ERCP
endoscopic retrograde cholangiopancreatography
spondylolisthesis - what makes the spine unstable
the “scotty dog” neck - the pars
Luke or Harrington rod
for scoliosis correction
ORIF
open reduction (fx that needs reduced) internal fixation
placing rods and screws typically
PLIF
posterior lumbar internal fixation
patient position for lumbar laminectory
prone, arms above head
patient position for cervical laminectomy
prone, arms tucked
c-arm position for laminectomy
usually lateral
possible AP
Why is a laminectomy performed?
alleviate pain caused by nerve impingement
What is laminectomy
laminae or some disc is removed to reduce nerve pressure
What is spinal fusion
installation of screws and bracket hardware to stop spondylolisthesis or stabilize the spine
ACDF
anterior cervical discectomy fusion
Why do you angle for an AP spine in OR
endplates are not always aligned, disc spaces slightly closed because of lordotic curve in lumbar
How would you overcome spinous processes are not equal in ap spine case?
oblique projection, move tube angle laterally
why is kyphoplasty done?
kyphosis
compression fx
What is kyphoplasty/vertebroplasty
cement inserted into vertebral body to “lift up” the vertebrae
what is considered a closed reduction
non surgical reduction/fix of a fx without cutting the skin, using casts or splints
ilizarov frame/brace
external fixation to hold/reduce a fx, typically for the long bones
rods are typically used for _____ bones
long
How would you fix a femoral neck fx
cannulated screws
ERCP
endoscopic retrograde choloangio-pancreatography
Know the ducts associated with Cholangiogram
common hepatic duct
common bile duct
cystic duct
describe retrograde urography
injecting contrast retrograde from the bladder to the kidneys to see ureters and kidneys
what is patient position for retrograde urography
lithotomy
(supine with legs in abductors)
Define retrograde
against the flow
Patient position for ERCP
LAO
What defines a sterile procedure
one that requires incisions in the skin
surgical attire
in an OR
What procedures are considered non-sterile
GI procedures: endoscopies, ERCP
What is subtraction?
ability to remove bones and such from the picture to better visualize the vessels
What are some procedures that use subtraction?
Vascular
AAA/TAA
IVS filter placement
fistulagram
fem-pop bypass
IVC
inferior vena cava
What does IVC filter placement do?
filter catches blood clots coming from the legs and prevent them from going to the lungs causing a pulmonary embolism
Common name for mobile fluoroscopy unit
C-arm
Two primary parts of a mobile fluoroscopy unit (on either side of the unit)
xray tube
image intensifier/image receptor
Why should the xray tube not be on top (AP position)
to reduce exposure to operator’s head and neck
with the c-arm in the horizontal position, which side should the surgeon stand if they must remain close to the patient? Why?
intensifier side because the exposure is decreased on that side
Name the feature that allows an image to be held on the monitor while also providing
continuous fluoroscopy imaging?
roadmapping
True or False: AEC exposure systems are not feasible with mobile fluoroscopy.
True
True or False: All mobile digital fluoroscopy units include the ability to magnify the image on the
monitor during fluoroscopy
False
List the four essential attributes of the successful radiologic technologist in surgical radiography:
Confidence
Communication
Problem solving
mastery
True or False: the intermittent mode used during mobile fluoroscopy procedures is helpful
during procedures to produce brighter images but results in significantly increased patient
exposure.
false
True or False: The technologist may violate the sterile environment in surgery if he/she is
wearing sterile gloves, mask, and surgical scrubs
false
True or False: The surgeon is responsible to maintain a safe radiation environment for all
personnel in the OR
false
What consists of the practice and procedures to minimize the level of infectious agents present
in the surgical environment?
surgical asepsis
List which parts of a sterile gown are considered sterile
front of the gown from the shoulders to the surgical field, and the arms up to two inches below the elbows
What portion(s) of the OR table is (are) considered sterile?
the top of the sterile drape
List the three measures that can be taken to maintain the sterile field when operating a C-Arm
unit in the surgical suite
Drapes
Cover cassettes/grids
Aware of surroundings/walk forward only
What is the primary advantage to using the “boost” feature during a mobile fluoroscopic
procedure?
creates a brighter image
What are the 3 cardinal rules of radiation protection?
distance
time
shielding
What cardinal rule is the most effective in reducing occupational exposure?
distance
What anatomy is examined during an operative (immediate) cholangiogram?
bile duct from the liver
A radiographic exam of the pelvicalyceal system only during surgery is termed what?
retrograde pyelogram
In what position is the patient placed during retrograde urography?
lithotomy
List an orthopedic procedure that is considered nonsurgical?
closed reduction
List an example of an orthopedic device that is classified as an external fixator
Ilizarov Device
List an orthopedic device that is often used during a hip pinning
screws or nails
What type of device is often used to reduce femoral, tibial, and humeral shaft fractures?
nails and external rods
What type of pathology is addressed through a vertebroplasty?
compression fractures
What is the surgical procedure performed to alleviate pain caused by bony neural impingement
involving the spine?
laminectomy
In what position is the patient placed during most cervical laminectomies?
prone
What are 2 internal fixators commonly used during scoliosis surgery?
fusion screws/hardware
harrington rods
ORIF is the abbreviation for?
Open Reduction Internal Fixation
