OR Flashcards by Alyssa Dosch

surgical asepsis

separation between sterile and non-sterile areas

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several methods to drape the C-arm

plastic drape w/adhesive
snap covers
shower curtain cover

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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)

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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

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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)

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mag mode

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pulse mode

intermittent radiation delivered at intervals

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snapshot

computer enhanced images

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ERCP

endoscopic retrograde cholangiopancreatography

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spondylolisthesis - what makes the spine unstable

the “scotty dog” neck - the pars

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Luke or Harrington rod

for scoliosis correction

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ORIF

open reduction (fx that needs reduced) internal fixation

placing rods and screws typically

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PLIF

posterior lumbar internal fixation

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patient position for lumbar laminectory

prone, arms above head

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patient position for cervical laminectomy

prone, arms tucked

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c-arm position for laminectomy

usually lateral
possible AP

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Why is a laminectomy performed?

alleviate pain caused by nerve impingement

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What is laminectomy

laminae or some disc is removed to reduce nerve pressure

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What is spinal fusion

installation of screws and bracket hardware to stop spondylolisthesis or stabilize the spine

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ACDF

anterior cervical discectomy fusion

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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

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How would you overcome spinous processes are not equal in ap spine case?

oblique projection, move tube angle laterally

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why is kyphoplasty done?

kyphosis
compression fx

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What is kyphoplasty/vertebroplasty

cement inserted into vertebral body to “lift up” the vertebrae

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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