Pre-natal Flashcards

1
Q

Radiologic investigation of the nonpregnant uterus, accessory organs, and vagina are denoted by the terms hysterosalpingography, pelvic pneumography, and vaginography.
Each procedure requires the use of a contrast medium and should be carried out under aseptic conditions.

A

Nonpregnant patient

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2
Q

involves the introduction of a radiopaque contrast medium through a uterine cannula. The procedure is performed to determine the size, shape, and position of the uterus and uterine tubes; to delineate lesions such as polyps, submucous tumor masses, or fistulous tracts; and to investigate the patency of the uterine tubes in patients who have been unable to conceive.

A

Hysterosalpingography

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3
Q

which requires the introduction of a gaseous contrast medium directly into the peritoneal cavity, is now rarely performed because of the development of ultrasonic techniques for evaluating the pelvic cavity.

A

Pelvic pneumography

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4
Q

is performed to investigate congenital abnormalities, vaginal fistulae, and other pathologic conditions involving the vagina.

A

Vaginography

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5
Q

Various opaque media are used in examinations of the female genital passages.
The water-soluble contrast media employed for intravenous urography are widely used for hysterosalpingography and vaginography.

A

Constrast media

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6
Q

Preps for intestinal tract

A

I. A non-gas-forming laxative is administered on the preceding evening if the patient is constipated.
2. Before reporting for the examination, the patient receives cleansing enemas until the return flow is clear.
3. The meal preceding the examination is withheld.

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7
Q

Gynecologic examinations should be scheduled approximately __ days after the onset of menstruation. This is the interval during which the endometrium is least congested. More importantly, because this time interval is a few days before ovulation normally occurs, there is little danger of irradiating a recently fertilized ovum.

A

10

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8
Q

To deliver the least possible amount of radiation to the gonads, the radiologist restricts __ and imaging to the __ required for a satisfactory examination.

A

fluoroscopy, minimum

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9
Q

is performed by a physician with spot radiographs made while the patient is in the supine position on a fluoroscopic table. The examination may also be performed by the physician with conventional radiographs obtained using an overhead tube. When fluoroscopy is used, spot radiographs may be the only images obtained

A

Hysterosalpingography

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10
Q

Px prerp for hysterosalpingography

• After irrigation of the vaginal canal, complete emptying of the bladder, and perineal cleansing,
• Adjust the patient in the lithotomy position,
• When a combination table is used,

A

place the patient on the examining table.

with the knees flexed over leg rests.

adjust the patient’s position to permit the IRs to be centered to a point 2 inches (5cm) proximal to the pubic symphysis; 24 X 30 cm IRs are used for all studies and are placed lengthwise.

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11
Q

Evaluation criteria for hysterosalpingography

A

The pelvic region 2 i nches (5 cm) above the pubic symphysis centered on the radiograph
• All contrast media visible, including any “spill” areas
• A short scale of contrast on radiographs

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12
Q

are the terms used to denote radiologic examinations of the female pelvic organs by means of intraperitoneal gas insufflation

A

Pelvic pneumography, gynecography, and pangynecography

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13
Q

is used in the investigation of congenital malformations and pathologic conditions such as vesicovaginal and enterovaginal fistulas. The examination is performed by introducing a contrast medium into the vaginal canal .

A

Vaginography

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14
Q

Because ultrasonography provides visualization of the fetus and placenta with no apparent risk to the patient or fetus, it has become the preferred diagnostic tool for examination of the pregnant female. In some situations, however, certain radiologic examinations are still indicated

A

Pregnant patient

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15
Q

is the demonstration of the fetus in utero. If possible, this examination technique is avoided until after the eighteenth week of gestation because of the danger of radiation-induced fetal malformations.

A

Fetography

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16
Q

are performed to demonstrate the architecture of the maternal pelvis and to compare the size of the fetal head with the size of the maternal bony pelvic outlet.

A

Pelvimetry and fetal cephalometry

17
Q

is the radiographic examination in which the walls of the uterus are investigated to locate the placenta in cases of suspected placenta previa. At one time radiographs were the only means available to detect such conditions.

A

Placentography

18
Q

Radiologic examinations of pregnant patients are performed only when required information __ . In addition to the danger of genetic changes that may result from reproductive cell irradiation is the danger of radiation induced malformations of the developing fetus.

A

can be obtained in no other way

19
Q

Although it is desirable to clear the large bowel of gas and fecal material with a cleansing enema shortly before any radiologic examination, preliminary preparation depends on the?

A

condition of the patient

20
Q

The patient who is in labor or is bleeding because of a placental separation must be treated as an __ and must be under __ by qualified personnel.

A

emergency, constant observation

21
Q

change in the oxygen content of the maternal blood causes the fetus to react quickly by movement. Just before suspension of __ for the exposure, the mother’s blood should be __ by having her inhale deeply __ and then __

A

respiration, hyperaerated, several times, suspend respiration during the inspiration phase.

22
Q

In fetography __ are obtained to demonstrate the __ and __

A

AP or PA and lateral projections, maternal pelvis, developing fetus

23
Q

The following steps are observed in fetography:

• Whenever possible,

• If the prone position cannot be used,

• For the lateral projection,

• Center the perpendicular central ray to the __.

A

situate the patient in a prone position to place the fetus closer to the I R . To accomplish this, place supports under the chest, upper abdomen, and femora.

place the patient supine on the radiographic table with a support under the knees to relieve back strain.

have the patient lie on her side and support the abdomen to be parallel to the table if needed.

abdomen

24
Q

The two projections (AP and lateral) employed in this method of pelvimetry require the use of the __ . This device consists of a metal ruler perforated at centimeter intervals and mounted on a small stand in such a way that it is always parallel to the plane of the J R . The ruler can be rotated in a complete circle and adjusted for height.

A

Colcher-Sussman pelvimeter

25
Q

Px position in ap projection colcher sussman method

A

Px in supine position and center midsagittal plane of body to midline of grid

26
Q

Position part in ap projection colcher-sussman method

Flex the patient’s knees to elevate the fore pelvis,
• Center the horizontal ruler to the gluteal fold at the level of the ischial tuberosities. The tuberosities are easily palpated through the median part of the buttocks.
• Center the IR
• Respiration: After determining that the fetus is quiet,

A

and separate the thighs enough to permit correct placement of the pelvimeter.

If preferred, localize the tuberosities by placing the ruler 10 cm below the superior border of the pubic symphysis.

I.5 inches (3.8 cm) superior to the pubic symphysis.

instruct the patient to suspend respiration at the end of expiration.

27
Q

Central ray in ap projection colcher sussman method

A

Perpendicular to the midpoint of the IR and 1.5 inches (3.8 cm) superior to the pubic symphysis

28
Q

EVALUATION CRITERIA
The following should be clearly demonstrated in ap projection colcher-sussman method:

A

Entire pelvis
• Metal ruler with centimeter markings visible
• Density permitting visualization of all pelvic landmarks and intersecting diameters
• No rotation of the pelvis
• Entire fetal head

29
Q

px position in Lateral projection colcher-sussman method R or L position

A

As px to turn to a lateral position and center midcoronal plane of px body to midline of table

30
Q

Position of part in lat projection colcher-sussman method R or L


• Place a folded sheet or other suitable support under the lower thorax, and adjust the support so that the long axis of the lumbar vertebrae is parallel with the tabletop.

• Turn the ruler lengthwise, and adjust its height to coincide with the midsagittal plane of the patient’s body.
• Place the pelvimeter so that the metal ruler lies within the upper part of the gluteal fold and against the midsacrum

• Respiration:

A

Partially extend the patient’s thighs so that they do not obscure the pubic bones.

Place sandbags under and between the patient’ knee and ankle to immobilize the legs.

Adjust the patient’s body in a true lateral position.

Center the IR at the level of the most prominent point of the greater trochanter

Suspend at the end of expiration.

31
Q

Central ray in lateral projection colcher-sussman method

A

Perpendicular to the most prominent point of greater trochanter

32
Q

Lateral projection colcher-sussman method R or L position
EVALUATION CRITERIA
The following should be clearly demonstrated:

A

• Superimposed hips and femora
• No superimposition of the pubic symphysis by the femurs
• Entire pelvis, sacrum, and coccyx
• Metal ruler with centimeter markings visible
• Density permitting visualization of all pelvic landmarks and intersecting diameters
• Entire fetal head