Pre-natal Flashcards
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.
Nonpregnant patient
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.
Hysterosalpingography
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.
Pelvic pneumography
is performed to investigate congenital abnormalities, vaginal fistulae, and other pathologic conditions involving the vagina.
Vaginography
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.
Constrast media
Preps for intestinal tract
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.
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.
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To deliver the least possible amount of radiation to the gonads, the radiologist restricts __ and imaging to the __ required for a satisfactory examination.
fluoroscopy, minimum
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
Hysterosalpingography
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,
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.
Evaluation criteria for hysterosalpingography
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
are the terms used to denote radiologic examinations of the female pelvic organs by means of intraperitoneal gas insufflation
Pelvic pneumography, gynecography, and pangynecography
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 .
Vaginography
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
Pregnant patient
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.
Fetography
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.
Pelvimetry and fetal cephalometry
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.
Placentography
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.
can be obtained in no other way
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?
condition of the patient
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.
emergency, constant observation
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 __
respiration, hyperaerated, several times, suspend respiration during the inspiration phase.
In fetography __ are obtained to demonstrate the __ and __
AP or PA and lateral projections, maternal pelvis, developing fetus
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 __.
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
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.
Colcher-Sussman pelvimeter
