Quiz 4

Question 1

What is lymphography?

Answer 1

the radiologic exam of the lymph vessels and nodes after they have been opacified by an injected oil based contrast media

Question 2

What is a lymphadenography?

Answer 2

a radiographic study of the lymph nodes performed 24 hours after the injection

Question 3

What is a lymphangiography?

Answer 3

a lymphatic radiographic study of the lymph vessels carried out within one hour after the injection of the contrast media

Question 4

What is an indication?

Answer 4

the reason why we are doing the test

Question 5

What are the indications for lymphography?

Answer 5

1) assess the clinical extent of lymphoma
2) staging of radiation treatment
3) obstruction or other impairment of the lymphatic system
4) locating nodes for biopsy or surgical removal

Question 6

What is a contraindication?

Answer 6

reason why you’re not doing an exam

Question 7

What are contraindications of lymphography?

Answer 7

1) sensitivity to the vital dye, contrast media or local anesthetic
2) respiratory insufficiency
3) concurrent radiation therapy to the lungs

Question 8

Who gets the informed consent signed?

Answer 8

the radiologist only

Question 9

How long does the patient need to be NPO of solid foods prior to the procedure, although clear liquids are permitted.

Answer 9

8 hours

Question 10

What kind of scout is taken prior to the procedure?

Answer 10

chest to assess the lungs

Question 11

Due to the injection do vital dye, the patient may void what color tinted urine and may see some discoloration of the skin on the foot and along the course of the lymphatic vessels?

Answer 11

Blue

Question 12

What are the four colors of vital dye?

Answer 12

-Patent Blue V
-Evans Blue
-Brilliant Blue GFF
-Direct Sky Blue

Question 13

What are the four colors of vital dye?

Answer 13

-Patent Blue V
-Evans Blue
-Brilliant Blue GFF
-Direct Sky Blue

Question 14

How much blue dye is injected between the toes?

Answer 14

.25 to .50 mL

Question 15

How much blue dye is injected between the toes?

Answer 15

.25 to .50 mL

Question 16

How long should it take for the dye to visualize the lymphatic vessels?

Answer 16

15 minutes

Question 17

How is incision made on the dorsum of the foot to locate the dye filled lymphatic?

Answer 17

longitudinal

Question 18

How many sutures are placed around the vessel?

Answer 18

2

Question 19

The lymphography needle is advanced what side up into the lumen?

Answer 19

bevel

Question 20

Why is normal saline injected slowly into the vessel?

Answer 20

it dilates it

Question 21

How long is oil contrast media slowly injected into the vessel?

Answer 21

30 to 45 minute period

Question 22

What radiographs are taken after about one minutes of the injection time to ensure that the contrast media is a lymphatic vessel?

Answer 22

Foot and Ankle area

Question 23

What kind of contrast media is used in lympoangiogram?

Answer 23

oil-based contrast

Question 24

If the contrast is too thick, what might you have to do to it?

Answer 24

warm it up

Question 25

How long does ethiodol remain in the lymph vessels for after injection?

Answer 25

up to three to four hours

Question 26

How long does ethiodol remain in the nodes after injection?

Answer 26

for periods of three to four weeks

Question 27

How long may abnormal nodes retain the contrast media?

Answer 27

several months

Question 28

After how long are the lymph nodes best demonstrated post contrast media?

Answer 28

24 hours

Question 29

What is the recommended dose per lower extremity for an adult?

Answer 29

6 to 8 mL

Question 30

What is the recommended setting at a rate of?

Answer 30

0.1 to 0.2 mL/minutes

Question 31

How long is the total injection time approximately?

Answer 31

30 to 45 minutes

Question 32

What are routine radiographs?

Answer 32

-Lower extremities -AP Pelvis -AP Abdomen -RPO/LPO Abdomen

Question 33

What are optional radiographs?

Answer 33

-Lateral view of the Abdomen -AP Chest

Question 34

What is post procedural care?

Answer 34

The needle is removed, the cut sutured and antibiotic ointment applied

Question 35

How long after are the sutures removed?

Answer 35

5 to 7 days

Question 36

What are complications?

Answer 36

1) Contrast media reactions 2) Pain and possible vessel rupture 3) pulmonary cerebral or hepatic emboli 4) infection at the injection site may occur if sterile technique is not maintained

Question 37

When are vascular obstructions best visualized?

Answer 37

On the initial set of films (Day 1)

Question 38

What kind of syringe is used?

Answer 38

Tuberculin Syringe

Question 39

What is arthography?

Answer 39

a contrast media study of synovial joints and related soft tissue structures

Question 40

What joints are studied in arthrography?

Answer 40

hip, knee, ankle, shoulder, elbow, wrist, and TMJ

Question 41

What is the purpose of knee arthrograms?

Answer 41

performed to demonstrated and assess the knee joint and associated soft tissue structures for pathology

Question 42

What are knee arthrography indications?

Answer 42

-tears of the joint capsule -menisci or ligaments maybe caused by trauma

Question 43

What are knee arthrography contraindications?

Answer 43

known to be allergic to iodine based contrast medium or local anesthetics

Question 44

What is patient prep for knee arthrography?

Answer 44

-procedure explained thoroughly to patient -Informed consent signed -Patient advised of any complications that may occur

Question 45

How much positive contrast medium is drawn up for injection?

Answer 45

5mL with 10 mL syringe and an 18 gauge needle

Question 46

The physician injects the skin, underlying tissues and joint capsule with local anesthetic using what kind of syringe and needle?

Answer 46

a 10 mL syringe and a 21 or 25 gauge needle

Question 47

Where is the injection usually injected?

Answer 47

in the medial aspect of the knee

Question 48

What color is normal knee joint fluid?

Answer 48

clear and tinged yellow

Question 49

What color is abnormal knee joint fluid?

Answer 49

cloudy and should be sent to the lab for assessment

Question 50

What is injected after the knee joint fluid is aspirated?

Answer 50

the positive contrast injected through the 20 gauge needle

Question 51

If the knee arthrography is dual contrast what do you need?

Answer 51

50mL syringe is used to inject negative contrast

Question 52

Why is an ace bandage wrapped around the distal femur?

Answer 52

Collapse/dissolve the area of the area of the suprapatellar bursae

Question 53

What kind of contrast media is used for knee arthrography?

Answer 53

radiolucent medium or radiopaque water soluble medium or combo of both

Question 54

What kind of contrast study is the method of choice?

Answer 54

Dual

Question 55

What are three kinds of negative medium can be used?

Answer 55

Carbon dioxide, oxygen, room air

Question 56

Why after the medium injected is the knee flexed?

Answer 56

produces a thin even coating of the soft tissue structures with the positive medium

Question 57

What technologist images are taken for knee arthrography?

Answer 57

AP and Lateral to demonstrate the entire articular capsule by the combination of negative and positive contrast media

Question 58

Why is shoulder arthrography done?

Answer 58

to demonstrate the joint capsule, rotator cuff, the long tendon of the biceps muscle and the articular cartilage

Question 59

How much contrast is used for a single contrast study for shoulder arthrography?

Answer 59

10-12 mL of positive contrast

Question 60

How much contrast is used for a double contrast study for shoulder arthrography?

Answer 60

3 to 4 mL of positive and 10/12 mL of negative contrast

Question 61

What are the routine radiographs are suggested images?

Answer 61

AP projections with internal and external rotations; and a glenoid fossa, transaxillary or intertubcular groove projection