Specialty Imaging and Venipuncture Flashcards
What is the name of the procedure that examines the CNS structures situated within the vertebral canal?
Myelogram
Most pathology and trauma occur in the ____ and ____ areas of the spine
Cervical and lumbar
What are some of the indications for a myelogram?
- Extrinsic spinal cord compression caused by a herniated disk, bone fragment, cyst or tumor
- Spinal cord swelling resulting from traumatic injury
- Identifies narrowing of subarachnoid space
What are some of the contraindications for a myelogram?
Blood within CSF, arachnoiditis, increased intracranial pressure, recent lumbar puncture
What type of injection is used for a myelogram?
Intrathecal injection
Where is the contrast for a myelogram commonly injected?
L2-L3 or L3-L4 interspace; also at cisterna magna between C1 and occipital bone
What are some common complications of a myelogram?
Headache, nausea/vomiting, seizure, allergic reaction, bleeding, infection
What is the name of the procedure for radiolgraphy of a joint or joints?
Arthogram
What are the most frquent sites for an arthogram to be performed?
- Knee and shoulder
- Hip, wrist and TMJ
What are some common indications for a knee arthogram?
Tears of the joint capsule, menisci or ligatments (trauma); Baker’s cyst (nontrauma)
What are indications for a shoulder arthogram?
- Evaluation of partial or complete tear in rotator cuff of glenoidal labrum
- Persistent pain or weakness
- Frozen shoulder
Where is the injection site for a shoulder arthogram?
- 1/2 inch inferior and lateral to the coracoid process
- Spinal needle is used due to deep location of capsule
What is the name of the radiologic procedure that examines the nonpregnant uterus, accessory organs and vagina?
Hysterosalpangiogram (HSG)
What are some indications for an HSG?
- Size, shape and position of uterus and uterine tubes
- Delinate lesions (polyps, tumor masses or fistulous tracts)
- Patency or uterine tubes
What are some contraindications for an HSG?
Pregnancy, acute pelvic inflammatory disease, active uterine bleeding
The HSG examination should be schedules approx ____ after the onset of menstruation.
7 to 10 days
What position will the patient be placed in to facilitate the flow of contrast during an HSG?
Trendenlenburg
Where should the contrast spill out into when performing an HSG
Peritoneal cavity
How much contrast is used to fill the uterine cavity and how much is needed to fill the uterine tubes?
4 to 5 ml (additional 4 to 5 ml for uterine tube patency)
In order to access an extremity for venipuncture on a patient with a prior mastectomy, what must one have to access the extermity involved in the lymph node removal?
Physician’s order
What happens to the veins when a patient is apprehensive or is cold and fearful of the procedure?
The veins constrict and disappear making venipuncture more difficult
What type of information must one obtain from a patient prior to the veinpuncture procedure?
- Possible allergies
- Current medications
- Prior surgeries to include mastectomy with lymph node involvement
What is the average range for the GFR, BUN and creatinine levels?
GFR = 90 to 130 BUN = 10 to 20 mg/dL Creatinine = 0.05 to 1.2 mg/dL
As the gauge of the needle increases, the diameter of the bore ___.
Decreases
Which is larger an 18 gauge or a 22 gauge needle?
18 gauge
What are the components to a needle?
Hub - part that attaches to syringe
Cannula/shaft - length of needle
Bevel - slanted portion of needle tip
Where are the veins typically located for IV access for use in radiologic examinations?
Anterior forearm, posterior hand, antecubital space
Are you allowed to use the anterior wrist for starting an IV?
No, could damage radial nerve
Feet and legs for IV access require an order on all patients __ years and older
3
When applying the tourniquet, how far above the intended site of puncture must it be positioned?
6 to 8 inches
How much should the BP cuff be inflated if using it to secure a site for venipuncture?
60 to 80 mm/Hg
At what angle should the needle be placed when it is about to enter the skin’s surface?
20 to 30 degrees
How many attempts should be made before the IV team needs to be called?
No more than 3 attempts
What is infiltration/extravasation?
- A process where fluid has passed into the tissue instead of the vein
- The most common cause is needle displacement
What are some symptoms associated with a mild anaphylactic reaction?
Dizziness, shaking, altered taste, itching, pallor, flushing, chills, sweats, rash/hives, nasal stuffiness, swelling eyes/face, anxiety
