Specialty Imaging and Venipuncture

Question 1

What is the name of the procedure that examines the CNS structures situated within the vertebral canal?

Answer 1

Myelogram

Question 2

Most pathology and trauma occur in the ____ and ____ areas of the spine

Answer 2

Cervical and lumbar

Question 3

What are some of the indications for a myelogram?

Answer 3

• 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

Question 4

What are some of the contraindications for a myelogram?

Answer 4

Blood within CSF, arachnoiditis, increased intracranial pressure, recent lumbar puncture

Question 5

What type of injection is used for a myelogram?

Answer 5

Intrathecal injection

Question 6

Where is the contrast for a myelogram commonly injected?

Answer 6

L2-L3 or L3-L4 interspace; also at cisterna magna between C1 and occipital bone

Question 7

What are some common complications of a myelogram?

Answer 7

Headache, nausea/vomiting, seizure, allergic reaction, bleeding, infection

Question 8

What is the name of the procedure for radiolgraphy of a joint or joints?

Answer 8

Arthogram

Question 9

What are the most frquent sites for an arthogram to be performed?

Answer 9

• Knee and shoulder

- Hip, wrist and TMJ

Question 10

What are some common indications for a knee arthogram?

Answer 10

Tears of the joint capsule, menisci or ligatments (trauma); Baker’s cyst (nontrauma)

Question 11

What are indications for a shoulder arthogram?

Answer 11

• Evaluation of partial or complete tear in rotator cuff of glenoidal labrum
• Persistent pain or weakness
• Frozen shoulder

Question 12

Where is the injection site for a shoulder arthogram?

Answer 12

• 1/2 inch inferior and lateral to the coracoid process

- Spinal needle is used due to deep location of capsule

Question 13

What is the name of the radiologic procedure that examines the nonpregnant uterus, accessory organs and vagina?

Answer 13

Hysterosalpangiogram (HSG)

Question 14

What are some indications for an HSG?

Answer 14

• Size, shape and position of uterus and uterine tubes
• Delinate lesions (polyps, tumor masses or fistulous tracts)
• Patency or uterine tubes

Question 15

What are some contraindications for an HSG?

Answer 15

Pregnancy, acute pelvic inflammatory disease, active uterine bleeding

Question 16

The HSG examination should be schedules approx ____ after the onset of menstruation.

Answer 16

7 to 10 days

Question 17

What position will the patient be placed in to facilitate the flow of contrast during an HSG?

Answer 17

Trendenlenburg

Question 18

Where should the contrast spill out into when performing an HSG

Answer 18

Peritoneal cavity

Question 19

How much contrast is used to fill the uterine cavity and how much is needed to fill the uterine tubes?

Answer 19

4 to 5 ml (additional 4 to 5 ml for uterine tube patency)

Question 20

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?

Answer 20

Physician’s order

Question 21

What happens to the veins when a patient is apprehensive or is cold and fearful of the procedure?

Answer 21

The veins constrict and disappear making venipuncture more difficult

Question 22

What type of information must one obtain from a patient prior to the veinpuncture procedure?

Answer 22

• Possible allergies
• Current medications
• Prior surgeries to include mastectomy with lymph node involvement

Question 23

What is the average range for the GFR, BUN and creatinine levels?

Answer 23

GFR = 90 to 130
BUN = 10 to 20 mg/dL
Creatinine = 0.05 to 1.2 mg/dL

Question 24

As the gauge of the needle increases, the diameter of the bore ___.

Answer 24

Decreases

Question 25

Which is larger an 18 gauge or a 22 gauge needle?

Answer 25

18 gauge

Question 26

What are the components to a needle?

Answer 26

Hub - part that attaches to syringe
Cannula/shaft - length of needle
Bevel - slanted portion of needle tip

Question 27

Where are the veins typically located for IV access for use in radiologic examinations?

Answer 27

Anterior forearm, posterior hand, antecubital space

Question 28

Are you allowed to use the anterior wrist for starting an IV?

Answer 28

No, could damage radial nerve

Question 29

Feet and legs for IV access require an order on all patients __ years and older

Answer 29

3

Question 30

When applying the tourniquet, how far above the intended site of puncture must it be positioned?

Answer 30

6 to 8 inches

Question 31

How much should the BP cuff be inflated if using it to secure a site for venipuncture?

Answer 31

60 to 80 mm/Hg

Question 32

At what angle should the needle be placed when it is about to enter the skin’s surface?

Answer 32

20 to 30 degrees

Question 33

How many attempts should be made before the IV team needs to be called?

Answer 33

No more than 3 attempts

Question 34

What is infiltration/extravasation?

Answer 34

• A process where fluid has passed into the tissue instead of the vein
• The most common cause is needle displacement

Question 35

What are some symptoms associated with a mild anaphylactic reaction?

Answer 35

Dizziness, shaking, altered taste, itching, pallor, flushing, chills, sweats, rash/hives, nasal stuffiness, swelling eyes/face, anxiety