Specialty Radiography #6

Question 1

A radiologic exam of the central nervous system, structures situated within the vertebral canal is what?

Answer 1

Myelograms; caused by herniated disk, bine fragments, cysts or tumors

• Most common is HNP
• Uses Nonionic, water-soluble contrast

Question 2

Where does the spinal cord end and what is it called?

Answer 2

L1-L2, Conus meduaris

• 18” to 20” long
• Connects to 31 pairs of spinal nerves

Question 3

Where does most pathology and trauma occur in the spine cord?

Answer 3

The cervical and lumbar

Question 4

Name the meninges?

Answer 4

Pia mater= inner sheath
Subarachnoid Space= wide space separating arachnoid from pia mater
Arachnoid= delicate, central sheath
Dura mater= outer most sheath
Subdural Space= separates dura from arachnoid space

Question 5

Where is CSF contained? And where is it produced?

Answer 5

1) Contained in the ventricles and subarachnoid space.

2) Produced in ventricles

Question 6

What meninges do not communicate with the ventricular system?

Answer 6

Subdural Space

Question 7

What are the contraindications of Myelograms?

Answer 7

Blood within CSF, Arachnoiditis (Inflammation), Increased intracranial pressure, Recent lumbar puncture within 2 weeks

Question 8

How many hours for a hazy effect and when nonionic, water-soluble contrast is undetectable for myelograms?

Answer 8

1) 4-5 hrs for hazy effect

2) 24 hrs for undetectable

Question 9

For a myelogram, contrast is injected where?

Answer 9

L2-L3 or L3-L4, Cisternia Magna between C1 and the occipital bone

• It’s a Intrathecal injection
• Most common contrast used is Isovue and Omnipaque

Question 10

What position is the patient in for a Lumbar Myelogram?

* 9 to 12 mL of contrast injected in the subarachnoid space *

Answer 10

Prone or Lateral and slightly trendelenburg to widen interspinous space, if prone place a pillow or towels under patient to flex spine

Question 11

After a myelogram patient is monitored 4-6 hrs with head and shoulder elevated 30-45 degrees as well as avoid strenuous activity for 72 hrs, True or False?

Answer 11

True

Question 12

Myelogram demonstrates?

Answer 12

Deformity in subarachnoid space

Question 13

What radiologic exam, examines for soft tissue structures of joints after injection of 1 or 2 contrast agents into capsular space?

Answer 13

Arthrograms

Question 14

What has reduced the numbers of arthrograms?

Answer 14

MRI

Question 15

What is the most frequent site for an arthrogram?

Answer 15

Shoulder

*Knee, Hip, Wrist, TMJ

Question 16

Baker’s cyst located where?

Answer 16

Popliteal cyst, nontrauma

Question 17

Contrast is injected where for an arthrogram of the knee?

Answer 17

Retropatellar, lateral or medial approach

Question 18

Contrast is injected where for an arthrogram of the wrist?

Answer 18

Dorsal wrist at articulation of radius, scaphoid, and lunate

* 1.5 to 4 mL of contrast

Question 19

Hip arthrograms are often performed on children, True or False?

Answer 19

True, evaluates congenital hip dislocation before and after treatment
* For an adult, detects loose hip prosthesis

Question 20

Arthrograms, the subtraction technique is needed for what exam?

Answer 20

When a patient has a prosthesis

*Barium sulfate is added to the cement

Question 21

Contrast is injected where for an arthrogram of the hip?

Answer 21

3/4” distal to inguinal crease and 3/4” lateral to palpated femoral pulse
* Spinal needle is needed

Question 22

Contrast is injected where for an arthrogram of the shoulder?

Answer 22

1/2” inferior and lateral to coracoid process

* Spinal needle recommended

Question 23

What arthrogram exam can use either single or double contrast methods?

Answer 23

Shoulder

• Single= 10 to 12 mL of contrast
• Double= 3 to 4 mL of contrast and 10 to 12 mL of air

Question 24

What would follow a double contrast arthrogram shoulder?

Answer 24

CT, images obtained at 5 mm intervals

Question 25

What uses gadolinium contrast?

Answer 25

MRI

Question 26

What exam investigates of a nonpregnant uterus, accessory organs, and vagina?

Answer 26

Hysterosalpingography

Question 27

Contrast is injected where for an Hysterosalpingography?

Answer 27

Through the uterine cannula using water-soluble, iodinated contrast

• Contrast should flow through uterine tubes and spill out into the peritoneal cavity
• Using 4 to 5 mL to fill uterine cavity
• Additional 4 to 5 mL required for uterine tube patency

Question 28

A Hysterosalpingography can be a therapeutic tool, True of False?

Answer 28

True

Question 29

What are the contraindications of Hysterosalpingogram?

Answer 29

Pregnancy, Pelvic Inflammatory Disease (PID), Uterine bleeding (Scheduled 10 days after menstruation)

Question 30

What position is the patient in for HSG?

Answer 30

Lithotomy or Supine