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Radposi 2 > Surgical > Flashcards

Surgical Flashcards

1
Q

Is a dynamic experience. The challenges a radiographer encounters in the surgical suite are unique knowing the machinery and its capabilities and limitation is most important

A

Surgical radiology

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2
Q

Surgical fluoroscopic procedures
- abdomen:
- chest-line placement:
- cervical spine:
- lumbar spine:
- hip:
-
-
Humerus:
-
-

A

Cholangiogra
Bronchoscopy
Anterior cervical discectomy and fusion
Lumbar spine
Cannulated hip screws or hip pinning, decompression hip screw
Femoral and tibial nailing
Extremitt fluoroscopy
Shoulder in beach chair position
Transsphenoidal resection of pituitary tumor
Femoral/tibial arteriogram

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3
Q

Mobile surgical radiography procedures

A

Localization examinations of cervical, thoracic, and lumbar spine
Mobile extremity examination in OR

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4
Q

• A surgeon, one or two assistants, a surgical technologist, an anesthesia provider, a circulating nurse, and various support staff surround the patient. These individuals, each with specific functions to perform, form the OR team.

A

Surgical team

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5
Q

scrub their hands and arms, don a sterile gown and gloves over proper surgical attire, and enter the sterile field. The sterile field is the area of the OR that immediately surrounds and is specially prepared for the patient.

A

Sterile team members

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6
Q

is a licensed physician who is specially trained and qualified by knowledge and experience to perform surgical procedures.

A

Surgeon

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7
Q

is a qualified surgeon or resident in an accredited surgical educational program. The assistant should be capable of assuming responsibility for performing the procedure for the primary surgeon.

A

Surgical assistant (1st)

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8
Q

is a nonphysician allied health practitioner who is qualified by academic and clinical training to perform designated procedures in the OR and in other areas of surgical patient care.

A

Physician assistant

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9
Q

is a registered nurse (RN) who is specially trained to work with surgeons and the medical team in the OR.

A

Scrub nurse

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10
Q

is responsible for maintaining the integrity, safety, and efficiency of the sterile field throughout the surgical procedure. The __ prepares and arranges instruments and supplies and assists the surgical procedure by providing the required sterile instruments and supplies. In some institutions, a licensed practical nurse (LPN) or RN may assume this role.

A

Certified surgical technologist (CST)

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11
Q

do not enter the sterile field; they function outside and around it.

A

Nonsterile team members

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12
Q

is physician (anesthesiologist) or certified RN anesthetist who specializes in administering anesthetics.

A

Anesthesia provider

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13
Q

is preferably an RN. The __ monitors and coordinates all activities within the OR, provides supplies to the CST during the surgical procedure, and manages the care of the patient.

A

Circulator

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14
Q

role in the OR is to provide intraoperative imaging in a variety of examinations and with various types of equipment.

A

Radiographers

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15
Q

•The OR team may also include biomedical technicians, monitoring technologists, and individuals specialized in equipment or monitoring devices necessary during the surgical procedure.

A

Others

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16
Q

__ may change from institution to institution but should be available for review, understood, and followed by all staff members. Although some small variances in protocol exist among institutions, there are common standards.

A

Surgical attire protocols

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17
Q

__ should never be worn within semirestricted or restricted areas of the surgical suite.
__ should be donned at the beginning of each shift in the OR suite and as needed if the attire becomes wet or grossly soiled.
__ should be changed to reduce the potential of cross-infection.
__ including shoe covers is unattractive and can also be a source of cross-infection or contamination.

A

Street clothes,
Clean, fresh attire,
Soiled surgical attire,
Blood-stained or soiled attire

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18
Q

•Occupational Safety and Health Administration (OSHA) regulations require __ to be worn when contamination from blood or body fluids is possible.

A

Protective eyewear

19
Q

should be worn at all times in the OR but are not necessary in all semirestricted areas.

A

Mask

20
Q

should be worn when contamination from blood or body fluids can be reasonably anticipated. Shoe covers should be changed whenever they become torn, soiled, or wet and should be removed before leaving the surgical area.

A

Shoe covers

21
Q

should be worn to cover and contain hair at all times in the restricted and semirestricted areas of the OR suite. Hoods are also available to cover hair, such as facial hair, that cannot be contained by a cap and mask.

A

Caps

22
Q

should be worn when contact with blood or body substances is anticipated

A

Gloves

23
Q

__ and __ should be worn at all times.

A

Radiation badge, proper identification

24
Q

•A person with an acute infection, such as a cold, open cold sore, or sore throat, is known to be a carrier of transmittable conditions and ___ within the OR suite.

A

should not be permitted

25
Q

The CST __ open toward the radiographer.
The radiographer should hold one end of the IR while placing the other end of the IR into the sterile IR cover.
The CST grasps the IR and wraps the protective cover securely

A

holds a sterile IR cover

26
Q

After the exposure is made, the radiographer needs to retrieve the IR. The radiographer must be wearing __ to accept a covered IR that has been in the sterile field or under an open incision. The protective cover is possibly contaminated with blood or body fluids and should be treated accordingly.

A

gloves

27
Q

Lengthy or complex procedures increase the chance of sterile field contamination. Physical limitations, such as crowding, poor lighting, and staffing levels, are also a consideration. The floor is always considered contaminated.

A

The radiographer should avoid placing IRs, lead aprons, and shields on the floor.

28
Q

Used for extremity examinations in OR

A

C-arm/fluoroscopic system and mini mobile c-arm

29
Q

The x-ray equipment should be __ after each surgical case. If possible, the radiographer should __ the mobile image machine, including the base, in the OR suite, especially when the equipment is obviously contaminated with blood or surgical scrub solution. __ within the OR helps reduce the possibility of cross-contamination.

A

cleaned, clean, Cleaning

30
Q

Operative cholangiography

Px position
C-arm position
Ss

A

Supine

Centered over right side of abdomen just below rib line
Use true pa projection, so C-arm may have to be angled or tilted to align with px anatomy

Contrast filled biliary system

31
Q

Or chest

Px position
C-arm position
Ss

A

Supine

Cover with sterile cover, entire sterile field perpendicular to px, for line placement C-arm scans from point of insertion to catheter end

Anatomy of chest cavity
Any instrumentation introduced during procedure

32
Q

C-spine
Px position
C-arm position- ap
C-arm position- lateral
Ss

A

Supine, chin elevated, neck in flexion

C-arm position- ap: cover with sterile drape, entire field perpendicular to px, tilt c-arm 15* cephalad, center beam over c-spine

C-arm position-lateral: rotate c-arm to place beam parallel to floor, angle if required to obtain true lat projection, center spine in image

Affected area of c-spine, hardware inserted

33
Q

Lumbar spine

Px position
C-arm position- pa
C-arm position- lateral
Ss

A

Prone lying on rolls or frame to flex spine, arms place on boards to bring out of FOV

C-arm Pa projection- cover with sterile drape, enters field perpendicular to px center beam over affected area raise C-arm to leave enough room for surgeon to work
C-arm lat projection- rotate into lateral position raise or lower to bring spine into center of monitor

Affected area of spine, including bodies disk spaces spinous process lamina pedicles and facets

34
Q

hip

Px position
C-arm position
Ss

A

Supine with legs abducted affected leg in traction arms on affected side crossed over body and kept out of FOV

Between px legs, beam center over affected hip rotate as needed to demonstrate hardware relationship to anatomy

Proximal femur and hip joint, including acetabular rim femoral head and neck lesser and greater trochanter and hardware

35
Q

Femur nail

Px position

A

Rod or nail inserted into intralmedullary (IM) canal to reduce fracture
Inserted either antegrade through greater thorachanter or retrograde through popliteal notch

Antegrade insertion (supine or lateral)

36
Q

Tibia nail

Px position
C-arm position
Ss

A

Supine, knee flexed to allow acess to tibial tuberosity

On opposite side of table from injured leg, cover with sterile drape, enter field perpendicular to px, center beam over leg, tilt to match angle of leg, center beam on fracture site and turn wheels horizontally to allow machine to move down the shaft of the leg

37
Q

Humerus

Px position
C-arm position
Ss

A

Supine or reclining, injured arm resting on mayo stand, shoulder of affected arm off side of table

Cover with sterile drape, enter field parallel or at 45* angle to px, surgeon assistant will rotate arm medially and flex eblow 90*, rotate c-arm to accomodate px (arm) angle on lat and pa projection, center beam on humerus

38
Q

Transphenoid resection of pituitarty tumor

Px position
C-arm position

A

Supine, head maybe held off end of table in halo, chin extended, head tilt toward surgical team

Perpendicular to px, rotate to lat, tilt and rotate to obtain true lat, center beam on temporal bone, sella in center, place IS, closer to skull to magnify pituitary region

39
Q

Femoral/tibial arteriogram

Px position
C-arm position

A

Supine, lower limb may be rotated to remove superimposition from vessels

Cover with sterile drape, enter perpendicular to px, leg in center of monitor, turn wheels horizontally to allow machine to move L or R without taking leg out of FOV, use road-mapping and subtraction feature

40
Q

Or mobile procedures

  • Lateral projection of cervical spine
  • thoracic or lumbar spine
  • __
  • __
  • extremity examinations
A

Lateral projections
Pa projections

41
Q

Cervical spine

Px position
Ir and mobile unit position

A

Upright, supine, prone, head held in traction device to align spine, chin elevated

Ir holder covered in sterile drape, position ir on lateral side of px centered to c-spine, heam horizontal and perepndicular to ir, cr enter center of ir to prevent grid cut-off

42
Q

Thoracic or lumbar spine

Px position
Ir and mobile unit position- lateral and pa
Ss

A

Prone or supine, arms by head, frame used to support chest and abdomen and flex spine

Lateral- ir in holder covered with sterile drape, position along side of px, center to region of spine of interest, cr perpendicular to ir and parallel to floor

Pa- Place ir in slot under table and center to spine, cover field with sterile drape, center CR to IR and perpendicular to long axis of spine

Spine in pa and lateral projection
Spine bodies, spinous processes, facets and lamina, hardware, instrumentation

43
Q

Extremity examinations

Px position
Ir and mobile unit position

A

Varies with procedure and part, surgeon may choose to support limb in desired position and hold ir, use of holder and positioning aides reduces exposure to surgeon

Unit approaches perpendicular to px, tube, field, and IR may all be covered in sterile drape, if field is draped, surgeon will usually mark or point to center of image

Pertinent anatomy in correct alignment
All hardware

Radposi 2 (10 decks)

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