Surgical

Question 0

What are the different options for covering the C-arm during surgery?

Answer 0

Plastic cover, temporary draping and shower curtain

Question 1

What proper attire is needed when in the surgical suite or department?

Answer 1

Mask, shoe covers, hair cover/cap, gloves, ID and radiation badge, protective eyewear

Question 2

What is another name for a mobile fluoroscopic unit?

Answer 2

C-arm

Question 3

Which of the monitors with the c-arm unit is considered the active?

Answer 3

Left

Question 4

Which of the monitors hold or saves the last image?

Answer 4

Right

Question 5

What is the name of the function on the c-arm that allows images to be recorded in rapid sequence and then are displayed as a moving image (contrast injection)?

Answer 5

Cine loop

Question 6

What are some of the different functions or operational modes on the c-arm?

Answer 6

Mag or magnification, plus mode, snapshot or digital, film mode, auto/manual exposure, subtraction, roadmapping, boost, foot pedal

Question 7

As a general rule for radiation exposure, a radiographer should stand at ___ or ___ degrees to the primary beam and the object being radiographed.

Answer 7

Right angle or 90

Question 8

The __ amount of scatter radiation occurs on the __ side of the fluoro unit. Therefore it is recommended that the X-ray tube be placed ___.

Answer 8

Greatest, tube, and under patient

Question 10

The exposure region on the X-ray tube side of the patient is significantly __ than the region near the intensifier tower.

Answer 10

Greater

Question 11

Tilting the C-arm significantly increases the exposure to the upper body and facial region when not shielded by a lead apron. A tilt of 30 degrees increases the dose by a factor of __.

Answer 11

4

Question 12

What is the difference between a closed and open reduction?

Answer 12

Closed reduction - nonsurgical procedure with fractured fragments realigned by manipulation
Open reduction - surgical procedure that includes using screws, plates and rods

Question 13

What does ORIF stand for?

Answer 13

Open reduction internal fixation

Question 14

What is operative cholangiography?

Answer 14

• Performed during biliary tract surgery

- Bile is drain and ducts are filled with contrast (6 to 8 ml)

Question 15

What is the purpose for performing an operative cholangiogram?

Answer 15

• Checking for patency of bile ducts
• Functional status of sphincter of hepatopancreatic ampulla
• Stones, neoplasms, strictures or dilation of ducts

Question 16

Where is the C-arm placed during an operative cholangiogram?

Answer 16

• Center c-arm in the PA projection over right side of abdomen below rib line
• Tilt patient to the left or Trendelenburg position for flow of contrast

Question 17

Where is the C-arm positioned for line placement or for a bronchoscopy?

Answer 17

C-arm enters sterile field perpendicular to patient or side of patient (PA projection)

Question 18

What is the purpose of using the c-arm for line placement or for a chest bronchoscopy?

Answer 18

Line placement - to determine point of insertion and follow catheter to verify position and identify any kinks
Bronchscopy - performs biopsies, insert stents and for dilation purposes

Question 19

What does ACDF stand for and what is the purpose of the procedure?

Answer 19

• Anterior Cervical Diskectomy and Fusion

- Treats nerve roots or spinal cord compresson by decompressing and stabilizing corresponding vertebrae

Question 20

What is a laminectomy?

Answer 20

• Performed to relieve pressure on spinal cord or nerve roots
• Posterior arch is removed

Question 21

Why is the rainbow postions for the c-arm used when performing a c-spine procedure?

Answer 21

Used for larger patients if unable to raise c-arm to obtain anatomy in center of beam

Question 22

How are hip fractures classified?

Answer 22

According to anatomic location; femoral neck, intertrochonteric and subtrochanteric fractures

Question 23

What is a hip ORIF?

Answer 23

• A long fixator is placed on lateral side of fractured hip and secured with screws through fixator into femoral head and neck
• Smaller screws are placed below trochanters that transverse shaft of femur

Question 24

What is the procedure for a hip fracture surgery?

Answer 24

• Special fracture or orthopedic table for traction and fluoro during procedure
• Shower curtain
• Fracture is reduced through traction and manipulation
• Patient is supine with legs abducted and affected leg in traction
• Radiographer is positioned between patient’s legs

Question 25

When a nail or rod is inserted into the intramedullary canal for a femur to reduce a fracture of the shaft, what approaches might the surgeon utilize?

Answer 25

• Antegrade (greater trochanter or prozimal end of long bone)
• Retrograde (popliteal notch or distal end of long bone)

Question 26

Explain the femur nail procedure

Answer 26

• Fracture table is utilized
• Bone reamer is used to widen intramedullary cavity
• Guidewires inserted
• C-arm used to verify location of guidewires and fracture alignment along with any screws used
• Center c-arm over fx site during canal reaming to esnxure fx remains reduced
• Holes should appear round and not oblong

Question 27

Explain the procedure for a humerus

Answer 27

• Supine or in a reclining beach chair
• Shoulder off side of table to prevent humerus from being blocked by table
• Arm will be rotated medially with elbow at 90 degrees
• C-arm enters parallel to patient or at a 45 degree angle

Question 28

What is the procedure when using the portable machine for surgical procedures?

Answer 28

• Portable machine approaches patient perpendicular
• Cover sterile field
• Angle tube if necessary to match IR
• Surgeon may hold extremity in position during exposure -shield