Surgical Flashcards
What are the different options for covering the C-arm during surgery?
Plastic cover, temporary draping and shower curtain
What proper attire is needed when in the surgical suite or department?
Mask, shoe covers, hair cover/cap, gloves, ID and radiation badge, protective eyewear
What is another name for a mobile fluoroscopic unit?
C-arm
Which of the monitors with the c-arm unit is considered the active?
Left
Which of the monitors hold or saves the last image?
Right
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)?
Cine loop
What are some of the different functions or operational modes on the c-arm?
Mag or magnification, plus mode, snapshot or digital, film mode, auto/manual exposure, subtraction, roadmapping, boost, foot pedal
As a general rule for radiation exposure, a radiographer should stand at ___ or ___ degrees to the primary beam and the object being radiographed.
Right angle or 90
The __ amount of scatter radiation occurs on the __ side of the fluoro unit. Therefore it is recommended that the X-ray tube be placed ___.
Greatest, tube, and under patient
The exposure region on the X-ray tube side of the patient is significantly __ than the region near the intensifier tower.
Greater
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 __.
4
What is the difference between a closed and open reduction?
Closed reduction - nonsurgical procedure with fractured fragments realigned by manipulation
Open reduction - surgical procedure that includes using screws, plates and rods
What does ORIF stand for?
Open reduction internal fixation
What is operative cholangiography?
- Performed during biliary tract surgery
- Bile is drain and ducts are filled with contrast (6 to 8 ml)
What is the purpose for performing an operative cholangiogram?
- Checking for patency of bile ducts
- Functional status of sphincter of hepatopancreatic ampulla
- Stones, neoplasms, strictures or dilation of ducts
Where is the C-arm placed during an operative cholangiogram?
- 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
Where is the C-arm positioned for line placement or for a bronchoscopy?
C-arm enters sterile field perpendicular to patient or side of patient (PA projection)
What is the purpose of using the c-arm for line placement or for a chest bronchoscopy?
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
What does ACDF stand for and what is the purpose of the procedure?
- Anterior Cervical Diskectomy and Fusion
- Treats nerve roots or spinal cord compresson by decompressing and stabilizing corresponding vertebrae
What is a laminectomy?
- Performed to relieve pressure on spinal cord or nerve roots
- Posterior arch is removed
Why is the rainbow postions for the c-arm used when performing a c-spine procedure?
Used for larger patients if unable to raise c-arm to obtain anatomy in center of beam
How are hip fractures classified?
According to anatomic location; femoral neck, intertrochonteric and subtrochanteric fractures
What is a hip ORIF?
- 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
What is the procedure for a hip fracture surgery?
- 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
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?
- Antegrade (greater trochanter or prozimal end of long bone)
- Retrograde (popliteal notch or distal end of long bone)
Explain the femur nail procedure
- 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
Explain the procedure for a humerus
- 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
What is the procedure when using the portable machine for surgical procedures?
- Portable machine approaches patient perpendicular
- Cover sterile field
- Angle tube if necessary to match IR
- Surgeon may hold extremity in position during exposure -shield
