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Specialized Imaging > Surgical Radiography > Flashcards

Surgical Radiography Flashcards

1
Q

Mobile C-arm fluoro includes

A
  • C-arm with x-ray tube and image intensifier

- two tv monitors

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2
Q

Features of the mobile C-arm fluoro

A
  • digital imaging and storage
  • image hold feature
  • image enhancement, masking and subtraction
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3
Q

Controls and operation modes of the mobile C-arm in fluoro

A
  • mag mode
  • pulse mode
  • snapshot or digital mode
  • automatic/manual exposure control
  • foot pedal
  • road mapping
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4
Q

C-arm movements

A
  • In-Out lock: moves the c-arm front and back from the base
  • wig-wag: enables the c-arm to wave side to side from the base
  • lateral-parallel: c-arm “C” moves from AP to lateral position
  • cephalad-caudad: angles tube and IR up or down the table
  • up and down: raises and lowers the “C” of the c-arm
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5
Q

What does the in-out lock do?

A

In-Out lock: moves the c-arm front and back from the base

-forward and back

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6
Q

What does wig-wag do?

A

wig-wag: enables the c-arm to wave side to side from the base
-move from left to right

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7
Q

What does the lateral-parallel do?

A

lateral-parallel: c-arm “C” moves from AP to lateral position

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8
Q

What does the cephalad-caudad do?

A

cephalad-caudad: angles tube and IR up or down the table

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9
Q

What does the up and down movement do?

A

up and down: raises and lowers the “C” of the c-arm

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10
Q

C-arm control panels: collimator controls

A

Use these controls to position the shutters and iris as close to the area of interest as possible to minimize scatter radiation

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11
Q

Foot pedal for c-arm

A
  • low dose fluoro (LDF): used to guide, position initial fluoro
  • vascular foodswitch (to toggle between fluoro and subtraction mode)
  • high dose fluoro (HDF)
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12
Q

Setup for C-arm

A
  1. Insert view station plug into wall outlet
  2. Connect the view station cable into the C-arm stand by aligning the red dots
  3. Connect the foot pedal cable to the C-arm stand by aligning the red dots
  4. Switch on the system at either the C-arm stand or view station
  5. Insert the key at the rear of the C-arm to enable radiation
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13
Q

The monitor stand is the

A

Patient work list
C-arm monitor worklist:
-in most OR suites, you are able to bring your RIS via ethernet cable or WI-FI
-if the network is down, you are also able to manually enter the patient information and send your images later

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14
Q

C-arm monitor dose report displays?

A
  • dose
  • demographics
  • fluoro time (each c-arm will have an alarm one a max fluoro time has been reached)
  • the image of all this is sent with the patients images to PACS
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15
Q

C-arm orientation and exposure patterns for a vertical PA:

A
  • least exposure to the operator
  • x-ray rube below
  • I.I above patient
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16
Q

C-arm orientation and exposure patterns for a 30 degree C-arm tilt:

A

-increased exposure to face and neck by a factor of four

17
Q

C-arm orientation and exposure patterns for a horizontal exposure:

A

-increased exposure at x-ray tube end

18
Q

C-arm orientation and exposure patterns for a vertical AP orientation:

A
  • must be avoided, increased exposure to head and neck

- tube and the top and I.I at the bottom

19
Q

Surgical accessories and clothing:

A
  • scrub clothes
  • gown to cover scrub clothes
  • hat or hood to cover all hair
  • shoe covers
  • mask
  • (protective eyewear)
  • (nonsterile gloves)
20
Q

Equipment in surgery:

A
  • clean equipment before and after OR procedures
  • operational check
  • proper equipment location:
    • monitor in clear vision of surgeon
    • locate power outlet
    • not in way of traffic
21
Q

What two positions should you use to minimize operator dose?

A
  • vertical projection, PA position (x-ray tube under the patient/table)
  • horizontal projection, AP position (operator standing on the side of the image instensifier)
  • stand 6 feet away when possible
  • use LIH (last image hold) features or intermittent fluoro when possible
22
Q

OR personnel:

A
  • surgeon
  • surgical assistant
  • anesthesiologist
  • scrub nurse
  • circulating nurse
  • patient
  • radiographer
23
Q

Who’s responsibility is radiation protection?

A

OURS!

  • MRT’s responsibility
  • ensure staff is wearing lead aprons, give them enough time and notice to protect themselves
24
Q

What is included in the sterile field?

A
  • sterile corridor
  • sterile instruments
  • c-arm could be draped
  • shower curtain drape
  • temporary patient drape
25
Q

Surgical asepsis in surgical radiography

A
  • non sterile personnel must not come in contact with sterile personnel
  • any contaminated sterile drape or cover must be reported and replaced
26
Q

sterile gowns considered sterile

A
  • from shoulder to level of sterile field

- at the sleeve from cuff to just above elbow

27
Q

OR tables are considered sterile only at level of the _____

A

The table top

28
Q

What do we do in surgical radiography?

A
  • orthopedic surgeries
  • urology procedures
  • abdominal surgeries
  • cardiac surgeries
29
Q

Orthopedic procedures

A
  • ORIF (open reduction, internal fixation)

- can be any bone, any joint

30
Q

ORIF hip and femur

A

-setup
-c-arm is positioned on unaffected side
PA/AP position:
-approach the affected hip is approximately 45 degrees
-use rotation feature on c-arm to orientate the image
Lateral position:
-superoinferior (swing image intensifier towards you)
-along the axis of the patient unaffected leg
-adjust height over the hip joint

31
Q

I.I is ____ dose when on the top

A

Less

32
Q

Increase brightness you _____ pt dose

A

Increase patient dose (increasing technical factors)

33
Q

Max fluoro time is ___ minutes

A

5

-in extreme, difficult cases, you can go over 5 min

34
Q

Closer to the x-ray tube = ____ dose

A

More

35
Q

Cardiac pacemaker insertion

A
  • the surgeon makes an incision below the collarbone, and the pacemaker is inserted into the chest. Wires are threaded via the superior vena cava directly into the right atrium and/or right ventricle of the heart using fluoro to visualize
  • the surgeon will perform tests of the pacemaker to ensure it is functioning correctly
  • c-arm will most commonly be parked on right side of patient, opposite the surgeon
  • x-ray tech will fluoro over the patient chest to demonstrate location of wires as they are directed towards the heart
36
Q

Kidney stone removal

A
  • there are several different ways urologists surgically remove kidney stones
  • in most cases a catheter is inserted into the ureter and up to the kidney to the location of the stone. The urologist can simply remove small stones with an extractor, or break a large stone into smaller pieces to remove
  • some OR suites are equipped with x-ray tables, other times a C-arm is required
  • MRT provides fluoro and/or images over the patients kidneys or abdomen to visualize the stone or location of tools being used to remove the stone
  • often, one the kidney stone is removed, the urologist uses x-ray contrast to check for any damage to the kidneys or ureters or to check for further blockage
  • a stent is often placed in the affected ureter
37
Q

Operative cholangiogram

A
  • performed during a cholecystectomy to demonstrate the biliary duct system, drainage to the duodenum, or any residual stones in the biliary system
  • the surgeon places a small catheter called a T-tube into the biliary ducts and injects a small amount of iodinated contrast
  • the radiographer can capture images either using fluoro or digital spot images with a C-arm, or by taking plain abdomen images with a mobile until and grid- cassettes
38
Q

Foreign body localization in surgery

A
  • can utilize fluoro or “flare plate” radiography with mobile
  • used for:
    • incorrect sponge count post surgery
    • incorrect instrument count post surgery
    • locating metallic fragments (buckshot, bullet fragments)

Specialized Imaging (9 decks)

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