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Semester 6 study notes > Theory Review( not on test one) > Flashcards

Theory Review( not on test one) Flashcards

1
Q

Calcium Homeostasis

A

-a healthy body has a balance btw amount of calcium stored in the bones, calcium in the blood and excess calcium excreted by kidneys
-controlled by the endocrine system
-calcitonin and parathormone control calcium concentration in our bodies

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2
Q

Bone composition

A

-two types of bone: compact or cortical and spongy( cancellous) or trabecular bone

-compact bone is dense and strong
-cancellous bone has many open spaces giving it a spongy appearance

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3
Q

osteoporosis

A

loss of spongy or cancellous bone and thinning of cortical bone

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4
Q

risk factors fro low bone mass

A

female
advanced age
family history
ethnicity
low body weight
lifestyle
estrogen deficiency
calcium or Vit D deficiencies
sedentary lifestyle
alcohol abuse
tobacco abuse

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5
Q

What is BMD

A

a test used to assess the amount of minerals like calcium in your bones
-the test determines whether or not you have or are more likely to develop osteoporosis
-can be used to monitor osteoporosis treatment

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6
Q

indications for osteoporosis assessment

A

fracture with minor trauma
kyphosis
height loss
protruding abdomen
reduced pulmonary capacity
esophageal reflux

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7
Q

fragility fracture

A

-break occurs due to low impact activity
-happens b/c bones are weak
-joints usually affected include: spine(compression fracture), hip, wrist(collet from falling)

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8
Q

Purpose of BMD

A

-measure BMD
-detect bone loss
-establish the diagnosis of osteoporosis
-assess an individuals risk for fracture
-assess a patients response to therapy
-perform vertebral fracture assessment

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9
Q

BMD equipment

A

-Dual energy Xray absorptiometry( DEXA)
-uses two different xray beams with different energies to estimate bone density
-strong dense bone=less xray beam passes through
-peripheral dual-energy absorptiometry measure bone density in wrist, heel, finger
-QCT, QUS

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10
Q

T score

A

-compares patients BMD to the BMD of a young healthy adult of same sex
-osteoporosis is a T score of -.25 or 25% lower than the average 30 year old
-osteopenia-T score btw -1.0 and -2.5 below normal

T score -1 and above=normal bone density
T score -1 and -2.5=bone density below normal, may lead to osteoporosis
T score -2.5 and below=osteoporosis

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11
Q

Z score

A

-compares your bone density to average bone density of people your age and gender
-A z score of more than 2 standard deviations below others your age there may be medical conditions or medications that are causing low bone density

Z score above 2.0=normal

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12
Q

BMD radiation safety

A

-tech is in the room
-radiation form BMD is very low
-be at least 2M from the DXA couch

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13
Q

Biliary Tract Procedure
Operative Cholangiography

A

-doen to loof at gallbladder and cystic duct
-catheter is placed into biliary ducts and injects iodinated CM into the ducts

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14
Q

Operative Cholangiography C arm positioning

A

patient position- supine
C arm position- centered over right side of abdomen below rib line
structures shown- contrast filled biliary system

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15
Q

Biliary Tract Procedure
Laparoscopic Cholecystectomy

A

-less invasive approach for removal of gallbladder
-small opening in umbilicus and passes endoscope into abdominal cavity
-diseased gallbladder is removed from small opening

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16
Q

Biliary tract procedure
ERCP(endoscopic Retrograde Cholangiopancreatogrpahy)

A

-combined endoscopic and fluoroscopic procedure where a endoscope is used to visualize the anatomy and allows for passage of tools into biliary and pancreatic ducts
-xray is used to visualize the ducts through administration of contrast

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17
Q

ERCP clinical indications

A

-blockage or narrowing of one of the bile ducts
-obstructionmay be caused by gallstones, infection that causes inflammation, strictures or scarring, accumulation of tissue or fluid and non/cancerous tumours

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18
Q

ERCP common symptoms

A
  • persistent abdominal pain not diagnosable by other tests
  • jaundice, or yellowing of skin and eyes
  • light colored stools or dark urine
  • loss of appetite or weight
  • confirmed diagnosis of certain cancers in the affected organs
  • CT scan showing a stone or mass in the affected organs
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19
Q

urinary system procedure
retrograde urography

A

-examines urininary system in which contrast is introduced directly retrograde into pelvicalyceal system via cauterization
-performed to determine location of undetected calculi or other obstruction in urinary system

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20
Q

orthopaedic procedures
closed reduction

A

-fractured bone is manipulated and realigned without surgery
-performed externally using manual technique or traction devices

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21
Q

orthopaedic procedures
open reduction

A

-surgery performed by orthopaedic surgeons to treat fractures
-internal fixation is physically connecting the bones
-uses screws, plates, wires or nails to align the bones

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22
Q

orthopaedic procedures
External fixation

A

-pins or wires are inserted into bone percutaneously and held together via external scaffold
-done for severe open fractures, comminuted closed fractures, arthrodesis, infected joints, major alignment and length deficits

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22
Q

orthopaedic procedures
intramedullary fixation

A

-rods and nails are inserted within the shaft of long bones to stabilize fractures
-popular in humerus, tibia and femur

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23
Q

orthopaedic procedures
hip fractures

A

-femoral neck fractures
-intertrochanteric fractures
-subtrochanteric fractures
-subcapital fractures

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24
Q

orthopaedic procedures
hip pinning( open reduction with internal fixation)

A

-non displaced femoral neck fracture is usually treated with hip pining
-surgical pins or screws are passed across the fracture site to hold the ball of the femur in place
-pinning prevents the femoral head from dislodging or slipping off the femoral neck

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25
Q

hip surgery procedure

A

patient position- supine with legs abducted, affected leg in traction
C arm position- between patients legs, beam centered over affected hip, rotate as needed to demonstrate hardware
-structures shown-prox femur and hip joint, acetabular rim, femoral head and neck, lesser and greater trochanters, hardware

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26
Q

orthopaedic procedures
Total Hip Replacement( total hip Arthroplasty)

A

-surgical procedure in which the hip joint is replaced by a prothetic implant
-commonly done to relieve arthritic pain
-THA replaces Bothe acetabulum and femoral head
-hemiarthroplasty replaces only femoral head

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27
Q

spinal procedures
laminectomy

A

-surgical procedure performed to alleviate pain caused by neural impingement
-designed to remove a small portion of the bone or herniated disk material impinging on the nerve root to give the nerve root space

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28
Q

spinal procedures
spinal fusion

A

-connects two or more vertebra
-bones can’t move which eases neck or back pain
-often part of laminectomy procedure

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29
Q

spina procedures
inter body fusion cages

A

-titanium cages filled with bone that are inserted between vertebral bodies to maintain disk space height and fuse the joint

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30
Q

Thoracic procedures
pacemaker insertion

A

-a pacemaker is a medical device that is inserted to maintain a proper heart rhythm when the heart rate drops below a defined level
-leads of pacemaker are placed into one or more chambers of the heart
-C arm is placed over the heart to ensure the leads are properly placed

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31
Q

cardiovascular system functions

A

-transportation of oxygen, nutrients, hormones and chemicals
-removal of waste products, primarily through kidneys and lungs
-maintenance of body temperature, water and electrolyte balance

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32
Q

cardiovascular system
heart

A

-central organ of cardiovascular system
-responsible for pumping blood through circulatory system
-has rich supply of blood
-right side has deoxygenated,
-left side has oxygenated blood

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33
Q

herat anatomy

A

-4 chambers
-upper chambers right and left atria RECEIVE blood
-lower chambers, right and left ventricles PUMP blood OUT the heart
-left ventricle is thickest chamber b/c it pumps blood to entire body

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33
Q

blood vessels

A

-after blood leaves heart it is pumped through a network of blood vessels to different parts of the body
-ARTERIES-transport oxygen blood from he heart to tissues
-VEINS return deoxygenated blood to the heart
-ARTERIOLES -branch into networks of very small blood vessels called CAPILLARIES

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34
Q

Coronary Veins

A

-blood returns to right atrium via coronary veins

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34
Q

Coronary Arteries

A

-coronary circulation supplies blood to the heart itself
-first branches off the aorta: LEFT coronary artery(LCA) and RIGHT coronary artery(RCA)
-LCA supplies blood to both ventricles and left atrium
-RCA supplies blood to right atrium and right ventricle

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35
Q

coronary sinus

A

large vein with three main branches: Great, Middle< small cardiac veins

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36
Q

3 main branches off aorta

A
  1. brachiocephalic artery
    2.left common carotid artery
    3.left subclavian artery
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36
Q

4 arteries that supply blood to the brain

A

1.Right common carotid
2.left common carotid
3.right vertebral
4.left vertebral

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37
Q

carotid arteries

A

-bifurcates into external and internal portions
-EXTERNAL carotid artery carries blood to the face
-INTERNAL carotid artery supplies blood to the cerebral hemisphere of the brain

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38
Q

what do the vertebral arteries branch off of?

A

subclavian arteries

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39
Q

major branches

A

-2 main arterial branches come off the internal carotid artery: anterior and middle cerebral arteries
-posterior cerebral artery branches off the basilar artery

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40
Q

Circle of Willis

A

-left and right internal carotid arteries
-left and right anterior cerebral arteries
-left and right posterior cerebral arteries
-left and right posterior communicating arteries
-basilar artery
-anterior communicating artery

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41
Q

Circle of Willis main function

A

-provide a collateral blood flow between the anterior and posterior arterial systems of the brain.
-offers the alternate blood flow pathways between the right and leftcerebral hemispheres
-This way the circle protects the brain from ischemia and stroke in cases of vascular obstruction or damage.

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42
Q

major veins of head and neck

A

internal jugular vein
external jugular vein
vertebral vein

43
Q

Thoracic Arteries

A

-two main arteries in the chest are AORTA and PULMONARY arteries
-off the right ventricle the pulmonary arteries supply blood to the lungs with DEOXYGENATED blood
-the aorta coming from the left ventricle RECEIVES OXYGENATED blood to be carried to entire body

44
Q

Aorta

A

-extends from the heart to 4 lumbar vertebra and divides into thoracic and abdominal sections

44
Q

Aorta
what is the Thoracic section subdivided into?

A

1.aortic bulb(root)
2.ascending aorta
3.aortic arch
4.descending aorta

45
Q

aorta anatomy
Aorta Bulb or root

A

-most proximal segment
-coronary arteries come off the aortic root
-from left ventricle aorta rises into the chest were it becomes ascending aorta

46
Q

Aorta anatomy
ascending aorta

A

-terminates at around second sternocostal joint and becomes the arch

47
Q

aorta anatomy
arch of aorta

A

-three main branches come off the arch: brachiocephalic, left common carotid, left subclavian artery

48
Q

Thoracic Veins

A

1.superior vena cava( return deoxygenated blood to right atrium)
2.inferior vena cava(( return deoxygenated blood to right atrium)
3.azygous- carries deoxygenated blood from thorax to SVC
4.pulmonary veins-carry OXYGENATED blood from lungs back to left atrium

49
Q

aorta anatomy
abdominal aorta

A

-once thoracic aorta passes diaphragm it becomes abdominal aorta
-sits informs of vertebra
-bifurcates into right and left common iliac arteries at L4

50
Q

major abdominal aorta branches

A

1.celiac trunk
2.superior mesenteric artery
3.left renal artery
4.right renal artery
5.inferior mesenteric artery

51
Q

major abdominal aorta branches
Celiac artery

A

-has 3 main branches:
1.left gastric(oxygenated blood to stomach and esophagus)
2.splenic
3.common hepatic arteries( supplies blood to liver)

52
Q

major abdominal aorta branches
Superior Mesenteric Artery(SMA)

A

-inferior to celiac trunk at L1
-supplies blood to pancreas, most of small intestine, portions of large intestine on right side(cecum, ascending colon,half transverse colon)

53
Q

major abdominal aorta branches
renal arteries

A

-branch from abdominal aorta at disk of L1/L2
-right is longer and lower than left

54
Q

major abdominal aorta branches
inferior mesenteric artery

A

-originates from aorta at apron L3 about 1 1/4 inches above bifurcation
-supplies blood to portions of large intestine(left half of transverse colon,descending colon,sigmoid colon, most of rectum)

55
Q

common iliac arteries

A

-distal portion of abdominal aorta bifurcates at the level of L4 into right and left common iliac arteries
-each divides into internal and external iliac arteries
-INTERNAL iliac artery supplies pelvic organs( bladders ectum, reproductive organs, pelvic muscles)
-EXTERNAL iliac artery supplies lower limbs

56
Q

Abdominal veins

A

-blood is retired from structures below diaphragm to right atrium by IVC
-major veins in abdomen are: R and L common iliac, Internal iliac, external iliacs, renal veins, hepatic portal system
-iliac veins drain pelvic area and lower limbs
-renal veins return blood from kidneys
-The superior and inferior mesenteric veins return blood from the small and large intestine through the hepatic portal vein and the hepatic veins and into the IVC

57
Q

upper limb arteries

A

-blood supply begins at subclavian artery
-subclavian artery becomes axillary artery and then brachial artery
-brachial artery bifurcates into ulnar and radial arteries
-radial and ulnar arteries join to form two palmar arches that supply fingers and hands with blood

58
Q

upper limb veins

A

-cephalic and basilica are primary tributaries of the superficial venous system
-anterior to elbow joint is median cubital vein-most used to draw blood
-arm veins eventually drain into SVC and then into right atrium

59
Q

lower limb arteries

A

-begins at external iliac artery and ends at arteries in the foot
-first artery to enter lower. limb is common femoral artery
-common femoral divide into femoral and deep femoral arteries
-femoral artery extends down the leg and becomes popliteal artery at level of the knee
-major branches off the popliteal artery are anterior tibial and posterior tibial arteries
-The anterior tibial artery continues as the dorsalis pedis artery, with branches to the ankle and foot
-The posterior tibial artery supplies the calf and plantar surface of the foot.

60
Q

lower limb veins

A

-the superficial veins include great saphenous and small saphenous
-majpr deep veins are posterior tibial, anterior tibial, popliteal and femoral
-anteriro and posterior tibial form popliteal vein
-popliteal veins continues upward to become femoral vein before becoming external iliac vein

60
Q
A
61
Q

angiographic procedures
equipment requirements

A

-island type table with all four-way floating capability
-C arm with subtraction
-programmable digital image acquisition system
-specialized xray tube with heat load capacity and rapid cooling to meet need of high mA, high Fram rates, and multiple acquisition series
-physiologic monitoring equipment

61
Q
A
62
Q

cerebral angiography
purpose

A

-provide imaging to localize and diagnose pathology or anomalies of the arteries of the brain and neck

63
Q

cerebral angiography
clinical indications

A

-vascular stenosis and occlusions
-aneurysms
-trauma
-arteriovenous malformations
-neoplastic disease

64
Q
A
65
Q

cerebral angiography
common vessels for catheterization

A

-the common carotid arteries
-internal carotid arteries
-external carotid arteries and
-vertebral arteries

66
Q

how much contrast is used for cerebral angiography

A

depends on which vessel is being examined but usually ranges from 5ml to 10ml

67
Q

cerebral angiography
imaging

A

-digital C arm and/or flat detector digital fluoroscopy is preferred
-imaging sequence must include all phases of circulation-arterial, capillary, venous

68
Q

what is the purpose of Thoracic Angiography

A

study ascending aorta, the arch, the descending portion of thoracic aorta and major branches

69
Q

purpose of pulmonary arteriography

A

study pulmonary vessels almost always to investigate for pulmonary embolus

70
Q

thoracic angiography
clinical indications

A

aneurysms
congenital abnormalities
vessel stenosis
embolus
trauma

71
Q

thoracic angiography
catheterization

A

-perferred puncture site is femoral artery
-catheter is advanced to desired location in thoracic aorta
-femoral vein is used for imaging of pulmonary arteries
-catheter goes through IVC, through right atrium into right ventricle and into pulmonary artery

72
Q

how much contrast is used in thoracic angiography

A

between 30-50ml

73
Q

what is the purpose of Angiocardiography (Coronary Angiography)

A

imaging of the heart and coronary arteries
-aka cardiac catheterization
-The most common procedures include aortography (aortic root flush), and coronary arteriography (left and right sided).

74
Q

Angiocardiography
clinical indications

A

-coronary artery disease and angina
-myocardial infarct
-valvular disease
-atypical chest pain
-congenital heart anomaly
-other heart and aorta pathology

75
Q

which artery is often used to inject contrast media for Angiocardiography

A

femoral artery and radial artery are common but risks are lowered using radial artery

76
Q

Angiocardiography
imaging

A

-imaging rate for coronary arteries is 15-30 frames/sec
-routinely six views of left coronary artery and two views of right coronary artery are obtained

77
Q

abdominal angiography clinical indications

A

aneurysm
congenital abnormality
gastrointestinal bleed
stenosis or occlusion
trauma

77
Q

abdominal angiography purpose

A

-demonstrates the contour and integrity of the abdominal vasculature
-placement or displacement of abdominal vessels being studied and possible obstruction or tears(eg aneurysm)

78
Q

abdominal angiography catheterization

A

-for aortogram the aorta is accessed by femoral artery
-pigtail catheter is usually used due to large amount of contrast used

79
Q

abdominal angiography
selective arteriogram

A

-require the use of specially shaped catheters to access the vessel of interest

80
Q

what are common selective arteriogram studies

A

celiac artery
renal arteries
superior and inferior mesenteric arteries
all selected when a gastrointestinal bleed is investigated

81
Q

Abdominal Angiography
super selective study

A

-involves study of selecting a branch of a vessel
-comon example is section of the hepatic or splenic artery

82
Q

Abdominal Angiography
catheterization

A

-seldinger technique is used to access femoral artery or an alternative injection site for a peripheral arteriogram
-for lower limb arteriograms the side of acres depends on if it is unilateral or bilateral
-unilateral studies usually require access from contralateral side of interest
-for bilateral either femoral artery may be accessed

83
Q

peripheral angiography clinical indications

A

-atherosclerotic disease
-vessel occlusion and stenosis
-trauma
-neoplasm
-embolus and thrombus

83
Q

what is the purpose of a peripheral angiography

A

-examine the peripheral vasculature after injection of contrast
-may be an arteriogram where the injection is done by catheter or venogram where the injection is placed into distal vein of extremity

84
Q

peripheral angiography catheterization

A

-seldinger technique is used to access femoral artery or an alternative injection site for a peripheral arteriogram
-for lower limb arteriograms the side of acres depends on if it is unilateral or bilateral
-unilateral studies usually require access from contralateral side of interest
-for bilateral either femoral artery may be accessed

84
Q

Peripheral Angiography Upper Limb Catheterization

A

-catheter is advanced along the abdominal and thoracic aorta
-the side being examined is the Side the subclavian artery is used

85
Q

Peripheral Angiography imaging lower limb

A

more common due to peripheral arterial disease

86
Q

Joint injections

A

image guided joint access is commonly used.
-can be used for therapeutic injections or diagnostic purposes(injections for MR and CT arthrogrpahy,anesthetic testing for pain relief)

87
Q

angioplasty

A

-procedure in which a balloon tipped catheter is used to open narrowed or blocked blood vessel
-imaging guidance is used to place catheter across narrowing

88
Q

embolization

A

-brain aneurysms and arteriovenous malformations/fistulas
-uses imaging guidance to place metal coils into and aneurysm to block flow of blood and prevent rupturing
-also used to fill AVMS-abnormal connection btw veins and arteries- with liquid embolic agents
-embolization treats aneurysms and AVMS previously thought to be inoperable

89
Q

catheter Embolization

A

-places medications or synthetic materials called embolic agents through a catheter into a blood vessel to block blood flow to an area of the body
-may be used to control or prevent abnormal bleeding, close off vessels supplying blood to a tumour, eliminate abnormal connections btw arteries and veins, or treat aneurysms

90
Q

catheter directed thrombolysis

A

-teats vascular blockages and improve blood flow by dissolving abnormal blood clots
-uses fluoroscopic imaging and a catheter to guide thrombolytic meds or medical device to the site of blood clot to dissolve the blockage

91
Q

percutaneous Abscess Drainage

A

-abscess is a infected fluid collection
-uses image guidance to place a needle or catheter through the skin into the abscess to remove or drain the fluid
-faster recovery than open surgery

92
Q

needle biopsy-

A

-uses imaging guidance to help locate a nodule or abnormality and remove a tissue sample for examination
-biopsy may be needed when imaging can not confirm if nodule is benign
-will need an expiration chest Xray after to rule out possible pneumothorax

93
Q

abscess drainage- CT

A

valuable in gaining access to deeper or more posterior parts of the body

94
Q
A
94
Q

IVC filters

A

-inferior vena cava filter is a end-vascular device typically placed in the infrarenal IVC to prevent pulmonary embolism
-most commonly done by interventional radiologist with fluoroscopic guidance

95
Q

IVC filter indications

A

-contraindication to anticoagulation, eg active gastrointestinal bleed or recent neurosurgery
-pulmonary embolism despite anticoagulation
-poor patient compliance with anticoagulation treatment
-large iliocaval or floating IVC thrombus “widow-maker” thrombus

96
Q

TIPSS(Transjugular Intrahepatic Portosystemic Shunt)

A

-creates an artificial passageway for portable venous circulation
-used to connect two veins within the liver
-shunt is kept open by a stent
-using image guidance a tunnel through the liver to connect the portal vein to one of the hepatic veins
-stent is placed in the tunnel to keep the pathway open

97
Q

ureteral stent

A

-double stent, JJ stent, retrograde ureteric stent
-urological catheters that have two J shaped(curled) ends, one end is anchored in the renal pelvis and the other inside the bladder
-stents are used for passage of urine from kidney to the bladder
-ureteric stents may be placed integrate or retrograde
-stnets may be used for short or long period of time depending on indication

98
Q

indication for a ureteric stent

A

-obstruction form urolithiasis-stones in the ureter
-malignant obstruction
-benign strictures
-retroperitoneal fibrosis

99
Q

vertebroplasty

A

-is an imaging-guided procedure which entails percutaneous injection of surgicalbone cement into a diseased vertebral body
-provides pain relief and strengthens the bone of vertebrae

100
Q

vertebroplasty indications

A

-It can be used as a treatment or as a palliative measure for:
-insufficiency fracture
-aggressivehemangioma
-vertebralmultiple myeloma
-vertebral metastases

101
Q

Arterial stenting

A

expandable tubular medical meshwork devices used for interventional treatment of coronary artery disease, peripheral artery disease and AAA

102
Q

esophageal stent

A

-treatment option in patients with esophageal strictures
-most commonly used for symptomatic relief in those with dysphagia
-stent is inserted with endoscopic and fluoroscopic control
-distal esophagus is most common site

103
Q

Tracheobronchial stent

A

-device used in the treatment of symptomatic airway compression
-inserted under bronchoscope guidance in patients with external compression from mediastinal based malignancy( lung cancer, esophageal cancer)
-bronchial stents can also treat post lung transplantation airway stenosis

Semester 6 study notes (7 decks)

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