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nmed 291 - clinical procedures 2 > V/Q Scan > Flashcards

V/Q Scan Flashcards

1
Q

two inter alveoli connections that allow for collateral air movement

A
  1. Pores of Kohn
  2. Canals of Lambert
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2
Q

___ are better ventilated than the ____.

A

bases of the lungs are better than the apices

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3
Q

blood flow is gravity dependent.
when someone is standing or sitting, there is ___ more perfusion at the bases than apices.

A

3-5x

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4
Q

indications for V/Q scans

A
  • PE?
  • assessing anticoagulant tx
  • covid reso
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5
Q

patient prep

A
  • CXR within 24hrs
  • rehearsing the breathing procedure
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6
Q

contraindications for V/Q

A
  • severe pulmonary HTN
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7
Q

when do we reduce particle numbers?

A
  • pts with pneumonectomy or lobectomy
  • peds
  • R-L cardiac shunts
  • pulmonary HTN
  • pregnancy
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8
Q

RP - ventilation aerosol

A

133Xe

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9
Q

RP - ventilation gas

A

DTPA, MDP, SC

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10
Q

dose of RP aerosol injected into nebulizer

A

900-1300 MBq

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11
Q

ideal aerosol size

A

0.1 - 0.5 um

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12
Q

patient receives approximately ___% of the dose added to the nebulizer

A

2-5%

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13
Q

ventilation technegas RP

A

pert

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14
Q

dose of pert for the technegas machine

A

400-900 MBq, pt only receives 10%

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15
Q

ideal size for the aerosol from technegas

A

30-60 nm

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16
Q

dose and rp for perfusion part of the study

A

74-222 MBq MAA

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17
Q

ideal # of particles

A

200k-700k with 350k ideal

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18
Q

why are ventilation images usually done first?

A

to check for image quality - positioning, artifacts

19
Q

views for Q scan

A

ANT/POST, RAO/LPO, LAO/RPO, LATs, SPECT

20
Q

difference with acquiring if using technegas vs. Xe gas or DTPA aerosols

A

technegas - statics and SPECT
Xe - dynamic views of inspiration, eq., expiration

21
Q

Xe133
inspiration image is done by…

A

having the pt take a deep breath and holding it for 10 secs

22
Q

Xe133
equilibrium images are done by…

A

having pt breathe into the machine and obtaining 3, 30 sec images

23
Q

Xe133
how are washout images acquired

A

turning off the Xe and having the patient breathe normally into the machine

24
Q

how long are patients supposed to breathe the aerosol for?

A

3-7 mins or 1500-2000 cps

25
Q

which phase of the technegas production actually produces the technegas?

A

burn phase

26
Q

when injecting the patient for the Q, patients can be sitting or supine. it’s up the patient. t/f

A

false
patients must be supine

27
Q

inject the patient for the q scan over _____ respiratory cycles

A

3-5

28
Q

what ensures a good injection?

A

3x the count rate of vent

29
Q

if a V/Q scan is needed for a pregnant pt, what should we do?

A
  • reduce the number of particles
  • do perfusion first, vent, if needed, can be done the next day
30
Q

advantage of vent imaging done with xenon

A

washout images allow for good sensitivity in detecting ventilation pathologies

31
Q

what is the flow rate of O2 administered through the nebulizer?

A

8-12LPM

32
Q

ab in same location on both V and Q

A

matched

33
Q

likely indicator for vent abnormalities

A

matched

34
Q

Q abnormality, normal vent

A

mismatched

35
Q

mismatched defects most likely indicate…

A

PE

36
Q

normal Q, abnormal vent

A

reverse mismatch

37
Q

modified PIOPED
HIGH (>85% PPV)

A

2 or more large mismatched segmental defects with normal CXR
large = >75% of segment

38
Q

what will happen if you pull blood back into the MAA syringe?

A

it’ll cause hot spots on the images

39
Q

quantum mottle

A

less than 60k particles injected

40
Q

indication for quantitative lung scan

A
  • eval relative lung perfusion preoperatively
41
Q

what are the best views for a quant lung scan?

A

ANT/POST

42
Q

normal % uptake for right lung? left lung?

A

right lung = 55%
left lung = 45%

43
Q

expiratory reserve volume of ____ is high risk for pulmonary insufficiency post op

A

<800 ml

nmed 291 - clinical procedures 2 (11 decks)

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