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positt IV biliary

advanced positioning - IV biliary flouro set 2

QuestionAnswer
IV administered contrast is absorbed by the: liver
Biliary tract examinations are done to evaluate: liver function, patency of bile ducts, concentrating and emptying of the gallbladder
what kV range should be used for radiographic examinations of the billiary system? 70-80 kVp
oral cholecystography (OCG) is done to evaluate: eval for symptoms persistent with gallbladder disease
what are the contraindications for an OCG? pt. with vomiting, diarrhea, pyloric obstruction, malabsorption, jaundice or liver dysfunction, hypersensitivity to iodinated contrast
pt. prep for an OCG lo fat diet, no laxatives prev 24 hours, no food after oral contrast
contrast administration for OCG single dose given 2-3 hours post evening meal on night prior to exam, 3g telepaque (4-6 tablets). Absorption in 10-12 hours.
Pt. position for an OCG scout and why prone to place the biliary structures closer to the IR
PA gallbladder IR sizes 10X12 LW for scout, 8X10 for subsequent exposures
PA gallbladder pt. position (prone) center R abdomen to IR, pt. turns head to rest L cheek on pillow (may need to center 2-4” inf. To loc. Of gallbladder when prone)
PA gallbladder pt. position (upright) center gallbladder to IR CR perpendicular, patient holds on expiration
what is demonstrated on a PA gallbladder? opacified gallbladder, entire gallbladder and cystic duct, short scale of contrast, no motion, adequate technique
pt position LAO gallbladder pt. rotated 15-40 degrees, (thin pt. needs more rotation) perp. CR, center to gallbladder.
what is demonstrated on an LAO gallbladder? opacified gallbladder free from superimposition and foreshortening, entire gallbladder and cystic duct, short scale of contrast, no motion
lateral gallbladder is done right to: differentiate gallstones form renal calliculi, separate the gallbladder form the vertebral column (thin pt.) long axis of gallbladder parallel to IR
a R lateral gallbladder demonstrates what: opacified gallbladder free from superimposition or forshortening, entire gallbladder and cystic duct, short scale of contrast and no motion
AP R lat. Decub gallbladder pt. position pt. R lat. Recumbent, elevated 2-3 inches on support to center gallbladder to film.
AP R lat. Decub gallbladder demonstrates: stratification of gallstones, stones heavier that bile are not visualized, entire gallbladder and cystic duct, short scale of contrast, no motion
Operative cholangiography is done for bile-duct patency, sphincter of oddi function, presence of calculi, intraluminal neoplasms, stricture or dilation of ducts
C-arm placement for operative cholangiography (pt. RPO w/ 15-20 degree rotation) PA over R side of abdomen below inferior ribs ensure no overlap of vertebrae (may need to rotate c-arm)
Structures shown in operative cholangiography biliary system full of contrast, hepatic branches, pancreatic duct, no extravasation, contrast emptying into duodenum, retained gallstones
Where is a “t-tube” placed? in the common bile duct
Why would a pt. need a T-tube placed? assess to biliary drainage, patency, stones, strictures
What images are taken with a T-tube placement? AP scout, RPO, lateral.
Created by: annaluz87