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Chapter 14 final
chapter 14 final-class 3
| Question | Answer |
|---|---|
| the kidneys and ureters are located in the _____________ space | retroperitoneal |
| the _________ glands are located directly superior to the kidneys | suprarenal (adrenal) |
| which structures create a 20 degree angle between the upper pole and lower pole of the kidney? | posts major muscles |
| what is the specific name for the mass of fat that surrounds each kidney? | perirenal fat/adipose capsule |
| what degree of rotation from supine is required to place the kidneys parallel to the IR? | 30 degrees |
| which 2 landmarks can be palpated to locate the kidneys? | Xiphoid process and iliac crest |
| which term describes an abnormal drop of the kidneys when the patient is placed erect? | nephroptosis |
| 3 functions of the urinary system | remove nitrogenous waste, regulate h20 levels, regulate acid-base balance |
| a buildup of nitrogenous waste in the blood is called: | uremia |
| the longitudinal fissure found along the central medial boarder of the kidney is called the: | hillim |
| the peripheral or outer portion of the kidneys is called the | cortex |
| the term that describes the total functioning portion of the kidney is | renal parenchyma |
| the microscopic functional and structural unit of the kidney is the | nephron |
| t/f the efferent arterioles carry blood to the glomeruli | false |
| what is another (older) name for the glomerular capsule? | bowman |
| t/f the glomerular capsule and proximal and distal convoluted tubules are located in the medulla of the kidney | false- cortex |
| which structure of the medulla is made up of a collection of tubules that drain into the minor calyx? | renal pyramids |
| which 2 processes move urine through the ureters to the bladder? | peristalsis and gravity |
| which one of the following structures is located most anterior as compared with the others? a. proximal ureters b. kidneys c. urinary bladder d. suprarenal glands | urinary bladder |
| what is the name of the junction found between the distal ureters and urinary bladder? | uterovesical jx |
| what is the name of the inner, posterior region of the bladder formed by the 2 ureters entering and the urethra exiting? | trigone |
| what is the name of the small gland found just inferior to the male bladder? | prostate gland |
| the total capacity for the average adult bladder is: | 350 to 500mL |
| which one of the following structures is considered to be most posterior? a. ovaries b. urethra c. vagina d. kidneys | kidneys |
| intravenous contrast media may be administered by either: | bolus or drip infusion |
| t/f the patient(or legal guardian) must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient | true |
| for most IVU's, veins in the ___________ are recommended for venipuncture | antecubital fossa |
| the most common size of the needle used for bolus injections on adults is: | 18 to 22 gauge |
| the 2 most common types of needles used for bolus injection of contrast media are | butterfly & over-the-needle catheter |
| in correct order list the 6 steps during a venipuncture procedure (pg 535-537) | 1. wash hands/gloves 2. select site/tourniquet/clean 3. initiate puncture 4. confirm entry/ secure needle 5. proceed 6. remove needle/ catheter |
| t/f the bevel of the needle needs to be facing downward during the actual puncture into a vein | false- up |
| t/f if extravasation occurs during the puncture, the tech should slightly retract the needle and then push it forward again | false- withdraw and pressure |
| t/f if unsuccessful during the initial puncture, a new needle should be used during the second attempt | true |
| t/f the radiologist is responsible for documenting all aspects of the venipuncture procedure in the patients chart | false- the tech does this |
| ionic contrast media | |
| nonionic contrast media | |
| which one of the following compounds is a common anion found in iconic contrast media? a. diatrizoate or iothalamate b. sodium or meglumine c. benzoic acid d. none of the above | a. diatrizoate or iothalamate |
| any disruption in the physiologic functions of the body that may lead to a contrast media reaction is the basis for the: a. homeostasis theory b. Anaphylactoid theory c. vasovagal theory d. chemotoxic theory | d. chemotoxic theory |
| an expected outcome to the introduction of contrast media is described as a________ | side effect |
| the normal creatine level for an adult should range between | 0.6 to 1.5mg/dL |
| normal BUN levels for an adult should range between | 8-25mg/100mL |
| the American college of radiology recommends that metformin be withheld for __________ hrs after a contrast media procedure and resumed only if kidney function is again determined to be within normal limits | 48 hrs |
| the leakage of contrast media from a vessel into the surrounding soft tissues is called | extravasation |
| list the two general categories of contrast media reactions | local and systematic |
| which type of reaction is a true allergic response to iodinated contrast media? | Anaphylactic reaction |
| which type of reaction is caused by the stimulation of the vagus nerve by introduction of a contrast medium, which causes heart rate and blood pressure to fall? | vasovagal reaction |
| t/f vasovagal reactions are not considered to be life threatening | false |
| brachycardi (<50 beats/minute) | severe reaction |
| tachycardia (>100beats/minute) | moderate reaction |
| angioedema | moderate reaction |
| Lightheadedness | mild reaction |
| hypotension (Systolic BP <80mm Hg) | severe reaction |
| temporary renal failure | severe reaction |
| laryngeal swelling | severe reaction |
| cardiac arrest | severe reaction |
| mild hives | mild reaction |
| t/f mild-level contrast media reactions do not usually require medication or medical assistance. | true |
| t/f urticaria is the formal term for excessive vomiting | false |
| a temporary failure of the renal system is an example of a(n): | severe reaction |
| convulsions 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 4. severe systemic |
| metallic taste 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 1. side effect |
| angioedema 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 3. moderate systemic |
| Bradycardia 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 4. severe systemic |
| itching 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 2. mild systemic |
| vomiting 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 2. mild systemic |
| temporary hot flash 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 1. side effect |
| respiratory arrest 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 4. severe systemic |
| pulmonary edema 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 5. local |
| extravasation 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 4. severe systemic |
| severe urticaria 1. side effect 2. mild systemic 3. moderate systemic 4. severe systemic 5. local | 3. moderate systemic |
| what should the tech do first when a patient is experiencing either a moderate or a severe level contrast media reaction? | call for medical assistance |
| what is the primary purpose of the premedication procedure before an iodinated contrast media procedure? | to reduce the severity of reactions |
| which of the following drugs is often given to the patient as part of the premedication procedure? a. epinephrine b. valium c. combination of benadryl and prednisone d. lasix | c. combination of benadryl and prednisone |
| which type of patient is a likely candidate for the premedication procedure before a contrast media study? a. elderly b. asthmatic c. pediatric d. patient with hypertension | b. asthmatic |
| in addition to notifying a nurse or physician when contrast media has extravasated into the soft tissues, what should the tech first do to increase reabsorption? | elevate or use a cold then hot compress |
| t/f tissue inflammation from extravasated contrast media peaks 1 to 2 hours after the incident | false- 24 to 48 hours |
| t/f acute renal failure may occur 48 hours after an iodinated contrast media performed | true |
| contraindications that may prevent a patient from having a contrast media procedure performed | CHF, sickle cell anemia, renal failure, hypersensitivity to iodinated contrast media, diabetes, hepatic/renal disease, multiple myeloma, anuria |
| a trademark name for a diuretic drug is | lasix |
| why is the term IVP incorrect in describing a radiograph examination of the kidneys, ureters, and bladder after intravenous injection of contrast media? | because IVP= study of renal pelvis, IVU is the correct term |
| which one of the following conditions is a common pathologic indication for an IVU? a. sickle cell anemia b. multiple myeloma c. hematuria d. anuria | c. hematuria |
| which of the following conditions is described as a rare tumor of the kidney? a. pheochromocytoma b. multiple myeloma c. melanoma d. renal cell carcinoma | a. pheochromocytoma |
| pneumouria | presence of gas in urine |
| urinary reflux | backward return flow or urine |
| uremia | excess urea and creatine in the blood |
| anuria | complete cessation of urinary secretion |
| polyuria | passage of large volume of urine |
| micturition | act of voiding |
| retention | inability to void |
| oliguria | diminished amount of urine being excreted |
| glycosuria | presence of glucose in urine |
| urinary incontinence | constant or frequent involuntary passage of urine |
| renal agenesis | absence of a functioning kidney |
| acute renal failure | indicated by presence of uremia, oliguria, or anuria |
| enlargement of the prostate gland | benign prostatic hyperplasia |
| fusion of the lower poles of kidneys during the development of the fetus | horseshoe kidney |
| inflammation of the capillary loops of the glomeruli of the kidneys | glomerulonephritis |
| artificial opening between the urinary bladder and aspects of the large intestine | vesicorectal fistula |
| a large stone that grows and completely fills the renal pelvis | staghorn calculus |
| increased blood pressure to the kidneys due to atherosclerosis | renal hypertension |
| normal kidney that fails to ascend into the abdomen but remains in the pelvis | ectopic kidney |
| rapid excretion of contrast media | renal hypertension |
| mucosal change within bladder | cystitis |
| bilateral, small kidneys with blunted calyces | chronic bright disease |
| irregular appearance of renal parenchyma or collecting system | renal cell carcinoma |
| signs of abnormal fluid collections | vesicorectal fistula |
| abnormal rotation of the kidney | malrotation |
| elevated or indented floor of bladder | BPH |
| signs of obstruction of urinary system | renal calculi |
| a condition characterized by regions or areas of subcutaneous swelling caused by allergic reaction to food or drugs is termed: | angiodema |
| contraction of the muscles within the walls of the bronchi and bronchioles, producing a restriction of air passing through them, is a condition called | bronchospasm |
| loss of consciousness resulting from reduced cerebral blood flow is termed | syncope |
| what type of renal calculi is often associated with chronic urinary tract infections? | staghorn calculi |
| t/f the patient should void before IVU to prevent possible rupture of the bladder if compression is applied | true |
| what is the primary purpose of ureteric compression? | to enhance filling of pelvicaliceal system |
| what conditions could contraindicate the use of ureteric compression | a. possible ureteric stones b. abdominal mass c. abdominal aortic aneurysm d. acute abdominal pain e. abdominal trauma |
| when does the timing for an IVU exam start? | at the start of injection of contrast |
| list the routine five-step imagine sequence for a routine IVU: | 1. 1 minute nephrogram/nephrotomography 2. 5 minute KUB 3. 10-15 minute KUB 4. 20 minute RPO&LPO 5. postvoid (prone PA or erect AP) |
| t/f a retorgrade urogram examines the anatomy and function of the pelvicaliceal system | false |
| t/f the brodney clamp is used for male and female cystourethrograms | false- male only |
| which of the following involves a direct introduction of contrast media into the structure being studied? a. retrograde urogram b. retrograde cystogram c. retrograde urethrogram d. all of the above | d. all of the above |
| which of the following alternative imaging modalities is NOT routinely being used to diagnose Renal calculi? a. nuclear medicine b. sonography c. magnetic resonance imaging d. computed tomography | c. magnetic resonance imagine |
| t/f urinary studies on pediatric patients should be scheduled early in the morning to minimize the risk for dehydration? | true |
| t/f the number of retrograde urography procedures for uretheral calculi has been reduced as a result of the increased use of CT. | true |
| t/f the number of retrograde urography procedures for urethral calculi has been reduced as a result of the increased use of CT | true |
| exposure factors used during a CT procedure can be adjusted to compensate for a decrease or increase in body size according to __________ and ________ | height and weight |
| t/f the patient does not require extensive bowel preparation before a CT scan for renal calculi | true |
| which imaging modality is used to detect subtle tissue changes following a renal transplant? a. MRI b. CT c. Radiography-IVU d. nuclear medicine | a. MRI |
| t/f nuclear medicine is highly effective in demonstrating signs of vesicorueteral reflux | true |
| how will an enlarged prostate gland appear on a post void radiograph taken during an IVU | |
| where should the pneumatic paddle be placed for ureteric compression phase of an IVU? | medial to asis & lateral to spine |
| what can be done to enhance filling of the calyces of the kidney if ureteric compression is contraindicated? | 15 degrees trendelenburg |
| a retrogarde pyelogram is primarily a nonfunctional study of the_____________ | renal pelvis, major and minor calyces |
| what are 4 reasons a scout projection is taken before the injection of contrast media for an IVU? | 1. check patient prep 2. exposure factor 3. positioning 4. abnormal calcifications |
| what specific anatomy is examined during a retrograde ureterogram? a. primarily the ureters b. primarily the renal pelvis and calyces c. entire urinary system d. urinary bladder | a. primarily the ureters |
| which specific position is recommended for a male patient during a voiding cystourethrogram? | 30 degrees RPO |
| which kV range (analog and digital) is recommended for an IVU? | 70-80KV |
| t/f male and female patients should have the gonads shielded for an AP scout projection? | false |
| t/f tomograms taken during an IVU with an exposure angle of 10 degrees or less are called zonography | true |
| how many tomograms (zonograms) are usually produced during a routine IVU? | 3 |
| at what stage of an IVU is the renal parenchyma best seen? | within 1 minute after injection |
| where is the CR centered for a nephrotomogram? | midway between xiphoid process and iliac crest |
| which position, taken during an IVU, places the left kidney parallel to the IR? | RPO |
| how much obliquity is required for the LPO/RPO projections taken during an IVU? | 30 degrees |
| which position best demonstrates possible nephroptosis ( also called floating kidney or renal ptosis, abnormal condition in which the kidney drops down into the pelvis when the patient stands up.) | erect |
| which CR angle is used for the AP projection taken during a cystogram? | 10 to 15 degrees caudad |
| The concave medial border of the kidney where the blood vessels and ureter exit is called the | helim |
| Which of the following serve(s) as a reservoir to store urine? | urinary bladder |
| How long is the urethra in the female? | 2 inches |
| What is the central-ray angle for the AP oblique projections of the urinary system? | 0 degrees |
| Where do the ureters lie in relation to the peritoneum? | Behind the peritoneum |
| The vessels most often used for venipuncture are found on the: | anterior forearm and posterior hand |
| cystoscopy | the visual examination of the urinary bladder using a cystoscope |
| The concentration of iodine in ionic contrast media is | 50 to 70% |
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Hmaeesomy
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