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ADV Pro Unit 1

Function of the kidneys filters and removes toxic wastes from blood, eliminates by urine
Urography investigation of the renal drainage or collecting system
Antegrade with the flow Study: IVU=Intravenous Urogram
Retrograde against the flow Study: Pyelography
Post void pee
Post evac poo
Cystogram Retrograde study (nonfunctional)
voiding Cystourethrography (VCUG) Retrograde study (funtional)
IVU (Intraveneous Urography) aka Excretory Urography common procedure for urinary system, injection of non-ionic contrast (antegrade study), excretory functional exam to access kidney function
What is a true functional test? contrast media molecules are rapidly removed from the bloodstream and are excreted completely by the normal kidney
Purpose of IVU exam To visualize; minor and major calyces, renal pelvis, ureters, bladder. Assess functional ability of kidneys, evaluate urinary system
Non-ionic contrast lower osmolality (still contains iodine), fewer reactions and more expensive, lower risks of affects, widely used today
Extravasation leakage of IV infused medications onto the site around the infusion
Anaphalaxis severe allergic response (systemic reaction) that can be fatal if not treated immediately
Dyspnea difficulty breathing
Dysphagia difficulty swallowing
Medications for contrast reaction Antihistimine (Benadryl), Epinephrine (Vasopressor) increases BP, Bronchodilator; relaxes smooth muscle of respiratory
Compression Bands slows flow into bladder, ensures filling of renal pelvis and calyces. Do Not use with pt with stones.
Cystography "static" retro grade study. catheter inserted into bladder and is filled slowly with contrast.
adult bladder capacity 500cc
AP axial cystogram 10-15 degree angle to free bladder of superimposition on pubic symphysis
VCUG; voiding cystourethrography funtional study AFTER cystogram. fluro images while pt standing and voiding(peeing)
non-voiding image only catheter seen
Nephrotomograms done to see "blushing"/outlines are sharp, measure pt and divide by 3 to know number of cuts
Nephrogram (renal blush) 1st radiograph taken after injection to show blush of the renal cortex
Retrograde urography/pyelography non-funtional study with pt in surgery or sedated. Ureterocystoscope is inserted through bladder into ureter with tip placed near renal pelvis. contrast is injected into the renal pelvis
Why IVU blush and not in retrograde urography? In IVU contrast is insterted into an IV an goes through the kidneys. Retrograde Urography does not go into kidneys.
Renal Angiography investigates blood vessels of kidneys and suprarenal glands. determines vascularity of lesions or lacerations, thrombi, fx of renal parenchyma.
Trauma "Golden Hour" first 60 min after major trauma has taken place
Trimodal Distribution of trauma deaths (3 Critical periods) 1st= seconds after injury 2nd= first 4 hours after injury. 3rd= weeks after injury
1st critical period seconds after injury. Immediate death can occur from lacerations of brain and spinal cord, heart and great vessels
2nd Critical Period first 4 hours after injury. Death results from intracranial hemorrhage, lacerations of the liver and spleen, or significant blood loss.
3rd Critical Period weeks after injury Death results from infection and multiple organ failure
Order of Importance: Priorities (6) 1 open airway 2 control bleeding 3 prevent/treat shock 4 attend wounds/fractures 5 provide emotional support 6 re-evaluate and follow up
Levels of Consciousness (LOC) 1 Alert and Conscious 2 Drowsy but responsive 3 Unconcious but reactive to painful stimuli 4 Comatose
Glabellomeatal line (GML) From EAM to right above the eyebrows (flat portion)
Orbitomeatal line (OML) From EAM through crease/ corner of eye
Infraorbitomeatal line (IOML) From EAM below the eyes
Acanthomeatal line (AML) From EAM to right below nose crease
Mentomeatal line (MML) From EAM to flat portion right above point of chin
Mid-coronal line Vertical straight up and down at EAM
Interpupillary line Horizontal line through the eyes
Mid- sagittal line Vertical line down mid face at nose
myelography radiographic study of the spinal cord and its nerve roots
cauda equina nerve roots resemble a horses tail
spinal cord extends from medulla oblongata to L1-2 (conus medullaris)
spinal cord connected to _____ pairs of spinal nerves 31
meninges inner to outer pia mater, arachnoid, dura mater (PAD)
Where is CSF produced? choroid plexus in the ventricles
"jelly donut" part of disk annulus fibrous= ring, nucleus pulposus= inside filling
fowlers position head elevated 30-45 degrees
most common injection site for myelogram lumbar region L2-3 or L3-4
contrast used for myelogram nonionic, water soluble compounds. Isovue or Omnipaque (low toxicity)
diskography exam of individual intervertebral disks to determine reason for back pain
laminectomy surgical procedure to remove portion of lamina to gain access to the spinal column
percutaneous vertebroplasty stabilizes collapsed vertebra using bone cement injected into fracture under fluoro, outpatient
kyphoplasty uses balloon to inflate vertebra then uses bone cement to keep the bone up
most common shoulder injury rotator cuff (tendon) tear
Arthogram contrast agents CT and xray= Isovue or Omnipaque. MRI= Gadolinium
Created by: jveliz91