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Venography
| Question | Answer |
|---|---|
| Scout radiographs for lower limb | -AP w/ overhead tube or PA with flouro under tube -poss Lateral |
| Lower leg indications (6) | -DVT, venous obstruction, recurrent varicose veins, varicose ulcers, venous malformations, swollen leg of unknown etiology |
| Lower leg CONTRAindications (3) | -contrast allergy, local sepsis, significant compromise of veins |
| Contrast type for venography | -iodine-based water-soluble, low-osmolarity preferred (costs more but reduces pain and less complications) |
| Type of needle for lower limb | -19 or 21-guage butterfly needle |
| Tournequet placement for lower limb | -1 above knee -1 above ankle |
| Injections site for ascending lower leg | -dorsal venous arch |
| If severe swelling of leg, patient should do what the night before? | -elevate leg |
| Patient position for lower leg | -supine, head raised abt 40deg (Fowler's position) |
| Done if sever swelling of lower leg | -small incision made to expose vein for injection |
| Tourniquet pressure should occlude witch veins? | -superficial, not deep |
| Amount of contrast for lower leg | -40 to 50mL |
| During contrast injection, care should be taken to avoid what and why? | -extravasation, may cause necrosis if already compromised |
| When are spot films taken? | -as injection is given |
| If extra images are needed, what should the patient do and why? (lower limb) | -valsalva maneuver, slows down contrast flow into pelvic region |
| Done after injection but before removing needle, and why? (for upper and lower limb) | -flush with 0.9% saline to prevent risk of phlebitis |
| If unable to do ascending lower leg so descending is required, where is contrast injected? | -femoral vein |
| Normal radiographs for lower leg | -AP, uncluding all vessels up to common femoral and iliac veins |
| For lower leg, why should leg be slightly rotated, and in witch direction? | -to separate tib and fib and deep veins of the calf, rotated medially |
| Alternative radiographs, after injection (lower limb) | -overhead radiographs of calf and thigh, immediately after needle is removed |
| After lower limb veonography,what could changes in leg pain mean? | -presence of thrombophlebitis |
| After lower limb veonography,injection site should be monitored to ensure no... | -inflammation, infection, necrosis |
| After lower limb veonography, patient should be advised to do what? | -exercise the limb |
| A possible risk association w/ venography | -dislodging blood clot(s) |
| Injection site for varicose vein study, primary and possible secondary | -in a varicosed vein below the knee, possibly repunctured above the knee |
| Why is the upper arm of more interest than lower? | -upper arm has greater likelihood of thrombus |
| Injection site for upper limb venography(upper arm) and why | -medial cubital vein, flows into axillary vein |
| Indications for upper limb (3) | -edema of arm or hand, venous obstruction, suspected thrombosis |
| Major vein of upper arm | -axillary vein |
| Contraindication for upper limb | -contrast allergy |
| Type of needle for upper limb | -18,19,or 21-gauge butterfly needle |
| Tournequet placement | -1 above wrist -1 above elbow |
| Scout radiographs for upper limb | -AP or PA of affected side, usually includes shoulder and upper arm |
| Patient position for upper limb | -supine, hand supinated and abducted from torso |
| Amount of contrast injected for upper limb | -apporx 30mL |
| Radiographs taken during upper limb exam | -PA and obliques with overhead tube (immediately after injection) |
| Most common lower limb pathology found | -DVT |
| Most common upper limb pathology found | -thrombosis |
| Most common type of venogram | -lower limb |
| Major vein that drains the upper limb | -subclavian |
| Largest vein in upper arm | -basilic |
| Injection site for inferior venacavagram or renal venogram | -posterior chest, b/t two ribs |
Created by:
kairis276
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