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Venography

QuestionAnswer
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