advanced positioning - IV biliary flouro set 2
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| IV administered contrast is absorbed by the: | liver
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| Biliary tract examinations are done to evaluate: | liver function, patency of bile ducts, concentrating and emptying of the gallbladder
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| what kV range should be used for radiographic examinations of the billiary system? | 70-80 kVp
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| oral cholecystography (OCG) is done to evaluate: | eval for symptoms persistent with gallbladder disease
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| what are the contraindications for an OCG? | pt. with vomiting, diarrhea, pyloric obstruction, malabsorption, jaundice or liver dysfunction, hypersensitivity to iodinated contrast
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| pt. prep for an OCG | lo fat diet, no laxatives prev 24 hours, no food after oral contrast
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| 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.
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| Pt. position for an OCG scout and why | prone to place the biliary structures closer to the IR
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| PA gallbladder IR sizes | 10X12 LW for scout, 8X10 for subsequent exposures
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| 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)
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| PA gallbladder pt. position (upright) | center gallbladder to IR CR perpendicular, patient holds on expiration
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| what is demonstrated on a PA gallbladder? | opacified gallbladder, entire gallbladder and cystic duct, short scale of contrast, no motion, adequate technique
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| pt position LAO gallbladder | pt. rotated 15-40 degrees, (thin pt. needs more rotation) perp. CR, center to gallbladder.
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| 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
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| 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
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| 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
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| AP R lat. Decub gallbladder pt. position | pt. R lat. Recumbent, elevated 2-3 inches on support to center gallbladder to film.
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| 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
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| Operative cholangiography is done for | bile-duct patency, sphincter of oddi function, presence of calculi, intraluminal neoplasms, stricture or dilation of ducts
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| 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)
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| Structures shown in operative cholangiography | biliary system full of contrast, hepatic branches, pancreatic duct, no extravasation, contrast emptying into duodenum, retained gallstones
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| Where is a “t-tube” placed? | in the common bile duct
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| Why would a pt. need a T-tube placed? | assess to biliary drainage, patency, stones, strictures
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| What images are taken with a T-tube placement? | AP scout, RPO, lateral.
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