Chapter 13 Diagnostic Procedures

When a vessel cannot be assessed percutaneously for angiography, how else could it be done?

"Cut down"

List the steps, in order, for percutaneous placement of a femoral artery catheter using the Seldinger

1% Xylocaine injected into femoral region, Small incision made with #11 knife-blade, Introduction into femoral artery with cannula inserted at angle, Guidewire inserted through cannula and into artery, Catheter positioned, Catheter flashed with heparinized solution, X-rays taken

In normal blood gas ranges, arterial oxygen saturation should be at or near what percentage range of capacity?

96-100%

A type of organism that dies quickly when exposed to air is called:

Anaerobic

What is the symptom that a patient with a myocardial ischemia would experience?

Angina

Rapid serial film changers and pressure injectors are used in what diagnostic imaging study?

Angiogram

List four intraoperative applications for fluoroscope

Angiography, cholangiography, retrograde urography, verification of catheter placement

Prosthesis

Artificial device used to replace a body structure, aid bodily function, or give a cosmetic appearance; may be permanent or removable

What is stained in a Gram stain test?

Bacteria

Patient diagnosed with cholecystitis and cholelithiasis. What laboratory studies do you expect to find on the patient's chart?

CT, ultrasonography, MRI

Pulse oximetry for oxygen measurement and __ for end- tidal C02 measurement are helpful during surgery for monitoring the respiratory status

Capnography

What noninvasive study assesses the amount of carbon dioxide in the arterial system of a patient on mechanical ventilation?

Capnography

Symptom

Caused patient to seek medical attention

What type of radiography can be used to visualize the structures of the biliary tract?

Cholangiography

What diagnostic studies might be performed for generalized periumbilical pain that has now localized to the RLQ.

Colonoscopy, CT, Ultrasonography

Cholangiography is the diagnostic study that images which anatomical structure?

Common bile duct

__ for intraoperative cholangiograms may be used full strength or in half- and -half solution

Contrast medium

Hypaque, Cytografin, and Renografin are:

Contrast mediums

What type of dye is used for staining tissue for diagnosis?

Crystal violet and iodine

What diagnostic study will indicate the presence of an infection?

Culture and sensitivity

What study assists a surgeon in determining the MOST effective antibiotic therapy for treatment of an SSI?

Culture and sensitivity

Name three types of visualization

Direct (naked eye), enhanced (otoscope/ opthalmoscope), indirect (pharyngeal mirror)

EEG

Display and recording of brains electrical activity by measurement of changes in electric potentials

Why is ultrasonography ideal for examination of a fetus?

Do not use ionizing radiation

Biopsy

Excision of tissue or aspiration fluid to determine nature of disease or for treatment

Palpation

External (abdominal or thyroid) and/or internal (pelvic or digital rectal) exam

What artery is MOST commonly accessed with the Seldinger technique during cardiac catheterization?

Femoral artery

What are the arteries that can be used to insert a Swan-Ganz pulmonary artery catheter?

Femoral vein, left subclavian vein, or internal jugular vein

CSF

Fluid that flows through ventricles, brain, subarachnoid space, and spinal cord; provides cushion

What diagnostic method requires the use of an image intensifier?

Fluoroscopy

An AP view on a radiograph is taken:

Front to back

What is considered the first step in determining the etiology of a patient's condition? Why?

Gathering medical, social (including any ethic and/or religious info that may impact the course of the treatment), and physiological info about the patient, and if applicable, the patient's family

In a Gram stain study, the bacteria that retains the blue coloration following staining, alcohol rinse, and restraining is :

Gram positive

Obstruction

Hindrance of blockage of a passage

What is the name of the 24- hour monitoring device for cardiac dysrhythmias?

Holter monitor

Identify six purposes of radiographic exams in the OR

ID location of abnormalities and foreign bodies, locate retained sponges, sharps, or instruments. Discover fluid or air within body cavities, verify correct location for operative procedure, aid in bone realignment and prosthesis placement, verify placement of indwelling catheters, tubes, and drains

Contrast media is routinely introduced:

IV

What is the advantage of fluoroscopy?

Images may be viewed during movement and projected in "real time"

Sign

Indicates the presence of pathological condition

Cystoscopy

Insertion of an endoscope through the urethra and into bladder for the purpose of viewing for diagnosis and treatment

Angina

Intermittent or continuous cardiac pain causes by anoxia of the myocardium

Describe the scrub responsibilities for the IOC during cholecystectomy. What does IOC stand for?

Intraoperative Cholangiogram Keep sterile field from being contaminated

What is a common component of many contrast media that may be a contraindiction for use in allergic patients?

Iodine

UA (urianalysis)

Lab examination of a urine specimen for diagnostic purposes

Gram stain

Lab method of identifying bacteria Positive- pink, Negative- purple

A portable x-ray cassette holder is used for __ fild

Lateral

What structures might be involved in the right lower quadrant?

Liver, kidney, appendix, gallbladder

B - cells and T - cells are types of:

Lymphocytes (WBCs)

ECG

Noninvasive study provides 2D image of the heart by directing beams of ultrasonic waves from a solar- like device through the chest wall

What is another term used for diagnostic isotope scanning?

Nuclear membrane

A corneal abrasion would be assess using a(n):

Opthalmoscope

Why is contrast media used?

Outlines obstructions under fluoroscopy

A deep vein thrombosis can be diagnosed by what diagnostic study?

Phleborheography

What condition of excess fluid is analyzed by thoracentesis?

Pleural effusion

Thoracentesis is removal of fluid from the :

Pleural space

Describe the process of shooting an IOC

Preop or intraop during Cholecystectomy or common bile duct exploration, a catheter inserted and contrast medium injected into biliary system to outline calculi or other obstructions under fluoroscopy

Cholangiography

Preoperative and intraoperative diagnostic tool in which catheter is inserted into common bile duct and contrast medium injected to outline calculi under fluoroscopy

During a portable x-ray of the surgical site, what is the duty of the surgical technologist in the scrub role?

Protect the sterile field from contamination

The __ is the standard unit of an absorbed dose of ionizing radiation measured by the radiation monitoring device worn at the collar outside the lead shield

RAD

Rotentenography, named for the German physicist who discovered it, is better known today as:

Radiography (x-ray)

Isotope

Scanning involves IV injection of a radioactive isotope into patient prior to imaging study

A neurologist might order an EEG for a patient with what suspected diagnosis?

Seizure disorder, brain tumor, epilepsy and other diseases and injury to the brain

The __ uses a J- wire fluoroscopy for guidance and easy access into a vessel

Seldinger technique

Contrast medium

Solution inserted into arteries, veins, or ducts during a radiograph exam that's radiopaque, and therefore it stands out in contrast to surrounding tissues

What test involves a lumbar puncture for collection and analysis of CSF?

Spinal tap

Auscultation involves use of a(n):

Stethoscope

Indwelling

Substance or item that remains in place either permanently or short time period

Gram

Suffix meaning written record

Which wave of the cardiac cycle in an electrocardiogram indicates the ventricular repolarization phase?

T wave

C- arm

Type of portable fluoroscope, it's named for its configuration

Ultrasonography

Use of high frequency that are directed into body and are reflected from tissues to record an image for diagnostic purposes

Capnography

Used in anesthetic setting to provide a breath-by- breath analysis of expired C02 (end- tidal C02)

What type of examination is necessary to identify an atelectasis (collapsed lung)?

X-ray

Graph

X-ray; produces a drawing or writing

Will pressure readings from a Swan-Ganz catheter placed in the pulmonary artery be useful in diagnosing pulmonary embolism?

Yes, rule out changes