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