Name three reasons for obtainging a scout or preliminary radiograph with the patient recumbent for an IVU
To evaluate the exposure factors
To demonstrate any urinary calculi
To demonstrate location & size of kidneys
What type of contrast is commonly used for an IVU
Water soluble iodinated
Durring an IVU what is best demonstrated 30 seconds after the bolus injected
Contrast seen within nephrons of the kidney nephrogram (BLUSH)
Durring an IVU what is best demonstrated 2-8 minutes after the bolus injected
Contrast begins to appear in the pelvicalyceal system
Durring an IVU what is best demonstrated15-20 minutes after the bolus injected
Greatest concentration
The supine position best demonstrates in a IVU
The upper calyces
The upright postion best demonstrated in a IVU
The motility of the kidneys
The trendelenburg best demonstrates in a IVU
The distal/lower ureters( as the bladder fundus stretches superiorly) and pelvicalyceal region
What degree of obliquitly for an POV during an IVU
30 degrees
What does an RPO view best demonstrate
LT. kidney which is parallel to IR and the RT. proximal ureter is demonstrated free of the spine
What does an LPO view best demonstrate
RT kidney which is parallel to the IR and the LT proximal ureter is demonstrated free of the spine
Most IVU images are obtained on what repiration cycle
On suspended expiration or exhilation
When performing IVU examinations what is best demonstrated by the supine position
Filling of upper calyces
When performing IVU examinations what is best demonstrated by the Erect positon
Motility of kidneys
When performing IVU examinations what is best demonstrated by the Trendenlenburg position
Distal ureters ( as bladder fundus stretches superiorly) and pelvicalyceal region
What does a post void image demonstrate in a IVU examination
Residual urine in bladder
Why is compression sometimes applied during an IVU examination?
To retard the flow of contrast into the bladder & ensure adequate filling of the calyces
Where should the compression band be placed in a IVU examination
Over the distal ends of the ureters at the level of the ASIS
Why must the compression be released slowly in a IVU examination
To avoid visceral rupture
Define retrograde Urography
NON - FUNCTIONAL radiographic study of the urinary system using contrast during cystoscopy
Where is the contrast placed for retrograde urography
Directly into the pelvicalyceal system via catheterization
In retrograde Urography what is the purpose of tilting the table10-15 degrees trendelenburg
Aids in keeping the contrast medium in the kidneys
What is the purpose of performing a Modified Retrograde Urogram
To assess kidney function by using an injectable colored dye and not contrast
Good for patients with sensitivitly to contrast
Define Cystograghy
A NON FUNCTIONAL radiographic examination of the urinary bladder using contrast
What is the main difference between cystography and voiding cystography
Coiding cystography is a FUNCTIONAL study wehre images are taken as the patient voids cehreas cystography is a NON FUNCTIONAL study (retrograde study)
What must the adult patient do prior to begining these procedures
Empty their bladder
So that the contrast does not get diluted
Define cystourethrography
A NON functional radiographic demonstration of the urethra using a contrast medium
What is the difference between cystourethrography and voiding cystourethrography
Voiding cystourethrography is a FUNCIONAl study whereas a cystourethrography is NON functional against normal flow
What two projection/views are done for a Cystourethrography and voiding cystourethrography examination
Usually an AP and Posterior oblique views
Name 3 reasons for performing a percutaneous catheter nephrostomy(PCN)
Drainage
Drug installation
Instrument insertion
What does ESWL stand for
Extracorporeal Shock Wave Lithotripsy
Name two methods of stone removal after apercutanous nephrolithotomy
Basket extraction
Ultrasonic lithotripter
Define hysterosalpingography
A radiographic examination of the uterus and fallopian tubes that involves an injection of contrast medium into a catheter inserted in the uterus
What is the optimun time durring a females menstrual cycle to perform an hysterosalpingography examination
This procedure must take place 10 days after the onset of menstruation because the endometrium congested then
Describe the postion of each kidney?Which one is more superior and why
The kidneys are positioned between T12 and L3
Which part of the kidney lies most anterior and which part lies most posterior
The left is more superior due to the liver pushing down the right kidney
Which part of the ureter is most anterior? Where does it join the bladder( what aspect)
The superior portion of the kidney is most posterior and the inferior portion is most anterior
Why are the location /position of the kidney an important consideration when performing contrast studies of this area
To help influence the location of the contrast media when positioning the patients body
Why is it necessary for thepatient to empty their bladdeer prior to a cystogram being performed
To prevent dilution of the contrast media
Why is retrograde urography considered a NON functional study
It by passes the circulatory system therefore the contrast does not get filtered by the kidneys
What would be done to make it functional study (retrograde Urography examination)
Injecting a colored dye and seeing how long it takes to become visible in the urine
When a hysterosalpingiogram is being booked what factors must be considered
Patient must not be pregnant
Procedure must be booked 10 days after the onset of menstruation
A hysterosalpingiogram is used to determine if a patient is pregnant?
True or false
False
When is a KUB (kidney,Urine,Bladder) requested?
From an emergency department to determine the site of a kidney stone in a patient with renal colic
Radiographich images for a KUB
AP abdomen
AP Bladder
Radiographic images for a retrograde urography
AP
posterior oblique view
Radiographic images for a cystourethrography
AP
Posterior oblique view
Basket insertion
Performed to remove small free floating calculi in the kidney. The stone is trapped in the basket and dragged through the incision out of the body
Ultrasound lithotripter
Small device that can be inserted into an opeining in the kidney and rest up against a calculus. Ultrasound vibrations are transmitted to the calculi whihc will break up the stone.
Suction device will remove fragments
Intravenous urogram
Examnination of the urinary system that involves an injection of iodinated contrast media to demonstrate the collecting system of the kidneys ureters & bladder. Images taken in time intervolts after injection
Retrograde urogram
Examination of the urinary system that involves an injection of iodinated contrast media into the kidneys and ureters through catheters placed into the urinary system during cystoscopy.Demonstrates anatomy of the collecting system of the kidney & ureters
Cystography
Examination of the bladder that involves injection of iodinated contrast media into a catheter inserted into the bladder & images are taken in various patient positions
Voiding cystourethrography
Examination of the bladder & urethra that invovles injection of an iodinated contrast media into a catheter in the bladder.
The bladdder is filled the catheter is removed & patient is instructed to void on the fluoroscopic table . Images taken while patient is voiding
Nephrostomy
Examination that involves injection of drugs or for removal of calculi
Nephrostography
Examination involves injection of iodinated contrast media into a nephrostomy tube
Lithotripsy (ESWL)
Is a procedure in which shock waves will disintegrate calculi in the kidney without an incision -like lazor treatment`
Hysterosalpingraphy
is the radiographic examination of the uterus and fallopian tubes that involves an injection of contrast media into acatheter inserted in the uterus