RAD-146 POSITIONING IVP VCUG CYSTO

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what is the patient prep for a IVU/IVP
- usually the same as a BE
- light evening meal before procedure
- bowel cleansing laxative
- npo after midnight (minimum of 8 hours)
With a pt undergoing a n IVU study but has a foley catheter in place what must you do before injecting contrast media

the tech must clamp the catheter first then inject contrast after study is done unclamp so contrast flows into the bag
what is the purpose of uteric compression

enhances the filling of contrast in the kidneys and pelvicalyceal system
where are the uteric compression pads placed when in use

over the pelvic brim just medial to ASIS
what are the contraindications to using a uteric compression
- possible uteric stones
- abdominal mass
- abdominal aortic aneurysm
- recent abdominal surgery
- severe abdominal pain
- acute abdominal trauma
what three urinary studies involve characterization of the pt through the urethra
- retrograde urogram/pyelogram
- cystogram
- voiding cystourethrogram
what is the radiographic procedure that involves the injection of contrast media through a vein

IVP/IVU
what two studies involve the function of the kidneys

IVP/IVU and voiding cystourethrogram
what two procedures visualize how the bladder fills and the shape of it

retrograde urogram/pyelogram and cystogram
when injecting a pt the only contrast needed to use is ____

iodine
Barium is only used ______

enterically (through mouth or rectum)
what is and IVU and what are the two purposes
radiographic examination of the urinary system
- visualizes the collecting portion of the urinary system
- assess the functional ability of the kidneys (timed procedure)
what is the basic routine and special of an IVU
- scout radiograph
- injection (note time at beginning of injection)
- 1min nephrogram or nephrotomography
- 5min ap supine
- 15min ap supine
- 20min poster obliques (LPO RPO)
- PA
- Post void
- Special:
- Uteric Compression
In the ap scout film we must see what of the kidneys
what is the breathing and where do we center
- must see upper poles of kidneys and bottom of bladder
- suspend respiration on expiration
- iliac crests
what size cassette do we use for a nephrogram or nephrotomogram
where is the CR
- 11x14 crosswise
- CR midway btw xiphoid tip and iliac crest
what technical factors is appropriate for the studies of the kidney
once we inject contrast what must we annotate on the film
- 70-75kv
- how much time has passed i.e. 5 min 15min 20min
why are nephrograms taken early in the study

to demonstrate the functional portion of the kidney (whole kidney)
when taking a nephrotomogram we must warn the patient about what

we must warn them that the tube wil lbe moving back and forth so they dont get scared
in the RPO and LPO position of the IVU what is the degree of obliquity and where is the CR for the RPO
what is the breathing
The RPO position best visualizes what (2 things)
- 30 deg oblique
- iliac crests
- suspend on expiration
- left kidney is placed in profile and is parallel to the IR
- Right ureter is also visualized b.c it is projected away from the spine free of superimposition
where is the CR for the LPO
what is the breathing
The LPO position best visualizes what (2 things)
- iliac crests
- suspend on expiration
- visualizes the right kidney in profile (b/c of 30 deg oblique)
- also visualizes the left ureter projected away from the spine
what best position visualizes the distal and mid ureters filled with contrast and visualizes the upper poles of kidneys and bottom of bladder

pa
what position is best to rule out a nephroptosis

erect abdomen centered at crests
what structures are best shown in a Post void ap in an IVU
what position is used for a post void
where is the cr for a postvoid
- entire urinary system with only resiudal contrast media visible
- demonstrates enlarge prostate or prolapsed bladder
- erect or pa
- at crests centered one inch lower to include a prolapsed bladder
which one of the procedures is done in the OR with the patient in the lithotomy position (legs spread open)

Retrograde Urogram/Pyelogram
during a retrograde urogram in the OR when should make an exposure
Is this a functional study
how much kv do we need
- expose after anesthesist suspends respiration if pt is under general anesthesia
- no
- 70-75
what is a cystogram

radiographic study of the bladder after instillation of an iodinated contrast medium via a urethral cathe
what cassette do you need for a cystogram
what is the breathing
where is the cr for an ap
what is the tube angle
- 11x14 crosswise
- on expiration
- 2in above pubic symphysis
- 10-15deg caudad angle
what is the purpose of the caudal tube angle on an ap cystogram

it pushes the pubic symphysis inferior to the bladder
what is the obliquity of the LPO and RPO cystogram
the steeper the oblique shows what
where is the CR
- 45-60deg
- the posterior portion of the bladder
- 2'' above symphysis pubis and 2'' medial to upside ASIS
where is the CR for a lateral cystogram
cassette?
- 2in superior and posterior to the pubis symphysis
- 11x14 lengthwise
for a VCUG male what is the position and obliquity used
what is the size cassette
where is the catheter and directions for pt
where is the CR for a VCUG male
- RPo 30 deg oblique
- 10x12 lengthwise
- catheter must be removed and pt should be instructed to void
- @ pubis symphysis
what is best shown in a VCUG male

male urethra containing contrast medium
what positioned is used or VCUG female
size cassette?
where is the CR
what is pt instruction during exposure and catheter must be where
- ap with legs slightly extended and separated
- 10x12 length wise
- @ pubis symphysis
- exposure when pt is voiding and catheter must be remove first
what structure is shown in a female VCUG

female urethra filled with contrast
what is flank pain

kidney stones
what are the clinical indications/pathologies for an IVU
- abdominal mass
- renal or urethral calculi
- kidney trauma
- hematuria
- hypertension
- renal failure
- UTI
where must you center the CR when using a uteric compression
what size cassette do we use
- midway btw xiphoid tip and crests
- 11x14 crosswise
what is the routine for a cystogram and special
what is the routine for a vcug male and female
- ap
- rpo
- lat (optional)
- male rpo
- female ap
which of the the exams require a fluoring of the doctor
which exam requires informed consent
- cystogram
- vcug
- IVP

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anatomy12

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RAD-146 POSITIONING IVP VCUG CYSTO

Description

xray

Updated

2014-06-19T10:31:15Z

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