what are the most common areas in arthrography
shoulder, knee, hip, wrist, and TMJ
Which modality has greatly reduced the number of arthrograms performed?
MRI
What are some indications for a knee arthroscopy
tears in joint capsule, tears of meniscus, or tears of ligaments
indications for shoulder arthrography
rotator cuff tears, pain/weakness, loss of ROM (frozen shoulder)
when is wrist arthrography done?
trauma, persistant pain, limited ROM
When is hip arthrography mostly done
to detect loose hip prosthesis or to confirm presence of infection
TMJ arthrography is done when
to look for abnormalities of the articular disk located between the condyle of the mandible and the mandibular fossa
contraindications to performing arthroscopy
allergies to contrast
low renal function
why is the joint manipulated
to disperse the contrast
What are the 3 rules for injectable contrast
check the bottle 3 times
show the bottle to the rad
keep the bottle to document the type and amount
why is stress device sometimes used for knee
to open up the joint space and allow for better distribution of contrast around meniscus
What position is the patient usually in for knee
prone
most common projections/positions for knee arthrogram
AP, 20 degree medial and lateral obliques, lateral, and PA axial
How much contrast is used for wrist arthrography
1.5-4 mL
where is the injection site for wrist
the articulation of the radius, scaphoid, and lunate
most common projections for wrist arthrography
PA, lateral, and both obliques
what kind of needle is used on shoulder
spinal needle
how much contrast for shoulder
10-12 mL
injection site for a shoulder
1/2 in inferior/lateral to coracoid process
common projections/positions for shoulder arthrogram
AP(internal and external), inferosuperior axial, AP oblique, and tangential
how much contrast used for TMJ
.5-1 mL
injection site for TMJ
1/2 in anterior to tragus
3 parts of the brainstem
midbrain, pons, and medulla onlongata
the pons is the "___" between the ___, ___, and ___
bridge
cerebrum, medulla oblongata, and cerebellum
sits directly superior to the pons
midbrain
contains the thalamus, hypothalamus, epithalamus, and 3rd ventricle
diencephalon
the cerebellum has 2 hemispheres separated by a constricted area called
vermis
the outer portion of the cerebrum is called the
cerebral cortex
what kind of matter is the cerebral cortex
gray
what separates the rt and lt hemispheres of the brain
longitudinal fissure
bands of nerve fibers between the hemispheres
commisures
what is the largest commissure in the brain
corpus callosum
function of the ventricles
contain CSF and produce it
what 4 structures protect the brain
CSF, meninges, skull, and BBB
the inner portion of the spinal cord is what kind of matter
what about outer?
gray
white
the pointed, tapered end of the spinal cord
conus medullaris
how many pairs of spinal nerves
31
what 3 structures protect spinal cord
vertebrae, meninges, and CSF
inner layer of the meninges
pia mater
the delicate central or middle layer of the meninges
arachnoid mater
the outermost layer of the meninges
dura mater
special folds/partitions of the dura mater that separates the cerebral hemispheres.
falx cerebri
the falx cerebri connects anteriorly to the ___ of the ethmoid
crista gali
tent-shaped fold of the dura mater that separates the cerebrum and cerebellum
tentorium
each lateral ventricle has 3 prolonged portions called the
anterior, inferior, and posterior horns
what connects the lateral and 3rd ventricles
foramina of Monroe or interventricular foramen
what connects 3rd and 4th ventricles
cerebral aqueduct or aqueduct of sylvius
the 4th ventricle opens into the subarachnoid space via
foramina of Luschka or magendie
what produces CSF
choroid plexus
what type of contrast is used for myelogram
non-ionic
Which form of omnipaque can be used intrathecally
300 (350 cannot)
why is a pillow placed under the spine for lumbar myelogram
to flex the spine
what space is contrast injected into for myelogram
subarachnoid
puncture site for lumbar myelogram
L3-L4
puncture site for cervical myelogram
C1-C2
how much contrast for myelogram
9-12 mL
risks suring myelogram
bleeding and infection
why must the pt hyperextend chin during myelogram
to prevent contrast from entering the head
contraindication for myelogram
blood in CSF
arachnoiditis
recent lumbar puncture
allergies to contrast
why are venograms performed
to look for thrombosis or occlusions
where is contrast injected for upper limb venogram
elbow or wrist
Long bone measurement is also called
orthorentgenography
2 treatment methods for different limb lengths
1. metaphyseal-epiphyseal fusion @ distal femur/ proximal tib/fib
2. surgically cutting femur frame placed around ends and extended to outside of body. Gradual pressure on frame separates bone, extends leg, and promotes healing @ same time
how far apart must the ankles be for leg length study
5-6 inches
what is the specialized ruler called
Bell Thompson ruler
which 3 joints does the CR pass through for leg length study
hip, knee, and ankle
what type of joints does arthrography deal with
synovial joints
where are the turnoquets placed for lower limb venogram
near foot and higher up on tib/fib
where is contrast injected for lower limb venogram
top of foot
why does rad raise the leg on lower limb venogram
what is this often called
so the contrast fills the IVC
the dump film
what is the structure that attaches each ovary to the uterus
ovarian ligament
the mature developed follicle is called
Graafian follicle
after ovulation, the ruptured follicle is called
corpus luteum
What hormone does the corpus luteum secrete to maintain a pregnancy
progesterone
what is another name for fallopian tubes
uterine tubes
short segment of fallopian tube nearest the uterus
the longest middle portion
the terminal, flared end
isthmus
ampulla
infundibulum
lare finger-like processes that sweep ovum into tube
fimbriae
smaller ligament that helps hold the uterus in place
round ligament
the large ligament around most of the uterus that holds uterus in place
broad ligament
the rounded superior portion of the uterus
the narrow distal end
the large part below fundus
the superior part
fundus
cervix
body
isthmus
the uterus of a woman that has never given birth
nulliparous
3 layers of tissue of the uterus
peritoneum(serosa)
myometrium
endometrium
medical term for giving birth
parturition
the developing baby from fertilization to the end of the 2nd month
embryo
2 protective coverings that form around the baby
chorion(outer)
amnion(inner)
why should gynecological exams be scheduled 10 days after onset of menstruation
endometrium is least congested and it is before ovulation, so there is the lowest chance of irradiating a fertilized ovum
what does an HSG show
size, shape and position of uterus
lesions
investigate patency of tubes
what kind of gland is the testes
endocrine and exocrine
convoluted tubules in testes, in which the sperm develop
seminiferous tubules
cells which secrete testosterone
interstitial cells or cells of Leydig