Flashcards
Unit I: Vascular Shit
Cards in this deck (71)
- 1Special Proceduresradiographic method of demonstrating anatomic features that lack natural contrast. This is performed by using contrast; Diagnostic and Therapeutic
- 2Arteriographyradiographic examination of arteries with contrast
- 3Venographyradiographic study of veins using contrast
- 4Angiographyradiographic study of vascular structures with use of contrast. Diagnostic.
- 5Interventional Radiographyany selective catheter or needle technique used for diagnosis or treatment of a disease. Therapeutic.
- 6Digital Subtraction angiogrpahysubtraction mask is created; removes unwanted anatomy
- 7Credentials of a cardiovascular-interventional technologistRT(R)(CV)
- 8Patient AssessmentPrior - Explain to patient; Informed Consent; Establish baseline vitals
During - Know possible reactions; Know the patient and what they are susceptible to; monitor vitals.
After - Monitor patient for at least 20 minutes after injection; continue to evaluate vitals - 9What is the purpose of an automatic injection device?To achieve consistency in flowrate. To match the flowrate of the blood in the vessel.
- 104 Components of an InjectorControl Panel - Set parameters.
Syringe Assembly - Disposable syringes
Heating Device - Maintain CM temperature.
High Pressure Mechanism - Electromechanical motor; pushes plunger to inject contrast. - 112 Types of Mechanisms to achieve HIGH PRESSUREElectromechanical system - motor used to drive the pistons down into the syringe.
- 12Safety devices of an automatic injectorAcceleration Regulator - set time period of motor; eliminates catheter whip
Pressure limiting device - maximum limit of pressure
Volume limiting device - maximum limit of volume
Arming device - prevents air in syringes - 13Optional Components of an automatic injectorECG Triggering device
Detachable Injector Head
Double Syringe Assembly - 14Define flowratethe amount delivered per unit time.
- 15Reasons flowrate should be adjustedViscosity
Length/Diameter of Catheter
Injection Pressure - 16How does diameter size affect flowrate?Greater diameter = greater flowrate.
Greater diameter = less resistance to flow
Greater diameter = less pressure to maintain flowrate. - 17How does catheter length affect flowrate?Greater length = less flowrate because resistance is applied over a greater distance.
- 18How does viscosity affect flowrate?Greater viscosity = Less flowrate
Heating CM decreases the resistance - 19How do sideholes affect flowrate?More sideholes = greater flowrate (10-20%)
More holes increases chance of clot. - 20What is the purpose of a catheter?A catheter serves as a "pipeline" for contrast media to be introduced to a specific vessel.
- 21What are the advantages to using a catheter?Less dilution of CM required
Ability to retrieve biopsy
Smaller bolus of CM
Ability to measure vascular pressure
Less CM = Safer for the patient - 22What is catheter memory?the ability for the catheter to maintain its original shape once the guidewire is removed
- 23What is catheter torque?the response of a catheter to twisting and turning
- 24What are three materials used in catheters?Teflon - lowest friction coefficient
Polyethelene - more flexible
Polyurethene - better memory - 25How are catheter sizes listed?catheter sizes are listed by diameter outside (French), inside (mm), and length (cm).
- 26Describe the French sizing scale0.33 mm = 1 French
French numbers: 1 - 30
Directly proportional;
Greater number = greater diameter
Most catheters available in 5 - 7 F - 27List the various catheter curvesSingle
Double
Multi-Curve
Pigtail - 28What will be on the label for a catheter?Length
Inside Diameter
Outside Diameter
Presence of holes - 29What are the purposes for side and endholes?Needed flowrate, Type of exam
- 30Why would you use a Pigtail catheter?The pigtail is used for large arteries with a high flowrate. Used when higher volumes are needed with less catheter whip
- 31Common catheter size?100 cm, 5-7 F
- 32What is catheter flushing and why do we do it?Catheter flushing is performed on large vessels that require large volume and high flowrate.
- 33What is SAS flushing?Saline: check for blood return
Add: medication or contrast
Saline: flush with 5 ml of normal saline - 34What is SASH flushing?Same as SAS, but heparinized saline is used at the end. Used on all lines without CLC2000 caps
- 35What are the ratios of heparinized saline and the accompanying color caps?Blue: 5 ml of 10 units heparin per 1 ml normal saline.
Yellow: 5 ml of 100 units heparin per 1 ml normal saline.
White: Normal Saline - 36What is the purpose of a guide wire?used to advance a catheter. Give catheters strength, stability and allow them to be moved through the body
- 37How long should a guide wire be in relation to a catheter?At least double the length of the catheter for catheter exchanges.
- 38Tips of guide wiresFlexible
Stiff - 39What size in diameter does a guide wire need to be in relation to the catheter?Needs to match the inside diameter of the catheter
- 40How are guide wires labeled?Size measured in inches to match inside of catheter.
- 41Most common guide wire length?145 cm
- 42What is used to insert a guide wire?Percutaneous Arterial Needle
- 43What are the components of a Percutaneous Arterial Needle?Hub
Base Plate
Outer Cannula
Obturator
Stylet/Trochar - 44What is the Stubbs needle gauge system?Similar to French, but for needles. Stubbs number represents the outside diameter of the needle.
Greater number = smaller needle
Example: 18 gauge is bigger than 21 gauge.
7 - 33 sizes - 45What is a dilator?Thick walled plastic tubing with tapered end; used to make opening to vessel bigger.
Must match guide wire size.
Measured in French - 46What is a sheath?Mini catheter that goes over the top of the guidewire that will remain in place in artery for length of the whole procedure.
Protects integrity of the artery. - 47Five major injection sitesFemoral: Can access almost any artery from here; low complication rate.
Radial: preferred for cardiac because of angle of access. Lt side - arterial, Rt side venous.
Brachial/Axillary: Left preferred more direct to heart. 2x complication rate
Aorta/Translumbar: Directly into aorta; least used.
Direct Puncture - 48What is the Seldinger Technique?Doublewall needlestick.
Pull back until blood flows.
Watch how needle moves - 49List the steps of the Seldinger technique1. Puncture w/ needle
2. Remove inner cannula
3. Insert guide wire
4. Remove Needle
5. Sheath/Dilator/Catheter over guide wire
6. Remove guide wire and dilator - 50Where is the "true" seldinger technique performed?Femoral
- 51Post care procedure?Firm pressure on injection site 15-30 min.
Recovery for 4-8 hours
Vital signs monitored for 24 hours
Check frequently for bleeding - 52What is a Central Venous Catheter?Used when frequent or continuous injections of medications or fluids are needed or when no perpheral veins available
Chemo, dialysis etc
Short, Mid, and Long term. - 53Short Termless than 1 week
Standard IV
Hep/Saline Lock
Triple Lumen central catheter
Swan-Ganz (quadruple lumen)
Quinton catheter - 54What are the two central venous catheters that are not fed into the SVC?Triple Lumen
Swan-Ganz - 55What is a Swan-Ganz catheter for?monitoring the hemodynamics of a patient. Used when a patient is in critical condition
- 56What does each lumen on a Swan-Ganz catheter measure?1st in right atria – measures central venous pressure
2nd in pulmonary artery – systolic and diastolic pressure
3rd and 4th - capillary pulmonary wedge pressure - 57Mid-term1-8 weeks
Midline catheter
PICC Lines - 58Where does the midline catheter go?median cubital vein advanced into basilic artery just shy of the shoulder.
- 59Where are midterm catheters usually placed?RT/LT basilic veins (medial in arms)
RT/LT cephalic veins (lateral in arms) - 60What is a PICC line and where is it placed?Peripherally Inserted Central Catheter
basilic vein to the SVC - 61Cons of a PICC linehigh maintenance (requires flushing)
tends to migrate
limits lifestyle - 62Pros to a PICC lineEasily inserted/removed
Inexpensive
Low complication rate - 63Long-term> 3 months
Hickman, Groshong
IVAD, Hahn
plasmepheresis catheter
Usually tunneled to subclavian/jugular to end in SVC - 64What is a bi-cuff?enlarged area of the catheter that is roughened. Below skin surface to cause irritation to form barrier.
- 65What is a Hickman catheter used for?Long-term medications. inserted into chest wall and tunneled. single or double lumen
- 66What is different between the Hickman and Groshong catheters?A Groshong catheter has a "coin-purse" end with a valve. Hickman has an open end.
- 67What is an IVAD?Implantable Venous Access Device
usually subcutaneous ports, usually used for chemo.
Example: Port-a-Caths - 68What is used to access a Port-a-Cath?Huber needle at a 90 degree angle.
- 69What is a Hahn catheter?Similar to a Hickman, but shorter and does not require surgical placement.
- 70What is a plasmapheresis catheter used for?bone marrow transplant, marrow replacement
- 71What is a CVAD?Central Venous Access Device
Example: Power PICC, Powerloc
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- Flashcards on Unit I: Vascular Shit, created by sdfsdf wdfdf on 18/02/2016.
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