1
Q
➢ Show organs or parts of the body
in contrast to their surrounding
tissue.
➢ Increase differential attenuation
between a soft tissue structure and
surrounding tissue
A
contrast media/agent
2
Q
- type of contrast used to decrease organ density
to produce contrast
➢ Low atomic number
➢ Readily penetrated than the surrounding tissue
A
negative
3
Q
– used to increase organ density & improve radiographic visualization
➢ High atomic number
A
positive
4
Q
positive and negative contrast
agent
A
double contrast
5
Q
➢ A suspension which is dry powder
or premixed.
➢ Properties:
1. high atomic number
2. insoluble and stable
3. little upset to the intestinal
tract even in large doses
4. cheap
A
BaSO4
6
Q
- Organic soluble
- Iodinated oil
2.1. non-absorbable
2.2. slowly absorbable
A
Iodinated Contrast Agent
7
Q
not readily absorbed by the
body
A
oil based
8
Q
high osmolality
A
ionic
9
Q
low osmolality
A
non-ionic
10
Q
measure of the total number of
particles in solution/kg of H2O
A
osmolality
11
Q
fluidity
A
Viscosity
12
Q
may have adverse effects on cardiovascular system.
A
calcium binding
13
Q
stable for 5 years
A
chemical stability
14
Q
Categories of LOCM:
A
- Ionic dimer
- non-ionic monomers
- Non-ionic dimer
15
Q
MODE OF ADMINISTRATION
A
- Oral
- Parenteral
- Direct injection through opaque catheters
16
Q
Sensitivity Testing:
A
- Scleral method – 1 drop (gtt)
- Sublingual method – 1gtt of CM
- Intradermal method – 1cc
- IV – 1cc
17
Q
Clinical Manifestation of Expected Side Effects
A
- A feeling of flushing or warmth
- Nausea &/or vomiting
- Headache
- Pain of the injection site
- Altered taste, maybe metallic
18
Q
Clinical Manifestation of a Vasovagal Reaction
A
- pallor
- cold sweats
- rapid pulse
- syncope or complaint of feeling faint
- bradycardia
- hypertension
19
Q
Clinical Manifestations of a Moderate Adverse Reaction
A
- Nausea, vomiting - dizziness
- Cough - shaking
- Feeling warmth - itching
- Headache - pallor
20
Q
Clinical Manifestation of a Moderate Adverse Reaction
A
- Tachycardia or bradycardia
- Hypertension or hypotension
- Dyspnea
- Bronchospasm or wheezing
- Patient complains of feeling of throat closing
21
Q
Clinical Manifestations of a Severe Anaphylactic Reaction
A
- Dyspnea related to laryngeal edema
- Lack of patient response
- Hypotention
- Cardiac Arrest
- Seizures
- Cardiac arrhythmia
22
Q
result of an exaggerated hypersensitivity reaction to re-exposure to an antigen
that was previously encountered by the body’s immune system.
A
Anaphylactic Shock
23
Q
Classification of Clinical Manifestations:
A
- mild
- moderate
- extreme systemic reaction
24
Q
- nasal congestion, preorbital swelling, itching, sneezing and tearing of eyes
- peripheral tingling or itching at the side of injection
- feeling of fullness or tightness of the chest, mouth or throat
- feeling of anxiety or nervousness
A
mild systemic reaction
25
- all of the above symptoms, plus
- flushing, feeling of warmth, itching & urticaria
- bronchospasm & edema of the airways or larynx
- dyspnea, cough & wheezing
moderate systemic reaction
26
- all symptoms listed above with an abrupt onset
- decreasing BP, weak thread pulse either rapid or shallow
- rapid progression to bronchospasm, laryngeal edema, severe dyspnea
- dysphasia, abdominal cramping, vomiting & diarrhea
- seizure, respiratory & cardiac arrest
severe systemic reaction
27
MEDICATION: systemic reaction
Epinephrine, diphenhydramine,
hydrocortisone, & aminophylline
28
CHARACTERISTICS OF A GOOD CA:
1. Show structure/s clearly
2. Remain physically inert
3. Non-toxic
4. Eliminated unchanged
29
RULES TO BE OBSERVED WHN ADMINISTERING CA:
1. be sure you have the right patient
2. be sure you have the right & amount of CA
3. be sure to give the CA at the right time
4. never handle a tablet or powder with your fingers
5. read or chart the amount of CA given the time & initials of the RT
6. Technologist give oral (BaSO4, telepaque ect…) physician administer IV CA
30
- Radiographic examination of the salivary glands and ducts.
- Other imaging modality of choice: CT or MRI
SIALOGRAPHY
31
INDICATION: SIALOGRAPHY
- Fistula - Diverticulae - tumor - pain
- Stenosis - Sjoren’s Disease - Calculi - recurrent swelling
32
CONTRA INDICATION: SIALOGRAPHY
Acute infection or inflammation
33
CONTRAST MEDIA USED: SIALOGRAPHY
➢ Water-soluble iodinated CM
➢ Omnipaque 300
34
Attached to cannula or catheter
Manual pressure syringe
35
Used of syringe barrel with plunger removed
Attached to drip stand
Distance: 28 cm above level of patient’s mouth
Hydrostatic pressure
36
SECRETORY STIMULANTS
✓ Fresh lemons slice/juice
✓ 2-3 minutes before and after completion of the examination
37
PATIENT PREPARATION
1.) Removed dentures
2.) Removed radiopaque
items
38
ACCESSORY EQUIPMENT
✓ 3 mL syringe
✓ Cotton swabs
✓ Sterile gauze
✓ Extension tubing
✓ Adhesive tape
✓ Cannula : blunt-tipped or modified butterfly
✓ disposable sterile gloves
✓ topical anesthetic
✓ Preferred CM
✓ Lemon slice/juice
✓ Head lamp : For better illumination of the orifice
39
✓ Oral/buccal cavity
✓ First division of digestive
system
✓ Forms by cheeks, hard and
soft palates, and tongue
✓ Receives saliva
MOUTH
40
Space between teeth
and cheeks
Oral Vestibule
41
Oral Cavity/Mouth Proper
Space within dental arches
42
✓ Anterior portion
✓ Forms by horizontal plates of maxillae and palatine bones
Hard Palate
43
✓ Posterior portion
✓ Highly sensitive to touch
✓ Function:
- Partial septum between mouth and pharynx
✓ Uvula: pendulous process
✓ Anterior arches: project forward to the sides of the base of tongue
✓ Posterior arches: projects posteriorly to blend the posterolateral walls of the pharynx
Soft palate
44
triangular space occupied by anterior and posterior arches
palatine tonsil
45
✓ Forms the floor of the mouth
✓ Freely movable
✓ Base: directed posteriorly
✓ Apex: directed anteriorly
Tongue
46
free space under the tongue
Sublingual space
47
restricts the movement the tongue
Frenulum of the tongue
48
crest-like ridge
Sublingual fold
49
for mastication
teeth
50
process of chewing and grinding food into small pieces
mastication
51
- Softens the food
- Keeps the mouth moist
- Contributes digestive enzymes
Saliva
52
➢ Secretes saliva
➢ 1L of saliva/day
SALIVARY GLANDS
53
3 MAJOR SALIVARY GLANDS
1. Parotid
2. Submandibular/Submaxillary Gland
3. Sublingual Gland
54
- Largest
- Wedge-shaped gland
- Location: anterior and inferior to the ear
- Portion: Superior portion
Deep/Retromandibular portion
- Duct: Parotid duct/Stensen’s duct
Parotid Gland
55
- Second largest
- Irregular shaped gland
- Location: inferior and medial to the body of mandible
- Duct: Submandibular/Submaxillary duct/Wharton’s duct
Submandibular/Submaxillary Gland
56
muscle of the tongue and floor of the mouth
Mylohyoid muscle
57
- Smallest
- Elongated gland
- Location: floor of the mouthbeneath subligual fold
- Duct: Sublingual Duct/ Bartholin’s Duct
- Unique Structure: duct of
Sublingual Glands
58
-12 small ducts
- Helps transport saliva to oral cavity
Rivinus
59
4 MINOR SALIVARY GLANDS
1.) Labial Glands – lips
2.) Buccal Glands – cheeks
3.) Palatal Glands – palate
4.) Lingual Glands – tongue
60
POSITIONING ROUTINES
PP, RP, CR, SS
61
PP
Patient/Part Position
62
RP
Reference Point
63
CR
Central Ray
64
SS
Structures Shown
65
tangential projection
PP - Recumbent/seated
66
contrast
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