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Positioning Spring 2015 > Barium Enema > Flashcards

Barium Enema Flashcards

1
Q

barium enema purpose

A

to study the form and function of the large intestine to detect abnormal conditions
performed as single or double contrast

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2
Q

barium enema contraindications

A

possible perforated hollow viscus
possible large bowel obstruction
appendicitis

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3
Q

clinical indications for barium enemas

A 
colitis 
diverticulum 
intussusception
neoplasms
annular carcinoma 
polyps 
volvulus
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4
Q

colitis

A

inflammatory condition of the large intestine

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5
Q

ulcerative colitis

A

severe form of colitis
most commonly in young adults
chronic condition

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6
Q

long term bouts of ulcerative colitis may lead to

A

stovepipe or leadpipe colon

loss of haustral markings

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7
Q

diverticulum

A

outpouching of mucosal wall

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8
Q

diverticulosis

A

having numerous diverticula

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9
Q

diverticulitis

A

inflamed diverticula due to infection

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10
Q

is diverticula best demonstrated with a single or a double contrast BE ?

A

double contrast BE

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11
Q

intussusception

A

telescoping or invagination of one part of intestine into another

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12
Q

annular carcinoma

A

typical form of colon cancer
forms apple core or napkin ring
results in large bowel obstruction

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13
Q

polyps

A

saclike projections that project inward into the lumen of the intestine

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14
Q

volvulus

A

twisting of portion of intestine on its own mesentary
leads to mechanical obstruction
most common in men ages 20-50

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15
Q

barium enema patient prep

A 
large bowel must be completely empty of its contents
light evening meal prior 
bowel cleansing cathartics  
NPO after midnight 8HRS 
no gum chewing
no smoking
cleansing enema morning of exam 
(NO LAXITIVES MORNING OF EXAM)
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16
Q

contraindications to laxatives (cathartics)

A

gross bleeding
diarrhea
obstruction
inflammatory conditions

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17
Q

2 types of laxatives

A
  1. irritant laxatives

2. saline laxatives

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18
Q

irritant laxatives

A

ex: caster oil

rarely used for BE’s

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19
Q

Saline laxatives

A

magnesium citrate

magnesium sulfate

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20
Q

3 most common types of enema tips

A
  1. plastic disposable
  2. rectal retention
  3. contrast retention (double contrast)
21
Q

T or F
retention catheters should be fully inflated only under fluoroscopic guidance provided by the radiologist because of potential danger of intestinal rupture

A

true

22
Q

when is iodinated water soluble contrast used

A

in case of perforated or lacerated intestinal wall

or if pt. is scheduled for surgery right after

23
Q

temp of water

A

some say cold between 40-50 degrees F

some say room temp 85-90 degrees F

24
Q

what is a common side effect of a BE

A

a spasm

can be caused by pt. anxiety, discomfort etc.

25
Q

what my be added to the contrast to minimize spasm

A

lidocaine

26
Q

if spasm occurs during procedure what can be given intravenously

A

glucagon

27
Q

pt is placed in what position before enema tip is inserted

A

sims position

28
Q

what does sim’s position do

A

relaxes abdominal muscles and decreases pressure

29
Q

enema tip insertion

A

elevate right buttock laterally
tell pt. relax take deep breaths
tip inserted on expiration

30
Q

how should the tip be directed

A

1-1and1/2 inches aimed toward umbilicus then follow the curve of the rectum slightly superior

31
Q

the total insertion of the tip should not exceed

A

4 inches (10cm)

32
Q

the enema contents should be NO HIGHER than

A

24 inches (60 cm) above the xray table

33
Q

list of lower GI procedures

A
  1. single contrast BE
  2. double contrast BE
  3. evacuative proctography (defecography)
34
Q

single contrast BE

A 
positive contrast only 
barium fills large intestine 
rectum fills slowly 
when exam is done bag is lowered so barium flows back into bag 
pt. sent to bathroom 
postevac radiograph is taken
35
Q

most commonly obtained projections for a single contrast BE

A 
scout 
PA or AP 
PA or PA oblique 
axial
lateral 
post evac AP or PA
36
Q

double contrast barium enema

A

more effective for demonstrating polyps and diverticula

air and barium introduced into large intestine

37
Q

evacuative proctograpy purpose

A

functional study of anus and rectum that is conducted during the evacuation and rest phases of defecation

38
Q

T or F

no pt. prep necessary for defacography

A

TRUE

39
Q

defacography pathologic indications

A

rectocele
rectal intussusception
rectal prolapse

40
Q

rectocele

A

blind pouch of rectum caused by weakening of anterior or posterior wall

41
Q

rectal intussusception

A

telescoping or invagination of the rectal portion of the bowel

42
Q

rectal prolapse

A

protrusion of rectal tissue through the anus to the exterior of the body

43
Q

do you need very high density barium sulfate for defacography

A

yes

some departments mix barium with potato starch

44
Q

applicator for defacography

A

resembles a caulking gun
anatrast is the contrast put into the gun
flexible enema tip attatched

45
Q

defacography procedure

A

pt. in a lateral recumbant position on the cart
contrast media put into rectum
small BB placed at the anal orifice
pt. put on the commode for filming during defecation
a lateral recumbant post evac radiograph is taken

46
Q

anorectal angle

A

alignment between the anus and rectum that shifts between the rest and evacuation phases

47
Q

radiologist measures the anorectal angle during rest and evacuation phases to determine whether any abnormalities exist

A

TRUE

48
Q

colostomy

A

an incision into the colon to create an artificial opening to the exterior of the abdomen
serves as a substitute anus

49
Q

clinical indications for a colostomy barium enema

A

to asses for proper healing, obstruction or leakage, or to perform presurgical evaluation

Positioning Spring 2015 (6 decks)

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