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Positioning > Biliary system and UGI > Flashcards

Biliary system and UGI Flashcards

1
Q

Radiographic examination of the biliary system involves studying the manufacture, transport and storage of what?

A

bile

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2
Q

How much does the liver weigh?

A

3-4 pounds

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3
Q

What is the largest solid organ in the body?

A

liver

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4
Q

the liver occupies most of what quadrants?

A

RUQ & LUQ

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5
Q

how long is the widest part of the liver?

A

8-9 inches

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6
Q

what is the largest vertical dimension of the liver?

A

6-7 inches

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7
Q

what is the flow of bile?

A

liver-right & left hepatic duct-common hepatic duct-cystic duct-galbladder-cystic duct-common bile duct-hepatopancreatic ampulla-hepatopancreatic sphincter-duodenum of small intestine

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8
Q

what is the hepatopancreatic ampulla also called?

A

ampulla of vater

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9
Q

what is the hepatopancreatic sphincter also called?

A

sphincter of oddi

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10
Q

two major lobes of the liver are divided by what?

A

falciform ligament

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11
Q

what are the 2 major lobes of the liver?

A

right and left lobe

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12
Q

two minor lobes located on the medial aspect of the right lobe?

A

quadrate lobe or caudate lobe

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13
Q

what is the hilum of the liver called?

A

porta hepatitis

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14
Q

where is the hilum of the liver located

A

between 2 minor lobes

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15
Q

what function of the liver is most applicable to radiographic studies?

A

production of bile

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16
Q

how much bile does the liver secrete daily?

A

800-1000ml (1 quart)

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17
Q

what is the major function of bile?

A

to aid in the digestion of fats by emulsifying fat globules and the absorption of fat following its digestion

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18
Q

what is bile made of?

A

liquid substance composed of mainly bile salts, bile pigments, cholesterol and water

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19
Q

what facilitates the absorption of fats?

A

bile salts

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20
Q

if bile contains either insufficient bile salts or excessive cholesterol the cholesterol may form what?

A

gallstones

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21
Q

bile formed int he liver and travels to what ducts

A

right and left hepatic

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22
Q

hepatic ducts join to form ?

A

common hepatic duct

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23
Q

how much bile does the gallbladder hold?

A

30-40mL of bile

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24
Q

how big is the gallbladder?

A

7-10cm (3-4in long)

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25
Q

3 main parts of the gallbladder?

A

fundus, body and neck

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26
Q

the neck of the gallbladder continues on to form what?

A

cystic duct

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27
Q

How long is the cystic duct?

A

3-4 cm long

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28
Q

the cystic ducts contains folds called?

A

spiral valve

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29
Q

what is the function of the spiral valves?

A

prevent distention or collapse of cystic duct

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30
Q

3 primary functions of the gallbladder?

A

store, concentrate bile and contract when stimulated

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31
Q

bile is concentrated within the gallbladder as a result of a process called?

A

hydrolysis (removal of water)

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32
Q

what is choleliths?

A

gallstones

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33
Q

what forms the most common type of gallstones?

A

cholesterol coming out of solution

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34
Q

the foods stimulate the mucosa of the duodenum to secrete a hormone called?

A

cholecystokinin

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35
Q

what does cholecystokinin do in the pancreas?

A

stimulates the pancreas to secrete pancreatic juice and cause the hepatopancreatic sphincter to relax, which permits the flow of both bile and pancreatic juice into the duodenum

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36
Q

how long is the common bile duct?

A

7.5 cm long

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37
Q

where is the common bile duct located?

A

descends behind superior portion of duodenum and head of pancreas to enter descending portion of the duodenum

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38
Q

what is the pancreatic duct also called?

A

duct of wirsung

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39
Q

what two ducts come together to form the hepatopancreatic ampulla?

A

common bile duct and pancreatic duct

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40
Q

pancreatic duct and common bile duct remain separated in what % of people?

A

40%

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41
Q

what is a common site for impaction of gallstones?

A

hepatopancreatic ampulla

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42
Q

the presence of the hepatopancreatic sphincter causes a protrusion into the lumen of the duodenum known as what?

A

duodenal papilla

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43
Q

what position places the gallbladder closer to the IR?

A

prone

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44
Q

what does the supine position do for the gallbladder?

A

drain the gallbladder into the duct system

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45
Q

contrast medium was ingested orally for a cholecystogram and was called ?

A

oral cholecystogram (OCG)

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46
Q

what are the 4 advantages of US of the gallbladder over ocg’s

A

no ionizing radiation, able to detect small calculi, no contrast medium, less patient prep

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47
Q

what does chole- mean?

A

relationship with bile

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48
Q

what does cysto- mean?

A

bag or sac

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49
Q

what does choledocho-

A

common bile duct

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50
Q

what does cholangio- mean

A

bile duct

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51
Q

what does cholecyst-mean ?

A

gallbladder

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52
Q

what does choledocholithiasis mean?

A

presence of having stones in the biliary ducts

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53
Q

what are some symptoms of choledocholithiasis

A

pain, jaundice, tenderness in RUQ, pancreatitis

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54
Q

what are the 4 F’s for gallstones?

A

female, fat, forty, and fertile

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55
Q

what percent of gallstones are radiolucent?

A

85-90%

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56
Q

what is milk calcium bile?

A

Emulsion of biliary stones in the gallbladder, emulsion builds up of calcium deposits within gallbladder may be difficult to diagnose with ocg

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57
Q

what is cholecystitis?

A

inflammation of the gallbladder, can be acute or chronic

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58
Q

what is neoplasms?

A

growths that can be benign or malignant, cancer of GB can be aggressive

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59
Q

what is biliary stenosis?

A

narrowing of one of biliary ducts, may restrict flow of bile leading to obstruction

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60
Q

what is deglutition

A

swallowing

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61
Q

what is dysphagia

A

difficulty swallowing

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62
Q

what is dysphasia

A

difficulty speaking

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63
Q

what is cathartic?

A

an agent causing active movement of bowels

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64
Q

what are the accessory organs of the UGI?

A

salivary glands, pancreas, liver, gallbladder

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65
Q

what is the route of the alimentary canal?

A

oral cavity, pharynx, esophagus, stomach, duodenum and small intestine, large intestine, anus

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66
Q

what is the length of the GI tract?

A

about 30 feet long form the esophagus to the end of large intestine

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67
Q

about how long is the esophagus?

A

10inches

68
Q

about how long is the stomach?

A

10 inches

69
Q

about how long is the small intestine?

A

23 feet (stretched out)

70
Q

about how long is the large intestine?

A

5 feet

71
Q

During life, with good muscle tone, the actual length of the small intestine is about how many feet long?

A

15-18

72
Q

what are the 3 primary functions of the digestive system,?

A

intake and digestion(carbs, lipids, protein), absorption (essential elements absorbed from alimentary canal), elimination

73
Q

what are the two common radiographic procedures?

A

esophagram and upper GI

74
Q

what is the purpose of the esophagram

A

study the form and function of the pharynx and the esophagus

75
Q

what is the purpose of the UGI?

A

study the form and function of the distal esophagus, stomach, and duodenum

76
Q

the roof of the oral cavity is formed by what?

A

hard and soft palates

77
Q

what is the function of the uvula?

A

to prevent food from entering pharynx prematurely

78
Q

where does the soft palate begin

A

beings at the last color and is suspended from the posterior border of the hard palate

79
Q

what forms the hard palate?

A

palatine process of the maxillary bone and the 2 horizontal portion of the palatine bone

80
Q

three pairs of salivary glands secrete into the oral cavity?

A

parotid, submandibular, and sublingual

81
Q

where is the parotid salivary gland located?

A

inferior and anterior to the ears

82
Q

where is the submandibular salivary gland located

A

posterior part of the floor of the mouth

83
Q

where is the sublingual salivary gland located

A

below the tongue on the floor of the mouth

84
Q

what is saliva made up of?

A

99.5% water and .5 salt and digestive enzymes

85
Q

how much saliva is secrete daily?

A

1000-1500mL

86
Q

what is mumps?

A

inflammation of the parotid glands

87
Q

what is the second organ of the digestive system?

A

pharynx

88
Q

what is the pharynx often referred as

A

throat

89
Q

the pharynx serves as a passage way for what?

A

food and air

90
Q

what 3 parts is the pharynx divided into?

A

nasopharynx, oropharynx, and laryngopharynx

91
Q

what is the cartilage that covers opening of larynx during swallowing?

A

epiglottis

92
Q

what are the 7 cavities that communicate with the three portions of the pharynx

A

nasopharynx: tympanic cavities(2) via the eustachian tubes, and nasal cavities (2)
oropharynx: oral cavity
laryngopharynx: larynx, and esophagus

93
Q

what does esophagus translate too?

A

carry food

94
Q

what is the function of the esophagus?

A

transport food and fluids from the pharynx to the stomach

95
Q

what landmarks does the esophagus fall between?

A

cricoid cartilage (c5-c6) to stomach (T11)

96
Q

what are the 4 layers of the esophagus?

A

fibrous, muscular, submucosal, and mucosal

97
Q

what are the 2 indentations present in the esophagus?

A

aortic arch, and left primary bronchus

98
Q

distal esophagus passes through an opening in the diaphragm called what and located at what level?

A

esophageal hiatus at level of T10

99
Q

what is a condition where the upper portion of the stomach protrudes through the esophageal hiatus is called?

A

hiatal hernia

100
Q

what is the abdominal segment (slightly expanded) of the esophagus that is about 1 inch in length called?

A

cardiac antrum

101
Q

what is the opening/junction between the stomach and the esophagus called

A

esophagogastric junction (cardiac orifice) at T11

102
Q

what is the wavelike series of involuntary contractions that propels solid and semisolid materials through the entire alimentary canal

A

peristalsis

103
Q

what does ventriculus mean?

A

little belly in latin

104
Q

what is the most dilated portion of the alimentary canal

A

stomach

105
Q

what is the muscle that controls the esophagogastric junction

A

cardiac sphincter

106
Q

what is the notch located superior to the esophagogastric junction?

A

cardiac notch

107
Q

what is the opening leaving the stomach

A

pyloric orifice

108
Q

what is the muscle that controls the pyloric orifice?

A

pyloric sphincter

109
Q

what is the medial concave border of the stomach

A

lesser curvature

110
Q

what is the convex lateral border of the stomach

A

greater curvature

111
Q

how many times longer is the greater curvature compared to the lesser

A

4-5x longer

112
Q

what does the greater curvature extend between

A

cardiac notch and the pylorus

113
Q

in the upright position the fundus is usually filled with a bubble of swallowed air called?

A

gastric bubble

114
Q

the body of the stomach begins at the cardiac notch and ends at a constricted ring like area called?

A

angular notch (incisura angularis)

115
Q

what is the terminal portion of the stomach ro right or medial of angular notch?

A

pylorus

116
Q

the pylorus is divided into 2 portions called ?

A

pyloric antrum and pyloric canal

117
Q

what does rugae translate into?

A

wrinkles

118
Q

what do the rugae do for the stomach?

A

assist with mechanical digestion of food within stomach

119
Q

in the supine position barium would be in what part of the stomach?

A

fundus

120
Q

in the supine position air/gas would be in what part of the stomach?

A

pylors

121
Q

what does the RAO position do for barium/ air study?

A

allows air to form in the fundus and the barium to be in the pylorus

122
Q

what is the first part of the small intestine

A

duodenum

123
Q

most of the duodonem and pancreas are infra, intra or retropertioneal?

A

retroperitoneal

124
Q

what are the 4 parts of the duodenum?

A

superior, descending, horizontal and ascending

125
Q

what part of the duodenum is intrapertoneal?

A

first (superior) portion

126
Q

what part of the duodenum is commonly studies for a site of ulcers?

A

superior portion

127
Q

what is the longest segment of duodenum?

A

descending

128
Q

what is the junction of the duodenum and the jejunum called?

A

duodenojejunal flexure

129
Q

what is the duodenojejunal flexure relatively fixed and held in place by?

A

ligament of trite (suspensory muscle of the duodenum)

130
Q

what are the two types of digestion

A

mechanical and chemical (all chemical changes food undergoes as it travels through the alimentary canal)

131
Q

how long does the take for the stomach to empty after an average meal

A

2-6 hours

132
Q

how long does it take for solid/semisolid food to go from the mouth to the stomach? liquid?

A

4-8 seconds for solid, 1 second for liquid

133
Q

how long does chyme take to pass through the entire small intestine

A

3-5 hours

134
Q

where does most absorption of digestive products take place

A

small intestine

135
Q

in a hyperstenic patient the level of the stomach extends from?

A

T9-T12

136
Q

the duodenal bulb in a hyperstenic patient is at the level of

A

T11

137
Q

in the Asthenic/Hypostenic patient the stomach extends from?

A

T11-L5

138
Q

the duodenal bulb in a Asthenic/Hypostenic patient is at the level of

A

L3-L4

139
Q

in the sthenic patient the stomach extends from ?

A

T10-11 to L2

140
Q

in the upright position organs tend to drop how many inches from normal position

A

1-2 inches

141
Q

polyps, diverticula and ulcers of the stomach are better demonstrated with what kind of study?

A

double contrast study

142
Q

what are the two types of carbon dioxide gas used?

A

calcium citrate and magnesium citrate

143
Q

what are the 3 cardinal principles of radiation?

A

time, distance, shielding

144
Q

what are the 4 ways to demonstrate esophageal reflux

A

breathing technique, water test, compression paddle technique, and toe touch test

145
Q

what are the 2 types of breathing techniques

A

valsalva maneuver and mueller maneuver

146
Q

what is achalasia?

A

cardiospasm, motor disorder of esophagus in which peristalsis is reduced along distal 2/3 of esophagus

147
Q

what are anatomic anomalies?

A

may be congenital or caused by disease

148
Q

what is barrettes esophagus?

A

replacement of normal squamous epithelium ulcer tissue in lower esophagus

149
Q

what will produce a strictures or streaked like appearance in distal esophagus?

A

barretts esophagus

150
Q

what is esophageal varices

A

dilation of veins in the distal esophagus

151
Q

what will esophageal varices present like on a radiograph?

A

wormlike or cobblestone appearance

152
Q

what is zenkers diverticulum?

A

large outputting of the esophagus

153
Q

what is a bezoar?

A

mass of undigested martial that becomes trapped in stomach-hair veggie fibers

154
Q

what are diverticula?

A

pouchlike herniationsof a portion of mucosal wall

155
Q

what percent of gastric diverticula arise in posterior aspect of stomach

A

70-90

156
Q

what projection best demonstrates diverticula

A

lateral

157
Q

what is a schatzki’s ring

A

ringlike constriction at distal esophagus

158
Q

where would you find a schatzkis ring

A

sliding hiatal hernia

159
Q

what is hypertrophic pyloric stenosis

A

obstruction of pylorus

160
Q

where would u find a duodenal ulcer

A

2nd or 3rd part of duodenum

161
Q

where would you find a peptic ulcer

A

mucosa of esophagus, stomach or duodenum

162
Q

where would you find a gastric ulcer

A

gastric mucosa

163
Q

what % of ulcers lead to perforation

A

5

164
Q

how long should a child under 1 be NPO for

A

4 hours

165
Q

how long should a child older than 1 be NPO for

A

6 hours

166
Q

how much barium should be given to a child NB-1?
1-3?
3-10?
older than 10?

A

NB-1: 2-4 oz
1-3: 4-6
3-10: 6-12
over 10-12-16

Positioning (7 decks)

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