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Positioning Spring 2015 > biliary tract and upper GI > Flashcards

biliary tract and upper GI Flashcards

1
Q

radiographic examination of the biliary system involves ?

A

studying the manufacture, transport, and storage of bile

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2
Q

liver

A

large wedge shaped organ
inferior to the diaphragm
largest solid organ

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3
Q

what are the 2 major lobes of the liver

A

right lobe

left lobe

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4
Q

what are the 2 major lobes divided by

A

falciform ligament

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5
Q

what are the 2 minor lobes

A

quadrate lobe

caudate lobe

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6
Q

what is located between the 2 minor lobes

A

the hilum

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7
Q

what is the function of the liver most applicable to radiography

A

the production of bile

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8
Q

how much bile does the liver secrete in a day

A

800-1000mL or 1 quart of bile per day

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9
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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10
Q

what is bile

A

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

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11
Q

what can cause gallstones

A

if bile contains either insufficient bile salts or excessive cholesterol the cholesterol may crystallize to form gallstones

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12
Q

bile is formed where and then travels to

A

in the liver and travels to the R&L hepatic ducts

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13
Q

the hepatic ducts join to form

A

the common hepatic duct

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14
Q

gallbladder

A

pear shaped sac

7-10 cm long

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15
Q

how much bile does the gallbladder hold

A

30-40 mL

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16
Q

what are the 3 parts of the gallbladder

A

Fundus
Body
Neck

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17
Q

cystic duct

A

3-4 cm long

contains folds called spiral valve

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18
Q

what is the function of the spiral valve

A

to prevent distention or collapse of cystic duct

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19
Q

what are the 3 primary functions of the gallbladder

A
  1. store bile
  2. concentrate bile
  3. contract when stimulated
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20
Q

T or F

if bile is not needed for digestive purposes, it is stored for future use in the gallbladder

A

TRUE

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21
Q

what forms the most common type of gallstones?

A

cholesterol coming out of solution

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22
Q

the gallbladder contracts when fatty acids or fats are in the duodenum. these foods stimulate the mucosa of the duodenum and secrete a hormone called:

A

cholecystokinin (CCK)

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23
Q

Cholecystokinin does what

A

causes the Gallbladder to contract and the terminal opening of the common bile duct to relax
also causes increased exocrine activity by the pancreas

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24
Q

common bile duct

A

about 7.5 cm long
diameter is about the size of a straw
enters the duodenum

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25
Q

the common bile duct joins what to enter where

A

joins the pancreatic duct and enter the hepatopancreatic ampulla

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26
Q

what is a common site for impaction of gallstones

A

hepatopancreatic ampulla

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27
Q

the ampulla is controlled by a circular muscle called

A

hepatopancreatic sphincter

or sphincter of oddi

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28
Q

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

A

the duodenal papilla

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29
Q

what does the prone position do to the gallbladder

A

places it closer to the IR

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30
Q

why would the supine position be used

A

if the primary purpose is to drain the gallbladder into the duct system

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31
Q

oral cholecystogram

OCG

A

contrast medium was ingested orally

ultrasound has replaced this

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32
Q

sonography of gallbladder

A

non invasive means of studying gallbladder and biliary ducts

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33
Q

what are the 4 advantages of sonography over OCG

A
  1. no ionizing radiation
  2. able to detect small calculi
  3. no contrast medium
  4. less patient prep
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34
Q

chole

A

relationship with bile

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35
Q

cysto

A

bag or sac

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36
Q

choledocho

A

common bile duct

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37
Q

cholangio

A

bile ducts

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38
Q

cholecyst

A

gallbladder

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39
Q

cholangiogram

A

radiographic exam of the biliary duct

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40
Q

cholecystocholangiogram

A

study of both the gallbladder and the biliary ducts

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41
Q

choleliths

A

gallstones

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42
Q

cholelithiasis

A

condition of having gallstones

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43
Q

cholecystitis

A

inflammation of the gallbladder

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44
Q

choledocholithiasis

A

the presence of stones in the biliary ducts

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45
Q
  1. biliary calculi (gallstones)
A 
these stones can produce a blockage in the ducts 
symptoms:
pain 
tenderness in RUQ 
jaundice
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46
Q

who is at high risk for developing gallstones

A

females and obese patients

four F’s Fat, Female, near Forty, and Fertile

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47
Q

what percentage of gallstones are radiolucent

A

85-90%

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48
Q

what percentage of gallstones are radiopaque

A

10-15% can be visible on plain radiographs

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49
Q

pathologic indications for gallbladder and biliary ducts

A
  1. biliary calculi
  2. cholecystitis
  3. neoplasms
  4. biliary stenosis
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50
Q
  1. cholecystitis
A

inflammation of the gallbladder

can be acute or chronic

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51
Q
  1. neoplasms
A

growths that can be benign or malignant

cancer of gallbladder can be aggressive

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52
Q
  1. biliary stenosis
A

narrowing of one of the biliary ducts
may restrict flow of bile leading to an obstruction
may lead to cholecystitis and jaundice

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53
Q

mastication

A

chewing

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54
Q

deglutition

A

swallowing

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55
Q

dysphagia

A

difficulty swallowing

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56
Q

dysphasia

A

difficulty speaking

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57
Q

emesis

A

vomit

58
Q

hematemesis

A

blood in vomit

59
Q

cathartic

A

an agent causing active movement of the bowels

60
Q

alimentary canal

A

from the mouth to the anus

61
Q

how long is the GI tract from the esophagus to the end of the large intestine

A

about 30 feet long

62
Q

how long would the small intestine average

A

23 feet

63
Q

what are the 3 primary functions of the digestive system

A
  1. intake and digestion
  2. absorption
  3. elimination
64
Q

what are the common radiographic procedures for the upper gastrointestinal system

A

esophagram (barium swallow)

upper GI series

65
Q

what are the common radiographic procedures for the upper gastrointestinal system

A

esophagram (barium swallow)

upper GI series

66
Q

what is the purpose of the upper GI

A

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

67
Q

mouth (oral cavity)

A

beginning of GI tract where mastication of food occurs

68
Q

what are the 3 pairs of salivary glands

A
  1. parotid salivary glands
  2. submandibular (submaxillary)
  3. sublingual glands
69
Q

saliva consists of

A

99.5% water and 0.5% salts

70
Q

how much saliva is excreted daily

A

1000 to 1500mL

71
Q

mumps

A

inflammation and enlargement of the parotid glands

72
Q

pharynx

A

common passageway for foods liquids and air

73
Q

what are the 3 parts of the pharynx

A

nasopharynx
oropharynx
laryngopharynx

74
Q

7 cavities that communicate with the pharynx

A 
2 tympanic cavities 
2 nasal cavities 
1 oral cavity 
1 larynx 
1 esophagus
75
Q

what is the function of the esophagus

A

transport food and fluids from the pharynx to the stomach

76
Q

how long is the esophagus and where does it start/end

A

10 inches long 3/4 inches in diameter

extends from cricoid cartilage C5/C6 to stomach at T11

77
Q

4 layers of the esophagus

A

fibrous
muscular
submucosal
mucosal

78
Q

what are the 2 indentations on the esophagus

A
  1. aortic arch

2. left primary bronchus

79
Q

esophageal hiatus

A

where the esophagus passes through the diaphragm

at the level of T10

80
Q

hiatal hernia

A

a condition where the upper portion of the stomach protrudes through the esophageal hiatus

81
Q

cardiac antrum

A

abdominal segment of the esophagus

82
Q

esophogastric junction (cardiac orifice)

A

openin between esophagus and stomach

83
Q

esophogastric junction (cardiac orifice)

A

opening between esophagus and stomach at approximately T11

84
Q

peristalsis

A

wavelike series of involuntary muscular contractions

propels solid and semisolid material through the entire alimentary canal

85
Q

cardiac sphincter

A

muscle that controls the esophagogastric junction

86
Q

cardiac notch

A

notch located superior to esophagogastric junction

87
Q

cardiac antrum

A

slightly expanded portion of the terminal esophagus

88
Q

pyloric orifice

A

opening leaving the stomach

89
Q

pyloric sphincter

A

muscle that controls the pyloric orifice

90
Q

pylorus is divided into 2 parts

A
  1. pyloric antrum

2. pyloric canal

91
Q

in the supine position where is the barium and air

A

barium is in the fundus

air is in bottom

92
Q

in the prone position where is the barium and air

A

air in fundus

barium is in body/ pyloric region

93
Q

in the erect position where is the barium and air

A

air rises to the fudus

barium is in pyloric porttion

94
Q

in the erect position where is the barium and air

A

air rises to the fudus

barium is in pyloric portion

95
Q

in the erect position where is the barium and air

A

air rises to the fundus

barium is in pyloric portion

96
Q

in the erect position where is the barium and air

A

air rises to the fundus

barium is in pyloric portion

97
Q

duodenum

A

1st portion of small intestine
8-10 inches long
head of pancreas sits in c loop

98
Q

T or F

most of duodenum and pancreas are retroperitoneal

A

TRUE

99
Q

what are the 4 parts of the duodenum

A
  1. first (superior) portion
  2. second (descending portion)
  3. third (horizontal) portion
  4. fourth (ascending) portion
100
Q

ligament of treitz

A

separates the duodenum to jejunum

101
Q

ligament of treitz

A

separates the duodenum to jejunum

102
Q

what are the 2 types of digestion

A
  1. mechanical

2. chemical

103
Q

where is the stomach in a hypersthenic patient

A

high and horizontal

104
Q

where is the stomach in a hyposthenic/ asthenic patient

A

vertical and J shaped, low

105
Q

where is the duodenal bulb/GB in a hypersthenic pt.

A

T11/T12

106
Q

where is the duodenal bulb/GB in a hyposthenic/asthenic pt.

A

L3/L4

107
Q

where is the duodenal bulb/GB in a sthenic pt.

A

L1/L2

108
Q

what are contraindications to an esophagogram

A

no major ones except possible sensitivity to contrast media

109
Q

pathologic indications for esophagogram

A 
achalasia 
anatomic anomalies 
barrett/s esophagus 
carcinoma of the esophagus 
dysphagia 
esophageal varices 
foreign bodies 
GERD 
zenker's diverticulum
110
Q

achalasia

A

cardiospasm

motor disorder of esophagus where peristalsis is reduced

111
Q

achalasia

A

cardiospasm

motor disorder of esophagus where peristalsis is reduced

112
Q

barretts’s esophagus

A

replacement of normal squamous epithelium with columnar lined epithelium ulcer tissue in lower esophagus

113
Q

esophageal varices

A

dilation of veins in the distal esophagus

114
Q

GERD

A

when the contents of the stomach go into retrograde

115
Q

zenker’s diverticulum

A

large outpouching of esophagus

caused by weakening of muscle wall

116
Q

demonstration of esophageal reflux 4 ways

A
  1. breathing exercises
    a. valsalva maneuver
    b. mueller manuever
  2. water test
  3. compression paddle technique
  4. toe touch test
117
Q

valsalva maneuver

A

pt. takes a deep breath and holds breath while bearing down as trying to move bowels

118
Q

mueller nameuver

A

pt. exhales and tries to inhale against closed glottis

119
Q

water test

A

pt. swallows water while in LPO and if barium regurgitates into the esophagus then its a positive test

120
Q

UGI

A

radiographic exam to study the function and form of distal esophagus stomach and duodenum

121
Q

UGI contraindications

A

history of bowel perforation, laceration, or viscus rupture

122
Q

UGI contraindications

A

history of bowel perforation, laceration, or viscus rupture

123
Q

UGI pathologic indications

A 
bezoar 
diverticula
emesis
gastric carcinoma
gastritis
hiatal hernia
schatzki's ring 
hypertrophic pyloric stenosis HSP 
ulcers
124
Q

bezoar

A

mass of undigested material that becomes trapped in the stomach

125
Q

trichobezoars

A

hair balls

126
Q

phytobezoars

A

composed of food material non digestible by humans

127
Q

diverticula

A

pouchlike herniations of a portion of mucosal wall

128
Q

what is best demonstrated on a double contrast UGI study

A

gastric carcinoma
gastritis
ulcers

129
Q

gastritis

A

inflammation of mucosa

130
Q

hiatal hernia

A

portion of stomach herniates through diaphragmatic opening

131
Q

schatzki’s ring

A

ringlike constriction at the distal esophagus

132
Q

hypertrophic pyloric stenosis HPS

A

caused by hypertrophy of the antral muscle at pyloric orifice
produces an obstruction at the pylorus

133
Q

what is the most common type of gastric obstruction in infants

A

hypertrophic pyloric stenosis HPS

134
Q

ulcers

A

erosions of stomach or duodenal mucosa

135
Q

ulcers

A

erosions of stomach or duodenal mucosa

136
Q

UGI patient prep

A

NPO 8 hours prior to study
no gum chewing
no smoking

137
Q

4 part summary of positioning and procedures tips for UGI

A
  1. clinical history
  2. body habitus
  3. fluorosocopy
  4. high kV short exposure
138
Q

when would CT be used as the modality of choice

A

for demonstrating trauma and tumors of GI tract

139
Q

hemocromatosis

A

iron overload due to genetics or multiple blood transfusions
well visualized on MRI

140
Q

medical sonography is useful for

A

seeing HSP in infants

141
Q

nuclear med is useful for

A

diagnosing esophageal reflux and barrett’s esophagus

Positioning Spring 2015 (6 decks)

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