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Positioning 1 > Ch. 12 Biliary Tract and Upper Gastrointestinal System > Flashcards

Ch. 12 Biliary Tract and Upper Gastrointestinal System Flashcards

1
Q

what is bile manufactured by

A

liver

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2
Q

where is bile stored

A

gallbladder

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3
Q

largest, solid organ in the human body

A

liver

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4
Q

how much does the liver weigh

A

3-4 lbs (1.5-2 kg)

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5
Q

the liver occupies most of this quadrant

A

right upper quadrant

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6
Q

which abdominal region does the liver occupy

A

almost all the right hypochondrium, major part of the epigastrium, and significant part of the left hypochondrium

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7
Q

what is the widest portion of the liver and how long is it

A

superior border, 8-9” (20-23 cm)

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8
Q

what is the greatest vertical dimension of the liver and how long is it

A

right border, 6-7” (15-17.5 cm)

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9
Q

in the average person, the right border of the liver extends where

A

from the diaphragm to just below the body of the 10th rib

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10
Q

where is the gallbladder positioned

A

centrally in the posterior inferior region of the liver

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11
Q

the distal end of the gallbladder extends where

A

slightly below the posterior inferior margin of the liver

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12
Q

how is the liver divided

A

2 major lobes and 2 minor lobes

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13
Q

what are the only two lobes of the liver that can be viewed from the front

A

2 major lobes - left and right lobe

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14
Q

which of the 2 major lobes is larger

A

right

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15
Q

which of the 2 major lobes is smaller

A

left

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16
Q

what are the right and left major lopes separated by

A

falciform ligament

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17
Q

what lobes of the liver are visualized from the back

A

2 minor lobes - quadrate lobe and caudate lobe

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18
Q

this minor lobe is located on the inferior surface of the right love between the gallbladder and the falciform ligament

A

quadrate lobe

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19
Q

this minor lobe is just posterior to the quadrate lobe and extends superiorly to the diaphragmatic surface

A

caudate lobe

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20
Q

this contours over the surface of this caudate lobe

A

inferior vena cava

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21
Q

how many functions does the liver perform

A

over 100

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22
Q

what is the function of the liver most applicable to radiographic study

A

production of large amoutns of bile

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23
Q

how much bile does the liver secrete a day

A

1 quart (800-1000 mL) of bile a day

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24
Q

this is made soluble in bile by bile salts

A

cholesterol

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25
Q

major function of bile

A

aid in digestion of fats by emulsifying fat globules

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26
Q

the right and left hepatic ducts combine to then become this

A

common hepatic duct

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27
Q

bile is carried to the gallbladder for temporary storage by this

A

cystic duct

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28
Q

bile can be secreted directly into the duodenum by this

A

common bile duct

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29
Q

what is the common bile duct joined by

A

pancreatic duct

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30
Q

the common bile duct is joined by the pancreatic duct where

A

hepatopancreatic sphincter

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31
Q

bile empties into the duodenum through the hepatopancreatic sphincter via this

A

duodenal papilla

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32
Q

pear-shaped sac

A

gallbladder

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33
Q

what are the 3 parts of the gallbladder

A
  • fundus
  • body
  • neck
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34
Q

the distal end and the broadest part of the gallbladder

A

fundus

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35
Q

main section of the gallbladder

A

body

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36
Q

narrow proximal end of gallbladder which continues as the cystic duct

A

neck

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37
Q

how long is the cystic duct

A

1-1.5” (3-4 cm)

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38
Q

what are the membranous folds along the length of the cystic duct called

A

spiral valve

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39
Q

what does the spiral valve do

A

prevents distension or collapse of the cystic duct

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40
Q

how big is a normal gallbladder

A

2.5-4” (7-10cm) long and 1” (2.5cm) wide

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41
Q

how much bile does the gallbladder hold

A

2-2.5 Tbsp (30-40 mL)

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42
Q

what are the 3 primary functions of the gallbladder

A
  • store bile
  • concentrate bile
  • contract when stimulated
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43
Q

bile is concentrated in the gallbladder as a result of what

A

hydrolysis - removal of water

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44
Q

when do gallstones (choleliths) form in the gallbladder

A
  • when too much water is absorbed
  • cholesterol becomes too concentrated
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45
Q

what forms the most common type of gallstones

A

cholesterol

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46
Q

when does the gallbladder normally contract

A

when fats or fatty acids are in the duodenum

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47
Q

fats or fatty acids stimulate the duodenal mucosa to secrete this hormone

A

cholecystokinin (CCK)

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48
Q

increased levels of CCK in the blood cause this

A
  • gallbladder to contract
  • terminal opening of common bile duct to relax
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49
Q

CCK causes this of the pancreas

A

increased exocrine activity by the pancreas

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50
Q

how big is the common bile duct

A

3” (7.5 cm) long and diameter of straw

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51
Q

the common bile duct descends behind this to enter the second or descending portion of the duodenum

A

superior portion of the duodenum and the head of the pancreas

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52
Q

the terminal end of the common bile duct is closely associated with the terminal end of what

A

pancreatic duct (duct of Wirsung)

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53
Q

what percent of the population have their pancreatic duct and common bile duct enter the duodenum at separate openings

A

40%

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54
Q

what percent of the population have their common bile duct joint the pancreatic duct to form one common passageway through the single papilla into the duodenum

A

60%

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55
Q

this is a common site for impaction of gallstones

A

hepatopancreatic ampulla (ampulla of Vater)

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56
Q

near the terminal opening of the passageway of the hepatopancreatic ampulla into the duodenum, the duct walls contain circular muscle fiber called what

A

hepatopancreatic sphincter (sphincter of Oddi)

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57
Q

when does the sphincter of Oddi relax

A

CCK levels increase in the bloodstream

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58
Q

the presence of the sphincter of Oddi in the hepatopancreatic ampulla into the duodenum causes a protrusion in to the lumen of the duodenum called what

A

duodenal papilla (papilla of Vater)

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59
Q

where is the gallbladder situated in relation to the midcoronal plane

A

anterior

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60
Q

which position is more appropriate to get the gallbladder closer to the IR

A

prone position

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61
Q

if the primary purpose is to drain the gallbladder into the duct system how would the patient be positioned

A

supine

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62
Q

what 4 advantages does sonography offer when studying the gallbladder and the biliary ducts

A
  • nonionizing radiation
  • detection of small calculi
  • no contrast medium
  • less patient preperation
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63
Q

clinical indications for gallbladder diseases

A
  • nausea
  • heartburn
  • premature full feeling when eating
  • RUQ discomfort
  • vomiting
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64
Q

prefix denoting relationship to bile

A

chole-

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65
Q

prefix denoting sac or bladder

A

cysto-

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66
Q

gallstones

A

choleliths

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67
Q

condition of having gallstones

A

cholelithiasis

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68
Q

inflammation of the gallbladder

A

cholecystitis

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69
Q

surgical removal of the gallbladder

A

cholecystectomy

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70
Q

presence of stones in the biliary ducts

A

choledocholithiasis

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71
Q

condition of having abnormal calcifications or stones in the gallbladder

A

cholelithiasis

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72
Q

symptoms of choledocholithiasis

A
  • pain
  • tenderness in RUQ
  • jaundice
  • sometimes pancreatitis
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73
Q

increased levels of these 3 things may lead to the formation of gallstones

A
  • bilirubin
  • calcium
  • cholesterol
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74
Q

what are the two types of gallstones

A
  • cholesterol
  • pigment
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75
Q

what percent of gallstones are cholesterol type

A

75%

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76
Q

4 risk factors for developing gallstones

A
  • family history
  • excessive weight
  • being over 40 years old
  • being female
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77
Q

symptoms of cholelithiasis

A
  • RUQ pain usually after a meal
  • nausea
  • possible vomiting
  • complete blockages may cause jaundice
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78
Q

what are gallstones primarily composed of

A

cholesterol

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79
Q

what percent of gallstones are composed of crystalline calcium salts

A

20%

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80
Q

what percent of gallstones are primarily cholesterol and crystalline salts

A

25-30%

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81
Q

these type of gallstones are visible without contrast media

A

crystalline calcium salts

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82
Q

the emulsion of biliary stones in the gallbladder

A

milk calcium bile

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83
Q

inflammation of the gallbladder

A

cholecystitis

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84
Q

in acute cholecystitis, there is often a blockage here, which in 95% of the case is due to this

A

cystic duct; stone in the neck of the gallbladder

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85
Q

symptoms of acute cholecystitis

A
  • abdominal pain
  • tenderness in RUQ
  • fever
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86
Q

acute cholecystitis may also be caused by what other than a blockage

A
  • bacterial infection
  • ischemia of the gallbladder
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87
Q

this may lead to a gangrenous (dead tissue) gallbladder

A

gas-producing bacteria

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88
Q

chronic cholecystitis is almost always associated with this

A

gallstones

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89
Q

what else, other than gallstones, can chronic cholecystitis be due to

A

pancreatitis or carcinoma of the gallbladder

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90
Q

symptoms of chronic cholecystitis

A
  • RUQ pain
  • heartburn
  • nausea after a meal
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91
Q

chronic cholecystitis may produce repetitive attacks following meals that typically subside when

A

1-4 hours

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92
Q

new growths, which may be benign or malignant

A

neoplasms

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93
Q

how common are neoplasms of the gallbladder

A

rare

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94
Q

of the malignant tumors of the gallbladder, 85% are what

A

adenocarcinomas

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95
Q

of the malignant tumors of the gallbladder, 15% are what

A

squamous cell carcinomas

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96
Q

common benign tumors of the gallbladder include what

A

adenomas and cholesterol polyps

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97
Q

how many of the patients with carcinoma of the gallbladder have stones

A

80%

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98
Q

what are best modalities to demonstrate neoplasms of the gallbladder

A

sonography and CT

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99
Q

narrowing of one of the biliary ducts

A

biliary stenosis

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100
Q

this may result from biliary stenosis

A

cholecystitis and jaundice

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101
Q

during cholangiography how may the common bile duct appear in a biliary stenosis

A

elongated, tapered, and narrowed

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102
Q

appears as enlargement or narrowing of biliary ducts awing to presence of stones

A

choledocholithiasis - stones in biliary ducts

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103
Q

appears as both radiolucent and radiopaque densities seen in the gallbladder region; shadowing effect on ultrasound’ failure to accumulate radionuclide within gallbladder

A

cholelithiasis - stones in gallbladder

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104
Q

appears as thickened wall of gallbladder with ultrasound; failure to accumulate radionuclide within gallbladder

A

acute cholecystitis

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105
Q

appears as calcified plaques or calcification of wall of gallbladder

A

chronic cholecystitis

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106
Q

appears as a mass within gallbladder, liver, or biliary ducts; extensive calcification of gallbladder wall

A

neoplasms

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107
Q

list of the alimentary canal in order

A
  • oral cavity (mouth)
  • pharynx
  • esophagus
  • stomach
  • duodenum and small intestine
  • large intestine
  • anus
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108
Q

what are the accessory organs of the digestive system

A
  • salivary glands
  • pancreas
  • liver
  • gallbladder
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109
Q

what are the 3 primary functions of the digestive system

A
  • intake and digestion
  • absorption
  • elimination
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110
Q

what are the two common radiographic procedures involving the upper gastrointestinal (UGI) system

A
  • esophagography
  • upper GI series
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111
Q

specific examination of the pharynx and esophagus

A

esophagography

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112
Q

procedure designed to study the distal esophagus, stomach, and duodenum in one exam

A

upper gastrointestinal series (UGI/upper GI)

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113
Q

what is the preferred contrast medium for the entire alimentary canal

A

barium sulfate mixed with water

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114
Q

what is the roof of the oral cavity formed by

A

hard and soft palate

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115
Q

hanging from the midposterior aspect of the soft palate is a small conical process called what

A

palatine uvula

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116
Q

most of the floor of the oral cavity is formed by what

A

tongue

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117
Q

the oral cavity connects posteriorly with this

A

pharynx

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118
Q

what are chewing movements called

A

mastication

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119
Q

accessory organs of digestion associated with the mouth

A

salivary glands

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120
Q

what are the three pairs of glands that secrete most of the saliva in the oral cavity

A
  • parotid (near the ear)
  • submandibular/submaxillary (below the mandible/maxilla)
  • sublingual (below the tongue)
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121
Q

what is saliva made up of

A

99.5% water and 0.5% solutes or salts and certain digestive enzymes

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121
Q

where is the parotid gland located

A

just anterior to the external ear

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121
Q

largest of the salivary glands

A

parotid

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122
Q

how much saliva do the salivary glands secrete a day

A

1000-1500 mL daily

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123
Q

this dissolves the food to begin the digestive process

A

saliva

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124
Q

what enzyme does saliva contain and what does it break down

A

amylase; starches

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125
Q

specific salivary glands secrete thickened fluid that contains this

A

mucus

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126
Q

what does mucus do

A

lubricates food so it can form into a ball/bolus for swallowing

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127
Q

what is the act of swallowing termed

A

deglutition

128
Q

this salivary glad may be a site for infection

A

parotid

129
Q

an inflammation and enlargement of the parotid glands caused by a paramyxovirus

A

mumps

130
Q

mumps can cause inflammation of the testes in about how many infected males

A

30%

131
Q

how long is the pharynx

A

5” (12.5 cm)`

132
Q

part of the digestive tube found posterior to the nasal cavity, mouth, and larynx

A

pharynx

133
Q

portion of the pharynx posterior to the bony nasal septum, nasal cavities and soft palate; not part of the digestive system

A

nasopharynx

134
Q

portion of the pharynx directly posterior to the oral cavity proper; extends from the soft palate to the epiglottis

A

oropharynx

135
Q

membrane-covered cartilage that moves down to cover the opening of the larynx during swallowing

A

epiglottis

136
Q

portion of the pharynx that extends from the level of the epiglottis to the level of the lower border of the larynx (C6)`

A

laryngopharynx; hypopharynx

137
Q

these is seen anterior to the esophagus

A

trachea

138
Q

how many total cavities communicate with the pharynx

A

7

139
Q

which cavities connect to the nosopharynx

A
  • 2 nasal cavities
  • 2 tympanic cavities
140
Q

how do the tympanic cavities connect to the nasopharynx

A

via the auditory or eustachian tubes

141
Q

what cavity connects to the oropharynx

A

oral cavity posteriorly

142
Q

what cavities connect to the laryngopharynx inferiorly

A

larynx and esophagus

143
Q

during swallowing what does the soft palate do

A

closes off the nasopharynx

144
Q

this prevents food from reentering the the mouth when swallowing

A

tongue

145
Q

during swallowing, this is depressed to cover the laryngeal opening

A

epiglottis

146
Q

these also come together to help close the epiglottis

A

vocal folds/cords

147
Q

3rd part of the alimentary canal

A

esophagus

148
Q

muscular canal extending from the laryngopharynx to the stomach

A

esophagus

149
Q

how long is the esophagus

A

10” (25cm) long and 0.5” (1-2 cm) wide

150
Q

the esophagus begins posterior to the level of the lower border of what

A

cricoid cartilage of the larynx (C5-C6); upper margin of the thyroid cartilage

151
Q

what level does the esophagus terminate its connection to the stomach at

A

T11

152
Q

where is the esophagus in relationship to the larynx and trachea

A

posterior

153
Q

where is the descending aorta located in relation to the esophagus and thoracic spine

A

located between lower esophagus and thoracic spine

154
Q

what level does the esophagus pierce the diaphragm

A

T10

155
Q

narrowest part of the alimentary canal

A
  • proximal end entering the thorax
  • passes through the diaphragm at the esophageal hiatus
156
Q

just before passing through the diaphragm the esophagus presents this

A

distinct dilation

157
Q

where are the two indentations of the esophagus located at

A
  • aortic arch
  • esophagus crosses the left primary bronchus
158
Q

where on the diaphragm does the esophagus pass through

A

slightly to the left and posterior to the midpoint

159
Q

what is the abdominal segment of the esophagus called

A

cardiac antrum

160
Q

how long is the cardiac antrum

A

0.5” (1-2 cm)

161
Q

how does the cardiac antrum curve after passing through the diaphragm to attach to the stomach

A

sharply to the left

162
Q

what is the opening between the esophagus and the stomach called

A

esophagogastric junction

163
Q

the junction of the esophagus and stomach are normally securely attached to this

A

diaphragm

164
Q

what type of muscle does the upper third of the esophagus contain

A

skeletal muscle

165
Q

what type of muscle does the middle third of the esophagus contain

A

skeletal and smooth muscle

166
Q

what type of muscle does the lower third of the esophagus contain

A

smooth muscle

167
Q

wavelike series of involuntary muscular contractions that propel solid and semisolid materials through the tubular alimentary canal

A

peristalsis

168
Q

how is the esophagus positioned in relation to the heart

A

just to the right and posterior border of the heart

169
Q

greek word that means stomach

A

gaster-

170
Q

located between the esophagus and small intestine

A

stomach

171
Q

most dilated portion of the alimentary canal

A

stomach

172
Q

small, circular muscle which allows food and fluid to pass through the cardiac orifice

A

cardiac sphincter

173
Q

the esophagogastric junction is commonly called this

A

cardiac orifice

174
Q

directly superior to the cardiac orifice is this

A

cardiac notch

175
Q

the distal abdominal portion of the esophagus curves sharply into a slightly expanded portion of the terminal esophagus called what

A

cardiac antrum

176
Q

opening/orifice of the distal stomach

A

pyloric orifice/pylorus

177
Q

thickened muscular ring that relaxes periodically during digestion to allow stomach or gastric contents to move into the first part of the small intestine, duodenum

A

pyloric sphincter

178
Q

found along the medial border of the stomach, forms a concave border as it extends between the cardiac and pyloric orifices

A

lesser curvature

179
Q

found along the lateral border of the stomach, 4-5x longer than the lesser curvature and extends from the cardiac notch and the pylorus

A

greater curvature

180
Q

what are the 3 subdivisions of the stomach

A
  • fundus
  • body
  • pylorus
181
Q

ballooned portion of the stomach that lies lateral and superior to the cardiac orifice

A

fundus

182
Q

in an upright/erect position, the fundus is usually filled by a bubble of swallowed air called what

A

gastric bubble

183
Q

lower end of the body of the stomach has a constricted area that separates the body from the pyloric portion of the stomach, this constricted ringlike area is called

A

angular notch

184
Q

smaller terminal portion of the stomach to the right or medial to the angular notch is this

A

pyloric portion

185
Q

the pyloric portion of the stomach is divided into these two parts

A
  • pyloric antrum
  • pyloric canal
186
Q

portion of the pylorus shown as slight dilation immediately distal to the angular notch

A

pyloric antrum

187
Q

barium-filled stomach demonstrates the actual appearance and shape of the stomach on this projection

A

PA

188
Q

when the stomach is empty, the internal lining is thrown into numerous longitudinal mucosal folds called what

A

rugae

189
Q

rugae is most evident in this portion of the stomach

A

lower body of the stomach along the greater curvature

190
Q

this is formed by the rugae along the lesser curvature, and funnels fluid directly from the body of the stomach to the pylorus

A

gastric canal

191
Q

how is the fundus located in relation to the body of the stomach

A

posterior

192
Q

how does the body of the stomach curve from the fundus

A

inferior and anterior

193
Q

in a supine position what is in the fundus of the stomach

A

barium

194
Q

in an RAO position (prone) what is in the fundus

A

gas

195
Q

first portion of the small intestine

A

duodenum

196
Q

how long is the duodenum

A

7.5-9” (20-24 cm)

197
Q

shortest, widest, and most fixed portion of the small intestine

A

duodenum

198
Q

what is the c-shaped duodenum closely related with

A

head of the pancreas

199
Q

what is the “romance of the abdomen”

A

head of the pancreas inside the c-loop of the duodenum

200
Q

how are the duodenum and pancreas located in relation to the parietal peritoneum

A

retroperitoneum

201
Q

what are the 4 parts of the duodenum

A
  • superior portion
  • descending portion
  • horizontal portion
  • ascending portion
202
Q

longest segment of the duodenum

A

second (descending) portion

203
Q

opening for the common bile and pancreatic ducts into the duodenum

A

duodenal papilla

204
Q

which portion of the duodenum posses the duodenal papilla

A

second (descending) portion

205
Q

junction of the duodenum with the second portion of the small intestine

A

duodenojejunal flexure

206
Q

what is the duodenojejunal flexure held in place by

A

ligament of Treitz

207
Q

what is the first part of the superior section of the duodenum called

A

duodenal bulb/cap

208
Q

this is easily located during barium studies of the upper gastrointestinal tract and must be carefully studied due to it being a common site of ulcer disease

A

duodenal bulb

209
Q

the passage of solid or semisolid food from the mouth to the stomach takes how long

A

4-8 seconds

210
Q

the passage of fluid from the mouth to the stomach takes how long

A

1 second

211
Q

if the pyloric valve is closed, the stomach contents are churned or mixed with stomach fluids int o a semifluid mass called what

A

chyme

212
Q

when the pyloric valve opens, small amounts of chyme are passed into the duodenum by this

A

stomach peristalsis

213
Q

how long does it take the stomach to fully empty after an average

A

2-6 hours

214
Q

these types of foods leave the stomach in several hours

A

high carbohydrates

215
Q

these types of foods move through the stomach much more slowly

A

high protein or fat content

216
Q

churning or mixing activity of the small intestine

A

rhythmic segmentation

217
Q

intended to mix food and digestive juices thoroughtly

A

rhythmic sigmentation

218
Q

this propels intestinal contents along the alimentary canal

A

peristalsis

219
Q

how is peristaltic contraction in the small intestine compared to the esophagus and stomach

A

much slower and weaker

220
Q

how fast does chyme move through the small intestine

A

1cm/min

221
Q

how long does chyme usually taken to pass through the entire small intestine

A

3-5 hours

222
Q

what are the 6 classes of substances that are ingested

A
  • carbohydrates/complex sugars
  • proteins
  • lipids/fats
  • vitamins
  • minerals
  • water
223
Q

these are the only substances that must be chemically digested to be absorbed

A
  • carbohydrates
  • proteins
  • lipids
224
Q

chemical digestion is sped up by various what

A

enzymes

225
Q

biologic catalysts found in various digestive juices produced by salivary glands in the mouth and by the stomach, small bowel, and pancreas

A

enzymes

226
Q

what type of compounds are enzymes

A

organic compounds - proteins

227
Q

where does digestion of starches begin and end

A

mouth and completed in the small intestine

228
Q

end product of digestion of complex sugars

A

simple sugars

229
Q

where does protein digestion begin and end

A

stomach and completed in small intestine

230
Q

end product of protein digestion

A

amino acids

231
Q

where does lipid/fat digestion begin and end

A

only in the small bowel, but some enzymes for fat digestion are found in the stomach

232
Q

what is the end product of lipid digestion

A

fatty acids adn glycerol

233
Q

manufactured by the liver and stored in the gallbladder

A

bile

234
Q

does bile contain enzymes

A

no

235
Q

most of the absorption of digestive ends products occur here

A

small intestine

236
Q

what is absorbed in the stomach

A

some water, alcohol, vitamins and certain drugs but NO nutrients

237
Q

what are the primary functions of the digestive system

A
  • ingestion/digestion
  • absorption
  • elimination
238
Q

this has a major impact on the location of the gastrointestinal organs within the abdominal cavity

A

body habitus

239
Q

in this body habitus, the gallbladder is high and almost transverse; lies to the right in the upper abdominal cavity

A

hypersthenic

240
Q

where does the stomach extend from in the hypersthenic body

A

T9-T12, center of stomach about 1” distal to xiphoid, duodenal bulb about T11-T12 to right of midline

241
Q

how does the stomach extend in a hyposthenic/asthenic body

A

T11 down to L5 or lower, duodenal bulb at about L3-L4

242
Q

where is the gallbladder in hyposthenic/asthenic body

A

near midline at L3-L4 (iliac crest)

243
Q

how does the stomach extend in a sthenic body

A

T11 down to L2, duodenal bulb is about L1-L2 to the right of midline

244
Q

where is the gallbladder in a sthenic body

A

midway between lateral abdominal wall and midline

245
Q

how far do abdominal organs tend to drop in an erect position

A

1-2”

246
Q

only part of alimentary canal that can be easily identified on plain radiographs are what

A
  • fundus due to gastric bubble
  • parts of large intestine
247
Q

with increased use of this, the number of post-fluoroscopy radiographs has diminished greatly

A

digital fluoroscopy

248
Q

what type of contrast is radiolucent

A

negative

249
Q

examples of negative contrast

A
  • air
  • CO2
  • gas crystals
  • gas bubble
250
Q

this is frequently used to produce CO2 gas

A

calcium and magnesium citrate carbonate crystals

251
Q

most common positive contrast medium used to visualize GI system

A

barium sulfate (BaSO4)

252
Q

a mixture of barium sulfate and water forms this

A

colloidal suspension (NOT a solution)

253
Q

what is the ratio of thin barium

A

1 part BaSO4 to 1 part water

254
Q

what is average weight-to-volume (w/v) of thin barium mixtures

A

60% barium sulfate to water

255
Q

what is the ratio of thick barium

A

3-4 parts BaSO4 to 1 part water

256
Q

some commercially prepared thick barium may posses how much weight-to-volume

A

98% w/v of barium to water

257
Q

if large amounts of barium sulfate escape into the peritoneal cavity it can lead to this

A
  • intestinal infarcts
  • peritonitis
258
Q

what should be used incase of possible leak into peritoneal cavity

A

water-soluble iodinated contrast media

259
Q

how does water-soluble contrast travel compared with barium sulfate

A

travels much faster than barium

260
Q

when should water-soluble contrast media not be used

A
  • patient is sensitive to iodine
  • severe dehydration
261
Q

what are the two common forms of gas-producing crystals

A

calcium and magnesium citrate

262
Q

these are demonstrated with double-contrast techniques

A
  • polyps
  • diverticula
  • ulcers
263
Q

why should the tech ensure the bucky is all the way to the end of the table

A

brings out the bucky slot shield

264
Q

how much does the bucky slot shield cover

A

2” space directly under the tabletop

265
Q

protective aprons should be at least how much lead

A

0.5mm lead equivalency

266
Q

what is a better alternative than a hand in fluoro

A

compression paddle

267
Q

three cardinal rules

A
  • time
  • distance
  • shielding
268
Q

what is the most effective method of reducing dose during fluoroscopy procedures

A

distance

269
Q

what are the 2 common radiographic procedures of the upper GI system involving contrast media

A
  • esophagography
  • upper GI series
270
Q

common radiographic procedure or exam of the pharynx and esophagus

A

esophagography

271
Q

motor disorder of the esophagus in which peristalsis is reduced along the distal 2/3 of the esophagus. Evident at the esophagogastric sphincter because of its inability to relax during swallowing, occurs equally in males and females between 20-40 years

A

achalasia, cardiospasm

272
Q

congenital or caused by disease, such as cancer of the esophagus,

A

anatomic anomalies

273
Q

replacement of the normal squamous epithelium with columnar-lined epithelium ulcer tissue in the mid-to-lower esophagus. replacement may produce a stricture in the distal esophagus. advanced cases, a peptic ulcer may develop in the distal esophagus. nuclear medicine is the modality of choice for this condition

A

Barrett esophagus, Barrett syndrome

274
Q

carcinoma of the esophagus includes one of the most common malignancies of the esophagus, this

A

adenocarcinoma

275
Q

difficulty swallowing

A

dysphagia

276
Q

characterized by dilation of the veins in the wall of the distal esophagus, often seen with acute liver disease such as cirrhosis secondary to increased portal hypertension

A

esophageal varices

277
Q

entry f gastric contents into the esophagus, irritating the lining of the esophagus. reported as heartburn by most patients

A

gastroesophageal reflux disease (GERD), esophageal reflux

278
Q

demonstrated by an irregular or ulcerative appearance of the mucosa of he esophagus

A

esophagitis

279
Q

characterized by a large outpunching of the esophagus just above the upper esophageal sphincter. believed to be caused by weakening of the muscle wall. patients may experience dysphagia, aspiration, and regurgitation of food eaten hours earlier

A

Zenker diverticulum

280
Q

which hand is the cup of barium handed to the patient in for the esophagography

A

patients left hand

281
Q

what is the most common breathing exercise in esophagography

A

Valsalva maneuver

282
Q

when the patient takes a big deep breath in and bear down as though trying to move the bowel

A

Valsalva maneuver

283
Q

patient exhales and tries to inhale against a closed epiglottis

A

Mueller maneuver

284
Q

what does a positive water test result in

A

significant amounts of barium regurgitate into the esophagus from the stomach

285
Q

radiographic examination of the distal esophagus, stomach, and duodenum

A

upper GI or UGI

286
Q

mass of indigested material that becomes trapped in the stomach

A

bezoar

287
Q

mass of undigested material made of ingested hair

A

trichobezoar

288
Q

mass of undigested material made of ingested vegetable fiber or seeds

A

phytobezoar

289
Q

pouchlike herniations of a portion of the mucosal wall. can occer in the stomach or small intestine

A

diverticula

290
Q

how big are gastric dierticula

A

generally 0.5” but can be up to 3”

291
Q

of gastric diverticula, how many arise in the posterior aspect of the fundus

A

70-90%

292
Q

act of vomiting

A

emesis

293
Q

blood in the vomit

A

hematemesis

294
Q

gastric carcinomas account for how much of all stomach neoplasms

A

70%

295
Q

95% of gastric carcinomas are what

A

adenocarcinomas

296
Q

a large, irregular filling defect within the stomach, marked or nodular edges of the stomach lining, rigidity of the stomach, and associated ulceration of the mucosa

A

gastric carcinomas

297
Q

inflammation of the lining or mucosa of the stomach

A

gastritis

298
Q

intermittent condition that may be brought on by changes in diet, stress, or other factors

A

chronic gastritis

299
Q

manifests with sever symptoms of pain and discomfort

A

acute gastritis

300
Q

how is gastritis best demonstrated

A

double contrast studies

301
Q

condition in which a portion of the stomach herniates through the diaphragmatic opening

A

hiatal hernia

302
Q

second type of hiatal hernia that is caused by weakening of a small muscle (esophageal sphincter) located between the terminal esophagus and the diaphragm

A

sliding hiatal hernia

303
Q

most common type of gastric obstruction in infants

A

hypertrophic pyloric stenosis (HPS)

304
Q

erosions of the stomach or duodenal mucosa that are caused by various physiologic or environmental conditions

A

ulcers

305
Q

peptic ulcer situated in the duodenum

A

duodenal ulcer

306
Q

ulceration of the mucous membrane of the esophagus, stomach, or duodenum, caused by the action of acid gastric juice

A

peptic ulcer

307
Q

ulcer of the gastric mucosa

A

gastric ulcer

308
Q

ulcer that involves the entire thickness of the wall of the stomach or intestine, creating an opening on both surfaces

A

perforating ulcer

309
Q

what is patient prep for upper GI studies

A

NP form midnight before exam - at least 8 hours before exam

310
Q

when should radiographic studies be delayed until for pregnant women

A

at least the third trimester

311
Q

pediatric prep for upper GI

A
  • infant younger than 1: NPO for 4 hours
  • children older than 1: NPO for 6 hours
312
Q

how much barium is used for nerborns to 1 year olds

A

2-4oz

313
Q

how much barium is used for 1-3 year olds

A

4-6oz

314
Q

how much barium is used for 3-10 year olds

A

6-12 oz

315
Q

how much barium is used for children older than 10

A

12-16 oz

316
Q

where is L2 located in relation to the lower rib margin

A

1-2” above the lower rib margin

317
Q

how many routine images are there for esophagography

A

3 routine images

318
Q

how many routine images are there for upper GI studies

A

5 routine images

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