Ch. 12 Biliary Tract and Upper Gastrointestinal System Flashcards
1
Q
what is bile manufactured by
A
liver
2
Q
where is bile stored
A
gallbladder
3
Q
largest, solid organ in the human body
A
liver
4
Q
how much does the liver weigh
A
3-4 lbs (1.5-2 kg)
5
Q
the liver occupies most of this quadrant
A
right upper quadrant
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
7
Q
what is the widest portion of the liver and how long is it
A
superior border, 8-9” (20-23 cm)
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)
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
10
Q
where is the gallbladder positioned
A
centrally in the posterior inferior region of the liver
11
Q
the distal end of the gallbladder extends where
A
slightly below the posterior inferior margin of the liver
12
Q
how is the liver divided
A
2 major lobes and 2 minor lobes
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
14
Q
which of the 2 major lobes is larger
A
right
15
Q
which of the 2 major lobes is smaller
A
left
16
Q
what are the right and left major lopes separated by
A
falciform ligament
17
Q
what lobes of the liver are visualized from the back
A
2 minor lobes - quadrate lobe and caudate lobe
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
19
Q
this minor lobe is just posterior to the quadrate lobe and extends superiorly to the diaphragmatic surface
A
caudate lobe
20
Q
this contours over the surface of this caudate lobe
A
inferior vena cava
21
Q
how many functions does the liver perform
A
over 100
22
Q
what is the function of the liver most applicable to radiographic study
A
production of large amoutns of bile
23
Q
how much bile does the liver secrete a day
A
1 quart (800-1000 mL) of bile a day
24
Q
this is made soluble in bile by bile salts
A
cholesterol
25
major function of bile
aid in digestion of fats by emulsifying fat globules
26
the right and left hepatic ducts combine to then become this
common hepatic duct
27
bile is carried to the gallbladder for temporary storage by this
cystic duct
28
bile can be secreted directly into the duodenum by this
common bile duct
29
what is the common bile duct joined by
pancreatic duct
30
the common bile duct is joined by the pancreatic duct where
hepatopancreatic sphincter
31
bile empties into the duodenum through the hepatopancreatic sphincter via this
duodenal papilla
32
pear-shaped sac
gallbladder
33
what are the 3 parts of the gallbladder
- fundus
- body
- neck
34
the distal end and the broadest part of the gallbladder
fundus
35
main section of the gallbladder
body
36
narrow proximal end of gallbladder which continues as the cystic duct
neck
37
how long is the cystic duct
1-1.5" (3-4 cm)
38
what are the membranous folds along the length of the cystic duct called
spiral valve
39
what does the spiral valve do
prevents distension or collapse of the cystic duct
40
how big is a normal gallbladder
2.5-4" (7-10cm) long and 1" (2.5cm) wide
41
how much bile does the gallbladder hold
2-2.5 Tbsp (30-40 mL)
42
what are the 3 primary functions of the gallbladder
- store bile
- concentrate bile
- contract when stimulated
43
bile is concentrated in the gallbladder as a result of what
hydrolysis - removal of water
44
when do gallstones (choleliths) form in the gallbladder
- when too much water is absorbed
- cholesterol becomes too concentrated
45
what forms the most common type of gallstones
cholesterol
46
when does the gallbladder normally contract
when fats or fatty acids are in the duodenum
47
fats or fatty acids stimulate the duodenal mucosa to secrete this hormone
cholecystokinin (CCK)
48
increased levels of CCK in the blood cause this
- gallbladder to contract
- terminal opening of common bile duct to relax
49
CCK causes this of the pancreas
increased exocrine activity by the pancreas
50
how big is the common bile duct
3" (7.5 cm) long and diameter of straw
51
the common bile duct descends behind this to enter the second or descending portion of the duodenum
superior portion of the duodenum and the head of the pancreas
52
the terminal end of the common bile duct is closely associated with the terminal end of what
pancreatic duct (duct of Wirsung)
53
what percent of the population have their pancreatic duct and common bile duct enter the duodenum at separate openings
40%
54
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
60%
55
this is a common site for impaction of gallstones
hepatopancreatic ampulla (ampulla of Vater)
56
near the terminal opening of the passageway of the hepatopancreatic ampulla into the duodenum, the duct walls contain circular muscle fiber called what
hepatopancreatic sphincter (sphincter of Oddi)
57
when does the sphincter of Oddi relax
CCK levels increase in the bloodstream
58
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
duodenal papilla (papilla of Vater)
59
where is the gallbladder situated in relation to the midcoronal plane
anterior
60
which position is more appropriate to get the gallbladder closer to the IR
prone position
61
if the primary purpose is to drain the gallbladder into the duct system how would the patient be positioned
supine
62
what 4 advantages does sonography offer when studying the gallbladder and the biliary ducts
- nonionizing radiation
- detection of small calculi
- no contrast medium
- less patient preperation
63
clinical indications for gallbladder diseases
- nausea
- heartburn
- premature full feeling when eating
- RUQ discomfort
- vomiting
64
prefix denoting relationship to bile
chole-
65
prefix denoting sac or bladder
cysto-
66
gallstones
choleliths
67
condition of having gallstones
cholelithiasis
68
inflammation of the gallbladder
cholecystitis
69
surgical removal of the gallbladder
cholecystectomy
70
presence of stones in the biliary ducts
choledocholithiasis
71
condition of having abnormal calcifications or stones in the gallbladder
cholelithiasis
72
symptoms of choledocholithiasis
- pain
- tenderness in RUQ
- jaundice
- sometimes pancreatitis
73
increased levels of these 3 things may lead to the formation of gallstones
- bilirubin
- calcium
- cholesterol
74
what are the two types of gallstones
- cholesterol
- pigment
75
what percent of gallstones are cholesterol type
75%
76
4 risk factors for developing gallstones
- family history
- excessive weight
- being over 40 years old
- being female
77
symptoms of cholelithiasis
- RUQ pain usually after a meal
- nausea
- possible vomiting
- complete blockages may cause jaundice
78
what are gallstones primarily composed of
cholesterol
79
what percent of gallstones are composed of crystalline calcium salts
20%
80
what percent of gallstones are primarily cholesterol and crystalline salts
25-30%
81
these type of gallstones are visible without contrast media
crystalline calcium salts
82
the emulsion of biliary stones in the gallbladder
milk calcium bile
83
inflammation of the gallbladder
cholecystitis
84
in acute cholecystitis, there is often a blockage here, which in 95% of the case is due to this
cystic duct; stone in the neck of the gallbladder
85
symptoms of acute cholecystitis
- abdominal pain
- tenderness in RUQ
- fever
86
acute cholecystitis may also be caused by what other than a blockage
- bacterial infection
- ischemia of the gallbladder
87
this may lead to a gangrenous (dead tissue) gallbladder
gas-producing bacteria
88
chronic cholecystitis is almost always associated with this
gallstones
89
what else, other than gallstones, can chronic cholecystitis be due to
pancreatitis or carcinoma of the gallbladder
90
symptoms of chronic cholecystitis
- RUQ pain
- heartburn
- nausea after a meal
91
chronic cholecystitis may produce repetitive attacks following meals that typically subside when
1-4 hours
92
new growths, which may be benign or malignant
neoplasms
93
how common are neoplasms of the gallbladder
rare
94
of the malignant tumors of the gallbladder, 85% are what
adenocarcinomas
95
of the malignant tumors of the gallbladder, 15% are what
squamous cell carcinomas
96
common benign tumors of the gallbladder include what
adenomas and cholesterol polyps
97
how many of the patients with carcinoma of the gallbladder have stones
80%
98
what are best modalities to demonstrate neoplasms of the gallbladder
sonography and CT
99
narrowing of one of the biliary ducts
biliary stenosis
100
this may result from biliary stenosis
cholecystitis and jaundice
101
during cholangiography how may the common bile duct appear in a biliary stenosis
elongated, tapered, and narrowed
102
appears as enlargement or narrowing of biliary ducts awing to presence of stones
choledocholithiasis - stones in biliary ducts
103
appears as both radiolucent and radiopaque densities seen in the gallbladder region; shadowing effect on ultrasound' failure to accumulate radionuclide within gallbladder
cholelithiasis - stones in gallbladder
104
appears as thickened wall of gallbladder with ultrasound; failure to accumulate radionuclide within gallbladder
acute cholecystitis
105
appears as calcified plaques or calcification of wall of gallbladder
chronic cholecystitis
106
appears as a mass within gallbladder, liver, or biliary ducts; extensive calcification of gallbladder wall
neoplasms
107
list of the alimentary canal in order
- oral cavity (mouth)
- pharynx
- esophagus
- stomach
- duodenum and small intestine
- large intestine
- anus
108
what are the accessory organs of the digestive system
- salivary glands
- pancreas
- liver
- gallbladder
109
what are the 3 primary functions of the digestive system
- intake and digestion
- absorption
- elimination
110
what are the two common radiographic procedures involving the upper gastrointestinal (UGI) system
- esophagography
- upper GI series
111
specific examination of the pharynx and esophagus
esophagography
112
procedure designed to study the distal esophagus, stomach, and duodenum in one exam
upper gastrointestinal series (UGI/upper GI)
113
what is the preferred contrast medium for the entire alimentary canal
barium sulfate mixed with water
114
what is the roof of the oral cavity formed by
hard and soft palate
115
hanging from the midposterior aspect of the soft palate is a small conical process called what
palatine uvula
116
most of the floor of the oral cavity is formed by what
tongue
117
the oral cavity connects posteriorly with this
pharynx
118
what are chewing movements called
mastication
119
accessory organs of digestion associated with the mouth
salivary glands
120
what are the three pairs of glands that secrete most of the saliva in the oral cavity
- parotid (near the ear)
- submandibular/submaxillary (below the mandible/maxilla)
- sublingual (below the tongue)
121
what is saliva made up of
99.5% water and 0.5% solutes or salts and certain digestive enzymes
121
where is the parotid gland located
just anterior to the external ear
121
largest of the salivary glands
parotid
122
how much saliva do the salivary glands secrete a day
1000-1500 mL daily
123
this dissolves the food to begin the digestive process
saliva
124
what enzyme does saliva contain and what does it break down
amylase; starches
125
specific salivary glands secrete thickened fluid that contains this
mucus
126
what does mucus do
lubricates food so it can form into a ball/bolus for swallowing
127
what is the act of swallowing termed
deglutition
128
this salivary glad may be a site for infection
parotid
129
an inflammation and enlargement of the parotid glands caused by a paramyxovirus
mumps
130
mumps can cause inflammation of the testes in about how many infected males
30%
131
how long is the pharynx
5" (12.5 cm)`
132
part of the digestive tube found posterior to the nasal cavity, mouth, and larynx
pharynx
133
portion of the pharynx posterior to the bony nasal septum, nasal cavities and soft palate; not part of the digestive system
nasopharynx
134
portion of the pharynx directly posterior to the oral cavity proper; extends from the soft palate to the epiglottis
oropharynx
135
membrane-covered cartilage that moves down to cover the opening of the larynx during swallowing
epiglottis
136
portion of the pharynx that extends from the level of the epiglottis to the level of the lower border of the larynx (C6)`
laryngopharynx; hypopharynx
137
these is seen anterior to the esophagus
trachea
138
how many total cavities communicate with the pharynx
7
139
which cavities connect to the nosopharynx
- 2 nasal cavities
- 2 tympanic cavities
140
how do the tympanic cavities connect to the nasopharynx
via the auditory or eustachian tubes
141
what cavity connects to the oropharynx
oral cavity posteriorly
142
what cavities connect to the laryngopharynx inferiorly
larynx and esophagus
143
during swallowing what does the soft palate do
closes off the nasopharynx
144
this prevents food from reentering the the mouth when swallowing
tongue
145
during swallowing, this is depressed to cover the laryngeal opening
epiglottis
146
these also come together to help close the epiglottis
vocal folds/cords
147
3rd part of the alimentary canal
esophagus
148
muscular canal extending from the laryngopharynx to the stomach
esophagus
149
how long is the esophagus
10" (25cm) long and 0.5" (1-2 cm) wide
150
the esophagus begins posterior to the level of the lower border of what
cricoid cartilage of the larynx (C5-C6); upper margin of the thyroid cartilage
151
what level does the esophagus terminate its connection to the stomach at
T11
152
where is the esophagus in relationship to the larynx and trachea
posterior
153
where is the descending aorta located in relation to the esophagus and thoracic spine
located between lower esophagus and thoracic spine
154
what level does the esophagus pierce the diaphragm
T10
155
narrowest part of the alimentary canal
- proximal end entering the thorax
- passes through the diaphragm at the esophageal hiatus
156
just before passing through the diaphragm the esophagus presents this
distinct dilation
157
where are the two indentations of the esophagus located at
- aortic arch
- esophagus crosses the left primary bronchus
158
where on the diaphragm does the esophagus pass through
slightly to the left and posterior to the midpoint
159
what is the abdominal segment of the esophagus called
cardiac antrum
160
how long is the cardiac antrum
0.5" (1-2 cm)
161
how does the cardiac antrum curve after passing through the diaphragm to attach to the stomach
sharply to the left
162
what is the opening between the esophagus and the stomach called
esophagogastric junction
163
the junction of the esophagus and stomach are normally securely attached to this
diaphragm
164
what type of muscle does the upper third of the esophagus contain
skeletal muscle
165
what type of muscle does the middle third of the esophagus contain
skeletal and smooth muscle
166
what type of muscle does the lower third of the esophagus contain
smooth muscle
167
wavelike series of involuntary muscular contractions that propel solid and semisolid materials through the tubular alimentary canal
peristalsis
168
how is the esophagus positioned in relation to the heart
just to the right and posterior border of the heart
169
greek word that means stomach
gaster-
170
located between the esophagus and small intestine
stomach
171
most dilated portion of the alimentary canal
stomach
172
small, circular muscle which allows food and fluid to pass through the cardiac orifice
cardiac sphincter
173
the esophagogastric junction is commonly called this
cardiac orifice
174
directly superior to the cardiac orifice is this
cardiac notch
175
the distal abdominal portion of the esophagus curves sharply into a slightly expanded portion of the terminal esophagus called what
cardiac antrum
176
opening/orifice of the distal stomach
pyloric orifice/pylorus
177
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
pyloric sphincter
178
found along the medial border of the stomach, forms a concave border as it extends between the cardiac and pyloric orifices
lesser curvature
179
found along the lateral border of the stomach, 4-5x longer than the lesser curvature and extends from the cardiac notch and the pylorus
greater curvature
180
what are the 3 subdivisions of the stomach
- fundus
- body
- pylorus
181
ballooned portion of the stomach that lies lateral and superior to the cardiac orifice
fundus
182
in an upright/erect position, the fundus is usually filled by a bubble of swallowed air called what
gastric bubble
183
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
angular notch
184
smaller terminal portion of the stomach to the right or medial to the angular notch is this
pyloric portion
185
the pyloric portion of the stomach is divided into these two parts
- pyloric antrum
- pyloric canal
186
portion of the pylorus shown as slight dilation immediately distal to the angular notch
pyloric antrum
187
barium-filled stomach demonstrates the actual appearance and shape of the stomach on this projection
PA
188
when the stomach is empty, the internal lining is thrown into numerous longitudinal mucosal folds called what
rugae
189
rugae is most evident in this portion of the stomach
lower body of the stomach along the greater curvature
190
this is formed by the rugae along the lesser curvature, and funnels fluid directly from the body of the stomach to the pylorus
gastric canal
191
how is the fundus located in relation to the body of the stomach
posterior
192
how does the body of the stomach curve from the fundus
inferior and anterior
193
in a supine position what is in the fundus of the stomach
barium
194
in an RAO position (prone) what is in the fundus
gas
195
first portion of the small intestine
duodenum
196
how long is the duodenum
7.5-9" (20-24 cm)
197
shortest, widest, and most fixed portion of the small intestine
duodenum
198
what is the c-shaped duodenum closely related with
head of the pancreas
199
what is the "romance of the abdomen"
head of the pancreas inside the c-loop of the duodenum
200
how are the duodenum and pancreas located in relation to the parietal peritoneum
retroperitoneum
201
what are the 4 parts of the duodenum
- superior portion
- descending portion
- horizontal portion
- ascending portion
202
longest segment of the duodenum
second (descending) portion
203
opening for the common bile and pancreatic ducts into the duodenum
duodenal papilla
204
which portion of the duodenum posses the duodenal papilla
second (descending) portion
205
junction of the duodenum with the second portion of the small intestine
duodenojejunal flexure
206
what is the duodenojejunal flexure held in place by
ligament of Treitz
207
what is the first part of the superior section of the duodenum called
duodenal bulb/cap
208
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
duodenal bulb
209
the passage of solid or semisolid food from the mouth to the stomach takes how long
4-8 seconds
210
the passage of fluid from the mouth to the stomach takes how long
1 second
211
if the pyloric valve is closed, the stomach contents are churned or mixed with stomach fluids int o a semifluid mass called what
chyme
212
when the pyloric valve opens, small amounts of chyme are passed into the duodenum by this
stomach peristalsis
213
how long does it take the stomach to fully empty after an average
2-6 hours
214
these types of foods leave the stomach in several hours
high carbohydrates
215
these types of foods move through the stomach much more slowly
high protein or fat content
216
churning or mixing activity of the small intestine
rhythmic segmentation
217
intended to mix food and digestive juices thoroughtly
rhythmic sigmentation
218
this propels intestinal contents along the alimentary canal
peristalsis
219
how is peristaltic contraction in the small intestine compared to the esophagus and stomach
much slower and weaker
220
how fast does chyme move through the small intestine
1cm/min
221
how long does chyme usually taken to pass through the entire small intestine
3-5 hours
222
what are the 6 classes of substances that are ingested
- carbohydrates/complex sugars
- proteins
- lipids/fats
- vitamins
- minerals
- water
223
these are the only substances that must be chemically digested to be absorbed
- carbohydrates
- proteins
- lipids
224
chemical digestion is sped up by various what
enzymes
225
biologic catalysts found in various digestive juices produced by salivary glands in the mouth and by the stomach, small bowel, and pancreas
enzymes
226
what type of compounds are enzymes
organic compounds - proteins
227
where does digestion of starches begin and end
mouth and completed in the small intestine
228
end product of digestion of complex sugars
simple sugars
229
where does protein digestion begin and end
stomach and completed in small intestine
230
end product of protein digestion
amino acids
231
where does lipid/fat digestion begin and end
only in the small bowel, but some enzymes for fat digestion are found in the stomach
232
what is the end product of lipid digestion
fatty acids adn glycerol
233
manufactured by the liver and stored in the gallbladder
bile
234
does bile contain enzymes
no
235
most of the absorption of digestive ends products occur here
small intestine
236
what is absorbed in the stomach
some water, alcohol, vitamins and certain drugs but NO nutrients
237
what are the primary functions of the digestive system
- ingestion/digestion
- absorption
- elimination
238
this has a major impact on the location of the gastrointestinal organs within the abdominal cavity
body habitus
239
in this body habitus, the gallbladder is high and almost transverse; lies to the right in the upper abdominal cavity
hypersthenic
240
where does the stomach extend from in the hypersthenic body
T9-T12, center of stomach about 1" distal to xiphoid, duodenal bulb about T11-T12 to right of midline
241
how does the stomach extend in a hyposthenic/asthenic body
T11 down to L5 or lower, duodenal bulb at about L3-L4
242
where is the gallbladder in hyposthenic/asthenic body
near midline at L3-L4 (iliac crest)
243
how does the stomach extend in a sthenic body
T11 down to L2, duodenal bulb is about L1-L2 to the right of midline
244
where is the gallbladder in a sthenic body
midway between lateral abdominal wall and midline
245
how far do abdominal organs tend to drop in an erect position
1-2"
246
only part of alimentary canal that can be easily identified on plain radiographs are what
- fundus due to gastric bubble
- parts of large intestine
247
with increased use of this, the number of post-fluoroscopy radiographs has diminished greatly
digital fluoroscopy
248
what type of contrast is radiolucent
negative
249
examples of negative contrast
- air
- CO2
- gas crystals
- gas bubble
250
this is frequently used to produce CO2 gas
calcium and magnesium citrate carbonate crystals
251
most common positive contrast medium used to visualize GI system
barium sulfate (BaSO4)
252
a mixture of barium sulfate and water forms this
colloidal suspension (NOT a solution)
253
what is the ratio of thin barium
1 part BaSO4 to 1 part water
254
what is average weight-to-volume (w/v) of thin barium mixtures
60% barium sulfate to water
255
what is the ratio of thick barium
3-4 parts BaSO4 to 1 part water
256
some commercially prepared thick barium may posses how much weight-to-volume
98% w/v of barium to water
257
if large amounts of barium sulfate escape into the peritoneal cavity it can lead to this
- intestinal infarcts
- peritonitis
258
what should be used incase of possible leak into peritoneal cavity
water-soluble iodinated contrast media
259
how does water-soluble contrast travel compared with barium sulfate
travels much faster than barium
260
when should water-soluble contrast media not be used
- patient is sensitive to iodine
- severe dehydration
261
what are the two common forms of gas-producing crystals
calcium and magnesium citrate
262
these are demonstrated with double-contrast techniques
- polyps
- diverticula
- ulcers
263
why should the tech ensure the bucky is all the way to the end of the table
brings out the bucky slot shield
264
how much does the bucky slot shield cover
2" space directly under the tabletop
265
protective aprons should be at least how much lead
0.5mm lead equivalency
266
what is a better alternative than a hand in fluoro
compression paddle
267
three cardinal rules
- time
- distance
- shielding
268
what is the most effective method of reducing dose during fluoroscopy procedures
distance
269
what are the 2 common radiographic procedures of the upper GI system involving contrast media
- esophagography
- upper GI series
270
common radiographic procedure or exam of the pharynx and esophagus
esophagography
271
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
achalasia, cardiospasm
272
congenital or caused by disease, such as cancer of the esophagus,
anatomic anomalies
273
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
Barrett esophagus, Barrett syndrome
274
carcinoma of the esophagus includes one of the most common malignancies of the esophagus, this
adenocarcinoma
275
difficulty swallowing
dysphagia
276
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
esophageal varices
277
entry f gastric contents into the esophagus, irritating the lining of the esophagus. reported as heartburn by most patients
gastroesophageal reflux disease (GERD), esophageal reflux
278
demonstrated by an irregular or ulcerative appearance of the mucosa of he esophagus
esophagitis
279
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
Zenker diverticulum
280
which hand is the cup of barium handed to the patient in for the esophagography
patients left hand
281
what is the most common breathing exercise in esophagography
Valsalva maneuver
282
when the patient takes a big deep breath in and bear down as though trying to move the bowel
Valsalva maneuver
283
patient exhales and tries to inhale against a closed epiglottis
Mueller maneuver
284
what does a positive water test result in
significant amounts of barium regurgitate into the esophagus from the stomach
285
radiographic examination of the distal esophagus, stomach, and duodenum
upper GI or UGI
286
mass of indigested material that becomes trapped in the stomach
bezoar
287
mass of undigested material made of ingested hair
trichobezoar
288
mass of undigested material made of ingested vegetable fiber or seeds
phytobezoar
289
pouchlike herniations of a portion of the mucosal wall. can occer in the stomach or small intestine
diverticula
290
how big are gastric dierticula
generally 0.5" but can be up to 3"
291
of gastric diverticula, how many arise in the posterior aspect of the fundus
70-90%
292
act of vomiting
emesis
293
blood in the vomit
hematemesis
294
gastric carcinomas account for how much of all stomach neoplasms
70%
295
95% of gastric carcinomas are what
adenocarcinomas
296
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
gastric carcinomas
297
inflammation of the lining or mucosa of the stomach
gastritis
298
intermittent condition that may be brought on by changes in diet, stress, or other factors
chronic gastritis
299
manifests with sever symptoms of pain and discomfort
acute gastritis
300
how is gastritis best demonstrated
double contrast studies
301
condition in which a portion of the stomach herniates through the diaphragmatic opening
hiatal hernia
302
second type of hiatal hernia that is caused by weakening of a small muscle (esophageal sphincter) located between the terminal esophagus and the diaphragm
sliding hiatal hernia
303
most common type of gastric obstruction in infants
hypertrophic pyloric stenosis (HPS)
304
erosions of the stomach or duodenal mucosa that are caused by various physiologic or environmental conditions
ulcers
305
peptic ulcer situated in the duodenum
duodenal ulcer
306
ulceration of the mucous membrane of the esophagus, stomach, or duodenum, caused by the action of acid gastric juice
peptic ulcer
307
ulcer of the gastric mucosa
gastric ulcer
308
ulcer that involves the entire thickness of the wall of the stomach or intestine, creating an opening on both surfaces
perforating ulcer
309
what is patient prep for upper GI studies
NP form midnight before exam - at least 8 hours before exam
310
when should radiographic studies be delayed until for pregnant women
at least the third trimester
311
pediatric prep for upper GI
- infant younger than 1: NPO for 4 hours
- children older than 1: NPO for 6 hours
312
how much barium is used for nerborns to 1 year olds
2-4oz
313
how much barium is used for 1-3 year olds
4-6oz
314
how much barium is used for 3-10 year olds
6-12 oz
315
how much barium is used for children older than 10
12-16 oz
316
where is L2 located in relation to the lower rib margin
1-2" above the lower rib margin
317
how many routine images are there for esophagography
3 routine images
318
how many routine images are there for upper GI studies
5 routine images
