Ch. 12 Biliary Tract and Upper Gastrointestinal System Workbook Flashcards

1
Q

what is the average weight of the adult human liver

A

3-4 lbs (1.5 kg) (1/36 of total body weight)

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2
Q

which abdominal quadrant contains the gallbladder

A

RUQ

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3
Q

what is the name of the soft tissue structure that separates the right from the left lobe of the liver

A

falciform ligament

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4
Q

which lobe of the liver is larger, the right or the left

A

right

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5
Q

what are the minor lobes of the liver called

A

-quadrate
- caudate

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6
Q

how much bile does the average healthy adult liver produce in a day

A

1 quart (800-1000 mL)

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7
Q

what are the 3 primary functions of the gallbladder

A
  • store bile
  • concentrate bile
  • contracts to release bile into duodenum
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8
Q

what imaging modality produces cholescintigraphy

A

nuclear medicine

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9
Q

what two terms refer to a radiographic examination of the pharynx and esophagus

A
  • esophagography
  • barium swallow
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10
Q

which regions is peristaltic activity not found

A
  • oral cavity
  • pharynx
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11
Q

concentrated levels of this in bile may lead to gallstones

A

cholesterol

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12
Q

a churning or mixing activity that is present in the small bowel is called what

A

rhythmic segmentation

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13
Q

the end of the common bile duct and the end of the pancreatic duct are totally separated into 2 ducts rather than combining into one single passageway into the duodenum in what percent of the population

A

40%

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14
Q

what is the end product of digestion of lipids

A

fatty acids and glycerol

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15
Q

what types of mechanical digestion occur in the oral cavity

A
  • mastication
  • delgutition
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16
Q

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

A

digital fluoroscopy

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17
Q

what is the older term for the main pancreatic duct

A

duct of Wirsung

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18
Q

is the gallbladder located more anteriorly or posteriorly in the abdomen

A

anteriorly

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19
Q

what are the 4 advantages of using sonography as a noninvasive means to study the gallbladder and biliary ducts

A
  • no ionizing radiation
  • no contrast media required
  • less patient prep
  • better detection of small calculi
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20
Q

certain salts of barium are poisonous to humans, so barium contrast studies require this for human consumption

A

pure sulfate salt of barium

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21
Q

a cholecystocholagiogram is a radiographic exam of what

A

both gallbladder and biliary ducts

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22
Q

surgical removal of the gallbladder

A

cholecystectomy

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23
Q

condition of having gallstones

A

cholelithiasis

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24
Q

what are the 4 advantages or unique features and capabilities of digital fluoroscopy over conventional fluoroscopic recording systems

A
  • optional post fluoroscopy overhead images
  • multiple frames formatting and multiple original images
  • cine loop capability
  • image enhancement and manipulation
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25
Q

difficulty in swallowing

A

dysphagia

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26
Q

benign or malignant tumors

A

neoplasm

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27
Q

most common form is adenocarcinoma

A

carcinoma of esophagus

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28
Q

narrowing of the biliary ducts

A

biliary stenosis

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29
Q

what are the 7 major components of the alimentary canal

A
  • mouth
  • pharynx
  • esophagus
  • stomach
  • small intestine
  • large intestine
  • anus
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30
Q

what are the 4 accessory organs of digestion

A
  • liver
  • gall bladder
  • pancreas
  • salivary glands
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31
Q

what are the 3 primary functions of the digestive system

A
  • ingestion and digestion of food
  • absorption of digested food particles
  • elimination of solid waste products
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32
Q

which term describes the radiographic study of the distal esophagus, stomach, and duodenum

A

upper gastrointestinal (UGI) series/ upper GI

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33
Q

what is the act of swallowing called

A

deglutition

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34
Q

what are the 3 divisions of the pharynx

A
  • nasopharynx
  • oropharynx
  • laryngopharynx
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35
Q

what structures create the two indentations seen along the lateral border of the esophagus

A
  • aortic arch
  • left primary bronchus
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36
Q

what 3 structures pass through the diaphragm

A
  • esophagus
  • inferior vena cava
  • aorta
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37
Q

blind outpouching of the mucosal wall

A

diverticula

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38
Q

what term describes the junction between the duodenum and jejunum

A

duodenojejunal flexure

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39
Q

synonymous with gastric or duodenal ulcer

A

peptic ulcer

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40
Q

what type of structures are the c-loop of the duodenum and pancreas in relation to the peritoneum

A

retroperitoneal

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41
Q

how does the body of the stomach curve from the fundus

A

inferiorly and anteriorly

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42
Q

what are the 3 main subdivisions of the stomach

A
  • fundus
  • body
  • pylorus
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43
Q

portion of stomach protruding through the diaphragmatic opening

A

hiatal hernia

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44
Q

speckled appearance of gastric mucus on radiograph

A

gastritis

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45
Q

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

A
  • pyloric antrum
  • pyloric canal
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46
Q

what is another term for mucosal folds of the stomach

A

rugae

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47
Q

what are the two anatomic structures implicated in the phrase “romance of the abdomen”

A
  • head of pancreas
  • c-loop of duodenum
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48
Q

gastric bubble above diaphragm on radiograph

A

hiatal hernia

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49
Q

this includes movements of the entire gastrointestinal (GI) tract

A

mechanical digestion

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50
Q

which specific structure of the GI system is affected by hypertrophic pyloric stenosis (HPS)

A

antral muscle at the orifice of the pylorus

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51
Q

stomach contents are churned into a semifluid mass called what

A

chyme

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52
Q

what are the 3 groups of food that are ingested and must be chemically digested

A
  • carbohydrates
  • protein
  • lipids (fats)
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53
Q

biologic catalysts that speed up the process of digestion are called what

A

enzymes

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54
Q

esophagography usually begins with fluoroscopy with the patient in which position

A

erect

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55
Q

what are the 4 radiographic tests that may be performed to detect signs of GERD

A
  • breathing exercises
  • water test
  • compression (paddle) technique
  • toe-touch maneuver
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56
Q

what position is the patient usually placed during the water test

A

slight LPO

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57
Q

what is the suggested dose of barium sulfate for an upper GI on a nerborn-1 year old

A

2-4 oz

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58
Q

what is the end product of digestion of carbohydrates

A

simple sugars

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59
Q

what is the suggested dosage of barium for an upper GI on a 3-10 year old

A

6-12 oz

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60
Q

what is the end product of digestion of protein

A

amino acid

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61
Q

what is the name of the liquid substance that aids in digestion, is manufactured in the liver, and is stored in the gallbladder

A

bile

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62
Q

what is the suggested dosage of barium for an upper GI on a child older than 10 years old

A

12-16 oz

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63
Q

what type of fluoroscopy generator is recommended for pediatric procedures

A

pulsed, grid-controlled fluoroscopy

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64
Q

how does bile assist in emulsification of fat

A

large droplets are broken down to small fat droplets which have greater surface area and give enzymes greater access for breakdown of lipids

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65
Q

where does absorption of nutrients primarily take place at

A

small intestine

66
Q

why is the RAO preferred rather than the LAO for esophagography

A

places esophagus between vertebral column and heart

67
Q

some substances are absorbed through the lining of what

A

stomach

68
Q

how much rotation of the body is required for the RAO position during an upper GI on a sthenic patient

A

40-70 degrees

69
Q

what is the purpose of the PA axial projection for the hypersthenic patient during an upper GI

A

prevent superimposition of the pylorus over the duodenal bulb and visualize the lesser and greater curvature of stomach better

70
Q

which of the 3 primary food substances does the digestion begin in the mouth

A

carbohydrate

71
Q

what projection during an upper GI will best demonstrate the retrogastric space

A

lateral

72
Q

when should respiration be suspended for upper GI radiographs

A

expiration

73
Q

any residues of digestion or unabsorbed digestive products are eliminated from this as a component of feces

A

large intestine

74
Q

peristalsis is an example of which type of digestion

A

mechanical

75
Q

what term describes food after it is mixed with gastric secretions in the stomach

A

chyme

75
Q

a high and transverse stomach would be found in what type of patient

A

hypersthenic

76
Q

what procedure should be performed to rule out a hiatal hernia

A

upper GI series

77
Q

how are most foreign bodies of the esophagus located and removed today

A

endoscopy

78
Q

where would you center your CR on an asthenic patient post upper GI on an 11x14 IR

A

L3-L4 about 1.5-2” above iliac crest

79
Q

a j-shaped stomach that is more vertical and lower in the abdomen, with the duodenal bulb at the level of L3-L4 would be found on which type of patient

A

hyposthenic/asthenic

80
Q

in an erect position, how much will abdominal organs drop on average

A

1-2” (2.5-5 cm)

81
Q

if a PA projection during an upper GI series of an infant shows the body and pylorus of stomach superimposed what must be done to fix the repeat

A

angle CR 20-25 degrees cephalad

82
Q

what projection during the upper GI series demonstrates possible gastric diverticulum in the posterior aspect of fundus

A

lateral

83
Q

what two GI organs are most dramatically affected, in relation to location, by body habitus

A
  • stomach
  • gallbladder
84
Q

would the fundus be more superior or inferior during deep inhalation

A

inferior

85
Q

what types of mechanical digestion occur in the pharynx

A

deglutition

86
Q

what types of mechanical digestion occur int he esopagus

A
  • deglutition
  • peristalsis
87
Q

what types of mechanical digestion occur in the stomach

A
  • peristalsis
  • mixing
88
Q

what types of mechanical digestion occur in the small intestines

A
  • peristalsis
  • rhythmic segmentation
89
Q

what is another term for a negative contrast medium

A

radiolucent contrast medium

90
Q

what substance is most commonly ingested to produce carbon dioxide gas as a negative contrast medium for GI studies

A

magnesium or calcium citrate

91
Q

what is the most common form of positive contrast medium used for studies of the GI system

A

barium sulfate

92
Q

what type of mixture is barium sulfate

A

colloidal suspension

93
Q

what is the ratio of water to barium for a thin mixture of barium sulfate

A

1:1

94
Q

what is the chemical symbol for barium sulfate

A

BaSO4

95
Q

when is the use of barium sulfate contraindicated

A

when mixture may escape into peritoneal cavity

96
Q

what patient condition prevents the use of a water-soluble contrast medium for an upper GI series

A

sensitivity to iodine

97
Q

which 3 pairs of salivary glands are accessory organs of digestion associated with the mouth

A
  • parotid
  • sublingual
  • submandibular
98
Q

replacement of normal squamous epithelium with columnar epithelium

A

Barrett esophagus

99
Q

what is the major advantage for using a double-contrast medium technique for esophagogastric and upper GI series

A
  • better coating and visibility of the mucosa
  • polyps, diverticula, and ulcers are better demonstated
100
Q

what is the purpose of the gas with a double-contrast media technqiue

A

forces barium sulfate against the mucosa for better coating

101
Q

what device (found beneath the radiographic table when correctly positioned) greatly reduces exposure to the technologist from the fluoroscopic x-ray tube

A

bucky slot shield

102
Q

its presence indicates a possible sliding hiatal hernia on a radiograph

A

Schatzki’s ring

103
Q

how is the bucky slot shield activated or placed in its correct position for fluoroscopy

A

slid all the way to one end

104
Q

what is the minimum level of protective apron worn during fluoro

A

0.5mm Pb/Eq

105
Q

what is the major benefit of using a compression paddle during an upper GI study

A

reduces exposure to arms and hands of the fluoroscopist

106
Q

what are the 3 cardinal principles of radiation protection

A
  • time
  • distance
  • shielding
107
Q

which region of the GI tract is better visualized when the radiologist uses a compression paddle during esophagography

A

esophagogastric junction

108
Q

which cardinal principle is most effective in reducing exposure to the tech during a fluoroscopic procedure

A

distance

109
Q

common site for impaction, or lodging, of gallstones

A

duodenal papilla

110
Q

which capability on most digital fluoroscopy systems demonstrates a dynamic flow of contrast media through the GI tract

A

cine loop capability

111
Q

inflammation of lining of stomach

A

gastritis

112
Q

undigested material trapped in stomach

A

bezoar

113
Q

only 5% of ulcers lead to this condition

A

perforating ulcer

114
Q

may be secondary to cirrhosis of the liver

A

esophageal varices

115
Q

stricture of esophagus on radiograph

A

achalasia

116
Q

enlarged recess in proximal esophagus on radiograph

A

Zenker’s diverticulum

117
Q

which imaging modality is most effective in diagnosing hypertrophic pyloric stenosis (HPS) while reducing dose to the patient

A

ultrasound

118
Q

what does NPO stand for and mean

A

non per os; nothing by mouth

119
Q

patients must be NPO for what study

A

upper GI

120
Q

what materials may be used for swallowing to aid in diagnosis of radiolucent foreign bodies in the esophagus

A
  • barium soaked cotton balls
  • barium pills
  • marshmellows followed with thin barium
121
Q

what type of contrast medium should be used if the patient has a history of bowel perforation

A

water-soluble iodinated contrast

122
Q

what is the minimum amount of time that the patient should be NPO before an upper GI

A

8 hours

123
Q

why should cigarette use and gum chewing be restricted before an upper GI

A

they increase gastric secretions

124
Q

what hand does the patient usually hold the barium cup with during the start of an upper GI

A

left hand

125
Q

what is the suggested dosage of barium for an upper GI on a 1-3 year old

A

4-6 oz

126
Q

what optional position should be performed to demonstrate the mid-to-upper esophagus located between the shoulders

A

optional swimmers lateral

127
Q

what is the average kVp range for esophagography and an upper GI when using barium sulfate (single contrast)

A

110-125 kVp

128
Q

which aspects of the upper GI tract will be filled with barium in the PA projection (prone)

A

body and pylorus of stomach and duodenal bulb

129
Q

what is the recommended kVp range for a double-contrast upper GI projection

A

90-100 kVp

130
Q

what position does the upper GI series usually begin with the patient and table in

A

erect

131
Q

what are the 5 most common routine projections for an upper GI series

A
  • RAO
  • PA
  • R lateral
  • LPO
  • AP
132
Q

the major parts of the stomach on an average patient are usually confined to which abdominal quadrant

A

LUQ

133
Q

most of the duodenum is usually found to which side of the midline on a sthenic patient

A

right

134
Q

if the fundus of the stomach is filled with barium is the projection AP or PA

A

AP (supine)

135
Q

what radiographic study should be performed to demonstrated bezoar

A

upper GI study

136
Q

if the RAO projection during esophagography shows the esophagus superimposed over the vertebral column what is the problem

A

under-rotation

137
Q

what part of the upper GI tract is a common site for ulcer disease

A

duodenal bulb or cap

138
Q

inflammation of the gallbladder

A

cholecystitis

139
Q

also called cardiospasm

A

achalasia

140
Q

double-contrast upper GI is recommended for this type of tumor

A

gastric carcinoma

141
Q

irregular filling defect within stomach on radiograph

A

gastric carcinoma

142
Q

what modality is an alterative to esophagography in detecting esophageal varices

A

endoscopy

143
Q

what are the 3 most common routine projections for esophagography

A
  • RAO
  • L lateral
  • AP
144
Q

for an RAO projection during upper GI, do hypersthenic patients need more or less rotation in order to see the duodenal bulb in profile

A

more (70 degrees)

145
Q

what position during an upper GI will cause the fundus to be filled with barium, but the duodenal bulb to be air filled and seen in profile

A

LPO (supine)

146
Q

what imaging modality is most effective in diagnosing hemochromatosis

A

MRI (abnormal iron deposits in the liver parenchyma)

147
Q

the speed with which barium sulfate passes through the GI tract is called what

A

gastric motility

148
Q

large outpouching of the esophagus

A

Zenker diverticulum

149
Q

“lucent-halo” sign during upper GI on radiograph

A

ulcers

150
Q

which procedure is often performed to detect early signs of GERD

A

endoscopy

151
Q

a breathing technique in which the patient takes in a deep breath and bears down is called what

A

valsalva maneuver

152
Q

what are gastric emptying studies performed using

A

radionuclides

153
Q

how much rotation of the body should be used for the RAO projection of the esophagus

A

35-40 degrees

154
Q

which aspect of the GI tract is best demonstrated with an RAO position during an upper GI

A

pylorus and c-loop of duodenum

155
Q

what CR angle is required for the PA axial projection for a hypersthenic patient during an upper GI

A

35-45 degrees cephalad

156
Q

may lead to esophagitis

A

gastroesophageal reflux disease (GERD)

157
Q

“wormlike” appearance of esophagus on radiograph

A

esophageal varices

158
Q

other than esophagography what other imaging modality is ideal to demonstrate Barrett esophagus

A

nuclear medicine

159
Q

which of the following devices on a digital fluoroscopy system convers the analog into a digital signal

A

CCD - charge coupled device

160
Q

enlargement or narrowing of the biliary ducts because of the presence of stones

A

choledocholithiasis

161
Q

blood in vomit

A

hematemesis