Ch. 13 Lower GI System Workbook Flashcards
T/F - 0.1% barium sulfate suspension is often instilled before CT enteroclysis
true
T/F - a cleansing bowel prep is not required before a CTC
false
T/F - contrast BEs are performed commonly on patients who have a clinical history of diverticulosis
false
what projection is recommended during a small bowel series
prone PA
T/F - shielding is not recommended during studies of the lower GI tract
false
T/F - if a retention-type enema tip is used, it should be removed after fluoro is completed and before x-ray projections are taken to better visualize the rectal region
false
what kVp is recommended for a small bowel series (single-contrast study)
110-125
what are breathing instructions for a projection taken during a small bowel series
expiration
generally a small bowel series is complete after the contrast media reaches what
ileocecal valve
what type of patient may require 2 14x17 cw IRs for an AP BE projection
hypersthenic
what projections taken during a BE best demonstrates the right colic flexure
RAO and LPO
how much body rotation is required for oblique BE projections
35-45 degrees
in a person with good muscle tone, how long is the entire small intestine
15-18 ft (4.5-5.5m)
what position should be performed if the patient cannot lie prone on the table to visualize the left colic flexure
RPO
what projection during a double contrast BE series best demonstrates the descending colon for possible polyps
right lateral decub
what is the average length of the large intestine
5 ft (1.5m)
what are the 3 divisions of the small intestine in descending order
- duodenum
- jejunum
- ileum
which aspect of the large intestine is best demonstrated with an AP axial projection
rectosigmoid region
what is the advantage of performing an AP axial oblique projection rather than an AP axial
less superimposition of the rectosigmoid segments
what is another term describing the AP and PA axial projections
butterfly
what CR angle is required for the AP axial
30-40 cephalad
what CR angle is required for the PA axial projection
30-40 caudad
which divisions of the small intestine is the shortest
duodenum
what position is recommended for the post evacuation projection taken following a BE
PA prone
what kVp range is recommended for a postevac projection following a BE
90-100
what is recommended kVp range for oblique projections taken during a single contrast BE study
110-125
in which two abdominal quadrants would the majority of the jejunum be found
LUQ and LLQ
which division of the small intestine has a feathery or coiled-spring appearance during a small bowel series
jejunum
what is the recommended kVp range for oblique projections taken during a double contrast study
90-100
what medication can be given to minimize colonic spasm during a BE
glucagon
which division of the small intestine is the longest
ileum
how many sections of the colon are there and how many flexures
4 sections and 2 flexures
what are the two functions of the ileocecal valve
-prevents contents of the ileum from passing too quickly into cecum
- prevents reflux back into ileum
what is another term for appendix
vermiform appendix
longest aspect of the large intestine
transverse colon
widest portion of the large intestine
cecum
aspect of small intestine that is the smallest in diameter but longest in length
ileum
shortest aspect of small intestine
duodenum
lies in pelvis but possesses a wide freedom of motion
sigmoid colon
makes up 40% of the small intestine
jejunum
found between cecum and transverse colon
ascending colon
how long is the average small bowel if removed and stretched out during autopsy
23ft (7m)
what is the term for the 3 bands of muscle that pulls the large intestine into pouches
taeniae coli
what are the pouches or sacculation’s formed by the taeniae coli, seen along the large intestine called
haustra
which portion of the small intestine is located primarily to the left of the midline
jejunum
which portion of the small intestine is located primarily in the right lower quadrant
ileum
which portion of the small intestine has the smoothest internal lining and does not present a feathery appearance when barium filled
ileum
which quadrant does the terminal ileum connect with the large intestine
RLQ
what is the widest portion of the large intestine
cecum
which two aspects of the large intestine are not considered part of the colon
- cecum
- rectum
a blind pouch inferior to the ileocecal valve
appendix
distal part, also called the iliac colon
descending colon
which flexure of the large intestine usually extends more superiorly
left colic (splenic)
inflammation of the vermiform appendix
appendicitis
what is an older term for the mucosal folds found within the jejunum
plicae circulares
which structures will fill with air during a double contrast BE with the patient supine
transverse colon and sigmoid colon
which aspect of the GI tract is primarily responsible for digestion, absorption, and reabsorption
small intestine
which aspect of the GI tract is responsible for the synthesis and absorption of vitamins B and K and amino acids
large intestine
which of the digestive movements occurs in both large intestine and small intestine
peristalsis
which aspect of the small intestine is the most fixed in position
duodenojejunal flexure
which muscular band marks the junction between the duodenum and the jejunum
ligament of treitz
what type of patients should receive extra care when using water-soluble contrast medium
young and dehydrated
what is the classification of the sigmoid colon in relation to the peritoneum
intraperitoneal
what is the classification of the cecum in relation to the peritoneum
intraperitoneal
form of inflammatory disease of the GI tract
regional enteritis
what is the classification of the ascending colon in relation to the peritoneum
retroperitoneal
radiographically appears as cobblestone appearance
regional enteritis
what is the classification of the transverse colon in relation to the peritoneum
intraperitoneal
what is the classification of the descending colon in relation to the peritoneum
retroperitoneal
what is the classification of the upper rectum in relation to the peritoneum
retroperitoneal
what is the classification of the jejunum in relation to the peritoneum
intraperitoneal
what is the classification of the lower rectum in relation to the peritoneum
infraperiotneal
what is the classification of the c-loop of duodenum in relation to the peritoneum
retroperitoneal
common birth defect found in the ileum
meckel diverticulum
what is the classification of the ileum in relation to the peritoneum
intraperitoneal
what are the two conditions that may prevent the use of barium sulfate during a small bowel series
- possible perforated hollow viscus
- large bowel obstruction
common parasitic infection of the small intestine
giardiasis
obstruction of the small intestine
ileus
new growth
neoplasm
a form of sprue
celiac disease
inflammation of the intestine
enteritis
radiographically appears as an apple-core sign
adenocarcinoma
radiographically appears as large diverticulum of the ileum
meckel diverticulum
radiographically appears as a beak sign
volvulus
giardiasis is a condition acquired through what
- contaminated food
- contaminated water
- person to person contact
when is a small bowel series deemed complete
when contrast medium passes through ileocecal valve
T/F - fluoroscopy is sometimes used during a small bowel series to visualize the ileocecal valve
true
what two types of contrast media are used for an enteroclysis
- high density barium sulfate
- air or methylcellulose
what is the recommended patient prep before a small bowel series
NPO at least 8 hours before procedure and no gum chewing or smoking
which position is recommended for small bowel radiographs
prone to separate loops of intestine
a twisting of a portion of the intestine on its own mesentery
volvulus
outpouching of the mucosal wall
diverticulum
inflammatory condition of the large intestine
colitis
severe form of colitis
ulcerative colitis
telescoping of one part of the intestine into another
intussusception
inward growth extending from the lumen of the intestinal wall
polyp
which type of patient most often experiences intussusception
infant (<2 years old)
a condition of numerous herniations of the mucosal wall of the large intestine
diverticulosis
what pathologic condition may produce a tapered or corkscrew radiographic sign during a BE
volvulus
what condition may produce the cobblestone radiographic sign during a BE
ulcerative colitis
T/F - intestinal polyps and diverticula are very similar in structure
false
T/F - volvulus occurs more frequently in males than females
true
T/F - the BE is a commonly recommended procedure for diagnosing possible acute appendicitis
false
T/F - any stool retained in the large intestine may require the postponement of a BE study
true
T/F - an example of an irritant cathartic is magnesium citrate
false - castor oil
T/F - synthetic latex enema tips or gloves do not cause problems for latex-sensitive patients
true
what is the name of the patient position recommended for insertion of the rectal enema tip
sims position
the initial insertion of the rectal enema tip should be pointed toward what
umbilicus
what procedure is most effective to demonstrate small polyps in the colon
double contrast BE
T/F - a special tapered enema tip is inserted into the stoma before a colostomy BE
true
the enema bag should not be more than how far above the tabletop before the beginning of the procedure
no more than 24” (60cm)
T/F - the tech should review the patients chart before a BE to determine whether a sigmoidscopy or colonoscopy was performed recently
true
T/F - both CT and sonography might be performed to aid in diagnosing appendicitis
true
T/F - because of the density and the amount of barium within the large intestine, computed radiography should not be used during a BE
false
meckel diverticulum is best diagnosed with which imaging modality
nuclear medicine
whipple disease is a rare disorder of what
proximal small intestine
how much barium sulfate is generally given to an adult patient for a small bowel only series
2 cups (16 oz)
how long does it usually take to complete an adult small bowel series
2 hours
when is the first radiograph generally taken during a small bowel series
15-30 minutes after ingesting contrast
how long does it take barium sulfate in a healthy adult, given orally, to reach the rectum
24 hours
what is the tip of the catheter advanced to during an enteroclysis
duodenojejunal flexure
what is the purpose of introducing methylcellulose during an enteroclysis
dilates the intestinal lumen to produce a more diagnostic study
what is the most common form of carcinoma found in the large intestine
annular carcinoma
what 4 conditions would prevent the use of a laxative cathartic before a BE procedure
- gross bleeding
- sever diarrhea
- obstruction
- inflammatory lesion
what are the 3 types of enema tips commonly used (all are single use and disposable)
- plastic disposable
- rectal retention
- air-contrast retention
what water temp is recommended for BE mixtures
warm - 85-90 F (29-32 C)
to minimize spasm during a BE what can be added to the contrast media mixture
lidocaine
which aspect of the large intestine must be demonstrated during evacuative proctography
anorectal angle
which clinical condition is best demonstrated with evacuative proctography
rectal prolapse
what procedure uses the thickest mixture of barium sulfate
evacuative proctogram
what position is the patient placed for imaging during the evacuative proctogram
lateral
what is another term for CT colonography (CTC)
virtual colonoscopy
why is oral contrast media sometimes given during a CTC
to mark or tag fecal matter
what is the chief disadvantage of a CTC
cannot remove polyps discovered
how frequently should images be taken during a small bowel series on a pediatric patient
20-30 minutes
what position is a recommended alternative for the lateral rectum projection during a double contrast BE
ventral decub
where is CR centered for the 15 min radiograph during a small bowel series
2” above iliac crest
what projection taken during a double contrast BE produces an air-filled image of he right colic flexure, ascending colon and cecum
left lateral decub
where is the cR for a lateral projection of the rectum
level of ASIS at MCP
patients with lactose or sucrose sensitivities
malabsorption syndrome
radiographically appears as circular staircase or herringbone sign
ileus
radiographically appears as dilation of the intestine with thickening of circular folds
giardiasis
the term enteroclysis describes what type of a small bowel study
double contrast method
what two pathologic conditions are best evacuative through an enteroclysis procedure
- regional enteritis
- malabsorption syndrome
a procedure to alleviate postoperative distention of a small intestine obstruction
therapeutic intubation
