Chapter 12 (Biliary Tract/Upper GI) Flashcards
The liver is located primarily in the ____ of the abdomen.
a. LLQ
b. RLQ
c. RUQ
d. LUQ
RUQ
The liver is divided into ____ major and minor lobes.
a. three
b. four
c. two
d. six
Four
The liver secretes approximately ____ mL of bile per day.
a. 100 to 250
b. 500 to 700
c. 800 to 1000
d. 1200 to 1500
800 to 1000
The main function of bile is to:
a. break down cholesterol.
b. emulsify fats.
c. begin the digestion of proteins.
d. begin the digestion of complex sugars.
emulsify fats
Which aspect of the gallbladder is located most posterior within the abdomen?
a. Fundus
b. Body
c. Neck
d. Apex
Neck
The average adult gallbladder is ____ cm long and ____ cm wide.
a. 7 to 10; 3
b. 4 to 6; 2
c. 12 to 15; 5 to 6
d. 2 to 3; 1
7 to 10; 3
What is the primary purpose of the membranous folds located within the cystic duct?
a. Produces cholecystokinin.
b. Prevents gallstones from entering the gallbladder.
c. Provides blood supply to the gallbladder.
d. Prevents distention or collapse of the cystic duct.
Prevents distention or collapse of the cystic duct.
Where is bile formed?
a. Gallbladder
b. Duodenal mucosa
c. Liver
d. Pancreas
Liver
Which of the following functions is performed by the gallbladder?
a. Storage of bile
b. Concentration of bile
c. Contraction and release of bile
d. All of the options
All of the options
What is a primary function of cholecystokinin?
a. Serves as an enzyme to break down certain food nutrients.
b. Stimulates the production of bile.
c. Stimulates the gallbladder to contract.
d. Inhibits the formation of gallstones.
Stimulates the gallbladder to contract
Where is cholecystokinin produced?
a. Duodenal mucosa
b. Liver
c. Gallbladder
d. Pancreas
Duodenal mucosa
What is an older term for the pancreatic duct?
a. Duct of Wirsung
b. Hepatopancreatic duct
c. Duct of Langerhans
d. Ampulla of Vater
Duct of Wirsung
What is an older term for the hepatopancreatic sphincter?
a. Duodenal papilla
b. Sphincter of Vater
c. Duodenal sphincter
d. Sphincter of Oddi
Sphincter of Oddi
Which aspect of the gallbladder is labeled 1?
Fundus
Which biliary structure is labeled 4?
Cystic duct
Which structure is labeled 6?
Left hepatic duct
Which structure is labeled 9?
Pancreatic duct
Which region of the biliary system is labeled 10?
Hepatopancreatic ampulla
“Chole-” is a prefix for terms pertaining to the:
a. gallbladder.
b. ducts.
c. bile.
d. liver.
Bile
Radiographic examination of the biliary ducts only is termed:
a. cholecystography.
b. cholangiography.
c. cholelithiasis.
d. cholecystocholangiography.
cholangiography
Which of the following structures is not considered to be an accessory organ of digestion?
a. Liver
b. Pancreas
c. Salivary glands
d. Kidneys
Kidneys
Saliva contains certain enzymes to begin the digestion of:
a. starch.
b. minerals.
c. proteins.
d. lipids.
starch
The act of swallowing is termed:
a. mastication.
b. digestion.
c. deglutition.
d. aphasia.
Deglutition
Which of the following structures is not one of the salivary glands?
a. Parotid
b. Sublingual
c. Submandibular
d. All of the options
All of the options
The esophagus is located ____ to the larynx.
a. anterior
b. posterior
c. inferior
d. proximal
posterior
The aortic arch and the _____ create a normal indentation seen along the lateral border of the esophagus.
a. pulmonary artery
b. left primary bronchus
c. pulmonary veins
d. superior vena cava
left primary bronchus
Which two forces or processes propel food down the esophagus?
a. Peristalsis and gravity
b. Peristalsis and rhythmic segmentation
c. Gravity and deglutition
d. Deglutition and mastication
Peristalsis and gravity
The opening between the stomach and esophagus is termed the:
a. cardiac antrum.
b. cardiac notch.
c. esophagogastric junction.
d. esophagocardiac junction.
Esophagogastric junction
Part ii refers to the:
a. soft palate
b. tonsils
c. hard palate
d. epiglottis
soft palate
Part iv refers to the:
a. laryngopharynx
b. nasopharynx
c. oropharynx
d. posterior oral cavity
Orpharynx
Part ix refers to the:
a. soft palate
b. tonsils
c. uvula
d. epiglottis
epiglottis
Part iii refers to the:
a. nasopharynx
b. laryngopharynx
c. oropharynx
d. nasal cavity
Nasopharynx
Part vii refers to the:
a. esophagus
b. trachea
c. spinal cord
d. larynx
trachea
Part i refers to the:
a. nasal sinus
b. maxillary sinus
c. nasal cavity
d. upper oral cavity
nasal cavity
Part v refers to the:
a. nasopharynx
b. larynx
c. oropharynx
d. laryngopharnyx
laryngopharynx
The dilated portion of the distal esophagus is termed the:
a. cardiac antrum.
b. cardiac notch.
c. fundus.
d. incisura cardiaca.
Cardiac antrum
Which of the following is not a main subdivision of the stomach?
a. Fundus
b. Cardium
c. Pylorus
d. Body
Cardium
Which term describes the outer, lateral border of the stomach?
a. Lesser curvature
b. Incisura angularis
c. Gastric border
d. Greater curvature
Greater curvature
What is the term for the longitudinal mucosal folds found within the stomach?
a. Gastric canal
b. Valvulae conniventes
c. Haustra
d. Rugae
Rugae
Toward which aspect(s) of the stomach will barium gravitate with the patient in a prone position?
a. Body and pylorus
b. Fundus
c. Cardiac
d. Fundus and body
Body and pylorus
Which aspect of the stomach is attached to the duodenum?
a. Fundus
b. Body
c. Pylorus
d. Cardiac
Pylorus
Which specific part of the pancreas is adjacent to the C-loop of the duodenum?
a. Tail
b. Body
c. Head
d. Neck
Head
Which division of the duodenum contains the duodenal bulb or cap?
a. First (superior)
b. Third (horizontal)
c. Second (descending)
d. Fourth (ascending)
First (superior)
What structure indicates the junction between the duodenum and jejunum?
a. Duodenal cap
b. Suspensory muscle of the duodenum
c. Valvulae conniventes
d. C-loop of the duodenum
Suspensory muscle of the duodenum
Which part of the stomach is labeled 6?
a. Body
b. pyloric portion
c. pyloric antrum
d. pyloric canal
Pyloric antrum
Which part of the stomach is labeled 2?
a. Esophagogastric junction
b. Incisura angularis
c. Incisura cardiaca
d. Cardiac antrum
Cardiac antrum
Which part of the stomach is labeled 9?
a. Cardiac notch
b. Angular notch
c. Pyloric orifice
d. Incisura cardiaca
Angular notch
Which part of the stomach is labeled 3?
a. Angular notch
b. Cardiac notch
c. Incisura angularis
d. Esophagogastric junction
Cardiac notch
Once food enters the stomach and is mixed with gastric secretions, it is termed:
a. bile.
b. lipids.
c. chyme.
d. biologic catalysts.
Chyme
Which of the following substances is not digested chemically?
a. Minerals
b. Carbohydrates
c. Proteins
d. Lipids
Minerals
Enzymes that aid in chemical digestion are classified as:
a. lipids.
b. biologic catalysts.
c. digestive acids.
d. amino acids.
Biologic catalysts
Lipids (fats) are broken down into fatty acids and glycerol as they are digested and absorbed by the:
a. stomach and small bowel.
b. stomach only.
c. small bowel only.
d. none of the options (are not digested).
Small bowel only
Which aspect of the gastrointestinal (GI) tract is primarily responsible for the absorption of digestive end products along with water, vitamins, and minerals?
a. Stomach
b. Small intestine
c. Large intestine
d. Pancreas
Small intenstine
A high and transverse stomach would be found in a(n) ____ patient.
a. hyposthenic
b. asthenic
c. sthenic
d. hypersthenic
hypersthenic
A stomach with the duodenal bulb at the level of L1-2 would be found in a(n) ____ patient.
a. hyposthenic
b. asthenic
c. sthenic
d. hypersthenic
sthenic
What is the classification of barium sulfate as a contrast media?
a. Radiopaque
b. Radiolucent
c. Isodense
d. Negative-contrast media
Radiopaque
What type of solution is formed when barium is mixed with water?
a. Water-soluble solution
b. Isotonic solution
c. Hypotonic solution
d. Colloidal suspension
Colloidal suspension
Which of the following statements is true about barium sulfate?
a. It should be discarded if not used within an hour after mixing.
b. The patient may become ill if it is not prepared with sterile water.
c. It rarely produces an allergic reaction.
d. It is soluble in water.
It rarley produces an allergic reaction
Which of the following clinical indications would mandate the use of an oral, water-soluble contrast agent?
a. Patient with esophageal reflux
b. Patient with a bezoar
c. Patient with a possible perforated bowel
d. Patient with a possible peptic ulcer
Patient with a possible perforated bowel
What type of contrast media is ideal for demonstrating a diverticulum within the stomach?
a. Double-contrast barium/negative-contrast agent
b. Single-contrast barium sulfate
c. Water soluble
d. Radiolucent
Double-contrast barium/negative-contrast agent
Which of the following patient care concerns would prevent the use of an oral, water-soluble contrast medium?
a. The patient has a possible ulcer.
b. The patient is sensitive to iodine.
c. The patient has esophageal lux.
d. The patient has dysphasia.
The patient is sensitive to iodine
Which of the following is not one of the cardinal principles of radiation protection?
a. Time
b. Distance
c. Intensity
d. Shielding
Intensity
Which one of the following cardinal principles of radiation protection is most effective in reducing the dose to the technologist during fluoroscopy?
a. Time
b. Distance
c. Intensity
d. Shielding
Distance
Which of the following devices reduces scatter exposure during fluoroscopy from the fluoroscopy tube?
a. Compression paddle
b. Bucky tray
c. Bucky slot cover
d. Lead gloves
Bucky slot clover
Protective aprons worn during fluoroscopy must possess at least ____ mm lead equivalency (Pb/Eq.).
a. 0.25
b. 0.5
c. 0.75
d. 1
0.5
Which of the following conditions involves dilated veins in the distal aspect of the esophagus, which in some cases can lead to internal bleeding?
a. Esophageal varices
b. Esophageal reflux
c. Esophageal hypertension
d. Esophageal thrombosis
Esophageal varices
A large outpouching of the proximal esophagus above the upper esophageal sphincter is termed:
a. Barrett esophagus.
b. esophageal varices.
c. esophageal reflux.
d. Zenker diverticulum.
Zenker diverticulum
Achalasia is generally defined as:
a. difficulty in swallowing.
b. a common malignancy of the esophagus.
c. motor disorder of the esophagus.
d. large outpouching of the esophagus.
motor disorder of the esophagus
Which of the following definitions would describe a bezoar?
a. Inflammation of the gastric lining
b. Outpouching of the stomach wall
c. Mass of undigested material
d. Stomach neoplasm
Mass of undigested material
Research suggests that peptic ulcers may be caused by:
a. smoking.
b. bacteria.
c. alcohol.
d. antibiotics.
bacteria
Gastritis is defined as inflammation of the:
a. pancreas.
b. large intestine.
c. small intestine.
d. stomach.
stomach
Which of the following conditions is an example of GERD?
a. Esophageal varices
b. Gastric carcinoma
c. Esophageal reflux
d. Bezoar
Esophageal reflux
What is the most common radiographic procedure performed to diagnose GERD?
a. Endoscopy
b. Esophagogram
c. Upper GI series
d. CT
Endoscopy
Which of the imaging modalities or procedures is most effective and preferred in diagnosing HPS?
a. Nuclear medicine
b. CT
c. Upper GI series
d. Ultrasound
Ultrasound
What is a potential risk associated with the use of water-soluble contrast agents, especially for geriatric patients?
a. Bowel obstruction
b. Cardiac arrest
c. Dehydration
d. Shock
Dehydration
When using digital radiography systems, inadequate kVp or mAs will produce a ____ image.
a. dark
b. light
c. blurry
d. mottled
Mottled
Which of the following technical factors will best enhance a digital image taken during an upper GI series?
a. Collimation
b. Low-kVp techniques
c. Long SID
d. Use of compensation (wedge) filter
Collimation
Patient preparation for an esophagogram includes NPO _____ before the procedure.
a. 4 to 6 hours
b. 30 minutes to 1 hour
c. 4 to 6 hours and no gum chewing or smoking
d. None of the options; patient preparation is not needed as long as an upper GI
series is not scheduled to follow.
None of the options; patient preparation is not needed as long as an upper GI series is not scheduled to follow.
Most esophagograms begin with the patient:
a. recumbent-supine.
b. erect.
c. recumbent-prone.
d. in a left lateral decubitus position.
erect
Why would a patient undergo Valsalva maneuver during an esophagogram?
a. To demonstrate possible esophageal varices
b. To demonstrate possible esophageal reflux
c. To demonstrate possible esophagitis
d. To demonstrate a possible bezoar
To demonstrate possible esophageal reflux
Which of the following procedures will not demonstrate possible esophageal reflux?
a. Toe-touch maneuver
b. Water test
c. Reverse Trendelenburg method
d. Compression technique
Reverse Trendelenburg method
Which of the following positions is not normally considered to be part of the esophagogram basic routine?
a. Posteroanterior (PA)
b. Left lateral
c. Right anterior oblique (RAO)
d. Anteroposterior (AP)
Anteroposterior (AP)
Patient preparation for an adult upper GI series includes:
a. nothing; no patient preparation is required.
b. NPO 4 hours before the procedure.
c. NPO 8 hours before the procedure.
d. NPO 24 hours before the procedure.
NPO 8 hours before the procedure
Which of the following kVp ranges should be used for an upper GI series using barium sulfate (single-contrast study)?
a. 80 to 90 kVp
b. 90 to 100 kVp
c. 110 to 125 kVp
d. 125 to 140 kVp
110 to 125 kVp
Which of the following imaging modalities is an alternative to an esophagogram for detecting esophageal varices?
a. Sonography
b. CT
c. Nuclear medicine
d. MRI
Sonography
Which of the following imaging modalities is ideal for demonstrating signs of Barrett esophagus?
a. Nuclear medicine
b. MRI
c. Sonography
d. CT
Nuclear medicine
How much barium is typically given to a 3- to 10-year-old child during an upper GI series?
a. 4 to 6 ounces
b. 14 to 16 ounces
c. 6 to 12 ounces
d. 1 cup
6 to 12 ounces
Gastric emptying studies are performed using:
a. intraesophageal sonography.
b. radionuclides.
c. MRI.
d. CT.
radionuclides
CR centering for an esophagogram should be to the vertebral level of:
a. the sternal angle.
b. T3 or T4.
c. T5 or T6.
d. T7.
T5 or T6
How much obliquity is required for the RAO position for the esophagus?
a. 10 to 15 degrees
b. 20 to 30 degrees
c. 35 to 40 degrees
d. 45 to 60 degrees
35 to 45 degrees
The RAO position of the esophagus is preferred over the left anterior oblique (LAO) because it:
a. is a more comfortable position for the patient.
b. increases the visibility of the esophagus between the vertebrae and heart.
c. reduces thyroid exposure to the patient.
d. is easier for the patient to hold the cup of barium in his or her left hand.
increases the visibility of the esophagus between the vertebrae and heart
What type of breathing instructions should be given to the patient during an esophagogram using a thin barium mixture?
a. Suspended respiration while continuing to swallow
b. Suspended inspiration after the last swallow
c. Shallow breathing and continued swallowing during exposure
d. Exposure immediately after last bolus is swallowed (patient will not be breathing immediately after swallow)
Shallow breathing and continued swallowing during exposure
Other than the esophagogram, what imaging modality is performed to diagnose Barrett esophagus?
a. Computed tomography
b. Nuclear medicine
c. Magnetic resonance
d. Sonography
Nuclear medicine
Which of the following upper GI projections and/or positions will best fill the body and pylorus with barium?
a. AP
b. Right lateral
c. Left posterior oblique (LPO)
d. PA
PA
Which of the following upper GI projections and/or positions will best demonstrate the pylorus and duodenal bulb in profile during a double-contrast study?
a. AP
b. LAO
c. PA
d. LPO
LPO
At what level should the CR and image receptor be centered for the RAO or PA upper GI projection and/or position on asthenic body type of patient?
a. Lower costal margin
b. L1
c. L3-4
d. Iliac crest
L1
A radiograph taken during an upper GI series demonstrates poor visibility of the gastric mucosa. The following factors were used: 80 kVp, 30 mAs, and 1/40-second exposure time. Barium sulfate was used during the procedure. Which of the following factors needs to be modified during the repeat exposure?
a. Use of detail-speed screens (adjust mAs accordingly)
b. Shortened exposure time (increase mAs accordingly)
c. Use of a water-soluble contrast medium
d. Increased kVp (decrease mAs as needed)
Increased kVp (decrease mAs as needed)
A radiograph taken during an esophagogram using thin barium mixture demonstrates that there is very little contrast media in the esophagus. Which of the following points will improve filling of the esophagus? (The exposure was made on inspiration after the last swallow.)
a. Have the patient drink during the exposure.
b. Have the patient perform the Valsalva maneuver during the exposure.
c. Have the patient perform the Müller maneuver during the exposure.
d. Shorten the exposure time.
Have the patient drink during the exposure
A PA radiograph taken on a hypersthenic patient during an upper GI series reveals that the pylorus and duodenal bulb are superimposed. Which of the following modifications will best eliminate the superimposition between these structures?
a. Roll the patient into a slight RAO position.
b. Angle the CR 35- to 45-degree cephalad.
c. Place a rolled towel or a filled compression paddle under the patient’s abdomen before exposure.
d. Increase the kVp.
Angle the CR 35- to 45-degree cephalad
A PA radiograph taken on a hypersthenic patient during an upper GI series reveals that the pylorus and duodenal bulb are superimposed. Which of the following modifications will best eliminate the superimposition between these structures?
a. Roll the patient into a slight RAO position.
b. Angle the CR 35- to 45-degree cephalad.
c. Place a rolled towel or a filled compression paddle under the patient’s abdomen before exposure.
d. Increase the kVp.
Angle the CR 35- to 45-degree cephalad
A patient comes to radiology for an upper GI series. Her clinical history indicates that there may be a tumor posterior to the stomach. Which one of the following projections and/or positions will best demonstrate this condition?
a. RAO
b. PA
c. Right lateral
d. LPO
Right lateral
A pediatric patient enters the emergency department (ED) with a small, plastic object stuck in her esophagus. PA and lateral chest radiographs fail to demonstrate the foreign body. Which of the following procedures would be most effective in demonstrating the location of the object?
a. Upper GI series
b. Esophagogram with the water test
c. Esophagogram using very thick barium
d. Esophagogram using shredded cotton soaked in barium
Esophagogram using shredded cotton soaked in barium
A patient comes to radiology with a history of a gastric ulcer. Which of the following procedures would be most diagnostic to demonstrate this lesion?
a. Double-contrast upper GI series
b. Single-contrast barium sulfate upper GI series
c. Oral, water-soluble upper GI series
d. Carbon dioxide upper GI series
Double-contrast upper GI series
A patient comes to radiology for an esophagogram. The radiologist is concerned about the upper portion of the esophagus, near the level of T1, which did not visualize well on the previous routine projection-position esophagogram. Which of the following special projections and/or positions would be most helpful in demonstrating this region?
a. Soft tissue lateral
b. LAO
c. Cervicothoracic (swimmer’s) lateral position
d. AP with 25- to 30-degree cephalad CR angle
Cervicothoracic (swimmer’s) lateral position
One radiograph of an upper GI series needs repeating. The technologist is unsure which projection and/or position is seen on this radiograph. The fundus is filled with barium, and the pylorus and duodenal bulb are profiled and air filled. The patient was recumbent for all projections. Which projection and/or position needs to be repeated?
a. PA
b. LPO
c. RAO
d. Right lateral
LPO
A patient comes to radiology for an upper GI series. The patient has a clinical history of hiatal hernia. Which of the following positions may be helpful in demonstrating this condition?
a. AP Trendelenburg position
b. Left lateral decubitus, AP projection
c. Dorsal decubitus, lateral projection
d. LAO with compression technique
AP Trendelenburg position
A PA projection taken during an upper GI series performed on an infant reveals the body and pylorus of the stomach are superimposed. What modification needs to be made during the repeat exposure to separate these two regions?
a. Perform the AP projection instead.
b. Angle the CR 20- to 25-degree cephalad.
c. Angle the CR 30- to 45-degree cephalad.
d. Use the AP Trendelenburg position.
Angle the CR 20- to 25-degree cephalad
During an upper GI series, the “halo” sign appears in the duodenum. Which of the following conditions will produce this radiographic sign?
a. Ulcer
b. Bezoar
c. Diverticulum
d. Tumor
Ulcer
A patient comes to radiology with a clinical history of HPS. Which of the following imaging modalities will best demonstrate this condition?
a. CT
b. Nuclear medicine
c. Ultrasound
d. Upper GI series
Ultrasound
The liver performs more than 100 different physiologic functions (T/F)
True
The liver performs more than 100 different physiologic functions (T/F)
True
In 80% of all individuals, the common bile duct and the pancreatic duct unite before entering the duodenum. (T/F)
False
Sodium bicarbonate is often used as a negative-contrast medium during an upper GI series. (T/F)
False
Swallowed air can be used as a negative-contrast medium during an upper GI series. (T/F)
True
Digital fluoroscopy utilizes a flat panel detector to convert radiation to a digital signal. (T/F)
True
No cassettes are required for imaging with a digital fluoroscopy system. (T/F)
True
Digital fluoroscopy has distinct advantages but produces a slightly higher patient dose as compared with conventional fluoroscopy. (T/F)
False
With digital fluoroscopy edge enhancement, brightness and contrast can be manipulated both during the procedure and also at a later time. (T/F)
True
Duodenal ulcers are rarely malignant. (T/F)
True
Only 5% of all ulcers lead to bowel perforation. (T/F)
True
Hypertrophic pyloric stenosis (HPS) is the most common form of intestinal obstruction found in infants. (T/F)
True
