Chapter 13 Flashcards
Length of small bowel
15-23 feet (4.5-5.5 m)
Shortest, widest, and most fixed part of the small intestine
Duodenum
Makes up 2/5’s of the small bowel
Jejunum
Where is the duodenojejunal flexure located
LUQ
What causes the jejunum to have a feathery appearance?
Villi
Where is the ileum located
RUQ, mostly in the LLQ and RLQ
How long is the ileum?
3/5’s of the small bowel
Where is the ileocecal valve located
RLQ
The circumference of the ileum is _____________ than the rest of the small intestine
Smaller
Function of the ileocecal valve
Controls the dumping of it’s contents into the cecum; somewhat prevents reflux
Large intestine has 3 bands of muscle called:
Taeniae coli
Function of taeniae coli
Pull the colon up like drapes or pouches called haustra
The large intestine is located around the:
Periphery of the abdomen
A large pouch located inferior to the ileocecal valve
Cecum
True/false - the cecum is free floating and very movable
True
What is attached to the cecum
Appendix
4 parts of the colon
Ascending
Transverse
Descending
Sigmoid
Part that ascends towards the liver, ends at the hepatic flexure
Ascending
Located transverse or horizontal from the hepatic flexure to the splenic flexure
Transverse
Located from the splenic flexure and travels down to sigmoid colon
Descending
Lart part of the colon which turns into the rectum
Sigmoid
Final 1.5 inch of the intestine which terminates at the anus
Anal canal
What is the direction of the rectum
Starts inferior and posterior along sacrum.. curves to inferior and anterior along rectal ampulla.. curves inferior and posterior along anal canal
Barium location in supine position
Ascending & descending colon
Aspects of sigmoid
Barium location in prone position (intestines)
Transverse colon
Sigmoid
What part of the colon is the most anterior
Transverse
Sigmoid
Functions of the small intestine
Chemical and mechancial digestion
Functions of duodenum and jejunum
Absorption of nutrients, H2O, salts and proteins
Reabsorption of H2O and salts
Function of large intestine
Reabsorption of H2O and inorganic salts, vitamins B & K, amino acids
Elimination
Digestive movements of small intestine
Peristalsis
Rhythmic segmentation
Digestive movements of large intestine
Peristalsis
Haustral churring
Mass Peristalsis
Defecation
What does the term vermiform mean?
Worm like
The small bowel series is what type of procedure?
Timed Sequence
Contraindications for a small bowel series
Pre-surgery patients
Perforation
Obstruction
Pregnancy
How much barium is ingested for a small bowel series
2 cups
When does the small bowel series end?
When barium has reached the ileocecal valve
Films taken for a small bowel series are mostly:
Chabdomen/high abdominal
What is IR size and orientation for small bowel series?
14x17 LW
How is a patient positioned for small bowel series? Why?
Prone - to separate the bowels
What does it mean if the order says “colonoscopy or sigmoidoscopy”?
Possible perf - let rad know about it
Contraindications for BE/Lower GI
Perforated bowel
Obstruction
Pregnancy
What is a single contrast BE used for?
Function and patentcy
Patient prep for BE
Laxative or tap water enema
NPO
Contraindications for laxative
Severe diarrhea
Gross bleeding
Bowel obstruction
Appendicitis
What is the first image taken for a BE? Why?
Full abdominal prelim. Rad may change the single contrast to double or vice versa
How is single contrast mixed?
Barium is mixed in the bag with warm water to about 2200-2500cc’s (2/3-3/4ths). Make sure the flow is clamped off
What should you do after barium is mixed?
Let it flow through the tube until it almost reaches the enema tip, then clamp the tube off and hang on the IV pole
How many times should the balloon be checked on the enema tip?
At least 2 times
How many tubes are on the enema tip for a single contrast BE?
Two - one for barium, one to pump up balloon
After mixing the barium, what position do you put the patient in?
Sims
How do you enter the enema tip?
Have patient breathe deeply, put tube in on third exhale, inflate balloon, clamp everything
What is the next step after tipping the patient?
Put on your lead, put the patient in the starting position, and turn on the fluoro, go get the doc
Before the postevac picture, you will need to:
Drain the barium from the patient
Images for a single contrast BE
AP
LPO
RPO
LT LAT Rectum
Erect
Post void
Images for a double contrast BE?
AP
R decub
L decub
Ventral and/or Dorsal decub (with or without tip)
Sigmoid
Erect
In a double contrast BE, what side is best visualized?
Side with air
How much do you fill the bag for a double contrast BE?
1/2 to 2/3 full
What level does the rectum start?
S3
What is the rectal ampulla?
Dilated portion of the rectum located anterior to the coccyx
What is enteroclysis?
A double contrast study
An injection of nutrients or medicinal liquid into the duodenum
What is the standard height of the IV pole for the bag?
18-24 inches
How many tubes lead to the tip of the enema for a double contrast BE?
3, 1 for balloon pump, 1 for barium, and 1 for air
What is a Defecogram
Functional study of the anus and rectum
For a left lateral decub where is the barium and air?
Barium: lateral border of descending and medial border of ascending
Air: medial border of the descending and lateral border of the ascending
For the right lateral decub where are the barium and air?
Barium: medial border of the descending and the lateral border of the ascending, the
Air: lateral border of the descending and the medial border of the ascending
Widest part of large intestine
Cecum
Another name for descending colon
Iliac colon
Part of the colon that lies in the pelvis but posseses a wide freedom of motion
Sigmoid
What two types of contrast are used for enteroclysis?
High-density barium
Air/methylcellulose
What two pathologic conditions are best evaluated through enteroclysis?
Crohn’s disease
Malabsorption
What water temp is recommended for BE mixtures?
85-90 degrees
What are the four parts of the large intestine
Cecum
Colon
Rectum
Anal canal
What is the w/v % for single-contrast barium
15-25%
What is the w/v % for double-contrast barium
75-95%
What is the w/v % for evacuative proctogram?
100%