Chapter 13 (Lower GI) Flashcards by Jason Tarte

Which part of the small intestine has a feathery appearance when filled with barium?
a. Ileum
b. Jejunum
c. Cecum
d. Duodenum

Jejunum

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Which part of the small intestine has the largest diameter?
a. Duodenum
b. Ileum
c. Jejunum
d. Cecum

Duodenum

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Which part of the small intestine is the shortest?
a. Duodenum
b. Ileum
c. Jejunum
d. Pylorus

Duodenum

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Which part of the small intestine makes up three-fifths of its entirety?
a. Duodenum
b. Jejunum
c. Ileum
d. Ilium

Ileum

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Which aspect of the large intestine is located highest, or most superior, in the abdomen?
a. Right colic flexure
b. Left colic flexure
c. Transverse colon
d. Ascending colon

Left colic flexure

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Which of the following structures is not considered part of the colon?
a. Transverse colon
b. Right and left colic flexures
c. Rectum
d. All of the options

Rectum

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Which part of the large intestine is located between the rectum and the descending colon?
a. Left colic flexure
b. Right colic flexure
c. Sigmoid colon
d. Cecum

Sigmoid colon

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Which part of the large intestine has the widest diameter?
a. Descending colon
b. Transverse colon
c. Cecum
d. Ascending colon

Cecum

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Which aspect of the colon has the widest range of motion?
a. Descending colon
b. Transverse colon
c. Sigmoid colon
d. Ascending colon

Transverse colon

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What is the term for the three bands of muscle that pull the large intestine into pouches?
a. Haustra
b. Valvulae conniventes
c. Suspensory ligaments
d. Taenia coli

Taenia coli

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Which structure is labeled #6?

Vermiform appendix

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Which structure is labeled #1?

Left colic flexure

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Which structure is labeled #7?

Cecum

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Which sections of the large intestine will most likely be filled with air with the patient in the prone position during a double-contrast barium enema (BE)?
a. Ascending colon, descending colon, and rectum
b. Transverse and sigmoid colon
c. Rectum only
d. Right and left colic flexure and sigmoid colon

Transverse and sigmoid colon

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Which part of the gastrointestinal (GI) tract synthesizes and absorbs vitamins B and K?
a. Ileum
b. Duodenum
c. Jejunum
d. Large intestine

Large intestine

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Which of the following conditions may lead to an adynamic ileus?
a. Small bowel tumor
b. Scar tissue within the jejunum
c. Peritonitis
d. Stricture of ileum due to an inguinal hernia

Peritonitis

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Which of the following conditions may produce the “cobblestone” or “string” sign?
a. Whipple disease
b. Regional enteritis (Crohn’s disease)
c. Giardiasis
d. Ileus

Regional enteritis (Crohn’s disease)

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Which of the following procedures is considered as a functional study?
a. Barium enema (BE)
b. Enteroclysis
c. Air-contrast BE
d. Small bowel series

Small bowel series

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When are small bowel series deemed to be complete?
a. Two hours after the ingestion of barium
b. Once the contrast media passes the ileocecal valve
c. Once the contrast media reaches the rectum
d. Once the contrast media passes the duodenojejunal flexure

Once the contrast media passes the ileocecal valve

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The term describing a double-contrast small bowel procedure is:
a. two-stage small bowel procedure.
b. diagnostic intubation.
c. enteroclysis.
d. none of the options.

Enteroclysis

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The patient must be NPO a minimum of ____ hours before the small bowel series.
a. 4
b. 6
c. 8
d. 24

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The tip of the catheter is advanced to the ____ during an enteroclysis.
a. duodenojejunal junction (ligament of Treitz)
b. C-loop of the duodenum
c. pyloric sphincter
d. ileocecal sphincter

Duodenojejunal junction (ligament of Treitz)

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A twisting of the intestine on its own mesentery is termed:
a. intussusception.
b. volvulus.
c. diverticulosis.
d. enteritis.

Volvulus

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A telescoping, or invagination, of one part of the intestine into another is termed:
a. diverticulosis.
b. volvulus.
c. intussusception.
d. colitis.

Intussusception

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The “stovepipe” radiographic sign is often seen with: a. volvulus. b. intussusception. c. neoplasm. d. chronic ulcerative colitis.

Chronic ulcerative colitis

The “tapered,” or “corkscrew,” radiographic sign is often seen with: a. diverticulosis. b. neoplasm. c. volvulus. d. intussusception.

Volvulus

Which radiographic sign is frequently seen with adenocarcinoma of the large intestine? a. “Sail” sign b. Diverticula c. “Napkin ring” or “apple core” sign d. Thickened mucosa

"Napkin ring" or "apple core" sign

Which of the following is classified as an irritant laxative? a. Magnesium citrate b. Magnesium sulfate c. Castor oil d. None of the options

Castor oil

Which of the following conditions would contraindicate the use of a cathartic before a barium enema? a. Colitis b. Diverticulosis c. Obstruction d. Diverticulitis

Obstruction

At what stage of respiration should the enema tip be inserted into the rectum? a. During deep breaths b. During shallow breaths c. Suspended inspiration d. Suspended expiration

Suspended expiration

In what position is the patient placed for the enema tip insertion? a. Sims’ b. Lithotomy c. Modified lithotomy d. Prone

Sims'

During the initial enema tip insertion, the tip is aimed: a. toward the coccyx. b. toward the umbilicus. c. directly posterior. d. directly superior.

toward the umbilicus

Which of the following pathologic conditions is best demonstrated with evacuative proctography? a. Intussusception b. Volvulus c. Rectal prolapse d. Diverticulosis

Rectal prolapse

Which specific aspect of the large intestine must be demonstrated during evacuative proctography? a. Sigmoid colon b. Haustra c. Anorectal angle d. Rectal ligament

Anorectal angle

The ideal kVp range for a double-contrast barium enema is: a. 70 to 80. b. 90 to 100. c. 100 to 125. d. 130 to 140.

90 to 100

Which imaging modality can demonstrate abscesses in the retroperitoneum? a. MRI b. Nuclear medicine c. Sonography d. Conventional radiography

MRI

Which one of the following imaging modalities and/or procedures is very effective in detecting the Meckel diverticulum? a. CT b. Double-contrast barium enema c. Sonography d. Nuclear medicine

Nuclear medicine

Which of the following statements is NOT true in regard to a pediatric small bowel series? a. The transit time for barium through the small intestine is frequently longer than that of an adult. b. Barium sulfate is the contrast medium of choice. c. The small bowel series should be scheduled early in the morning. d. A gonadal shield often cannot be used during the later stages of the study.

The transit time for barium through the small intestine is frequently longer than that of an adult

What type of enema tip is recommended for a barium enema on an infant? a. Rectal retention b. Plastic disposable c. 10 Fr, flexible silicone catheter d. Foley catheter

10 Fr, flexible silicone catheter

Central ray and image receptor centering for a 1-hour small bowel radiograph should be: a. 2 inches (5 cm) above level of the iliac crest. b. at the level of the iliac crest. c. 1 inch (2.5 cm) below the level of the iliac crest. d. at the level of the ASIS.

at the level of the iliac crest

Which projection and/or position is most commonly performed during an evacuative proctogram? a. Anteroposterior (AP) erect b. Lateral c. Right posterior oblique (RPO) and left posterior oblique (LPO) d. AP axial

Lateral

Why is the posteroanterior (PA) rather than the AP projection recommended for a small bowel series? a. Less gonadal dose for female patients b. More comfortable for patient c. Places small intestine closer to image receptor (IR) d. Better separation of loops of small intestine

Better separation of loops of small intestine

Which of the following positions best demonstrates the left colic flexure? a. LPO b. Left lateral decubitus c. Left lateral d. Left anterior oblique (LAO)

Left anterior oblique (LAO)

During a double-contrast barium enema (BE) procedure, the radiologist suspects a polyp in the descending colon. Which position would best demonstrate this? a. Supine for AP projection b. 45 degrees erect PA projection c. Right lateral decubitus d. Left lateral decubitus

Right lateral decubitus

A radiograph of an AP barium enema (BE) projection reveals poor visualization of the sigmoid due to excessive superimposition of the sigmoid colon and rectum. How can this area be better visualized on the repeat exposure? a. Perform AP axial projection with central ray (CR) 30- to 40-degree cephalad. b. Increase kVp. c. Take a PA projection with the patient in the left lateral decubitus position. d. Take a PA projection with a 30- to 40-degree cephalad CR angle.

Perform AP axial projection with central ray (CR) 30- to 40-degree cephalad

A patient comes to radiology for a barium enema (BE). He has a possible fistula extending from the rectum to the urinary bladder. Which one of the following projections and/or positions would best demonstrate the fistula? a. Lateral rectum position b. AP erect projection c. LPO axial projection d. LPO and RPO positions

Lateral rectum position

A patient comes to radiology with possible diverticulosis. Which of the following studies is most diagnostic for detecting this condition? a. Single-contrast barium enema b. Double-contrast barium enema c. Evacuative proctogram d. Small bowel series

Double-contrast barium enema

A patient comes to radiology for a double-contrast barium enema. The patient cannot lie on her side during the study. Which of the following projections could replace the lateral rectum projection? a. AP axial b. LPO axial projection c. Ventral decubitus d. Dorsal decubitus

Ventral decubitus

During a single-contrast barium enema, the radiologist detects a possible defect within the right colic flexure. Which of the following projections and/or positions best demonstrates this region of the colon? a. RPO b. LAO c. AP axial d. LPO

LPO

A patient comes to radiology with a history of rectocele. Which of the following procedures best demonstrates this condition? a. Single-contrast barium enema b. Evacuative proctography c. Double-contrast barium enema d. Enteroclysis

Evacuative proctography

An infant is brought to the ED with a possible intussusception. Which of the following procedures may actually correct this condition? a. Small bowel enema b. Small bowel series c. Defecography d. Barium or air enema

Barium or air enema

Which of the following barium enema projections and/or positions provides the greatest amount of gonadal dosage to both male and female patients? a. AP/PA b. Lateral rectum c. Left lateral decubitus d. Left posterior oblique

Lateral rectum

Which position taken during a barium enema will best demonstrate the left colic flexure? a. AP b. RPO c. LPO d. Left lateral decubitus

RPO

How much CR angulation is required for the AP axial projection taken during a barium enema examination? a. 10 to 15 degrees b. 20 to 25 degrees c. 30 to 40 degrees d. 45 degrees

30 to 40 degrees

While attempting to insert an enema tip into the rectum, the technologist experiences resistance. What should be the next step taken by the technologist? a. Retry the insertion using more lubrication. b. Ask the patient to try to insert it himself. c. Have the fluoroscopist insert it under fluoroscopic guidance. d. Cancel the procedure.

Have the fluoroscopist insert it under fluoroscopic guidance

Why is it important for the technologist to review the patient’s chart and inform the radiologist before beginning the barium enema examination if a biopsy was performed as part of a prior sigmoidoscopy or colonoscopy procedure? a. A sigmoidoscopy or colonoscopy would make the BE examination unnecessary. b. The biopsy of the colon may weaken that portion of the colon, which could lead to a perforation during the BE examination. c. The radiologist would want to confer with the referring physician to see whether the biopsy revealed a malignancy. d. None of the options; the radiologist does not need to know this information before the BE examination.

The biopsy of the colon may weaken that portion of the colon, which could lead to a perforation during the BE examination

During barium enema fluoroscopy, the fluoroscopist detects a possible defect in the right colic flexure. He asks the technologist to produce a radiograph that will best demonstrate this region of the large intestine. Which one of the following positions will accomplish this goal? a. LAO b. AP axial projection c. AP recumbent d. LPO

LPO

Why is oral contrast media sometimes given during computed tomography colonography? a. To determine if a fistula is present b. To mark or “tag” possible fecal matter c. To demonstrate possible diverticula d. To prevent spasm of the large intestine

To mark or "tag" possible fecal matter

The average time to scan the large intestine during a computed tomography colonography is: a. 1 hour. b. 20 minutes. c. 30 minutes. d. 10 minutes.

10 minutes

(T/F) The ascending colon and upper rectum are intraperitoneal structures.

False

(T/F) The circular staircase, or herringbone pattern, is a common radiographic sign for a mechanical ileus.

True

(T/F) Meckel diverticulum is best diagnosed with a radionuclide (nuclear medicine) scan.

True

(T/F) The enteroclysis procedure is indicated for patients with clinical history of regional enteriris.

True

(T/F) For an average adult, the amount of barium ingested is one 16-oz cup for a small bowel only series.

True

(T/F) Ultrasound, with graded compression, can be used in diagnosing acute appendicitis

True

(T/F) CT may be performed to diagnose acute appendicitis.

True

(T/F) Synthetic latex enema tips are safe to use for latex-sensitive patients.

True

(T/F) Rectal retention enema tips should be fully inflated by the technologist before beginning a barium enema

False

(T/F) Evacuative proctography is most commonly performed on geriatric patients

False

(T/F) During a colostomy barium enema, a double-contrast retention enema tip is used.

False

(T/F) The opening leading into the intestine for the patient with a colostomy is termed the stoma.

True

(T/F) The height of the enema bag must be set at 40 inches (100 cm) above the radiographic table at the onset of the study.

False

(T/F) Overhead, radiographic projections are often not taken when using digital fluoroscopy

True

(T/F) A single-stage, double-contrast barium enema involves instilling both the negative and positive contrast media at the same time

True

(T/F) Removal of polyps can be performed during computed tomography colonography (CTC)

False