Chpt. 13 Flashcards
3 divisions of sm intestine in descending order?
duodenum (widest division), jejunum, ileum
avg length of lg intestine?
5 ft, 1.5m
shortest division of sm intestine?
duodenum
2 quadrants that the majority of the jejunum can be found?
LUQ, LLQ
which division of sm intestine has a feathery/coiled-spring appearance?
jejunum
longest division of small intestine
ileum
2 aspects of lg intestine not considered part of colon?
cecum, rectum
the colon is divided into ___ sections and has ___ flexures
4; 2
2 f(x)’s of ileocecal valve
prevents ileum contents from passing too quickly into cecum;
prevents reflux back into ileum
another term for appendix
veriform appendix
makes up 40% of the small intestine
jejunum
shortest aspect of sm intestine
duodenum
aspect of sm intestine that is the smallest in diameter but longest in length
ileum
widest portion of lg intestine
cecum
a blind pouch inf to the ileocecal valve
appendix
found btw cecum and transverse colon
ascending colon
dist. part; also called the iliac colon
descending colon
longest aspect of the lg intestine
transverse colon
lies in pelvis but possesses a wide freedom of motion
sigmoid colon
term for 3 bands of mm that pull the lg into pouches
taeniae coli
the pouches, or sacculations, seen along the lg intestine wall are called
haustra
what is an older term for the mucosal folds found w/in the jejunum?
plicae circulares
which portion of the sm intestine is located primarily to the L of the midline
jejunum
which portion of the sm intestine is located primarily in the RLQ
ileum
which portion of the sm intestine has the smoothest internal lining and does not present a feathery appearance when barium-filled
ileum
which aspect of the sm intestine is most fixed in pos?
duodenojejunal junction
in which quadrant does the terminal ileum connect w the lg intestine
RLQ
which muscular band marks the junction btw the duodenum and jejunum
suspensory mm of duodenum/ligament of Treitz
widest portion of the lg intestine is
cecum
which flexure of lg intestine usually extends more sup?
L colic (splenic)
inflammation of the veriform appendix
appendicitis
which aspect of GI tract is primarily responsible for digestion, absorption, reabsorption?
sm intestine
which aspect of GI tract is responsible for the synthesis/absorption of vitamins B & K, and amino acids
lg intestine
Which digestive movement occurs in the large intestine and in the small intestine?
Peristalsis
Is the cecum intraperitoneal retroperitoneal or infraperitoneal?
Intraperitoneal
Is the ascending colon intraperitoneal retroperitoneal or infraperitoneal
Retroperitoneal
Is the transverse colon intraperitoneal retroperitoneal or infraperitoneal
Intraperitoneal
Descending colon is a _________ structure?
retroperitoneal
sigmoid colon is a ________ structure?
intraperitoneal
upper rectum is what structure?
retroperitoneal
lower rectum is what structure?
infraperitoneal
C loop of duodenum is what structure?
retroperitoneal
jejunum is what structure?
intraperitoneal
ileum is what structure?
intraperitoneal
list 2 conditions that may prevent the use of BaSO4 during a SBS?
possible perf-hollow viscus; lg bowel obstruction
common birth defect found in the ileum
meckel’s diverticulum
what type of pt should be given extra care when using a H2O-soluble contrast medium?
young & dehydrated
common parasitic infection of the sm intestine
giardiasis
obstruction of the small intestine
ileus
pt w lactose or sucrose sensitivities
malabsorption syndrome
new growth
neoplasm
a form of sprue
celiac disease
intestine inflammation
enteritis
form of inflammatory disease of the GI tract
regional enteritis
circular staircase or herringbone sign
ielus
cobblestone appearance
regional enteritis
apple core sign
adenocarcinoma
intestine dilation w thickening of circular folds
giardiasis
lg diverticulum of the ileum
meckel’s diverticulum
“beak sign”
volvulus
giardiasis is a condition acquired through? (3)
contaminated food/water & person-to-person contact
meckel’s diverticulum is best diagnosed w which imaging modality?
nuclear med
whipple’s disease is a rare disorder of the
prox sm intestine
how much BaSO4 is generally given to adults for SBS
2 cups, 16 oz
when is SBS complete?
when contrast passes thru ileocecal valve
how long does it usually take to complete an adult SBS?
2 hrs
when is the 1st XR generally taken during a SBS?
15-30 min after contrast ingestion
what is sometimes used during a SBS to vis. ileocecal valve?
fluoro
the term enteroclysis describes what type of SB study?
double-contrast method
what 2 types of contrast are used for enteroclysis?
BaSO4 & air/methylcellulose
which 2 path conditions are best evaluated thru enteroclysis?
regional enteritis (Chron’s disease) & malabsorption syndrome
it takes approx how long for BaSO4 in a healthy adult, given orally, to reach the rectum?
24 hours
the tip of the catheter is advanced to the _______ during an enteroclysis
duodenojejunal flexure (suspensory ligament)
what is the purpose of introducing methyl cellulose during enteroclysis?
dialates intestinal lumen for a more diagnostic exam
a procedure to alleviate postoperative distention of a sm intestine obstruction is called
therapeutic intubation
what is the recommended pt prep before a SBS?
NPO at least 8 hrs before; no smoking/gum
which pos is recommended for SBS XR? why?
prone; to separate intestinal loops
a twisting of a portion of the intestine on its own mesentery
volvulus
out-pouching of the mucosal wall
diverticulum
inflammatory condition of the lg 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 pt usually experiences intussusception?
infant
a condition of numerous herniations of the mucosal wall of the lg intestine
diverticulosis
path condition that produces “tapered/corkscrew” XR sign during BE?
volvulus
which condition may produce the “cobblestone” XR sign during BE?
ulcerative colitis
most common form of carcinoma found in lg intestine
annular carcinoma
T/F: intestinal polyps and diverticula are very similar in structure
F
T/F: volvulus occurs more frequently in males
T
T/F: BE is commonly recommended for diagnosing possible acute appendicitis
F
T/F: any stool retained in the lg intestine may require postponement of a BE
T
4 conditions that would prevent the use of a laxative cathartic before a BE?
gross bleeding, obstruction, severe diarrhea, and inflammatory lesions
T/F: an ex. of an irritant cathartic is magnesium citrate
F. (castor oil)
3 commonly used enema tips
plastic disposable, rectal retention, air-contrast retention
T/F: synthetic latex enema tips/gloves do not cause problems for latex-sensitive pt’s
T
recommended H2O temp for BE
room temp (85-90º)
to min. spasms during BE, ______ can be added to the contrast
lidocaine
recommended pt pos for insertion of rectal enema tip?
Sim’s pos
initial insertion of rectal enema tip should be pointed toward the:
umbilicus
which procedure best demonstrates small polyps in colon?
double-contrast BE
which aspect of lg intestine must be demonstrated during evacuative proctography?
anorectal angle
which of the following clinical conditions is best shown w evacuative proctography: intussusception, volvulus, diverticulosis, rectal prolapse
rectal prolapse
which of the following procedures uses the thickest mix of BaSO4? single-contrast BE, double-contrast BE, evacuative proctogram, enteroclysis
evacuative proctogram
into which pos is the pt placed for imaging during the evacuative proctogram?
lat
T/F: a special tapered enema tip is inserted into the stoma before a colostomy BE
T
T/F: the enema bag should not be more than 36”/92cm above table-top before the beginning of the procedure
F (not more than 24”)
T/F: the technologist should review the pt’s chart before a BE to determine whether a sigmoidoscopy/colonoscopy was performed recently
T
T/F: both computed tomography and sonography may be performed to aid in diagnosing appendicitis
T
T/F: bc of the density and the amount of BaSO4 w/in the lg intestine, computed radiography should not be used during a BaSO4
F
how much BaSO4 suspension is often instilled before CT enteroclysis?
0.1%
another term for CT colonography (CTC) is
virtual colonoscopy
T/F: a cleansing bowel prep is not required before a CTC
F
why is oral contrast sometimes given during a CTC
to mark/”tag” fecal matter
chief dis’advtg of CTC
cannot remove polyps discovered during CTC
T/F: single-contrast BE are commonly done on pt’s w a clinical history of diverticulosus
F
which following XR is recommended to be taken during a SBS? (supine AP, prone AP, erect AP, L lat decub)
prone AP
T/F: shielding is not recommended during studies of lower GI tract
F
due to faster transit T of Ba from the stomach to the ileocecal valve in pedi pt’s, how frequently should imgs be taken during a SBS to avoid missing critical anatomy and possible path?
every 20-30 min
T/F: if a retention-type enema tip is used, it should be removed after fluoro is completed and before overhead XRs are taken to better vis. the rectal region
F (generally not removed until after overhead XRs are completed, unless directed by radiologist)
the _________ pos is a recommended alt for the lat rectum XR during a double-contrast BE
vent decub
what kV is recommended for a SBS (single-contrast)
100-125 kV
where is CR centered for the 15 min XR during a SBS
2” above iliac crest
breathing instructions of SBS
exp
which BE XR best shows R colic flexure?
RAO/LPO
how much body rotation required for obl BE XRs?
35-45º
which pos should be performed if pt cannot lie prone to vis. L colic flexure?
RPO
which XR, taken during double-contrast BE, produces an air-filled img of the R colic flexure, ascending colon, and cecum?
L lat decub
where is CR centered for a lat XR of the rectum?
level of ASIS @ MCP
which XR during a double-contrast BE best shows the descending colon for possible polyps?
R lat decub (L side up)
which aspect of lg intestine is best shown w an AP axial projection?
rectosigmoid region
what is the advtg of performing an AP axial obl rather than an AP axial?
less superimposition of rectosigmoid segments
what is another term describing the AP/PA axial projection
butterfly
CR angle for AP axial butterfly
30-40º cephalic
CR angle for PA axial butterfly
30-40º caudad
What kV range is recommended for a postevacuation XR following a BE?
90-100 kV
recommended kV for obl XR during single-contrast BE
100-125 kV
recommended kV for obl XRs for double-contrast BE
90-100 kV
what med can be given during a BE to min. colonic spasm during BE
glucagon (make sure pt not diabetic)
