Digestive System: Alimentary Canal Flashcards
1
Q
A musculomembranous tube that extends from the mouth to the anus
A
Alimentary Canal
2
Q
*Long muscular tube
*Functions to convey food and saliva from laryngopharynx to stomach
A
Esophagus
3
Q
Components of the Alimentary Canal:
A
*Mouth
*Pharynx
-esophagus
*Stomach
*Small intestine
*Large intestine (terminated at anus)
4
Q
Where does the Esophagus originate at?
A
C6
4
Q
What plane does the Esophagus Lie
A
Lies in midsagittal Plane (MSP)
5
Q
-passes through diaphragm at T10
-joins stomach at esophagogastric junction at T11
A
Esophagus
5
Q
Four parts of the stomach:
A
*Cardia
*Fundus
*Body
*Pyloric Portion
5
Q
Dilated, saclike portion of the digestive tract extending between the esophagus and small intestine
A
Stomach
5
Q
is superior portion that fills the left hemidiaphragm
A
fundus
5
Q
Expanded terminal end of the esophagus
A
Cardiac antrum
5
Q
what is the section surrounding esophageal opening of the stomach
A
Cardia
5
Q
Inferior surface contains numerous longitudinal folds called:
A
Rugae
5
Q
located between fundus and pyloric portion
A
body of the stomach
6
Q
what is the last portion of the stomach
A
pyloric portion
7
Q
lesser curvature of stomach=
A
right border
7
Q
consists of the pyloric antrum and narrowed pyloric canal
A
pyloric portion
7
Q
greater curvature of stomach=
A
Left border
8
Q
Sharper angle at esophagogastric junction
A
Cardiac notch
9
Q
what is entrance and exit controlled by
A
sphincters
10
Q
opening between esophagus and stomach
A
cardiac orifice
10
Q
what controls the opening between the esophagus and stomach
A
cardiac sphincter
10
Q
opening between stomach and small intestine
A
pyloric orifice
11
Q
what is the opening between stomach and small intestine controlled by
A
Pyloric Sphincter
12
Q
how is the stomach in a hypersthenic body structure
A
Higher and horizontal
12
how is the stomach in a asthenic body structure
lower and more midline
13
The most superior portion of the stomach is the
fundus
13
Contraction waves by which the digestive tube propels contents toward the rectum
Peristalsis
13
Storage area for food during part of digestion
stomach
13
mechanically breaks down food by churning and peristalisis
stomach
14
secrets acids, enzymes, and other chemical to chemically break down food
stomach
15
average transit time to ileocecal valve is
2 to 3 hours
15
how many waves per minute occur in the filled stomach
3 to 4
15
Radiographic demonstration of the alimentary canal requires what?
the use of contrast media
15
what is the most common contrast for the alimentary canal
Barium sulfate
15
average emptying time for stomach
2 to 3 hours
16
what is another form of contrast media that can be used
water soluble iodinated contrast
17
which solution moves through the GI tract quicker
Iodinated solutions move through the GI tract
quicker than barium sulfate
18
How fast does the iodinated solution clear the stomach?
clear the stomach in 1 to 2 hours
19
what does not adhere as well to esophageal mucosa
Iodinated solutions
19
provide satisfactory
examinations of the stomach, duodenum, and
large intestine
Iodinated solutions
19
Prep for the exam room
Room should be completely prepared before
patient enters.
Adjust equipment controls to correct settings.
Have footboard and shoulder supports ready.
Check filming devices and number of image
receptors (IRs) available.
Prepare type and amount of contrast.
20
what is peristalisis affected by
Peristalsis affected by body habitus,
pathology, use of narcotic pain medicine,
body position, and respiration
20
*easily removed by
aspiration before or during surgery
* Also readily absorbed by the body and
excreted by kidneys in cases of perforation
water-soluble
20
Before beginning examination, the
radiographer should
*Describe the contrast media and administration
(i.e., taste, enema tip insertion).
* Inform the patient that the room will be darkened
during the procedure.
*Introduce the patient and fluoroscopist to each
other.
21
what is peristalisis affected by
Peristalsis affected by body habitus,
pathology, use of narcotic pain medicine,
body position, and respiration
22
where is peristalsis greater
Peristalsis greatest in stomach and duodenum
22
Where does peristalsis slow down
Slows in distal part of GI tract
22
What is the challenge of GI radiography
to eliminate motion
23
time for upright position of esophagus
0.1 seconds or less
24
what inhibits respiration for several seconds
Deglutition
25
most exposures for the stomach are made with what breathing
Exposures made at the end of expiration in
routine procedures
25
Peristalsis is affected by
-body habitus
-use of narcotic pain medicine
-body position
25
how much time does hypermotility ( excessive movement) of the stomach require
0.1 seconds
26
normal peristaltic activity of the stomach would require how much time
Normal peristaltic activity – exposure time no
longer than 0.2 second
Never longer than 0.5 second
26
essential projections of the esophagus
-AP or PA
-AP or PA oblique
-Lateral
26
double contrast
barium and carbon dioxide crystals
27
where is the IR places for AP or PA esophagus
IR is placed so that top
is level with the mouth
27
First part of examination for AP or PA esophagus
fluoroscopy of swallowing
28
single contrast
barium or water soluble , iodinated
28
patient position for AP or PA esophagus
Patient position
Supine or prone without
rotation
Head turned to side to
facilitate drinking
29
incucation of problem with portal vein
varices
29
where should ir and elevated side of patients be aligned for ap/pa oblique position for the esophagus?
Align IR and elevated side
of patient approximately 2
inches (5 cm) lateral to
MSP
29
Criteria for AP or PA esophagus
Esophagus from lower part of
neck to its entrance into the
stomach*
Esophagus filled with barium*
Penetration of barium*
Brightness and contrast
sufficient to visualize the
esophagus through the
superimposed thoracic
vertebrae
No rotation
30
how long should the patient be NPO for for GI series ?
8-9 hours
31
patient position for AP/PA oblique esophagus
Recumbent 35- to 40-
degree right anterior oblique
(RAO) or left posterior
oblique (LPO) position
31
What should you see for AP or PA oblique esophagus
esophagus between the vertebrae and the heart
31
What is the CR for AP or PA esophagus
Central ray (CR)
perpendicular to
midpoint of IR
*Usually at level of T5-T6
31
where does cr enter for AP/PA oblique esophagus
CR enters perpendicular to
midpoint of IR
*Enters patient at 2 inches (5
cm) lateral to MSP at level
of T5 or T6
32
The stomach needs to be empty. what should patients not have other than food that could cause to stimulate gastric secretions with them
-smoking
-gum
32
indication there is a problem with the portal vein
Varices
33
if there is concern for perforation what should you not use?
Barium should not be used if concerned for perforation. Gastrografin should be used instead because it is water soluble.
34
Why do we not use gastrograpin
Is absorbed by the body it doesn’t coat as much, taste worst chance of perforation
35
When we are laying on our back supine where is the air?
the pyloric has the air
36
When we are laying on our back supine where is the barium?
barium will be in the fundus
37
Where is the barium when patient is laying on their stomach prone?
barium is in the pyloric
38
Where is the air when patients are laying on their stomach prone? PA
Air is in the fundus
39
Patient position for Lateral esophagus
Recumbent right or left lateral
position
Patient should face
radiographer
Arms forward Midcoronal plane (MCP)
centered
40
where does the CR enter for lateral esophagus
CR enters perpendicular to midpoint of IR
*enters pt. on MCP at level of T5-T6
41
Examination often referred to as a
gastrointestinal series (GI series) or upper
gastrointestinal series (UGI series)
Stomach :GI series
42
what may be included in a UGI or GI series:
May include:
Scout (KUB)
Fluoroscopic and serial radiographic studies of the
esophagus, stomach, and duodenum using
ingested contrast (usually barium)
When requested, the barium may be imaged as it
traverses the small intestines
43
combination single and double-contrast during the same
procedure
biphasic examination
44
GI Series Procedure
*Usually begin with patient in upright position,
if possible
* Radiologist may examine heart and lungs
with fluoroscopy and determine whether
stomach is empty
* Radiologist instructs patient to drink cup of
barium
* Esophagus is examined with first two to three
swallows
Spot films made as
needed
* Manual manipulation
used to coat gastric
mucosa
* Spot films may be made
* Patient drinks more
barium to fill stomach
* Spot films taken as needed
45
What does the GI series examination show?
Examination determines size, shape, and position of stomach; persitalsis; filling and emptying of the duodenal bulb; and abnormalities in function or contour of anatomy
46
essential projections : stomach and duodenum
-PA
-PA OBLIQUE
-AP OBLIQUE
-LATERAL (mediolateral)
-AP
47
Patient position for PA stomach and duodenum
recumbent or upright
48
breathing technique for PA stomach and deodenum
Exposure made at end of suspended expiration take a deep breath in and below all your air out
49
Where to center ir for PA stomach and duodenum
*Center IR 1 to 2 inches (2.5 to 5 cm) above lower rib
margin (level of L1-L2)
50
Where to center IR for upright PA stomach and duodenum
* Upright requires IR centered 3 to 6 inches (7.6 to 15
cm) lower
51
where should you align the midline of grid for PA stomach and duodenum
Align midline of grid to sagittal plane passing
halfway between vertebral column and left lateral
border of abdomen
52
criteria for pa stomach and duodenum
*Entire stomach
and duodenal
loop
*Stomach
centered at level
of pylorus
*PA- air in
fundus
*AP- barium in
fundus
Entire stomach and
duodenal loop
* No superimposition of
pylorus and duodenal
bulb
*Duodenal bulb and loop
* Stomach centered at
level of pylorus
53
patient position for PA oblique stomach and deodenum
Recumbent RAO position
54
where should midline of ir be aligned for PA oblique stomach and duodenum
Midline of IR aligned with sagittal plane passing
midway between vertebral column and lateral
border of elevated side
55
where should IR be centered for PA oblique Stomach and duodenum
IR centered to lower rib margin (level of L1-L2)
56
what should you adjust the rotation angle to for PA oblique stomach and duodenum and what does it show?
Adjust rotation to 40 to 70 degrees to demonstrate
pyloric canal and duodenum
57
What is the crieteria for PA oblique stomach and duodenum RAO position
Entire stomach and
duodenal loop
* No superimposition of
pylorus and duodenal
bulb
*Duodenal bulb and loop in profile
* Stomach centered at
level of pylorus
58
Patient position for for AP oblique stomach and duodenum
Recumbent LPO position
59
what should you adjust rotation to for AP oblique stomach and duodenum
30 to 60 degrees (average is 45)
60
where do you center IR for AP oblique stomach and duodenum
Center IR to a point midway between xiphoid process and lower rib margin
61
where to align midline of IR for AP oblique stomach and duodenum
Align midline of IR with a
sagittal plane passing
midway between the
vertebrae and the left
lateral border of the
abdomen
62
Criteria for AP Oblique Stomach and Duodenum
Entire stomach
and duodenal loop
* Fundic portion of
stomach
* No
superimposition of
pylorus and
duodenal bulb
*Body and pylorus
with double-contrast
visualization
63
Part position for Lateral stomach and duodenum
*true lateral position
*Align plane passing
midway between
MCP and anterior
surface of abdomen
to midline of grid
64
Where do you center IR for Lateral stomach and duodenum for recumbent position
Center IR at level of
L1-L2 for
recumbent position;
65
Where do you center IR for Lateral stomach and duodenum for upright position
L3 for upright
position
66
Patient position for Lateral Stomach and Duodenum
Recumbent right
lateral demonstrates
right retrogastric
space, duodenal
loop, and
duodenojejunal
junction
67
Criteria for Lateral stomach and duodenum
*Entire
stomach
and
duodenal
loop
* Stomach
centered at
level of
pylorus
68
Patient Position for AP stomach and Duodenum
Supine
69
What position for the AP stomach and duodenum would you do for demonstration of hiatal hernia
Trendelenburg’s for demonstration of hiatal hernia
70
What does the trendelenburg position show and what is it for?
Trendelenburg’s for demonstration of hiatal hernia
71
About how far is the trenedeleburg position
10 degrees
72
What does the treneleburg position show for the esophogus
to see if there reflex or hiatal hernia or varices of the esophagus
73
Part position for AP stomach and duodenum :
Where do you align midline of grid and center for a 10 X 12 inch IR
on 10- x 12-inch (24- × 30-cm) IR, align midline of
grid to sagittal plane passing midway between
MSP and left lateral margin of abdomen
Center 10- x 12-inch (24- x 30-cm) IR to level
midway between xiphoid and lower rib margin
74
Part position for AP stomach and duodenum :
Where do you align midline of grid and center for a 14 X 17 inch IR
*Align midline of grid to MSP on 14- x 17-inch (35-
× 43-cm) IR.
*Center 14- x 17-inch (35- × 43-cm) IR; may be
adjusted to demonstrate more diaphragm or small
bowel.
75
Criteria for AP stomach and Duodenum
*Entire stomach and
duodenal loop
* Double-contrast
visualization of
gastric body,
pylorus, and
duodenal bulb
* Retrogastric portion
of duodenum and
jejunum
76
antegrade
with the flow
structure and function
77
retrograde
goes against
shows structure
78
Where does the alimentary canal start and end at?
start at the mouth and ends in the anus
79
How long is the alimentary canal?
approximately 30 feet long
80
What ways can we check the esophagus?
by using barium and carbon dioxide fuzzies crystals
- single or double contrast
81
What is considered contrast?
-barium
-iodine
-air
82
Air is considered what kind of contrast?
negative contrast
83
Barium and iodine are considered what kind of contrast?
positive contrast
84
When doing an esophagus you first want to start what?
Upright
85
Best way to see the esophagus of the spine is what position?
RAO position
86
The very top of the stomach is what?
the fundus
87
What aspect is the lesser curvature of the stomach?
medial aspect
-right border
87
What is the sphincter that you first enter from the esophagus to the stomach?
-is the opening of the stomach
-closer to the heart
-helps so we don’t regurgitate up
Cardiac sphincter
88
What are the folds of the stomach called?
rugae
89
What aspect is the greater curvature of the stomach?
lateral aspect
-left border
90
The heaver and hypersthenic you are what happens to the stomach?
the more transverse or horizontal your stomach is
91
The more sthenic or asthenic you are, meaning skinnier what happens to the stomach?
the stomach will go closer to the spine, making it more vertical
92
When we get to the lower part of the stomach what is that called?
Pyloric region
93
Where is the duodenum bulb located at?
Pyloric sphincter
94
the opening between the stomach and the small intestine (duodenum)
Pyloric sphincter
95
The fundus is normally what?
tip back
96
If I am laying supine what happens to the fundus?
the fundus has the barium
97
If i am laying prone what happens to the fundus?
the fundus has air in it
98
If I am laying supine what happens to the pyloric
the pyloric has air
99
If i am laying prone what happens to the pyloric?
the pyloric has barium in it
100
The best way to see the retro or posterior aspect of the stomach is?
right lateral position you will see the duodenum and duodenum bulb
101
what is the expanded terminal end of the esophagus called?
cardiac antrum
102
chemically and mechanically altered food that leaves the stomach
chyme
