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Esophagography Flashcards

1
Q

a radiographic examination of the pharynx and esophagus utilizing a radiopaque contrast medium

A

Esophagography

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2
Q

What is the purpose of Esophagography?

A

To study radiographically the form and function of the swallowing aspects of the pharynx and esophagus.

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3
Q

Whats is the contrast media used in Esophagography?

A

Thin Barium Sulfate (BaSO4)

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4
Q

What are the Barium Sulfate Preparation?

A
  1. Thin BaSO4 mixture
  2. Heavy BaSO4 paste
  3. Gelatine Capsule filed with BaSO4
  4. Tufts or pledgets of cotton saturated with thin BaSO4
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5
Q

Used for the detection of stictures.

A

Thin BaSO4 mixture

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6
Q

For the detection of intra-luminal lesions

A

Heavy BaSO4 paste

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7
Q

Used for the demonstration of obstruction

A

Gelatine Capsule filed with BaSO4

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8
Q

Used for the demonstration of obstruction and detection of foreign bodies

A

Tufts or pledgets of cotton saturated with BaSO4

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9
Q

What are the types of examination in Esophagography?

A
  1. Single Contrast Study
  2. Double Contrast Study
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10
Q

The fluoroscopic and spot film examination is started with the patient in the upright position, whenever possible.

A

Single Contrast Study

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11
Q

The horizontal and Trendelenburg are used as indicated.

A

Single Contrast Study

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12
Q

Then the patient is instructed to take a cup containing the barium suspension in the left hand to drink it on request

A

Single Contrast Study

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13
Q

The technologist instructs the patient to perform various breathing maneuvers as the examination proceeds.

A

Single Contrast Study

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14
Q

a free flowing high density barium must be used for the type of examination

A

Double Contrast Study

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15
Q

A gas producing substance, usually carbon dioxide crystal or Gastroluft can be added to the barium suspension given.

A

Double Contrast Study

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16
Q

Spot radiographs are exposed during the examination and delayed images may be taken on request.

A

Double Contrast Study

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17
Q

of which patients may ingest a variety, include a bolus of food, metallic objects, and other materials lodging in the esophagus.

A

Foreign Body

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18
Q

closure of any part

A

Esophageal Atresia

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19
Q

an abnormal passage usually between two internal organs or leading from an anterior organ to the body surface

A

Esophageal Fistula

20
Q

narrowing of any part

A

Esophageal Stenosis

21
Q

Characterized by dilatation of the veins in the distal esophagus

A

Esophageal Varices

22
Q

abnormal constriction of any part of the esophagus

A

Esophageal Achalasia

23
Q

also termed as cardiospasm, is a motor disorder of the esophagus in which peristalsis is reduced along the distal two thirds of the esophagus

A

Esophageal Achalasia

24
Q

the protrusion of any structures through the esophageal hiatus of the diaphragm

A

Hiatal Hernia

25
Q

the entry of gastric contents into the esophagus, irritating the lining of the esophagus

A

GastroEsophageal Reflux Disease (GERD)

26
Q

characterized by a large outpouching of the esophagus just above the upper esophageal sphincter

A

Zenker’s Diverticulum

27
Q

insufficient control of the cardiac sphincter resulting to the reflux of food once the stomach is full

A

Cardio-Esophageal Incompetence

28
Q

What are the Extrinsic Pathology?

A
  1. Cardio-Esophageal Incompetence
  2. Study of the Heart
  3. Study of the Thyroid Enlargement
  4. Study of the Bronchi
  5. Study of the Trachea
29
Q

What is the Contra-Indication?

A

Possible sensitivity to the contrast media used.

30
Q

What are the Patient’s Preparation?

A
  1. All clothing and anything metallic between the mouth and the waist should be removed.
  2. The patient is then instructed to wear a hospital gown.
  3. Before the fluoroscopic procedure is performed, a pertinent history should be taken and the examination carefully explained to the patient.
31
Q

What are the following procedures may be performed to detect esophageal reflux?

A
  1. Breathing exercises
  2. Water Test
  3. Compression paddle technique
  4. The Toe-Touch maneuver
32
Q

designed to increase both intra thoracic and
intra abdominal pressures.

A

Breathing Exercise

33
Q

What are the most common breathing exercise?

A
  1. Valsalva Maneuver
  2. Modified Valsalva Maneuver
  3. Mueller Maneuver
34
Q

– the patient is asked to take a deep breath and, while holding the breathing, to bear down as though trying to move
the bowels.
- forces air against the closed glottis

A

Valsalva Maneuver

35
Q

accomplished as the patient pinches off the nose, closes the mouth , and tries to blow the nose. The cheeks should expand outward as though the patient were blowing up a balloon.

A

Modified Valsalva Maneuver

36
Q

can be performed as the patient exhales and then tries to inhale against a closed glottis.

A

Mueller Maneuver

37
Q
  • is done with the patient in
    the supine position and turned up slightly on the left side.
  • This slight left posterior oblique (LP) position fills the fundus with barium.
  • The patient is asked to swallow a mouthful of water through a straw. Under fluoroscopy, the radiologist closely observes
    the esophagogastric junction.
  • A positive water test occurs when significant amounts of
    barium regurgitate into the esophagus from the stomach
A

Water Test

38
Q
  • Compression paddle can be placed under the patient in
    the prone position and inflated as needed to provide pressure in the stomach region .
  • the radiologist can demonstrate the obscure esophagogastric junction during this process to detect possible esophageal reflux.
A

Compression Technique

39
Q
  • Designed for applying compression during G.I. series. A
    metal circle in the bladder ring fluoroscopically indicates the
    area under compression. Wall mounting brackets are included.
  • Specifications 25” Long, 6 5/8” Wide, 5/8” Thick.
    Approx shipping weight 1.5 lbs.
A

Wolf’s Compression Paddle

40
Q
  • The toe-touch maneuver also is performed to study
    possible regurgitation into the esophagus from the
    stomach.
  • Under fluoroscopy, the cardiac orifice is observed as the patient bends over and touches the toes
  • Esophageal reflux and hiatal hernias sometimes are demonstrated with the toe-touch maneuver.
A

Toe Touch Maneuver

40
Q

What are the 4 routine projection used in Esophagography?

A
  1. Scout Film PA Projection
  2. AP Projection
  3. RAO Position
  4. Left Lateral Position
41
Q

Scout Film PA Projection

A

FILM SIZE: 11 x 14 LW , with the upper edge of the cassette placed 2 inches above the shoulder or centered at the level of T5/T6.

BODY POSITION: Recumbent or erect

PART POSITION: Center MSP to grid

REFERENCE POINT: T5-T6

CENTRAL RAY: perpendicular to the midpoint of the film at the level of T5/T6 (2 to 3 inches inferior to jugular notch)

PATIENT INSTRUCTION: Suspended respiration

STRUCTURE SHOWN:
-Demonstrates the entire esophagus without contrast media.
-Demonstrates opaque foreign bodies.

42
Q

AP Projection

A

FILM SIZE: 11 x 14 LW , with the upper edge of the cassette placed 2 inches above the shoulder or centered at the level of T5/T6.

BODY POSITION: Recumbent or erect. Recumbent is preferred because of more complete filling of the esophagus (caused by the gravity factor with the erect position).

PART POSITION: Center MSP to grid

REFERENCE POINT: T5-T6

CENTRAL RAY: perpendicular to the midpoint of the film at the level of T5/T6 (2 to 3 inches inferior to jugular notch)

PATIENT INSTRUCTION: Respiration normally stops during and shortly
after the act of swallowing, so that patients need not be instructed to stop
breathing.

STRUCTURE SHOWN:
The entire barium-filled esophagus through the superimposed thoracic vertebrae. Include the fundus of the stomach for the esophageal-gastric junction

43
Q

RAO Position

A

FILM SIZE: 11 x 14 (either 1 in
1 or 2 in 1) LW, with the upper
edge of the cassette placed 2 inches above the shoulder or
centered at the level of T5/T6.

BODY POSITION: Recumbent or erect. Recumbent is preferred

PART POSITION: MSP forming an angle of 35 to 40 degrees from the grid device. Elevated side 2
inches lateral to MSP

REFERENCE POINT: T5-T6

CENTRAL RAY: perpendicular to the midpoint of the film at the level of T5/T6 (2 to 3 inches inferior to jugular notch)

PATIENT INSTRUCTION: Breathing instructions are
not necessary.

STRUCTURE SHOWN: Barium-filled esophagus demonstrated b/w vertebrae and heart

44
Q

LEFT LATERAL POSITION

A

FILM SIZE:11 x 14 (either 1 in 1 or 2 in 1) LW, with the upper edge of the cassette placed 2 inches above the shoulder or centered at the level of T5/T6.

BODY POSITION: Recumbent or erect. Recumbent is preferred

PART POSITION: Center the MCP to grid

REFERENCE POINT: T5-T6

CENTRAL RAY: perpendicular to
the midpoint of the film at the level of T5/T6 (2 to 3 inches inferior to jugular notch)

PATIENT INSTRUCTION: Breathing instructions are not necessary

STRUCTURE SHOWN: Barium-filled esophagus in lat proj

RCE (11 decks)

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