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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
the entry of gastric contents into the esophagus, irritating the lining of the esophagus
GastroEsophageal Reflux Disease (GERD)
26
characterized by a large outpouching of the esophagus just above the upper esophageal sphincter
Zenker's Diverticulum
27
insufficient control of the cardiac sphincter resulting to the reflux of food once the stomach is full
Cardio-Esophageal Incompetence
28
What are the Extrinsic Pathology?
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
What is the Contra-Indication?
Possible sensitivity to the contrast media used.
30
What are the Patient's Preparation?
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
What are the following procedures may be performed to detect esophageal reflux?
1. Breathing exercises 2. Water Test 3. Compression paddle technique 4. The Toe-Touch maneuver
32
designed to increase both intra thoracic and intra abdominal pressures.
Breathing Exercise
33
What are the most common breathing exercise?
1. Valsalva Maneuver 2. Modified Valsalva Maneuver 3. Mueller Maneuver
34
– 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
Valsalva Maneuver
35
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.
Modified Valsalva Maneuver
36
can be performed as the patient exhales and then tries to inhale against a closed glottis.
Mueller Maneuver
37
- 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
Water Test
38
- 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.
Compression Technique
39
- 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.
Wolf's Compression Paddle
40
- 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.
Toe Touch Maneuver
40
What are the 4 routine projection used in Esophagography?
1. Scout Film PA Projection 2. AP Projection 3. RAO Position 4. Left Lateral Position
41
Scout Film PA Projection
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
AP Projection
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
RAO Position
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
LEFT LATERAL POSITION
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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