EXAM #5 (UGI, BE, BILIARY)

Question 1

Anatomy: Large Intestine

Begins at junction of _____ _____ and ends at _____

Forms an arch around the loops of _____ _____

Four main parts:
?

Answer 1

Anatomy: Large Intestine

Begins at junction of small intestine and ends at anus

Forms an arch around the loops of small intestine

Four main parts:
Cecum
Colon
Rectum
Anal canal

Question 2

Anatomy: Large Intestine

Approximately __ feet long

_____ = series of pouches along large intestine

_____ = muscular bands that form haustra

_____ is pouchlike portion below the junction of the ileum and colon

Answer 2

Anatomy: Large Intestine

Approximately 5 feet long

Haustra = series of pouches along large intestine

Taeniae coli = muscular bands that form haustra

Cecum is pouchlike portion below the junction of the ileum and colon

Question 3

Anatomy: Large Intestine

_____ = attached to posteromedial side of cecum (appendix)

Colon has four portions:
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_

Answer 3

Anatomy: Large Intestine

Vermiform appendix = attached to posteromedial side of cecum (appendix)

Colon has four portions:
Ascending
Transverse
Descending
Sigmoid

Question 4

Anatomy: Large Intestine

_____ = sharp angle at ascending and transverse

_____ = sharp angle at junction of transverse and descending

Answer 4

Anatomy: Large Intestine

Right colic flexure = sharp angle at ascending and transverse

Left colic flexure = sharp angle at junction of transverse and descending

Question 5

Anatomy: Large Intestine

Sigmoid portion forms _____ and ends at _____ at level of third sacral segment

Rectum extends from _____ to _____ canal

Anal canal terminates at the _____

Answer 5

Anatomy: Large Intestine

Sigmoid portion forms S-shaped loop and ends at rectum at level of third sacral segment

Rectum extends from sigmoid to anal canal

Anal canal terminates at the anus

Question 6

Anatomy: Large Intestine

Function?

Answer 6

Anatomy: Large Intestine

Reabsorption of fluids
Elimination of waste products

Question 7

Examination Methods

Single-contrast
Double-contrast

May be performed as one- or two-stage procedure

Two-stage examinations with _____ first, then _____ or other _____ after _____ is evacuated

Answer 7

Examination Methods

Single-contrast
Double-contrast

May be performed as one- or two-stage procedure

Two-stage examinations with barium first, then air or other gas after barium is evacuated

Question 8

Contrast Media

Commercially prepared barium sulfate products generally used for routine retrograde examinations

High-density barium sulfate = newest product

Absorbs more _____
Useful for double-contrast examinations

Answer 8

Contrast Media

Commercially prepared barium sulfate products generally used for routine retrograde examinations

High-density barium sulfate = newest product

Absorbs more radiation
Useful for double-contrast examinations

Question 9

Contrast Media

_____ usually used in double-contrast studies

_____ may also be used

• More rapidly absorbed

Water-soluble iodinated agents may be orally administered when _____ is contraindicated

• Usually not satisfactory for double-contrast studies

Answer 9

Contrast Media

Air usually used in double-contrast studies

Carbon dioxide may also be used

More rapidly absorbed

Water-soluble iodinated agents may be orally administered when retrograde filling is contraindicated

Usually not satisfactory for double-contrast studies

Question 10

Preparation of Intestinal Tract

Large intestine must be completely _____ of all contents

Retained _____ can simulate small masses

Restricted diet and bowel cleansing regimen standard for healthy patients

Answer 10

Preparation of Intestinal Tract

Large intestine must be completely emptied of all contents

Retained fecal matter can simulate small masses

Restricted diet and bowel cleansing regimen standard for healthy patients

Question 11

Enema Tip Insertion

Adjust IV pole height so that bag is no higher than __ inches above level of anus.

Expose anal region only.

Run barium into basin to remove _____ from tubing.

Lubricate enema tip.
Instruct patient to take deep breaths.

Answer 11

Enema Tip Insertion

Adjust IV pole height so that bag is no higher than 24 inches above level of anus.

Expose anal region only.

Run barium into basin to remove air from tubing.

Lubricate enema tip.
Instruct patient to take deep breaths.

Question 12

Enema Tip Insertion

Insert tip slowly, steadily, and gently during expiration of deep breath.

Direct anteriorly __ to __ inches, then slightly superiorly

Total distance no more than __ inches

Never force insertion

Ask patient to assist if resistance is met and if patient is capable

Answer 12

Enema Tip Insertion

Insert tip slowly, steadily, and gently during expiration of deep breath.

Direct anteriorly 1 to 1½ inches, then slightly superiorly

Total distance no more than 4 inches

Never force insertion

Ask patient to assist if resistance is met and if patient is capable

Question 13

Enema Tip Insertion

After tip is inserted, hold in place while patient turns to supine or prone position.

Retention cuff may be inflated at this time.

Free tubing of compression to ensure free flow.

Answer 13

Enema Tip Insertion

After tip is inserted, hold in place while patient turns to supine or prone position.

Retention cuff may be inflated at this time.

Free tubing of compression to ensure free flow.

Question 14

Double-Contrast BE

Two methods
Closed system

Welin method:
Closed system does not require removal and reinsertion of enema tip

Patient remains on table for entire procedure

Welin method recommended for early detection of _____

Answer 14

Double-Contrast BE

Two methods
Closed system

Welin method:
Closed system does not require removal and reinsertion of enema tip

Patient remains on table for entire procedure

Welin method recommended for early detection of small lesions

Question 15

Double-Contrast BE

For single-stage closed-system method

Barium introduced and removed via bag position

Air introduced by bag inversion or by manual compression of sphygmomanometer bulb

Answer 15

Double-Contrast BE

For single-stage closed-system method

Barium introduced and removed via bag position

Air introduced by bag inversion or by manual compression of sphygmomanometer bulb

Question 16

Double-Contrast BE

For Welin method:
Barium introduced to left colic flexure, then tip removed and patient evacuates

Tip reinserted, barium introduced to sigmoid, and air instilled

Patient position altered to coat mucosa

Spot radiographs taken as needed

Answer 16

Double-Contrast BE

For Welin method:
Barium introduced to left colic flexure, then tip removed and patient evacuates

Tip reinserted, barium introduced to sigmoid, and air instilled

Patient position altered to coat mucosa

Spot radiographs taken as needed

Question 17

PA or AP Large Intestine

Part position:

_____ centered to midline

IR centered at level of _____

CR:

Perpendicular to center of IR

Enters _____ at level of _____

Answer 17

PA or AP Large Intestine

Part position:

MSP centered to midline

IR centered at level of iliac crests

CR:

Perpendicular to center of IR

Enters MSP at level of iliac crests

Question 18

PA Axial Large Intestine

Part position

_____ in midline

IR at level of _____

CR

Angled __ to __ degrees caudad

Enters _____ at level of _____

Answer 18

PA Axial Large Intestine

Part position

MSP in midline

IR at level of iliac crests

CR

Angled 30 to 40 degrees caudad

Enters MSP at level of anterior superior iliac spine (ASIS)

Question 19

PA Oblique Large Intestine

Patient position

__- to __-degree RAO or LAO

_____ best demonstrates right colic flexure, ascending colon, and sigmoid

_____ best demonstrates left colic flexure and descending colon

Answer 19

PA Oblique Large Intestine

Patient position

35- to 45-degree RAO or LAO

RAO best demonstrates right colic flexure, ascending colon, and sigmoid

LAO best demonstrates left colic flexure and descending colon

Question 20

PA Oblique Large Intestine

Part position

Supported by flexed knee and arm of elevated side

_____ centered to midline

IR centered to level of _____

CR

Perpendicular to IR

Enters __ to __ inches lateral to midline of body on elevated side at level of _____

Answer 20

PA Oblique Large Intestine

Part position

Supported by flexed knee and arm of elevated side

MSP centered to midline

IR centered to level of iliac crests

CR

Perpendicular to IR

Enters 1 to 2 inches lateral to midline of body on elevated side at level of iliac crests

Question 21

Lateral Large Intestine

Part position

_____ centered

Knees flexed slightly for stability

Shoulders, hips, and knees superimposed and perpendicular

IR centered to _____

Answer 21

Lateral Large Intestine

Part position

MCP centered

Knees flexed slightly for stability

Shoulders, hips, and knees superimposed and perpendicular

IR centered to ASIS

Question 22

Lateral Large Intestine

CR:

Perpendicular to IR

Enters _____ at level of _____

Answer 22

Lateral Large Intestine

CR:

Perpendicular to IR

Enters MCP at level of ASIS

Question 23

AP Axial Large Intestine

Part position

_____ aligned to midline of grid

IR centered to __ inches above iliac crests

Answer 23

AP Axial Large Intestine

Part position

MSP aligned to midline of grid

IR centered to 2 inches above iliac crests

Question 24

AP Axial Large Intestine

CR

Angled __ to __ degrees cephalad

Enters patient on _____ to enter inferior margin of _____

Answer 24

AP Axial Large Intestine

CR

Angled 30 to 40 degrees cephalad

Enters patient on MSP to enter inferior margin of pubic symphysis

Question 25

AP Oblique Large Intestine Patient position: __- to __-degree LPO or RPO position _____ demonstrates right colic flexure and ascending and sigmoid colon _____ demonstrates left colic flexure and descending colon

Answer 25

AP Oblique Large Intestine Patient position: 35- to 45-degree LPO or RPO position LPO demonstrates right colic flexure and ascending and sigmoid colon RPO demonstrates left colic flexure and descending colon

Question 26

AP Oblique Large Intestine Part position _____ centered to midline Sponge supporting elevated side Dependent knee flexed for support IR centered to level of _____

Answer 26

AP Oblique Large Intestine Part position MSP centered to midline Sponge supporting elevated side Dependent knee flexed for support IR centered to level of iliac crests

Question 27

AP Oblique Large Intestine CR Perpendicular to IR Enters patient __ to __ inches lateral to midline of MSP on elevated side at level of iliac crests

Answer 27

AP Oblique Large Intestine CR Perpendicular to IR Enters patient 1 to 2 inches lateral to midline of MSP on elevated side at level of iliac crests

Question 28

AP/PA Large Intestine Right or Left Lateral Decubitus On double-contrast studies, air or “up” is side of interest. _____ decubitus position demonstrates medial side of ascending colon and lateral side of descending colon. _____ decubitus demonstrates lateral side of ascending colon and medial side of descending colon.

Answer 28

AP/PA Large Intestine Right or Left Lateral Decubitus On double-contrast studies, air or “up” is side of interest. Right lateral decubitus position demonstrates medial side of ascending colon and lateral side of descending colon. Left lateral decubitus demonstrates lateral side of ascending colon and medial side of descending colon.

Question 29

AP/PA Large Intestine Right or Left Lateral Decubitus Part position Body elevated on radiolucent support to center _____ to midline of grid IR centered to level of _____

Answer 29

AP/PA Large Intestine Right or Left Lateral Decubitus Part position Body elevated on radiolucent support to center MSP to midline of grid IR centered to level of iliac crests

Question 30

AP/PA Large Intestine Right or Left Lateral Decubitus CR Horizontal and perpendicular to IR Enters midline of body at level of _____

Answer 30

AP/PA Large Intestine Right or Left Lateral Decubitus CR Horizontal and perpendicular to IR Enters midline of body at level of iliac crests

Question 31

Anatomy: Alimentary Canal A _____ tube that extends from the mouth to the anus ``` Components: _____ _____ _____ _____ _____ _____ 6 items ```

Answer 31

Anatomy: Alimentary Canal A musculomembranous tube that extends from the mouth to the anus ``` Components: Mouth Pharynx Esophagus Stomach Small intestine Large intestine (terminates at anus) ```

Question 32

Anatomy: Esophagus Long muscular tube Functions to convey food and saliva from _____ to _____ Lies in midsagittal plane (MSP) Originates at _____

Answer 32

Anatomy: Esophagus Long muscular tube Functions to convey food and saliva from laryngopharynx to stomach Lies in midsagittal plane (MSP) Originates at C6

Question 33

Anatomy: Esophagus Passes through diaphragm at _____ Joins stomach at esophagogastric junction at _____ Expanded terminal end = _____

Answer 33

Anatomy: Esophagus Passes through diaphragm at T10 Joins stomach at esophagogastric junction at T11 Expanded terminal end = cardiac antrum

Question 34

Anatomy: Stomach Dilated, saclike portion of the digestive tract extending between the _____ and _____ ``` Four parts: _____ _____ _____ _____ ```

Answer 34

Anatomy: Stomach Dilated, saclike portion of the digestive tract extending between the esophagus and small intestine ``` Four parts: Cardia Fundus Body Pyloric portion ```

Question 35

Anatomy: Stomach _____ is section surrounding esophageal opening _____ is superior portion that fills the left hemidiaphragm Body located between _____ and _____ portion Interior surface contains numerous longitudinal folds called _____

Answer 35

Anatomy: Stomach Cardia is section surrounding esophageal opening Fundus is superior portion that fills the left hemidiaphragm Body located between fundus and pyloric portion Interior surface contains numerous longitudinal folds called rugae

Question 36

Anatomy: Stomach Last portion is _____ portion Consists of _____ and narrowed _____ _____ = right border _____ = left border _____ = sharp angle at esophagogastric junction

Answer 36

Anatomy: Stomach Last portion is pyloric portion Consists of pyloric antrum and narrowed pyloric canal Lesser curvature = right border Greater curvature = left border Cardiac notch = sharp angle at esophagogastric junction

Question 37

Anatomy: Stomach Entrance and exit controlled by sphincters _____ = opening between esophagus and stomach - _____ controls opening _____ = opening between stomach and small intestine - Controlled by _____

Answer 37

Anatomy: Stomach Entrance and exit controlled by sphincters Cardiac orifice = opening between esophagus and stomach Cardiac sphincter controls opening Pyloric orifice = opening between stomach and small intestine Controlled by pyloric sphincter

Question 38

Anatomy: Stomach Stomach position greatly affected by body habitus Higher and more horizontal in _____ Lower and more midline in _____

Answer 38

Anatomy: Stomach Stomach position greatly affected by body habitus Higher and more horizontal in hypersthenic Lower and more midline in asthenic

Question 39

Functions: Stomach Storage area for food during part of digestion Secretes acids, enzymes, and other chemicals to chemically break down food Mechanically breaks down food by churning and peristalsis _____ = chemically and mechanically altered food that leaves stomach

Answer 39

Functions: Stomach Storage area for food during part of digestion Secretes acids, enzymes, and other chemicals to chemically break down food Mechanically breaks down food by churning and peristalsis Chyme = chemically and mechanically altered food that leaves stomach

Question 40

Gastrointestinal Transit _____ = contraction waves by which the digestive tube propels contents toward the rectum _____ to _____ waves per minute occur in the filled stomach Average emptying time for stomach is __ to __ hours Average transit time to ileocecal valve is __ to __ hours

Answer 40

Gastrointestinal Transit Peristalsis = contraction waves by which the digestive tube propels contents toward the rectum Three to four waves per minute occur in the filled stomach Average emptying time for stomach is 2 to 3 hours Average transit time to ileocecal valve is 2 to 3 hours

Question 41

Contrast Media Radiographic demonstration of the alimentary canal requires use of _____ Barium sulfate is most common contrast for the alimentary canal Water-soluble iodinated contrast media may also be used (_____) = if suspected perforation

Answer 41

Contrast Media Radiographic demonstration of the alimentary canal requires use of contrast media Barium sulfate is most common contrast for the alimentary canal Water-soluble iodinated contrast media may also be used (gastrographen) = if suspected perforation

Question 42

Contrast Media Iodinated solutions move through the GI tract quicker than barium sulfate Clears the stomach in __ to __ hours Iodinated solutions do not adhere as well to esophageal _____ as does barium sulfate Iodinated solutions provide satisfactory examinations of the stomach, duodenum, and large intestine

Answer 42

Contrast Media Iodinated solutions move through the GI tract quicker than barium sulfate Clears the stomach in 1 to 2 hours Iodinated solutions do not adhere as well to esophageal mucosa as does barium sulfate Iodinated solutions provide satisfactory examinations of the stomach, duodenum, and large intestine

Question 43

Contrast Media (Iodinated solutions) Water-soluble media easily removed by aspiration before or during surgery Also readily _____ by the body and _____ by kidneys in cases of perforation

Answer 43

Contrast Media Water-soluble media easily removed by aspiration before or during surgery Also readily absorbed by the body and excreted by kidneys in cases of perforation

Question 44

Exposure Time: Esophagus Upright position = __ second or less Exposure time may be slightly longer for recumbent position Barium passes slowly if swallowed at end of full _____ Barium is delayed in the lower portion if swallowed at the end of full _____ Deglutition inhibits respiration for several seconds

Answer 44

Exposure Time: Esophagus Upright position = 0.1 second or less Exposure time may be slightly longer for recumbent position Barium passes slowly if swallowed at end of full inspiration Barium is delayed in the lower portion if swallowed at the end of full expiration Deglutition inhibits respiration for several seconds

Question 45

Exposure Time: Stomach Normal peristaltic activity – exposure time no longer than __ second Never longer than __ second Hypermotility requires __ second or less Exposures made at the end of expiration in routine procedures

Answer 45

Exposure Time: Stomach Normal peristaltic activity – exposure time no longer than 0.2 second Never longer than 0.5 second Hypermotility requires 0.1 second or less Exposures made at the end of expiration in routine procedures

Question 46

AP or PA Esophagus Patient position Supine or prone without rotation Head turned to side to facilitate drinking IR is placed so that top is level with the _____ Central ray (CR) perpendicular to midpoint of IR Usually at level of _____

Answer 46

AP or PA Esophagus Patient position Supine or prone without rotation Head turned to side to facilitate drinking IR is placed so that top is level with the mouth Central ray (CR) perpendicular to midpoint of IR Usually at level of T5-T6

Question 47

AP/PA Oblique Esophagus Patient position Recumbent __- to __-degree _____ or _____ position Align IR and elevated side of patient approximately __ inches lateral to MSP CR enters perpendicular to midpoint of _____ Enters patient at __ inches lateral to MSP at level of _____

Answer 47

AP/PA Oblique Esophagus Patient position Recumbent 35- to 40-degree right anterior oblique (RAO) or left posterior oblique (LPO) position Align IR and elevated side of patient approximately 2 inches lateral to MSP CR enters perpendicular to midpoint of IR Enters patient at 2 inches lateral to MSP at level of T5 or T6

Question 48

Lateral Esophagus Patient position Recumbent right or left lateral position Patient should face radiographer Arms forward Midcoronal plane (MCP) centered CR enters perpendicular to midpoint of _____ Enters patient on MCP at level of _____

Answer 48

Lateral Esophagus Patient position Recumbent right or left lateral position Patient should face radiographer Arms forward Midcoronal plane (MCP) centered CR enters perpendicular to midpoint of IR Enters patient on MCP at level of T5-T6

Question 49

Stomach: GI Series _____ = combination single- and double-contrast during the same procedure Hypotonic duodenography is a MORE/LESS common examination

Answer 49

Stomach: GI Series Biphasic examination = combination single- and double-contrast during the same procedure Hypotonic duodenography is a LESS common examination

Question 50

PA Stomach and Duodenum Part position Align midline of grid to sagittal plane passing halfway between vertebral column and left lateral border of abdomen Center IR __ to __ inches above _____ Upright requires IR centered __ to __ inches lower

Answer 50

PA Stomach and Duodenum Part position Align midline of grid to sagittal plane passing halfway between vertebral column and left lateral border of abdomen Center IR 1 to 2 inches above lower rib margin (level of L1-L2) Upright requires IR centered 3 to 6 inches lower

Question 51

PA Oblique Stomach and Duodenum Part position: Midline of IR aligned with sagittal plane passing midway between vertebral column and lateral border of _____ side IR centered to lower rib margin (level of _____) Adjust rotation to __ to __ degrees to demonstrate pyloric canal and duodenum

Answer 51

PA Oblique Stomach and Duodenum Part position: Midline of IR aligned with sagittal plane passing midway between vertebral column and lateral border of elevated side IR centered to lower rib margin (level of L1-L2) Adjust rotation to 40 to 70 degrees to demonstrate pyloric canal and duodenum

Question 52

AP Oblique Stomach and Duodenum Part position: Align midline of IR with a sagittal plane passing midway between the _____ and the _____ of the abdomen Center IR to a point midway between _____ and _____ Adjust rotation to __ to __ degrees (average is __)

Answer 52

AP Oblique Stomach and Duodenum Part position: Align midline of IR with a sagittal plane passing midway between the vertebrae and the left lateral border of the abdomen Center IR to a point midway between xiphoid process and lower rib margin Adjust rotation to 30 to 60 degrees (average is 45)

Question 53

AP Oblique Stomach and Duodenum RPO/LPO shows the (barium-filled) fundus the best

Answer 53

AP Oblique Stomach and Duodenum LPO shows the (barium-filled) fundus the best

Question 54

PA Oblique Stomach and Duodenum Duodenal loop is best seen in the PA oblique RAO/LAO

Answer 54

PA Oblique Stomach and Duodenum Duodenal loop is best seen in the PA oblique RAO

Question 55

Lateral Stomach and Duodenum Recumbent _____ lateral demonstrates right retrogastric space, duodenal loop, and duodenojejunal junction Upright _____ lateral position demonstrates left retrogastric space

Answer 55

Lateral Stomach and Duodenum Recumbent right lateral demonstrates right retrogastric space, duodenal loop, and duodenojejunal junction Upright left lateral position demonstrates left retrogastric space

Question 56

Lateral Stomach and Duodenum Part position Align plane passing midway between MCP and anterior surface of abdomen to midline of grid Center IR at level of _____ for recumbent position; _____ for upright position True lateral position

Answer 56

Lateral Stomach and Duodenum Part position Align plane passing midway between MCP and anterior surface of abdomen to midline of grid Center IR at level of L1-L2 for recumbent position; L3 for upright position True lateral position

Question 57

AP Stomach and Duodenum Patient position Supine Trendelenburg’s for demonstration of _____

Answer 57

AP Stomach and Duodenum Patient position Supine Trendelenburg’s for demonstration of hiatal hernia

Question 58

Anatomy: Small Intestine Extends from _____ to _____ Average adult length = __ feet Three portions: _____ _____ _____

Answer 58

Anatomy: Small Intestine Extends from pyloric sphincter to ileocecal valve Average adult length = 22 feet Three portions: Duodenum Jejunum Ileum

Question 59

Anatomy: Small Intestine Duodenum is __ to __ inches long and C-shaped First portion is called _____ Portion that joins jejunum is a sharp curve called the _____ flexure Flexure is supported by the suspensory muscle of the duodenum (ligament of Treitz)

Answer 59

Anatomy: Small Intestine Duodenum is 8 to 10 inches long and C-shaped First portion is called duodenal bulb Portion that joins jejunum is a sharp curve called the duodenojejunal flexure Flexure is supported by the suspensory muscle of the duodenum (ligament of Treitz)

Question 60

Function of the small intestine?

Answer 60

Digestion and absorption of food

Question 61

Gastrointestinal Transit _____ = contraction waves by which the digestive tube propels contents toward the rectum Average transit time to ileocecal valve is __ to __ hours

Answer 61

Gastrointestinal Transit Peristalsis = contraction waves by which the digestive tube propels contents toward the rectum Average transit time to ileocecal valve is 2 to 3 hours

Question 62

Contrast Media Iodinated solutions become diluted in the small intestine, so clear anatomic detail CAN/CANNOT be seen. Does permit a rapid survey of the entire small intestine

Answer 62

Contrast Media Iodinated solutions become diluted in the small intestine, so clear anatomic detail CANNOT be seen. Does permit a rapid survey of the entire small intestine

Question 63

Exposure Time Normal peristaltic activity: exposure time no longer than __ second Never longer than __ second Hypermotility requires __ second or less Exposures made at _____ in routine procedures

Answer 63

Exposure Time Normal peristaltic activity: exposure time no longer than 0.2 second Never longer than 0.5 second Hypermotility requires 0.1 second or less Exposures made at the end of expiration in routine procedures

Question 64

Oral Method of Examination Examination complete when barium seen in cecum Typically __ hours after ingestion in patients with normal motility

Answer 64

Oral Method of Examination Examination complete when barium seen in cecum Typically 2 hours after ingestion in patients with normal motility

Question 65

PA or AP Small Intestine Part position MSP centered For __-minute interval, center IR at level of _____ For delayed images, center IR at _____

Answer 65

PA or AP Small Intestine Part position MSP centered For 30-minute interval, center IR at level of L2 For delayed images, center IR at iliac crests

Question 66

What is the biggest gland in the body?

Answer 66

The liver

Question 67

Falciform ligament divides liver into two major lobes, what are they? Two minor lobes evident on visceral surface, what are they?

Answer 67

Right + left lobes Caudate + Quadrate lobes

Question 68

Liver Two blood supplies: _____ supplies oxygenated blood from abdominal aorta _____ carries blood from digestive system to be filtered by liver

Answer 68

Liver Two blood supplies: Hepatic artery supplies oxygenated blood from abdominal aorta Portal vein carries blood from digestive system to be filtered by liver

Question 69

Liver Primary function from imaging standpoint is production of _____

Answer 69

Liver Primary function from imaging standpoint is production of bile

Question 70

Liver Bile is collected by ducts and carried to _____ for storage or passes into duodenum

Answer 70

Liver Bile is collected by ducts and carried to gallbladder for storage or passes into duodenum

Question 71

Biliary System Consists of what two things? Two main hepatic ducts in liver?

Answer 71

Biliary System Consists of bile ducts and the gallbladder Two main hepatic ducts in liver: Right Left

Question 72

Biliary System Right and left hepatic ducts join to form...? Common hepatic duct unites with cystic duct to form...?

Answer 72

Biliary System Right and left hepatic ducts join to form common hepatic duct Common hepatic duct unites with cystic duct to form common bile duct

Question 73

Purpose of an ERCP?

Answer 73

ERCP = looks for obstructions and anatomy in the ductwork, in the liver or pancreas

Question 74

Gallbladder Thin-walled musculomembranous sac usually found on visceral surface of _____ lobe of liver Position of gallbladder varies with body _____

Answer 74

Gallbladder Thin-walled musculomembranous sac usually found on visceral surface of right lobe of liver Position of gallbladder varies with body habitus

Question 75

Gallbladder Functions to store and concentrate _____ Evacuates bile when activated by hormone, _____ Neck of gallbladder consistent with cystic duct

Answer 75

Gallbladder Functions to store and concentrate bile Evacuates bile when activated by hormone, cholecystokinin Neck of gallbladder consistent with cystic duct

Question 76

Function of the spleen?

Answer 76

Filter for blood as part of the immune system. Helps fight certain kinds of bacteria that cause pneumonia

Question 77

Percutaneous Transhepatic Cholangiography Abbreviated PTC Performed on patients with _____ when the ductal system has been demonstrated as dilated by computed tomography (CT) or sonography, but the cause is unclear May also be used to place a _____ _____ to treat obstructive jaundice

Answer 77

Percutaneous Transhepatic Cholangiography Abbreviated PTC Performed on patients with jaundice when the ductal system has been demonstrated as dilated by computed tomography (CT) or sonography, but the cause is unclear May also be used to place a drainage catheter to treat obstructive jaundice

Question 78

Percutaneous Transhepatic Cholangiography Patient is _____ _____ side surgically prepared and draped Local anesthetic administered Special “_____” needle (Chiba) inserted Water-soluble iodinated contrast injected under fluoroscopy After ductal system is filled, spot _____ projections are made

Answer 78

Percutaneous Transhepatic Cholangiography Patient is supine Right side surgically prepared and draped Local anesthetic administered Special “skinny” needle (Chiba) inserted Water-soluble iodinated contrast injected under fluoroscopy After ductal system is filled, spot AP projections are made

Question 79

Postoperative (T-Tube) Cholangiography Also called delayed _____ Performed via a T-shaped tube left in the _____ _____ and _____ _____ ducts for postoperative drainage

Answer 79

Postoperative (T-Tube) Cholangiography Also called delayed cholangiography Performed via a T-shaped tube left in the common hepatic and common bile ducts for postoperative drainage

Question 80

Postoperative (T-Tube) Cholangiography Performed to demonstrate: _____ and _____ of ducts Status of _____ of the hepatopancreatic ampulla The presence of residual or previously undetected _____

Answer 80

Postoperative (T-Tube) Cholangiography Performed to demonstrate: Caliber and patency of ducts Status of sphincter of the hepatopancreatic ampulla The presence of residual or previously undetected stones

Question 81

Postoperative (T-Tube) Cholangiography Tube clamped _____ before procedure Fills tube with _____ to prevent air bubbles from entering Air bubbles mimic radiolucent _____ Preceding meal is _____ Cleansing enema _____ hour before procedure, if needed Preliminary _____ obtained

Answer 81

Postoperative (T-Tube) Cholangiography Tube clamped day before procedure Fills tube with bile to prevent air bubbles from entering Air bubbles mimic radiolucent stones Preceding meal is withheld Cleansing enema 1 hour before procedure, if needed Preliminary KUB obtained

Question 82

Postoperative (T-Tube) Cholangiography Patient positioned in _____ position with right upper quadrant centered to IR Contrast media injected into _____ under fluoroscopy _____ and _____ images made as indicated

Answer 82

Postoperative (T-Tube) Cholangiography Patient positioned in RPO position with right upper quadrant centered to IR Contrast media injected into T-tube under fluoroscopy Spot and conventional images made as indicated

Question 83

ERCP Used to diagnose _____ and _____ pathologic conditions Useful method when ducts are not _____ and ampulla is not _____ Performed by passing a fiber-optic endoscope through the mouth into the duodenum under fluoroscopy

Answer 83

ERCP Used to diagnose biliary and pancreatic pathologic conditions Useful method when ducts are not dilated and ampulla is not obstructed Performed by passing a fiber-optic endoscope through the mouth into the duodenum under fluoroscopy

Question 84

ERCP Patient’s _____ is sprayed with a local anesthetic to make passage of endoscope easier The hepatopancreatic ampulla is cannulated Contrast is injected into the...? _____ and _____ images are taken as indicated

Answer 84

ERCP Patient’s throat is sprayed with a local anesthetic to make passage of endoscope easier The hepatopancreatic ampulla is cannulated Contrast is injected into the common bile duct Spot and conventional images are taken as indicated

Question 85

Know the regions of the abdomen (what region liver is in)

Answer 85

Right Upper Quadrant- liver, right kidney, gall bladder, colon, pancreas

Question 86

Where is the spleen located?

Answer 86

Left upper quadrant behind pancreas

Question 87

What projection of the stomach demonstrates anterior and posterior surfaces

Answer 87

lateral

Question 88

What projection of the stomach will demonstrate a diaphragmatic hernia?

Answer 88

AP stomach and duodenum

Question 89

What exam requires a time marker on the images?

Answer 89

Small bowl series (UGI)

Question 90

What projection will demonstrate the rectal sigmoid area in a BE?

Answer 90

AP axial large intestine

Question 91

What projection best demonstrates the right colic flexure?

Answer 91

PA Oblique RAO Large Intestine

Question 92

What projection best demonstrates the ascending colon?

Answer 92

PA Oblique RAO Large Intestine

Question 93

PA oblique colon, LAO position clearly demonstrates what?

Answer 93

left colic flexure and descending colon

Question 94

What projections best demonstrates the left colic flexure?

Answer 94

PA Oblique LAO Large intestine

Question 95

What is demonstrated in the decubitus BE? Right Lateral Decubitus Colon- ? Left lateral Decubitus Colon- ?

Answer 95

What is demonstrated in the decubitus BE? Right Lateral Decubitus Colon- medial side of ascending colon and lateral side of descending colon Left lateral Decubitus Colon- lateral side of ascending colon and medial side of descending colon

Question 96

What is the advantage of having the recumbent for images of the esophagus?

Answer 96

obtains more complete contrast filling of the esophagus (especially the proximal part)

Question 97

What is the breathing technique for all these projections?

Answer 97

SUSPENDED ON EXPIRATION