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2017SP POSITIONING II > EXAM #5 (UGI, BE, BILIARY) > Flashcards

EXAM #5 (UGI, BE, BILIARY) Flashcards

1
Q

Anatomy: Large Intestine

Begins at junction of _____ _____ and ends at _____

Forms an arch around the loops of _____ _____

Four main parts:
?

A

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
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2
Q

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

A

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

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3
Q

Anatomy: Large Intestine

_____ = attached to posteromedial side of cecum (appendix)

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

Anatomy: Large Intestine

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

Colon has four portions:
Ascending
Transverse
Descending
Sigmoid
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4
Q

Anatomy: Large Intestine

_____ = sharp angle at ascending and transverse

_____ = sharp angle at junction of transverse and descending

A

Anatomy: Large Intestine

Right colic flexure = sharp angle at ascending and transverse

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

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5
Q

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 _____

A

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

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6
Q

Anatomy: Large Intestine

Function?

A

Anatomy: Large Intestine

Reabsorption of fluids
Elimination of waste products

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7
Q

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

A

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

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8
Q

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

A

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

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9
Q

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
A

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

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10
Q

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

A

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

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11
Q

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.

A

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.

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12
Q

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

A

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

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13
Q

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.

A

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.

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14
Q

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 _____

A

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

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15
Q

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

A

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

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16
Q

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

A

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

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17
Q

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 _____

A

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

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18
Q

PA Axial Large Intestine

Part position

_____ in midline

IR at level of _____

CR

Angled __ to __ degrees caudad

Enters _____ at level of _____

A

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)

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19
Q

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

A

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

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20
Q

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 _____

A

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

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21
Q

Lateral Large Intestine

Part position

_____ centered

Knees flexed slightly for stability

Shoulders, hips, and knees superimposed and perpendicular

IR centered to _____

A

Lateral Large Intestine

Part position

MCP centered

Knees flexed slightly for stability

Shoulders, hips, and knees superimposed and perpendicular

IR centered to ASIS

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22
Q

Lateral Large Intestine

CR:

Perpendicular to IR

Enters _____ at level of _____

A

Lateral Large Intestine

CR:

Perpendicular to IR

Enters MCP at level of ASIS

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23
Q

AP Axial Large Intestine

Part position

_____ aligned to midline of grid

IR centered to __ inches above iliac crests

A

AP Axial Large Intestine

Part position

MSP aligned to midline of grid

IR centered to 2 inches above iliac crests

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24
Q

AP Axial Large Intestine

CR

Angled __ to __ degrees cephalad

Enters patient on _____ to enter inferior margin of _____

A

AP Axial Large Intestine

CR

Angled 30 to 40 degrees cephalad

Enters patient on MSP to enter inferior margin of pubic symphysis

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25
Q

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

A

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

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26
Q

AP Oblique Large Intestine

Part position

_____ centered to midline

Sponge supporting elevated side

Dependent knee flexed for support

IR centered to level of _____

A

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

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27
Q

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

A

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

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28
Q

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.

A

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.

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29
Q

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 _____

A

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

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30
Q

AP/PA Large Intestine Right or Left Lateral Decubitus

CR

Horizontal and perpendicular to IR

Enters midline of body at level of _____

A

AP/PA Large Intestine Right or Left Lateral Decubitus

CR

Horizontal and perpendicular to IR

Enters midline of body at level of iliac crests

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31
Q

Anatomy: Alimentary Canal

A _____ tube that extends from the mouth to the anus

Components:
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
6 items
A

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)
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32
Q

Anatomy: Esophagus

Long muscular tube

Functions to convey food and saliva from _____ to _____

Lies in midsagittal plane (MSP)

Originates at _____

A

Anatomy: Esophagus

Long muscular tube

Functions to convey food and saliva from laryngopharynx to stomach

Lies in midsagittal plane (MSP)

Originates at C6

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33
Q

Anatomy: Esophagus

Passes through diaphragm at
_____

Joins stomach at esophagogastric junction at _____

Expanded terminal end = _____

A

Anatomy: Esophagus

Passes through diaphragm at
T10

Joins stomach at esophagogastric junction at T11

Expanded terminal end = cardiac antrum

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34
Q

Anatomy: Stomach

Dilated, saclike portion of the digestive tract extending between the _____ and _____

Four parts:
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
\_\_\_\_\_
A

Anatomy: Stomach

Dilated, saclike portion of the digestive tract extending between the esophagus and small intestine

Four parts:
Cardia
Fundus
Body
Pyloric portion
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35
Q

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 _____

A

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

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36
Q

Anatomy: Stomach

Last portion is _____ portion

Consists of _____ and narrowed _____

_____ = right border

_____ = left border

_____ = sharp angle at esophagogastric junction

A

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

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37
Q

Anatomy: Stomach

Entrance and exit controlled by sphincters

_____ = opening between esophagus and stomach

  • _____ controls opening

_____ = opening between stomach and small intestine

  • Controlled by _____
A

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

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38
Q

Anatomy: Stomach

Stomach position greatly affected by body habitus

Higher and more horizontal in _____

Lower and more midline in _____

A

Anatomy: Stomach

Stomach position greatly affected by body habitus

Higher and more horizontal in hypersthenic

Lower and more midline in asthenic

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39
Q

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

A

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

40
Q

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

A

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

41
Q

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

A

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

42
Q

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

A

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

43
Q

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

A

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

44
Q

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

A

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

45
Q

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

A

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

46
Q

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 _____

A

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

47
Q

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 _____

A

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

48
Q

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 _____

A

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

49
Q

Stomach: GI Series

_____ = combination single- and double-contrast during the same procedure

Hypotonic duodenography is a MORE/LESS common examination

A

Stomach: GI Series

Biphasic examination = combination single- and double-contrast during the same procedure

Hypotonic duodenography is a LESS common examination

50
Q

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

A

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

51
Q

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

A

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

52
Q

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 __)

A

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)

53
Q

AP Oblique Stomach and Duodenum

RPO/LPO shows the (barium-filled) fundus the best

A

AP Oblique Stomach and Duodenum

LPO shows the (barium-filled) fundus the best

54
Q

PA Oblique Stomach and Duodenum

Duodenal loop is best seen in the PA oblique RAO/LAO

A

PA Oblique Stomach and Duodenum

Duodenal loop is best seen in the PA oblique RAO

55
Q

Lateral Stomach and Duodenum

Recumbent _____ lateral demonstrates right retrogastric space, duodenal loop, and duodenojejunal junction

Upright _____ lateral position demonstrates left retrogastric space

A

Lateral Stomach and Duodenum

Recumbent right lateral demonstrates right retrogastric space, duodenal loop, and duodenojejunal junction

Upright left lateral position demonstrates left retrogastric space

56
Q

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

A

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

57
Q

AP Stomach and Duodenum

Patient position

Supine

Trendelenburg’s for demonstration of _____

A

AP Stomach and Duodenum

Patient position

Supine

Trendelenburg’s for demonstration of hiatal hernia

58
Q

Anatomy: Small Intestine

Extends from _____ to _____

Average adult length = __ feet

Three portions:
_____
_____
_____

A

Anatomy: Small Intestine

Extends from pyloric sphincter to ileocecal valve

Average adult length = 22 feet

Three portions:
Duodenum
Jejunum
Ileum

59
Q

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)

A

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)

60
Q

Function of the small intestine?

A

Digestion and absorption of food

61
Q

Gastrointestinal Transit

_____ = contraction waves by which the digestive tube propels contents toward the rectum

Average transit time to ileocecal valve is __ to __ hours

A

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

62
Q

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

A

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

63
Q

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

A

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

64
Q

Oral Method of Examination

Examination complete when barium seen in cecum

Typically __ hours after ingestion in patients with normal motility

A

Oral Method of Examination

Examination complete when barium seen in cecum

Typically 2 hours after ingestion in patients with normal motility

65
Q

PA or AP Small Intestine

Part position

MSP centered

For __-minute interval, center IR at level of _____

For delayed images, center IR at _____

A

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

66
Q

What is the biggest gland in the body?

A

The liver

67
Q

Falciform ligament divides liver into two major lobes, what are they?

Two minor lobes evident on visceral surface, what are they?

A

Right + left lobes

Caudate + Quadrate lobes

68
Q

Liver

Two blood supplies:

_____ supplies oxygenated blood from abdominal aorta

_____ carries blood from digestive system to be filtered by liver

A

Liver

Two blood supplies:

Hepatic artery supplies oxygenated blood from abdominal aorta

Portal vein carries blood from digestive system to be filtered by liver

69
Q

Liver

Primary function from imaging standpoint is production of _____

A

Liver

Primary function from imaging standpoint is production of bile

70
Q

Liver

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

A

Liver

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

71
Q

Biliary System

Consists of what two things?

Two main hepatic ducts in liver?

A

Biliary System

Consists of bile ducts and the gallbladder

Two main hepatic ducts in liver:
Right
Left

72
Q

Biliary System

Right and left hepatic ducts join to form…?

Common hepatic duct unites with cystic duct to form…?

A

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

73
Q

Purpose of an ERCP?

A

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

74
Q

Gallbladder

Thin-walled musculomembranous sac usually found on visceral surface of _____ lobe of liver

Position of gallbladder varies with body _____

A

Gallbladder

Thin-walled musculomembranous sac usually found on visceral surface of right lobe of liver

Position of gallbladder varies with body habitus

75
Q

Gallbladder

Functions to store and concentrate _____

Evacuates bile when activated by hormone, _____

Neck of gallbladder consistent with cystic duct

A

Gallbladder

Functions to store and concentrate bile

Evacuates bile when activated by hormone, cholecystokinin

Neck of gallbladder consistent with cystic duct

76
Q

Function of the spleen?

A

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

77
Q

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

A

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

78
Q

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

A

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

79
Q

Postoperative (T-Tube) Cholangiography

Also called delayed _____

Performed via a T-shaped tube left in the _____ _____ and _____ _____ ducts for postoperative drainage

A

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

80
Q

Postoperative (T-Tube) Cholangiography

Performed to demonstrate:

_____ and _____ of ducts

Status of _____ of the hepatopancreatic ampulla

The presence of residual or previously undetected _____

A

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

81
Q

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

A

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

82
Q

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

A

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

83
Q

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

A

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

84
Q

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

A

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

85
Q

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

A

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

86
Q

Where is the spleen located?

A

Left upper quadrant behind pancreas

87
Q

What projection of the stomach demonstrates anterior and posterior surfaces

A

lateral

88
Q

What projection of the stomach will demonstrate a diaphragmatic hernia?

A

AP stomach and duodenum

89
Q

What exam requires a time marker on the images?

A

Small bowl series (UGI)

90
Q

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

A

AP axial large intestine

91
Q

What projection best demonstrates the right colic flexure?

A

PA Oblique RAO Large Intestine

92
Q

What projection best demonstrates the ascending colon?

A

PA Oblique RAO Large Intestine

93
Q

PA oblique colon, LAO position clearly demonstrates what?

A

left colic flexure and descending colon

94
Q

What projections best demonstrates the left colic flexure?

A

PA Oblique LAO Large intestine

95
Q

What is demonstrated in the decubitus BE?

Right Lateral Decubitus Colon- ?

Left lateral Decubitus Colon- ?

A

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

96
Q

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

A

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

97
Q

What is the breathing technique for all these projections?

A

SUSPENDED ON EXPIRATION

2017SP POSITIONING II (9 decks)

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