fluoro Flashcards
acquiring a single image of a particular structure or structures with no movement involved
static imaging
allows for the observation of movement
dynamic imaging
ALARA is synonymous with the term ___________________________________
optimization for radiation protection (ORP)
3 cardinal principles of radiation protection
time, distance, shielding
abdomen regions right to left; most superior
right hypochondriac region, epigastric region, left hypochondriac region
abdomen regions right to left; middle region
right lumbar region, umbilical region, left lumbar region
abdomen regions right to left; most inferior
right iliac region, hypogastric region, left iliac region
area where common bile duct and main pancreatic duct join together
Ampulla of Vater
place where bile/pancreatic enzymes enter the proximal duodenum
Sphincter of Odi
lower GI begins at ________
jejunum
contrast agents affect _________________ so we can see the tissues of interest better and apart from the surrounding tissues
differential absorption
types of contrast media
barium sulfate, iodinated media, air
glucagon (is/is not) a contrast agent
is not
glucagon is used to_____________ and constrict the gallbladder to ________________
slow stomach motility, increase bile flow
Barium taste description…
-chalky
-consistency like liquid antacids such as Pepto-Bismol, Maalox, etc.
Barium is ______, (organic/inorganic), ___________ and ____________
inert, inorganic, non-iodinated, non-soluble
Barium is a ____________
colloidal suspension
barium is a mixture of small particles distributed __________ throughout water
evenly
water soluble iodinated contrast media (some not all)
Omnipaque
Gastrografin
Gastroview
Gadolinium
_______ barium is good at coating linings of organs
thick
iodinated contrast agents are usually classified by its ________: high or low __________
molality, osmolality
esophagram (barium swallow) studies
form and function of swallowing aspect of pharynx and esophagus
upper gastrointestinal series (UGI) looks at the _______________
distal esophagus, stomach, proximal duodenum in one exam
UGI with SBFT
-same procedure as UGI, but exam continues until contrast agent reaches ileocecal juncture
small bowel follow through is considered a ____________
lower GI tract study
with upper GI with small bowel follow through, do not let the floor nurse _________
turn on suction
small bowel will have a “____________” appearance compared to large bowel
feathery
no gum chewing and no smoking for ______ prior to exam
4 hours
BE pre-exam patient prep
-________________prior to exam
-Bowel-cleansing cathartics
-NPO after ____________
(________ minimum except for pediatric patients)
-No gum chewing
-No smoking
-Enema _________ exam
-light evening meal
-midnight, 8 hours
-morning of
ascending/descending colon are more posterior; transverse is more _______
anterior
with a BE exam, when a patient is prone, you are going to fill the _____________ (this will be white)
transverse colon with contrast
BE positioning visualization
prone = _________ colon
supine = _________ colon
prone = transverse colon
supine = ascending/descending colon
how to visualize what position patient is in for a BE? Scotty dog faces the _________
downside
LPO visualizes __________ flexure in a BE
right colic flexure
RPO visualizes __________ flexure in a BE
left colic flexure
what is a t-tube check?
a “T” shaped catheter is inserted into the common bile duct after a cholecystectomy if there are concerns for residual or left over stones in the duct.
what does ERCP stand for?
endoscopic retrograde cholangiographic pancreatography
the use of a long snake like endoscope that allows for the internal illumination of an internal lining of an organ or cavity
ERCP exam
where does the t-tube terminate in a t-tube exam?
outside the patient’s body
iodinated contrast studies in HSGs sometimes use ______; it is an oil based contrast rather than a water based one
Lipiodol
order of anatomy in duodenum
pyloric sphincter, duodenal bulb, D1, D2, D3, D4
where is the Papilla of Vater?
in the duodenum in the D2 section
what is the general collimation guidelines for esophragms?
5-6” wide, top of light field should be 2” above the patient’s shoulders
esophagram SID for RAO if recumbent; if standing
SID 40 for recumbent
SID 72 for standing
CR entrance for RAO esophragm
level at T-6 (2-3” below jugular notch)
what type of contrast should be used if a perforation is suspected?
not barium; water soluble contrast
SID for AP/PA esophagram; what is it for the lateral?
40 recumbent; 72 standing
same for lateral
CR centering for lateral esophagram
T-6
respiration for AP/PA esophagram
exposure on full expiration
types of procedures to detect esophageal reflux
breathing exercises, water test, compression technique, toe-touch
what is the Vasalva Maneuver?
commonly used to detect reflux; patient is asked to take in a deep breath and then bear down is if trying to move their bowels while holding their breath
what is the Mueller Maneuver?
patient exhales and then tries to inhale against a closed glottis
what position is best for a water test?
LAO (per book), facing provider
how do you conduct a water test?
while supine, the patient drinks water through a straw. A positive test is indicated when barium/water refluxes back into the esophagus
toe-touch maneuver: while performing fluoroscopy, the ______________ is monitored while the patient bends over and touches their toes
cardiac orifice
rotation for LAO/RAO esophagram
35-40 degrees
a mass of undigested material trapped in the stomach
bezoars
pouch like herniations
diverticula
CR centering for AP/PA esophagram
T-5 or T-6
range of RAO obliquity Upper GI
40-70 degrees
for a small bowel series/follow through exam, how often do you take images?
Images taken 15 to 20 mins for the first hour and shown to the radiologist
Follow up images are then taken at time intervals decided by the radiologist
respiration for small bowel series/follow through
expiration
CR entrance for small bowel series/follow through
midline at 2” above the iliac crest for the first hour, and then at the iliac crest after the first hour
inflammatory condition of the large intestine
colitis
outpouching of the mucosal walls
diverticula
telescoping of one part of the intestines into another
intussusception
abnormal masses of tissue
neoplasms
Most carcinomas encircle the lumen of the colon causing an irregular channel. These have been described as ______________ lesions
“apple core” or “napkin ring”
sac like projections that project into the lumen where diverticula project outward from the lumen wall
polyps
twisting of a portion of the intestine which leads to a mechanical obstruction
volvulus
respiration for all barium enema images
expiration
what is visualized in RAO barium enema image?
right colic flexure, ascending colon, sigmoid colon
what should be visualized in an RAO Upper GI?
entire stomach, C-loop of duodenum
what is visualized in LAO barium enema image?
left colic flexure, descending colon
what is visualized in LPO barium enema image?
right colic flexure, ascending colon, sigmoid colon
what is visualized in RPO barium enema image?
left colic flexure, descending colon
CR entrance for AP Axial barium enema image
at level 2” below the ASIS at MSP
CR angulation for AP Axial barium enema image
30-40 cephalic
RAO Upper GI centering and obliquity for sthenic body types
-45-55 degrees obliqued
-CR enters level of L1 (1-2” above lower lateral rib margin between spinal column and upside lateral abdominal margin)
CR entering and obliquity for RAO Upper GI for asthenic body type
-40 degrees obliqued
-CR enters 2” below level of L1
RAO Upper GI obliquity and CR centering for hypersthenic body type
-70 degrees obliqued
-CR enters 2” above level of L1
CR entering PA Upper GI for sthenic body type
at level of L1 and 1” left of vertebral column
CR entering PA Upper GI for asthenic body type
2” below level of L1
CR entering PA Upper GI for hypersthenic body type
2” above the level of L1 (and more midline)
Right Lateral Upper GI for sthenic body type
At level of L1 at the lower lateral rib margin and 1” to 1.5” anterior to the MCP
Right Lateral Upper GI for asthenic body type
2” above level of L1
Right Lateral Upper GI for hypersthenic body type
2” below the level of L1
Angle and CR centering for LPO Upper GI for sthenic body type
-45 degrees obliqued
-At level of L1 (between the lower lateral rib margin and xiphoid process and between midline of body and left lateral abdominal margin)
Degree and CR entering for LPO Upper GI for asthenic body type
-30 degrees obliqued
-2” below level of L1 (and more midline)
Degree and CR centering for LPO Upper GI for hypersthenic body type
-60 degrees obliqued
-2” above the level of L1
CR centering for AP Upper GI sthenic body type
At level of L1
(roughly midway between xiphoid process and lower rib margin) and between the midline and the left lateral margin of the abdomen
AP Upper GI for asthenic body type
2” below level of L1 (and more midline)
AP Upper GI for hypersthenic body type
2” above level of L1
order of pyloric portion of stomach
angular notch, pyloric antrum, pyloric canal, pyloric orifice (pylorus)
thick barium ratios
3-4 parts barium sulfate
1 part water
cooked cereal consistency
thin barium ratio
1 part barium sulfate
1 part water
thin milkshake consistency
what is the cecum and what are some characteristics?
proximal portion of large intestine; has ileocecal valve, widest portion of the large intestine
temperature of contrast for BE
85-90 degrees F
what sort of lubricant for a BE?
water soluble
what are double contrast BEs good for?
demonstrating polyps and diverticula
_________ are the pouches caused by ___________
haustra, taeniae coli
AP BE CR centering
iliac crest
RAO BE CR centering
iliac crest & 1” left of MSP
LAO BE CR centering
1-2” above iliac crest & 1” right of MSP
LPO/RPO BE CR centering
iliac crest & 1” to elevated side
lateral rectum BE CR centering
level of anterior ASIS
right lateral BE CR centering
iliac crest
left lateral BE CR centering
iliac crest
