Fluoro Notes Flashcards
1
Q
What are the 2 parts of the Digestive System?
A
alimentary canal & accessory glands
2
Q
Accessory Glands
A
-salivary glands, liver, gallbladder, & pancreas
-(all secrete digestive enzymes into alimentary canal
3
Q
Alimentary Canal
A
musculomembraneous tube & extends from mouth to anus
4
Q
How do the regions of the digestive system vary?
A
vary based on the specific part
5
Q
What are the parts of the Alimentary Canal? (6)
A
-mouth
-pharynx & esophagus
-stomach
-small intestine
-large intestine
-anus
6
Q
What is the mouth responsible for?
A
mastication & conversion into bolus (food passed through the mouth) by insalivation
7
Q
What are the swallowing organs?
A
Pharynx & Esophagus
8
Q
Where does digestion begin?
A
Stomach
9
Q
Where does digestion end?
A
Small intestine
10
Q
What is the purpose of the large intestine?
A
for egestion & water absorption
11
Q
What is the anus responsible for?
A
termination
12
Q
What are the 4 layers of the alimentary canal from outside to inside?
A
fibrous, muscular, submucosal, & mucosal (some might be more muscular
13
Q
Esophagus
A
long muscular tube that carries food & saliva to the stomach
14
Q
How long is an adult esophagus?
A
appx. 10” long & 3/4” in diameter
15
Q
What region does the esophagus lie?
A
MSP & MCP
16
Q
Where does the esophagus originate?
A
level of C6
17
Q
What does the esophagus pass through?
A
mediastinum
18
Q
Esophagus is anterior to ____ & posterior to _____.
A
anterior to vertebral bodies & posterior to trachea
19
Q
Where does the esophagus curve, increases & joins the stomach?
A
curves sharply left just under the diaphragm, increases in diameter (cardiac antrum), & joins the stomach at the esophagrastric junction
20
Q
What are the 4 parts of the stomach?
A
-cardia
-fundus
-body
-pyloris
21
Q
Cardia of the stomach
A
immediately surrounds around
22
Q
fundus of the stomach
A
superior portion & fills the dome of the left hemi diaphragm
23
Q
What is the most superior portion of the stomach?
A
fundus
24
Q
body of the stomach
A
middle portion of the stomach
25
Pylorus of the stomach?
most distal area of stomach
26
What is the middle portion of the stomach called & where does it connect?
called the pyloric canal & connects to duodenal bulb
27
Rugae
longitudinal bulbs of stomach to allow stomach to expand
28
Lesser curvature of the stomach
inferior/right side of patient
29
greater curvature of the stomach
exterior/left side of patient
30
Hypersthenic stomach
horizontal, high, & well above umbilicus
31
Asthenic stomach
vertical, low, & well below umbilicus
32
the skinnier the patient, the more ___ & ____ the stomach
vertical & lower
33
the bigger the patient, the more ____ & _____ the stomach
horizontal & higher
34
Cardiac sphincter
muscle that controls the opening of the esophagogastric notch
35
gastroduodenal junction
junction between the stomach & duodenum
36
How long is the small intestine?
about 22 ft. in an average adult
37
What does the mucosal layer of the small intestine have?
vili
38
3 parts of the small intestine proximal to distal (closer to the point of origin)-
-duodenum
-jejunum
-ilium
39
Duodenum of the small intestine-
-first & widest portion
-follows a C shaped course surrounding the pancreas
40
Jejunum of the small intestine-
-after the duodenum, but before the ilium
-is the 2nd portion
41
Ilium of the small intestine-
last & longest portion
42
Small intestine gathered in freely movable loops called ___.
Gyri
43
What are the only fixed portions of the small intestine called?
duodenum & ilium
44
Where does the large intestine begin?
in the right iliac region/right lower quadrant
45
What does the large intestine form?
a giant arch around the small intestine appx. 5 ft. long
46
The muscular layer of the large intestine has longitudinal bands called ___.
Taenia Coli
47
What do the longitudinal bands of the large intestine form?
pouch like structures called hausfrau
48
portions of the large intestine from proximal to distal (10)-
-cecum
-vermiform appendix
-ascending colon
-right colic flexure
-transverse colon
-left colic flexure
-descending colon
-sigmoid colon
-rectum
-anal canal
49
cecum of large intestine
pouch like portion just below the junction of the ilium & colon
50
What is the cecum also called?
ileocecal valve
51
what does the vermiform appendix attach to?
attached to the cecum & has no other known function
52
where does the Ascending colon extend?
extends from cecum to right colic flexure
53
What is the right colic flexure also called & why?
hepatic flexure bec of its position with the liver
54
Where does the transverse colon go across the body?
from the right colic flexure to the left colic flexure
55
What is the left colic flexure also called & why?
left splenic flexure bec of its close position with the spleen
56
Where does the descending colon extend?
from the left colic flexure to the sigmoid colon
57
Sigmoid colon
S shaped loop between descending colon & rectum
58
Where does the rectum extend?
from the sigmoid colon to anal canal & includes rectal ampulla
59
Anal Canal
most distal portion & includes distal sphincter
60
How does the size & shape of the large intestine vary?
the different body habits of patients
61
Negative Contrast creates-
radiolucent & lessens the amount of being absorbed
62
Positive Contrast are-
opaque & greater amount of radiation is absorbed
63
What is the atomic number of Barium Sulfate?
56
64
Barium Sulfate
-has highest contrast, therefore absorbs more radiation
-contrast of choice for alimentary canal studies, & can't be used in any other areas of the body
65
Barium Sulfate white chalky suspension-
may arrive in powder form & add water, must be shaken thoroughly just prior to prevent flocculation
66
How does barium sulfate pass through the body?
-pass through as still
-rate depends on intestinal motility
67
Contraindications of Barium Sulfate-
-allergy to barium or dyes/flavoring in suspension
-concern for aspiration
-possible perforations/ulcerations of bowel
-possible obstruction of bowel & will have to have surgically removed
68
extraversion
leaks out of where it's supposed to be
69
Thin Barium weight volume-
greater than 60% weight volume
70
Thick Barium weight volume-
98% or more weight volume
71
other barium types-
tablets, paste, & flavored barium
72
What is the atomic number for iodine?
53
73
Iodinated Contrast characteristics-
-thick/viscous, sticky substance
-comes in varying concentrations
-can be reabsorbed into the body, doesn't have to pass through
74
What does a higher concentration # of iodinated contrast mean?
more iodine/attenuation
75
What is iodinated contrast primarily used for?
-intravenous studies
-most can be used in alimentary canal studies
76
What is gastrografin specifically formulated for?
GI use
77
What can iodinated contrast also be used for?
-in alimentary canal
-in organs studied outside the alimentary canal (reproductive, biliary, & salivary)
78
allergies to iodine-
anaphylaxis/anaphylactic shock (throat closes, hives, reddening of skin/extreme heat feeling
79
When is the only other time gastrografin is used?
if barium is contraindicated for alimentary canal studies
80
Gastrografin
-cannot be used in any other areas of the body
-typically moves faster through patients digestive system
-more expensive than barium sulfate
81
Negative Contrast
room/air CO2
82
Why is CO2 preferred for GI?
can be readily absorbed in the body
83
What is Negative contrast used to create?
double contrast studies
84
Single contrast exams are only-
positive
85
Double Contrast exams are _____ & _______.
positive & negative
86
Biphasic contrast exams
single & double
87
How should exposure times be kept in fluoroscopy?
kept short per projection (0.1 - 0.2)
88
What is the patient prep for esophograms?
no prep
89
What is the pertinent history in esophograms & Upper GI?
dysphagia, reflux, hiatal hernia, ulcers, & surgeries
90
What supplies is used for esophograms & upper GI exams?
-cup, drinking straw/spoon (bottle with cut nipple for infants, & sip cup for toddler)
-single contrast (usually use barium sulfate, thin
-double contrast (barium sulfate thick with CO2 crystals)
91
What are some other supplies that may be requested for an esophogram?
-cotton dipped in barium for foreign body & barium tablets
92
How should the tube be warmed up for fluoroscopy exams?
place led aprons across table to protect equipment
93
What are the room set up instructions for esophograms & upper GI?
-begin with table up right & patient standing if possible (must have footrest secured to bottom of table)
-monitor in view of radiologist
-floor pedal in place
94
What are the typical overheads in an esophogram?
AP/PA, RAO, & lateral
95
What are the post exam instructions used in esophograms, upper GI, & SBFT?
-stool may be white & chalky
-drink lots of water over next few days to flush out barium
-if having any pain/don't pass barium call facility/radiologist or visit ER
96
What are the special instructions for esophageal varices esophograms?
perform trandelenburg exam, valsalva maneuver, & full expiration then swallow
97
What are the special instruction given for reflux esophograms?
perform trandelenburg exams
98
What are upper GI used to evaluate?
distal esophagus & proximal small intestine
99
What is the patient prep for an upper GI?
NPO past midnight
100
What other supplies may be requested for an Upper GI?
barium tablet
101
What are the typical overhead radiographs for an Upper GI?
PA, AP, PA Axial, PA Oblique RAO, AP Oblique LPO, & right lateral
102
Demonstrate a hiatal hernia in Upper GI-
can perform LPO with head lower 25*-30*
103
Demonstrate a regurgitation/reflux in upper GI-
can perform exam with slight rotation to the right & head lowered 10*-15*
104
What is a small bowel series (SBFT) used to evaluate?
stomach, entire small bowel, & proximal large intestine; specifically motility (how fast moving through/blockage)
105
what is the patient prep for a small bowel series?
-low residual/soft diet for 1-2 days
-NPO after evening meal the night before
-cleansing enema may be recommended
106
Explain procedure for patient & gather history for SBFT-
-length of exam usually 2-4 hours, can be longer
-pertinant history- obstruction or hx of obstruction & surgeries
107
What are the 3 ways to introduce contrast to patient?
-by mouth/nasogastric tube
-by reflux filling tube through barium enema
-enterocolitis tube placed with proximal small intestines, not common
108
What supplies is used for a SBFT?
-cup, drinking straw/spoon (bottle with cut nipple for infants, & sip cup for toddler)
-single contrast only, thin barium (entro-vu)
-other possibilities- pneumatic compression paddles
109
Procedure for SBFT-
-begin by taking scout image, clear scout with rad.
-have pt. drink contrast medium, as much as tolerable or requested amount complete
-perform initial image
-perform image in succession every 15-20 min. determined by facility protocol/rad.
-if longer than 2 hrs/moving slow, rad. may extend sequence to 30 min, 1 hr, or longer
-exam complete when rad. confirms contrast reaches ileocecal valve
-rad. may perform fluoro exam of ileocecal are to confirm/visualize mobility of valve
110
Increase intestinal motility for SBFT-
-pt. sit up/stand/walk around between projections
-if pt. can't stand/sit up, right lateral position works best (optional- slight tilt of table to raise head)
111
Pts. with nasogastric tubes in SBFT-
-exam of proximal colon complete when contrast reaches bag
-exam of distal colon requires reflux/retrograde filling
112
What is a barium enema used to observe?
large intestine filling & lining
113
What does a barium enema demonstrate?
colon polyps
114
why is a barium enema commonly performed?
due to incomplete colonoscopy
115
What kind of contrast can be given in a barium enema?
single or double
116
How is contrast typically administered in a barium enema?
via enema (can be given oral; donated, 3-4 hour wait)
117
What supplies is needed for a barium enema?
-high density contrast (polybag plus/powder w/ kit)
-enema kit- tip w/ tubes (single/double), balloon cuff & clamp, inflation bulb (if double contrast), & bag
-adjustable hanging pole, lubricant, towels, sheets & pillow, biohazard can, & bedpan
118
What are the enema types for a barium enema?
-single- just enema tip
-double- has bulb used to inject air
119
What are the dietary preparations for a barium enema?
clear liquids only (# days determined by physician/rad.) & bowel cleansing regimen (cleansing drink & cleansing enema)
120
Barium contraindications-
allergies & suspected perforations/obstructions
121
Pertinent history for barium enema-
obstruction or hx of obstructions, colon ca, colon polyps, & recent colonoscopy/diagnosis
122
Verify prep for barium enema-
-was BM clear? (just water)
-colon must be completely clear (fecal matter may stimulate polyps or masses
123
Barium enema for pts. with stoma/colostomy-
-proximal colon- contrast injected through stoma
-distal colon- contrast injected through enema
124
Large Intestine AP v. PA-
-supine- SATS, air in sigmoid & transverse colon
-prone- air in rectum, air in ascending & descending
125
hepatopancreatic ampulla opens into the-
greater duodenal papillia
