Fluroscopy: Upper Digestive System Flashcards
__1__ shield pts when exam allows
- Always
Always ____ yourself and the radiologist
Introduce
Always ask about __1__; usually NPO since __2__.
- Prep
2. Midnight
Esophagus: approx __1__ long; extended from __2__ to __3__; joins stomach to approx T-11 LES (__4__)/ cardiac sphincter
- 10”
- C-6
- T-10
- Lower esophageal sphincter
Esophagus: AP or PA. CR perpendicular @ __1__ and mid-esophagus (__2__). Top of film at __3__; try not to rotate pt.
- MSP
- T5-6
- EAM
Oblique Esophagus: __1__ suggested with rotation of __2__ degrees, CR perpendicular to the __3__ and approx __4__ laterally from the __5__
- RAO
- 35-40
- Mid-esophagus
- 2”
- Vertebral column (toward the side up/left)
Lateral Esophagus: we do a __1__ lateral with arms forward and out of the way. __2__ perpendicular to the IR, CR perp to the IR at __3__ (T5-6) and down the __4__.
- right
- MCP
- Mid-esophagus
- MCP
Stomach:
Most superior portion an is posterior
Funds
Stomach:
Contains rugea; more medial border is called the lesser curvature and more lateral border is called the greater curvature.
Body
Stomach:
Inferior and more anterior portion. Pyloric sphincter will open into small bowel.
Pelorus
UGI: PA.
-pt __1__; MSP in line (arms up or down). CR perp to IR to the level of __2__ (L1-2)
**__3__ filled with air
- Prone
- Costophrenic Angle
- Fundus
UGI, AP:
- pt __1__
- CR perp to IR to level of __2__
- __3__ filled with air
- Supine
- Costophrenic Angles
- Fundus
UGI-RAO:
- opposite of a __1__
- pt __2__
- rotate __3__
- CR perp to IR to the level of __4__ and midway from the vertebral column and lateral or elevated side of body (REMEMBER: stomach is on __5__ side)
- *RAO-barium in __6__**
- *LPO-barium in __7__**
- LPO
- Prone
- 40-70 degrees
- Costophrenic Angles
- Left
- Pyloric
- Fundus
UGI-LAO:
- opposite of __1__, pt prone, rotate approx __2__.
- CR perp to IR @ level of __3__ and midway from __4__ column and the elevated lateral border.
- *You will be demonstrating an __5__ body of the stomach
- RPO
- 40-70
- Costophrenic Angle
- Vertebral
- Elongated
SBS: Total length of approx __1__ feet; extends from the __2__ to the __3__ (RLQ). Contains villi for increased surface area. Has three divisions; __4__, __5__, __6__.
- 22-23
- Pyloric sphincter
- Ileocecal valve
- Duodenum
- Jejunum
- Ileum
SBS: AP or PA
- prone or __1__
- CR perp to IR @ __2__ to __3__
- *Entire __4__ on series.**
- *Be accurate on time**
- Supine
- L2
- Iliac crest
- Small bowel
8-10 inches, “C” shaped
Duodenum
2/5 of lower small bowel, feathery appearance
Jejunum
3/5 of lower small bowel, ends at the terminal ileum or ileocecal valve into the large intestine
Ileum
The folds of the stomach are called the _____
Rugae
The most anterior part of the stomach
Pyloris
The right lateral position/projection of the stomach best demonstrates the stomach in the lateral position and the _____
Duodenal loop
The term for wavelike movement of food stuff through the digestive tract is ______
Peristalsis
Proper respiration for an esophagus radiograph
There is no respiration instructions because the pt will be drinking barium
Under normal circumstances the stomach will empty in _____
2-3 hours
What stomach position best demonstrates the duodenal bulb
PA oblique RAO or LPO
What are some suggestions to make for quicker emptying/passing of barium through the bowel during a SBS?
- talk about food
- walk
- lay on right side
What is the best position/projection to demonstrate the esophagus without superimposition of the heart or spine?
RAO
What is the degree of obliquity for stomach radiography?
40-70
What is the degree of obliquity or esophagus radiograph and why?
35-40 because it gets it away from the spine
Explain why a higherLV is necessary for demonstration of the alimentary canal…
B/c barium has a higher atomic number and it is harder to penetrate
If a pt is lying supine, what portion of the stomach will contain barium?
Fundus
The top of the IR should be placed at __1__ or BASW radiograph. This correlates to the CR being directed to what vertebral level? __2__
- EAM
2. T5-T6
When barium studies of the upper intestinal tract are preformed, what are three ways that air may be introduced?
- Gas crystals
- Carbonated drink
- Drinking barium via straw
- The CR should be directed at this vertebral level for a stomach radiograph?
- This is at the bony landmark of the ____
- L1-L2
2. Costal angle
What body habitus requires a GREATER degree of obliquity for a stomach radiograph?
Hypersthenic
How will the stomach be demonstrated or seen when the LAO position is performed?
Elongated
List 2 things the Valsalva Maneuver may demonstrate during a BASW or UGI
- Esophageal varicies
2. GERD
What muscle structure allows food stuff or barium to pass into the large intestine and indicates the completion of a SBS?
Ileocecal valve
What is the purpose of air/gas being used during stomach studies?
Expand rugea
If a pt is examined in the upright position air will be in the
Pyloris
What is the term or examination of the small intestine by direct injection of barium under fluoroscopic guidance?
Enterocalysis
- A pt is radiographed using AP projection, oblique position and the duodenal bulb is well demonstrated. Name specific position.
- Barium will be in the ___ for the above position
- LPO
2. Fundus
What should the power respirations be for examination of the stomach, small bowel, or general abdominal cavity?
Suspend on exhalation
Explain the anterior/posterior centering when performing a lateral stomach?
Centering to L1-L2 2” from MCP bisect mid coronal plane and anterior border of pt
Failure of the smooth muscle of the alimentary canal to relax
Achalasia
Inflammation of the appendix
Appendicitis
Peptic ulcer of the lower esophagus, often with stricture
Barrett’s Esophagus
Digestion and absorption takes place in this portion of the alimentary canal
Small Intestines
Which position will demonstrate the entire duodenal loop?
Right lateral
Which projection, PA or AP is PREFERRED when demonstrating the small intestines?
PA
What is another name for the LES
Cardiac sphincter
Why would barium not be he contrast of choice if a pt has a suspected perforation?
Body cannot absorb barium, if it is leaked into peritoneum it could be toxic
What position will best demonstrate the duodenal bulb?
RAO
The structure that allows passage of food/barium from the small intestines into the large intestines called the ______
Ileocecal valve
What type of contrast should be used if there is a suspected perforation in the digestive tract and why?
Iodine, because body can absorb it if it leaks into the peritoneum due to perforation
What is meant by the term “full column” or single contrast study of the esophagus?
Entire esophagus filled with barium/using BA only (no gas)
List the proper prep for the following exams:
- BASW
- UGI
- SBS
- None
- NPO
- NPO
What position may better demonstrate hiatal hernias?
Trendelenburg
If a pt is positioned in an upright AP projection describe where the barium and air will be?
Barium-pylorus
Air-fundus
Which section of the small bowel is the shortest
Duodenum
Name three organs with ducts that enter/empty into the small bowel
Liver, gallbladder, pancreas
What organ is part of both the respiratory and digestive systems?
Pharynx