Intestine series Flashcards
After the duodenum comes the next ___of the mobile small intestine called the ___. The remaining ___ is the ___.
40%
jejunum
60%
ileum
The remainder of the small intestine is ____ within the ____ by a thin, broad-based mesentery that is attached to the posterior abdominal wall. This allows free movement of the small intestine within the abdominal cavity.
suspended, peritoneal cavity
•The jejunum occupies the ___ portion of the abdomen while the ileum is positioned in the ____of the pelvis.
left upper, right side and upper part
•The inner walls of the small intestine show mucosal folds.
•These are called the
plicae circulares
The plicae are more numerous in the early ____ and reduce in numbers in the later part and are completely absent in the
_____
jejunum, ileum
The small intestine ends at the ____ that leads it to the colon.
ileocecal valve
The wall of the small intestine and colon is composed of four layers:
•mucosa (or mucous membrane)
•Submucosa
•muscularis (or muscularis propria),
•adventitia (or serosa).
The main function of this organ is to aid in digestion.
Small Intestine
As a person grows, the small intestine increases ___ in length from about ___ in a newborn to almost ___ in an adult.
20 times, 200 cm, 6 m
The duodenum is about ____long; the jejunum is about ____ long and the ileum is about ____ long.
25 cm (10 inches)
2.5 m (8 feet)
3.6 m (12 feet)
– pseudo-obstruction, inactive intestinal muscle that prevents the passage of food and leads to a fundtional blockage of the intestine
Paralytic ileus
- a chronic inflammatory disease of the intestines, especially the colon and ileum, associated with ulcers and fistula
Crohn’s disease
- a disease in which the small intestine is hypersensitive to gluten, leading to difficulty in digesting food.
Celiac disease
- symptoms secondary to tumors
Carcinoid
– congenital condition, an outpouching or bulge in the lower part of the small intestine. The bulge is congenital (present at birth) and is a leftover of the umbilical cord
Meckel’s Diverticulum
- food and gastric juices from your stomach move to your small intestine in an uncontrolled, abnormally fast manner
Gastric dumping syndrome
- when intestines push though a weak spot or tear the lower abdominal wall
Inguinal hernia
- inversion of one portion of the intestine within another
Intussuseption
– caused by inadequate blood flow in the mesenteric vessel
Mesenteric ischemia
SRE of the small intestine by administering the barium sulfate by:
- mouth
- by complete reflux filling with a large volume of barium enema
- by direct injection into the bowel through an intestinal tube which is called the electrolysis
4.Small intestine Enema
•3-4 methods are only employed when oral method fails.
is the radiographic procedure in which the contrast medium is injected into the duodenum to examine the small bowel.
Enteroclysis
In enteroclysis double contrast media small bowel procedure, the contrast is injected through a ___ tube into the terminal duodenum.
BILBAO or SELLINK
I enteroclysis, barium is given at a rate of ___
100 ml/min
The suspensory muscle of duodenum is a thin muscle connecting the junction between the duodenum, jejunum, and duodenojejunal flexure to connective tissue surrounding the superior mesenteric artery and celiac artery.
Ligament of Treitz
- is a temporary lack of the normal muscle contractions of the intestines.
Bowel ileus
•Also known as small bowel enema.
•Uses NGT for introduction of CM for therapeutic and diagnostic purposes.
•Therapeutic - (Miller-Abbott tube) to relieve post-operative distention and small bowel obstruction.
Intubation Method Single CM
- Allows abdominal compression to separate various bowel loops.
2.Higher degree of visibility.
PRONE POSITION
1.Separate overlapping loops of ileum.
TRENDELENBURG
1.To take advantage of the superior and lateral shift of the barium-filled stomach for visualization of the retrogastric portions of the duodenum and jejunum
2.To prevent possible compression overlapping of loops of the intestine
SUPINE POSITION
Four sections of the large intestine
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Extends upward on the right side of the abdomen
Ascending colon
Extends from the ascending colon across the body to the left side
Transverse colon
Extends from the transverse colon downward on the left side
Descending colon
Named because of its S-shape; extends from the descending colon to the rectum The rectum joins the anus, or the opening where waste matter passes out of the body.
Sigmoid colon
The ____ is the final section of the gastrointestinal tract that performs the vital task of absorbing water and vitamins while converting digested food into feces.
large intestine
The large intestine is about ___ in length and ____ in diameter in the living body, but becomes much larger postmortem as the smooth muscle tissue of the intestinal wall relaxes
5 feet (1.5 m), 2.5 inches (6-7 cm)
•There are two basic radiologic methods of examining the large intestine by means of diagnostic or contrast enemas the:
single-contrast method
double-contrast method
- colon is examined with a barium sulfate suspension only.
single-contrast method
- two-stage or single-stage procedure.
double-contrast method
– aggressive bowel ceansing
Hypokalemia
– barium residue may harden into clumps
Constipation
– barium spill into abdominal cavity
Chemical peritonitis
Barium sulfate temperature should be below body temperature about (29° to 30° C).
85°to 90° F
SRE of the large intestine.
Barium Enema
This position relaxes the abdominal muscle , which decreases Intra-abdominal pressure on the rectum and makes relaxation of the anal sphincter less difficult
35-40 degrees lean forward on left side
•Air rises to the most anterior portion of the large intestine.
1.Transverse colon
2.Sigmoid colon
Barium fills the:
1.Ascending colon
2.Descending colon
SUPINE
•Air fills the:
1.Rectum
2.Ascending colon
3.Descending colon
BARIUM
1.Transverse colon
PRONE
• True lateral position.
•CR to MCP between ASIS and posterior sacrum.
BARIUM ENEMA LATERAL (RECTUM)
ROBIN’S MODIFICATION
Best demonstrates polyps, strictures and fistula between the bladder and uterus.
BARIUM ENEMA LATERAL (RECTUM)
ROBIN’S MODIFICATION
Best demonstrates the rectum and rectosigmoid portion.
BARIUM ENEMA LATERAL (RECTUM)
ROBIN’S MODIFICATION
The most important modification in barium enema.
BARIUM ENEMA LATERAL (RECTUM)
ROBIN’S MODIFICATION
Demonstrates a direct lateral view of the recto-sigmoid colon without superimposition.
BARIUM ENEMA LATERAL (RECTUM)
ROBIN’S MODIFICATION
•Best demonstrates the left colic flexure and the descending colon.
BARIUM ENEMA RPO POSITION
Best demonstrates the right colic flexure and the ascending and sigmoid portions of the colon.
BARIUM ENEMA LPO POSITION
•Air filled transverse colon filled.
BARIUM ENEMA AP PROJECTION
Opacified colon including flexures and rectum.
Barium Enema AP Projection
PA Projection
•Separates redundant and overlapping loops of the bowel.
TRENDELENBURG
Barium filled transverse colon filled.
BARIUM ENEMA PA PROJECTION
•CR 30- 40 degrees cephalad to 2 inches inferior to ASIS.
AP AXIAL PROJECTION
•LPO position (30°-40°) body rotation.
•CR 30°- 40° cephalad to
2 inches inferior and
2 inches medial to
right ASIS
AP AXIAL OBLIQUE PROJECTION
Best demonstrates an elongated view of the rectosigmoid area than on other views
BARIUM ENEMA
AP AXIAL /AP AXIAL OBLIQUE PROJECTION BUTTERFLY POSITION
•CR 30◦-40° caudad to level of ASIS
PA AXIAL
•RAO position (35°-45°) body rotation.
•CR 30°- 40° caudad to ASIS and 2 inches to left of lumbar spinous process.
PA AXIAL OBLIQUE PROJECTION
Best demonstrates the “up” medial side of the ascending colon and the lateral side of the descending colon when the colon is inflated with air.
Right Lateral Decubitus
CR horizontal to level of the iliac crests.
Right Lateral Decubitus
Left Lateral Decubitus
Air inflated portion of the colon is of primary importance.
Right Lateral Decubitus
Left Lateral Decubitus
Best demonstrates the “up” lateral side of the ascending colon and the medial side of the descending colon when the colon is inflated with air
Left lateral decubitus
Best demonstrates the “up” posterior portions of the colon and is most valuable in double-contrast examinations
Ventral decubitus
Demonstrates an axial projection of the rectum, rectosigmoid junction, and sigmoid.
AXIAL PROJECTION CHASSARD-LAPINE METHOD
A right angle view to the AP projection
AXIAL PROJECTION CHASSARD-LAPINE METHOD
Demonstrates the anterior and posterior surfaces of the lower portion of the bowel and permits the coils of the sigmoid to b e projected free from overlapping.
AXIAL PROJECTION CHASSARD-LAPINE METHOD
•Supine
•CR 35-45 degrees midway between ASIS.
•Prevent overlapping loop and separates sigmoid colon.
•Demonstrates recto-sigmoid area.
BILLING’S
•Supine
•CR 12 degrees caudad to 1 inch proximal to the upper border of the symphysis pubis.
OPPENHEIMERS
•LAO position (30°-35°)
•CR 30°-35° cephalad.
FLETCHERS MODIFICATION