Large Intestines Flashcards
2 basic methods of filling
1.
2.
- Single contrast method
2. Double contrast method
Double contrast method may be performed by 2 different filling methods.
- 2 stage double contrast method in which the colon is filled with __1__ contrast, the pt __2__ and returns to the table for insertion of __3__ to finish the exam.
- Single state double contrast in which the colon is selectively filled with the __4__ and __5__ at the same time
- Barium
- Evacuates
- Air
- Barium
- Air
Barium will demonstrate the anatomy and __1__ of the colon. The air contrast will __2__ the bowel to better visualize the _3__ lining and the __4__ areas for lesions such as __5__.
- Tonus
- Distend
- Mucosal
- Intraluminal
- Polyps
If too much water is absorbed into the bowel this causes __1__.
If not enough is absorbed then it will result in __2__.
- Constipation
2. Diarrhea
Commercially prepared barium sulfate, finely divided barium particles that resist precipitation.
Colloidal preparations
Barium that contains some form of suspending or dispersing agent
Flocculation-resistant preparations
Newer barium, these products absorb a greater percentage of radiation, similar to old thick barium products. High density barium is particularly useful in double contrast studies to better coat the mucosal lining.
High-density barium sulfate
What is the most common gaseous medium used?
Air
This gaseous medium can be used, it is absorbed more quickly by the pt.
Carbon dioxide
When retrograde filling of the colon is to possible a soluble __1__ products are administered orally. The disadvantage of this is that __2__ often is insufficient for satisfactory double-contrast visualization of the __3__ pattern. Transit time from ingestion to colonic filling is __4__ hours.
- Iodinated
- Evacuation
- Mucosual
- 3-4
Iodine solutions are practically non-absorbable by the colon, therefore they do not __1__ and do not __2__ or __3__ the mucosal wall.
- Coat evenly
- Dry
- Flake
Prep of the Intestinal tract:
- colon needs to be free of __1__ material so it does not mimic pathological __2__
- exception to the total cleansing of the colon are those pts who have severe bleeding, excessive __3__, obstruction, or any other prep that may harm the pt.
- May be performed under a “__4__” barium enema.
- Usual prep consists of dietary restrictions and cleansing enemas.
- Fecal
- Polyps
- Diarrhea
- No prep
PA Projection (essential)
- _____ film
- Place pt in the _____
- CR perp and directed to level of _____ and MSP.
- Table may need to be adjusted in the _____ position to prevent overlapping loops of bowel
- _____ respiration
- If performing this position with a double contrast study, the transverse colon will sometime appear filled with barium due to its _____ location
- 14x17
- prone
- iliac crest
- Trendelenberg
- Suspend
- anterior
PA Axial Projection (not typically routine):
- 14x17 lengthwise or __1__ lengthwise
- pt in __2__ position
- CR directed __3__ degrees __4__ at the level of __5__ and the MSP
- __6__ area of the colon will be demonstrated.
- 12x14
- Prone
- 30-40
- caudal
- ASIS
- Rectosigmoid
PA obliques demonstrate flexure ______
Down
AP obliques demonstrate flexure ____
Up
PA oblique:
__1__ position, 14x17 lengthwise. Pt in __2__ position; adjust pts arms and les and roll onto __3__ hip with __4__ degrees of rotation. CR perp and directed __5__” lateral to the midline of the body on the elevated side at the level of the __6__. Demonstrates the right colic flexure __7__, ascending colon, sigmoid position.
- RAO
- Prone
- Right
- 35-45
- 1-2
- Iliac crest
- Open
PA LAO projection:
14x17 position, pt in the __1__ position, adjust pts arms and legs then roll onto the __2__ hip with __3__ degrees of rotation. CR perp and directed __4__” lateral to the midline of the body on the elevated side at the level of the iliac crest. Demonstrates the __5__ flexure open, descending colon.
- Prone
- Left
- 35-45
- 1-2
- Left colic
Lateral projection: (right or left)
__1__ lengthwise, place the pt in lateral __2__ position with their knees bent for support. CR perp an directed to the level of __3__ and the midcoronal plane. The rectum and the distal __4__ colon will be best demostrated.
- 12x14
- Recumbent
- ASIS
- Sigmoid
AP projection:
14x17 lengthwise, pt in __1__ position, adjust the CR perp and directed to the level of the __2__ and MSP. The entire colon will be demonstrated (if done with a double contrast study, the __3__ may appear air filled due to its anterior location)
- Supine
- Iliac crest
- Transverse
AP Axial Projection:
__1__ lengthwise, pt in __2__ position, CR to the level of __3__” below the __4__ and the MSP with a __5__ angle. The __6__ area of the colon is best demonstrated.
- 12x14
- Supine
- 2
- ASIS
- 30-40
- Rectosigmoid
The side away from the IR is _____
Open
AP Oblique Projection: LPO (same direction as RAO)
-14x17 lengthwise, place pt in __1__ position. Adjust pts right knee bent slightly and adjust their shoulders so that their body has it’s right side elevated __2__ degrees lateral to the midline o the side up. The open __3__ colic flexure and the __4__ colon will be best demostrated.
- Position
- 35-40
- Right
- Ascending
AP Oblique Projection (RPO):
14x17 lengthwise, place pt in the supine position, adjust the pts __1__ knee bent slightly an adjust their shoulders so that their body has it’s left side elevated 35-45 degrees from the table. Adjust the CR perpendicular and to the level of the iliac crest and __2__ inches lateral to the __3__ of the side up. The open left __4__ and the descending colon will best demonstrated.
- Left
- 1-2
- Midline
- Colic flexure
Right Lateral Decub: AP or PA
- 14x17
- adjust the pt on their right side with their legs flexed for support; pt will be on an elevated radiolucent sponge.
- adjust CR horizontal @ level at __1__ and to MSP
- place IR __2__ to pt
- Side up will be demonstrated air filled and the down side will be filled with __3__
- Iliac crest
- Vertical
- Barium
Left lateral Decub: AP or PA
- 14x17
- pt on their left side with legs flexed for support
- horizontal CR @ crest
- Vertical IR
- side up will be filled with __1__
- side down will be filled with __2__
- Air
2. Barium
Lateral, right or left ventral Decub, X-table lateral:
- Pt __1__
- Pt on radiolucent sponge with either __2__ or __3__ side against the vertical IR
- horizontal CR directed at __4__
- This position best demonstrates the lateral projection of the barium filled __5__; best demo the “up” posterior portions of the colon; most valuable in __6__ studies
- Prone
- Right
- Left
- Iliac crest
- Colon
- Double contrast
General term for a surgical procedure of firing an artificial opening in the intestines.
Enterostomy
Colostomy, cecostomy, ileosomy, and jejunostomy are all other names or
Enters stormy
Why is an air BE study preferred over a single contrast barium enema?
To distend the bowel lumen to better visualize the mucosal lining
Barium is referred to as a ________ meaning that it will not ever totally mix and will not be absorbed by the body.
Suspension
Three methods or cleansing the bowel in prep for a barium enema exam
- NPO/dietary restriction
- Laxative
- Cleansing enema
Double contrast BE exams may be reformed by using 2 different methods for filling the colon with air and barium. Describe both.
- 2 stage. Tip pt, fill with barium, evacuate, tip again, fill with air
- Single stage. Tip pt one time, fill with barium and air.
Proper breathing method that should be explained to the pt that will assist them throughout the barium enema procedure
Slow, deep breathing and insert tip on exhalation
Preferred temp choice of barium?
41 degrees
The ___ position is used when inserting tip?
Sims
The ____ Method of filling the colon calls for Illini the colon with barium, emptying, and then filling with air
Welin
Most anterior structure of the large intestines
Transverse colon
External opening of lg intestines is the
Anus
The pouches of the lg intestine are called
Hamstring
When performing a routine barium enema exam, it is referred to as a _____ study
Retrograde
The ____ position will best open and demonstrate the hepatic flexure
LPO
When performing a left lateral decubitus radiograph of an air contrast BE, the ____ will be filled with air
Ascending colon
The CR should be directed to the approx level of ____ for a PA projection BE follow-up radiograph
Iliac crest
When performing an AP axial projection BE follow-up radiograph, the CR should be angled __1__ degrees __2__
- 30-40
2. Cephalic
