Lower Gastrointestinal System Flashcards
Radiographic procedure designed to study large intestine is termed:
Barium enema
Where does the small intestine begin?
At the pyloric valve of the stomach
The three parts of the small intestine
Duodenum
Jejunum
Ileum
The first part of the small intestine
Duodenum
The shortest widest and most fixed portion of the small bowel
Duodenum
What quadrant is e duodenum primary located?
RUQ and also extends to the LUQ where it joins the jejunum
Point of where the duodenum joins the jejunum
Duodenojejunal flexure
What quadrant is the jejunum primary located
LUQ and LLQ
Jejunum makes up what fraction of the small intestine
2/5 (two-fifths)
The jejunum contains numerous “mucosal folds.” What are those folds termed as and what is its function
These mucosal folds is termed “Plicae circulares” and they increase the surface area to aid with absorption of nutrients and they produce the “feathery appearance” of the jejunum
Radiographic examination specifically of the small intestine is termed:
Small bowel series (SBS)
Digestive movement through the small intestine is done by what mechanism?
By peristalsis and rhythmic segmentation.
When is the SBS complete?
When the contrast has gone through the ileocecal valve and into the large intestine.
Which quadrant does the large intention begins at
RLQ
The large bowel is consisted of what
Cecum, colon, rectum, and anal canal
The colon is consisted of what
Ascending colon rt. Colic flexure (hepatic flexure) Transverse colon LT colic flexure (splenic flexure) Descending colon Sigmoid colon
Where is the cecum and what is it
Cecum is a blind pouch located inferior to the ileocecal valve.
What is attached to the cecum
The appendix
Digestive movement through the LARGE bowel is throu what mechanism
Peristalsis
Haustral churning
Mass peristalsis
Defecation
Functions of the lower digestive system (small and large bowel)
Chemical and mechanical digestion
Absorption of nutrients, water, salt and proteins
Reabsorption of water and inorganic salts
Elimination by defecation
Gases that is produced by bacteria due to the release of hydrogen, carbon dioxide and methane during their digestion is termed…
Termed flatus…they also aid in breaking down remaining proteins into amino acids
Primary radiographic study to evaluate the large intestine is done through with procedure?
Barium Enema
Barium enema is performed to evaluate what?
The large intestine. They check for the form, function and detection of abnormal conditions
The cecum is which segment of the large intestine?
First part of the large intestine
AP or PA centering of BE?
Center at crest and midline
Centering for RAO of BE and what does it show?
Center at crest and 1” left of midline.
Shows the right colic flexure (hepatic flexure)
Ascending colon and sigmoid colon is open
Center for LAO of a BE and what does it show?
Center 2” above the crest and 1” to the right of the midline.
Shows the left colic flexure (splenic flexure) and descending colon.
Why do we center higher for a LAO of the BE?
Center higher than the RAO because the left colic flexure (splenic flexure) sits higher than the right colic flexure (hepatic flexure)
Which positioning of the BE shows the splenic flexure “open” (left colic flexure)
RPO and LAO
Which positioning of BE shows the hepatic flexure (right colic flexure) and the sigmoid “open”?
LPO and RAO
Finger like projections is termed?
Villi
What happens to the internal diameter as we move from duodenum to the ileum?
The internal diameter gets progressively smaller.
The large intestine consist of what 4 major parts
Cecum, colon, rectum and anal canal
The colon consist of how many sections and flexure so
4 sections and 2 flexures.
The ileocecal valve consist of what
Consist of 2 lips that extend into the large bowel.
Function of the ileocecal valve
Acts as sphincter to prevent contents of ileum from passing too quickly into cecum. Prevent reflux of large bowel into ileum.
The term “vermiform” means…
“Wormlike”
The rectum follows what curve
Rectum closely follows the sacrococcygeal curve
Direction of rectum, rectal ampulla and anal canal
Rectum- inferior and posterior
Rectal ampulla - inferior and anterior
Anal canal- inferior and posterior
3 differences between large intestine to small intestine
Large intestine is :
Larger internal diameter.
Contains taeniae coli (bands of longitudinal muscle)
Contains haustra ("pouches")
Large sits around the periphery while small is centrally locatedBarium distribution for supine
Air in transverse colon and loops of sigmoid colon
Barium in ascending and descending and parts of sigmoid
Barium distribution in prone position
Air in ascending and descending and rectum
Barium in transverse colon and loops of sigmoid
Which sections of the small bowel appears feathery and which one appears smoother
Duodenum and jejunum is feathery
Ileum is smoother
Percentage of water that is being reabsorbed in the small intestine
95% of water
Primary function of the large intestine
Elimination of feces (defecation)
Composition of feces
65% water and 35% solid matter
How long does it take the barium to reach the ileocecal valve after ingestion
Enters the stomach and reaches the ileocecal valve in 2-3 hours
What is celiac disease
Form of sprue or malabsorption that affects the proximal smal bowel especially the proximal duodenum. It involves the insoluble protein (gluten) found in cereal grains.
Since the muscle of the abdominal muscles relaxes on expiration, the enema tip should be inserted during what respiration?
Exhalation
Patient should be placed in what position for the insertion of the BE tip?
Sims position (patient laying on left side with right leg up and over)
The total insertion of the tip should NOT exceed what length to prevent injury to the wall of the rectum ?
3-4 cm.
The enema bag should be at what height?
No higher than 24 inches (60cm)
Insertion direction of the enema tip?
On expiration, dies the the enema tip towards the umbilicus approx. 1-1.5 inches. Then advance up superiorly and anteriorly.
The safety concerns of BE:
Review pt. chart
Never force enema tip
Height of enema bag should not exceed 24inches (60cm)
Check water temp of the contrast.
Escort pt. to restroom after every BE study
Centering of small bowels series
2” above crest then after an hour, center at crest
kVp for single contrast, double contrast and water soluble
Single: 100-125
Double: 90-100
Water soluble: 80-90
RAO/LPO what is open
Hepatic flexure
Ascending colon
Sigmoid colon
LAO/RPO what is open
Splenic flexure
Why do we center higher for LAO?
To include the left colic flexure (splenic) because it sits higher than the right colic flexure.
Why do we do lateral rectum
To evaluate the region between the rectum and bladders
Centering for lateral rectum?
Level of ASIS and 2 inches posterior
Centering for Ap sigmoid shot
Center 2” inferior of ASIS and 30-40 cephalad angle
Centering for post evac film
Center at crest. Can be AP or PA
