Lower GI Flashcards
1
Q
what are the parts of the alimentary canal??
A
mouth, pharynx, esophagus, stomach, duodenum, small intestine, large intestine, anus
2
Q
what is the study of the small bowel?
A
small bowel series
3
Q
what is the study of the large intestine?
A
barium enema
4
Q
where does the small intestine begin?
A
at the pyloric valve
5
Q
what are the 3 parts of the small intestine?
A
duodenum, jejunum, and ileum
6
Q
what quadrants is the duodenum located in?
A
RUQ and LUQ
7
Q
what is the shortest, widest and most fixed section of the small intestine?
A
duodenum
8
Q
where does the duodenum join the jejunum?
A
at the duodenojejunal flexure
9
Q
what quadrant is the duodenojejunal flexure located in?
A
LUQ
10
Q
what does jejunum mean
A
empty
11
Q
what quadrants is the jejunum located in?
A
LUQ and LLQ
12
Q
how much does the jejunum make up of the small bowel
A
2/5
13
Q
where does most of chemical and nutrient absorption occur?
A
jejunum
14
Q
what does the jejunum contain which increase surface area to aid with absorption
A
plicae circulares
15
Q
what is the distal 3/5 of the small bowel?
A
ileum
16
Q
what quadrants is the ileum located in?
A
RUQ, RLQ, and LLQ
17
Q
what is the last portion of ileum
A
terminal ileum
18
Q
where does the ileum join the large intestine?
A
ileocecal valve
19
Q
where is the ileocecal vale located
A
in the RLQ of the abdomen
20
Q
what does the ileocecal valve do?
A
controls the flow of chyme from the ileum to the cecum
21
Q
the duodenum has what look radiographically?
A
feathery appearance de to the villi in the place circularis
22
Q
which has the most feathery looking appearance of the small bowel?
A
the jejunum- number and size of fold gradually diminish as jejunum merge with ileum
23
Q
large intestine consists of 3 parts?
A
cecum, colon, rectum
24
Q
how long is the large intestine?
A
5 feet
25
what are the parts of the colon?
ascending colon, transverse colon, descending colon, sigmoid colon, right colic flexure, left colic flexure
26
what quadrant does the large intestine begin in
RLQ
27
what is the proximal end of the large intestine
cecum
28
acute appendicitis accounts for what % of emergency surgeries
50%
29
how many more time common is appendicitis in males than females
1.5 times more
30
what position demonstrates the right colic (hepatic) flexure
LPO
31
where does the ascending colon begin
cecum
32
what is the longest and most moveable part of the large intestine
transverse colon
33
how many inches can the transverse colon vary from recumbent to upright
7 inches
34
what projection best demonstrated the left colic (splenic) flexure?
RPO
35
as the brim of the pelvis the colon makes s shaped curved called what
sigmoid colon
36
at what level does the sigmoid colon become the rectum
s3
37
how long is the rectum
1/4 inch
38
what is the dilated portion of the rectum anterior to coccyx called
rectal ampulla
39
what are the 3 differences in the large vs the small intestine
internal diameter, haustra (in large) and relative positions (small intestine centrally located, large around the periphery)
40
what structures are intrapertioneal
cecum, transverse colon, sigmoid colon,
41
what structures are retroperitoneal
ascending colon, descending colon, upper rectum
42
what structures are infapertioneal?
lower rectum
43
what are the 4 primary functions of large and small intestine
Digestion, absorption, reabsorption, elimination
44
most digestion and absorption of nutrients, water, salt, and proteins takes place within what organ
small intestine
45
small intestine reabsorbs what percent of water and salts
95%
46
what is the primary function of the large intestine
defecation
47
vitamins and amino acids are produced by
bacterial action
48
what 3 types of gases are produced as by prodcuts of bacterial action
hydrogen, carbon dioxide and methane gas
49
what is haustral churning
moves contents from haustrarum to haustrum by muscular contractions
50
what is mass peristalsis
forces contents into sigmoid colon and rectum
51
what is defecation
eliminates feces by contractions is sigmoid colon and rectum
52
where does digestion occur
small intestine
53
where does absorption occur
duodenum and jejunum
54
where does reabsorption and elimination occur
large intesine
55
what are the 2 types of movements in the small intestine
peristalsis, and rhythmic segmentation
56
what are the 4 types of movements in the large intestine
peristalsis, haustral churning, mass peristalsis, defecation
57
what is the purpose of a small bowel series
study the form and function of the three components of the small bowel and detect abnormal conditions
58
when does the time for the small bowel study start
after the patient has ingested 8oz of contrast media
59
what are the 2 contraindications for a small bowel study
perforated hollow viscous & large bowel obstruction
60
what exams would you do if a patient has a large bowel obstruction
barium enema or acute abdominal series
61
what is enteritis
inflammation of the intestine-primarrily small intestine
62
what causes enteritis
bacteria or environmental factors
63
what is regional enteritis (segmental enteritis or crohns disease
form of inflammatory bowel disease of unknown origin- mostly the terminal ileum is involved
64
what appearance does regional enteritis produce on a SBS
cobblestone appearance
65
what is giardiasis
infection of small intestine caused by flagellate protozoan
66
what are symptoms of giardiasis
GI discomfort, mild to profuse diarrhea, nausea, anorexia, weight loss
67
what part of the small intestine does giardiasis involve
duodenum and jejunum
68
what appearance does giardiasis produce
dilation od intestine with thickening of place circulars
69
what is an ileus
obstruction of small bowel
70
what are the 2 types of ileus
adynamic (paralytic) and mechanical
71
what is adynamic or paralytic ileus
cessation of peristalsis, intestine is distended with a thin bowel wall
72
what is mechanical obstruction
physical blockage of bowel
73
what radiographic appearance does mechanical obstruction produce
circular staircase or herringbone pattern evident on an upright radiograph
74
what is meckels diverticulum
congenital defect found in ileum, persistence of the yolk sac resulting in an outpouching of the intestinal wall
75
what is meckels diverticulum best demonstrated with
nuc med
76
what is neoplasm
new growth, benign or malignant
77
what are carcinoid tumors
most common tumor of small bowel have a benign appearance but have potential to become malignant
78
what radiographic appearance does lymphomas produce
stacked coin which is caused by thickening coarsening and possible hemorrhage of mucosal wall
79
what radiographic appearance does adenocarcinomas produce
napkin ring defects within the lumen may lead to complete obstruction
80
what is the most frequent site for adenocarcinoma
duodenum and proximal jejunum
81
what are spur and malabsorption syndromes
condition in which GI tract is unable to process and absorb certain nutrients
82
what does spur and malabsorption syndromes look like radiographically
thickening of mucosal folds and poor definition of normal feathery appearance
83
what is celiac disease
form of sprue or malabsorption diseases that affects small bowel especially proximal duodenum
84
what is whipples disease
affects small bowel- dilation of small intestine, deposits of fat in bowel wall and mesenteric nodules
85
what are the 4 small bowel procedures
UGI-small bowel combo, small bowel, enteroclysis, intubation method
86
what types of study is a enteroclysis
double contrast
87
what are the clinical indications of enteroclysis
ileus, crohns or malabsorption syndrom
88
in an UGI-SBFT, after the UGI exam is performed the patient drinks a second cup of barium and how many min radiograph is performed
30 min centering high for proximal small bowel- then every 15 minutes
89
For small bowel a radiograph should be take every ____ minutes up to 2 hours then _ every hour after
15-30 minutes then every 1 hour
90
what is the disadvantage of enteroclysis
increased patine discomfort and possibility of bowel perforation during catheter placement
91
During a enteroclysis a special catheter is placed where
duodenojejunal junction
92
what is colitis?
inflammatoryu condition of the large intestine, intestinal mucosa thick and rigid
93
what appearance radiographically does colitis have
saw tooth appears from chronic inflammation and spasm
94
what is ulcerative colitis
severe form of colitis
95
what appearance radiographically does ulcerative colitis have
cobblestone appearance along mucosa
96
long term bouts of ulcerative colitis may lead to what?
stovepipe or leadpipe colon-loss of haustral marking
97
what is diverticulum
outputting of the mucosal wall
98
what is diverticulosis
condition of having numerous diverticula
99
what is diverticulitis
inflames diverticula due to infection
100
diverticula are best demonstrated with what
double contrast barium enema
101
what is intussusception
telescoping or invagination of one part of intestine to another
102
what does the barium do on a be with intussusception
mushroom shaped dilation
103
what is annular carcinoma
typical form of colon cancer
104
what appearance radiographically does annular carcinoma produce
apple core or napkin ring appearance as tumor grown and infiltrates bowel wall
105
what are polyps
saclike projections that project inward into the lumen of the intestine
106
what best demonstrates polyps of the large intesine
BE, CT and endo
107
what is volvulus
twisting of portion of intestine on its own mesentery
108
where are volvulus found
portions of jejunum, and ileum or cecum and sigmoid
109
what ages and gender is volvulus most common in
males 20-50 years old
110
what appearance radiographically does volvulus have
"beak" sign-narrowing
111
what is cecal volvulus
involves cecum and ascending colon
112
in the intubation method of small bowel, Placing patient in what position may aid in passes of tube from stomach into duodenum by gastric peristalsis.
RAO
113
what is intubation method used for
to relieve post operative distention
114
what kind of catheter do they used in intubation method
miller-abbot tube
115
for small bowel series what should you do on asthenic patients to separate overlying loops of bowel
place patient in trendelenburg position
116
before a barium enema you should make sure the patient has not had what exams that could weaken the wall of the intestine
sigmoidoscopy or colonoscopy
117
what is the substance that produces frequent bowel movements by increasing peristalsis in large (and sometimes small) intestine and accelerates passage of intestinal contents.
cathartics
118
3 most common type of enema tips
plastic disposable, rectal retention, and contrast retention
119
3 most common type of enema tips
plastic disposable, rectal retention, and contrast retention
120
what type of tip should only be inserted by rad and under fluoro for danger of intentional rupture
retention catheters
121
what type of catheter do you need a separate tip to inject air for a double contrast BE
contrast retention
122
what is the recommended range of weight to volume for single contrast BE
15% and 25%
123
what is the recommended range of weight to volume for double contrast BE
75% and 95%
124
what is the weight to volume for a evacuative proctography
100%
125
what is the weight to volume for a evacuative proctography
100%
126
what is the temperature for barium prep to make an anesthetic effect to increase retention of contrast
40-50 degrees
127
what is the temperature for barium prep to make an anesthetic effect to increase retention of contrast
40-50 degrees
128
what can be added to barium to reduce spasms
lidocaine
129
if spasms occur during an exam what can be injected intravenously
glucagon
130
what position should the patient be in when inserting a tip
sims-35-40 on left side
131
what does the sims position do for the patient
relaxes the ab muscles and decreases pressure in abdomen
132
how far should the total insertion of the tip be
4 inches
133
how should the tip be inserted
1-1 1/4 anteriorly then aimed toward umbilicus superiorly
134
the IV poled the enema bas if on should be no higher than
24 inches above the x-ray table
135
what is the function of evacuative proctography-defacography
functional study of anus and rectum that is conducted during the evacuation and rest phases of defecation
136
what is rectocele
blind pouch of rectum caused by weakening of anterior or posterior wall
137
what is rectal intussusception
telescoping or invagination of rectal portion of bowel
138
what is rectal prolapse
protrusion of rectal tissue through the anus to the exterior of the body
139
what is the commercially prepared ready to use contrast in evacuative proctography-defacography
anatrast
140
what is the purpose of a colostomy BE
to assess for proper healing, obstruction of leakage or to perform pre surgical evaluation
141
Methylcellulose is introduced into the small intestine during an enteroclysis to
dilate the loops of small intestine
142
What are 4 reasons to not use laxatives on a BE
Gross bleeding
Sever diarrhea
Obstruction
Inflammaotory condition
