Lower GI Tract Flashcards
Bowel is another word for…
Intestine
The right colic flexure is also known as the…
Liver/hepatic
The left colic flexure is also known as the…
spleen
The small intestine extends from the ____ of the ___ to the ____ where it joins the ____ at a _____
The small intestine extends from the PYLORIC SPHINCTER of the STOMACH to the ILEOCECAL VALVE where it joins the LARGE INTESTINE at a RIGHT ANGLE
What occurs in this portion of the alimentary canal (small intestine)?
Digestion and absorption of food
How long is the the length of the adult small intestine?
22 feet
The mucosa of the small intestine contains a series of ______projections called ____ which assist the process of ____ and ____.
The mucosa of the small intestine contains a series of FINGERLIKE projections called VILLI which assist the process of DIGESTION and ABSORPTION.
What 3 portions is the small intestine divided into?
- Duodenum
- Jejunum
- Ileum
Describe the duodenum, jejunum, and ileum
- Duodenum - widest portion, C-shaped, ~8-10inches
- Jejunum - middle portion, 2/5 of remainder of bowel
- Ileum - longest portion 3/5 of remainder of bowel
What is the purpose of a small bowel series?
To evaluate the motility and function of the small bowel using fluoroscopy and barium sulfate
What are the routine projections for a small bowel series?
- PA/AP scout
- PA/AP (to follow through)
- Ileocecal spots
Patient must be ___ to ensure that the ___ and ___ are ___ before the exam
Patient must be NPO to ensure that the STOMACH and BOWELS are EMPTY before the exam
What is taken before giving any barium to patient and why?
preliminary AP or PA scout film to serve as a baseline
When are films taken for a small bowel series and why?
- Films are taken at 15, 30, 60, and 90 minutes after consumption of barium
- done to follow barium through small bowel
When is a small bowel series complete?
When the barium passes through the terminal ileum or ileocecal valve (end of small bowel) to the cecum (start of large bowel)
Upon the barium reaching the cecum, what is taken, how, and why?
spot films are taken - using compression - to better evaluate the anatomy
The large intestine begins in the ___ with the ___, forms an arch around the ___ of the ______, and ends at the ____
The large intestine begins in the RLQ with the CECUM, forms an arch around the LOOPS of the SMALL BOWEL, and ends at the ANUS
What is the length and function of the large intestine?
- Length = 5 ft long with greater diameter than small bowel
- functions to reabsorb fluids and eliminates waste products (egestion)
What are the 4 main parts of the large intestine?
- Cecum
- Rectum
- Anal canal
- Colon
What are the folds of the colon called?
Haustra
What is the longest and most movable part of the colon?
Transverse colon
The rectum extends from ____ to ___.
The rectum extends from SIGMOID COLON to ANAL CANAL.
What are the methods to examine the large intestine with an enema?
- Single contrast method= barium sulfate or water-soluable contrast only - fills bowel
- Double contrast method = barium sulfate and air - either both together or with barium sulfate first to coat bowel walls, followed by an air enema
With a double contrast method, what will the barium and air demonstrate?
- Barium will demonstrate anatomy and any abnormalities
- Air contrast will distends the lumen of bowel to show tiny lesions such as polypoid tumors
Retained fecal masses during a barium enema can stimulate the appearance of…
Polyps or tumors
Why is the enema tip inserted on exhalation?
Due to relaxation of abdominal muscles and anal sphincter
How far into the rectum is an enema tip inserted? What position is the patient in for insertion and why?
4 inches in Sims position to relax abdominal muscles
Describe the Sims position?
Patient lying on their left side, leaning forward about 35-40° with right knee flexed on table in front of the left knee
A disposable rectal tension tip is used that contains a ____ which is ___ once tip is inserted to ensure tip is ___ for length of exam.
A disposable rectal tension tip is used that contains a BALLOON which is INFLATED once tip is inserted to ensure tip is SECURE for length of exam.
High density barium sulfate is used for a retrograde exam and is administered via rectal tip.
Define retrograde. Who controls the flow of barium?
Retrograde= against normal direction of flow
Radiologist or technologist controls flow
How is the barium emptied from the colon when doing a double contrast study? What happens after barium emptied from colon?
- The bag is lowered to the floor to drain
- Then air is administered via a handheld inflator
After the colon is filled with barium, the radiologist may want overhead films including…
PA or AP
LPO and RPO
RAO and LAO
Left lateral rectum
Left lateral decubitus
Right lateral decubitus
AP/PA angled sigmoid
How is the tube angled for an AP angled sigmoid film?
Tube is 45° cephalad
In what projection are post-evacuation films taken?
AP or PA
Define colitis
Inflammation of the colon
Define Crohn’s disease
A chronic inflammatory disease usually of the distal ileum
Define polyp
A spontaneous new growth of tissue forming an abnormal mass or tumor, which bleed easily and can become malignant, so should be removed surgically when found
Define diverticulum
A pouch created by the herniation of the mucous membrane through muscle
Define diverticulitis
Inflammation of the diverticula in the alimentary canal
Define diverticulosis
Diverticula in colon without inflammation or symptoms
Define ulcer
A depressed lesion on the surface of the alimentary canal
A bowel obstruction can be either ___ or ___.
A bowel obstruction can be either MECHANICAL or NONMECHANICAL.
A mechanical bowel obstruction is when the bowel is…
- volvulus -
- intussesception -
- fecal impaction -
A mechanical bowel obstruction is when the bowel is… PHYSICALLY BLOCKED
- volvulus - TWISTING OF A BOWEL LOOP ON ITSELF
- intussesception - “TELESCOPING” OR PROLAPSE OF A PORTION OF THE BOWEL INTO ITSELF
- fecal impaction - A LARGE MASS OF STOOL STUCK IN THE RECTUM
A non mechanical bowel obstruction is when…
- ileus -
A non mechanical bowel obstruction is when THE NERVES AND MUSCLES WITHIN THE BOWEL FUNCTION POORLY; CAN BE CAUSED BY CERTAIN MEDICATIONS, INFECTIONS, OR SURGERY
- ileus - FAILURE OF BOWEL PERISTALSIS
