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Pathology RS > Positioning Test 2 > Flashcards

Positioning Test 2 Flashcards

1
Q

What is the length of the small intestine in an average adult?

A

22 feet

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2
Q

What are the three portions of the small intestine?

A

Duodenum, jejunum, ileum

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3
Q

What are the primary functions of the small intestine?

A

Digestion and absorption of food

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4
Q

What are the main functions of the small intestine?

A

Digestion
Absorption (nutrients, H2O, salts, proteins)
Reabsorption (95% of H2O and salts)
Elimination (defecation)

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5
Q

What is the length of the duodenum?


A

8 to 10 inches long

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6
Q

What is the duodenojejunal flexure?


A

It is the sharp curve where the duodenum joins the jejunum

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7
Q

What supports the duodenojejunal flexure?


A

The suspensory muscle of the duodenum (ligament of Treitz)

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8
Q

What are plicae circulares and their function?


A

They are mucosal folds in the jejunum that increase surface area for absorption

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9
Q

Where does the terminal ileum join the large intestine?


A

At the ileocecal valve in the right lower quadrant (RLQ)

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10
Q

What is the quadrant location of the small intestine portions?


A

Duodenum: RUQ and LUQ
Jejunum: LUQ and LLQ
Ileum: RUQ, RLQ, LLQ
Ileocecal valve: RLQ

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11
Q

What are the two types of obstructions in the small intestine?


A

Adynamic/paralytic obstruction and mechanical obstruction

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12
Q

How can small intestine obstructions be identified radiographically?


A

By observing extended air-filled loops

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13
Q

What is Giardiasis?


A

A common intestinal illness caused by the microscopic parasite Giardia duodenales

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14
Q

What is Meckel’s Diverticulum?


A

A small pouch in the wall of the intestine near the junction of the small and large intestines

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15
Q

What is Crohn’s disease?


A

A chronic inflammatory bowel disease that can affect the entire digestive tract

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16
Q

What should be done to prepare the examination room for a small intestine examination?


A

Room should be completely prepared before patient enters
Adjust equipment controls to correct settings
Have footboard and shoulder supports ready
Check filming devices and number of IRs available
Prepare type and amount of contrast

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17
Q

What is peristalsis?


A

Contraction waves by which the digestive tube propels contents toward the rectum

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18
Q

What is the average transit time to the ileocecal valve?


A

3 hours

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19
Q

Why can clear anatomic detail not be seen in the small intestine?


A

Because iodinated solutions become diluted in the small intestine

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20
Q

What is the challenge of GI radiography?


A

To eliminate motion

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21
Q

How does peristalsis vary in the GI tract?


A

It is greatest in the stomach and duodenum, and slows in the distal part of the GI tract

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22
Q

What factors affect peristalsis?

A

Body habitus, pathology, use of narcotic pain medicine, body position, and respiration

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23
Q

What is the normal exposure time for peristaltic activity?


A

No longer than 0.2 seconds (never longer than 0.5 seconds)

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24
Q

What exposure time is required for hypermotility?


A

0.1 seconds or less

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25
Q

When should exposures be made during routine procedures?


A

At the end of expiration

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26
Q

What are the radiation protection measures in GI radiography?


A

Close collimation
Optimum technique factors
Shielding

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27
Q

What are the methods of administering barium or other opaque contrast for small intestine procedures?


A

Orally
Reflux filling via large-volume barium enema
Direct injection via a tube (enteroclysis)

28
Q

What is the recommended diet for patient preparation before a small intestine examination?


A

A soft or low-residue diet for 2 days before the study

29
Q

What should be done with food and fluid before the examination?


A

Withhold food and fluid after the evening meal on the day before the examination

30
Q

What are the pathologic indications for a small bowel series?


A

Enteritis, gastroenteritis, Meckel’s diverticulum, neoplasm, malabsorption syndrome, ileus

31
Q

What does enteritis indicate in a small bowel series?


A

Thickening of mucosal folds and poor definition of circular folds

32
Q

What is the appearance of Crohn’s disease in a small bowel series?


A

Segments of lumen narrowed with an irregular cobblestone appearance and string sign

33
Q

What does Giardiasis look like in a small bowel series?


A

Dilation of the intestine with thickening of circular folds

34
Q

What is the appearance of ileus in a small bowel series?


A

Abnormal gas patterns with dilated loops of bowel, showing a “circular staircase” or “herringbone” pattern

35
Q

What does malabsorption indicate in a small bowel series?


A

Thickening of mucosal folds and poor definition of normal feathery appearance

36
Q

What does a neoplasm look like in a small bowel series?


A

Narrowed segments of intestine with “apple core” or “napkin ring” sign

37
Q

What is Meckel’s Diverticulum in a small bowel series?


A

A large diverticulum of the ileum, proximal to the ileocecal valve

38
Q

What are the methods of examination for the small intestine?


A

Oral method (small bowel series)
Enteroclysis
Intubation method

39
Q

What is the oral method of examination for the small intestine?


A

It produces several identical images at timed intervals after ingestion of barium

40
Q

How are images obtained in the oral method of examination?


A

With the patient in either supine or prone position

41
Q

Why is the supine position used during the oral method of examination?


A

To take advantage of the superior and lateral shift of the stomach, improving visualization of the duodenum and jejunum

42
Q

Why is the prone position used during the oral method of examination?


A

To compress the abdomen and increase image quality

43
Q

When are the first images taken after ingestion of barium?


A

When are the first images taken after ingestion of barium?

15 minutes after ingestion

44
Q

When is the examination complete during the oral method?


A

When barium is seen in the cecum

45
Q

What are the contraindications for using BaSO4?


A

Presurgical patients, perforated hollow viscera, large intestine obstruction

46
Q

What is the procedure for an upper GI/small bowel combination examination?


A

Routine upper GI first (note time of first cup ingestion)
Ingest second cup
30-minute interval radiographs
1-hour interval radiographs (if needed)
Spot ileocecal valve (optional)

47
Q

What is the procedure for a small bowel only series examination?


A

Scout radiograph
16 ounces of BaSO4 (note time)
15–30-minute radiographs (first)
30-minute interval radiographs
Spot ileocecal valve (optional)

48
Q

What is the enteroclysis procedure?


A

A catheter is advanced to the duodenojejunal flexure, thin barium mixture is injected, and air or methylcellulose is instilled

49
Q

What is the purpose of the enteroclysis double contrast small bowel series?


A

To evaluate pathologic indications such as ileus, Crohn’s disease, and malabsorption syndrome

50
Q

What is the timing for PA projection in small bowel series?


A

15–30-minute radiographs, CR 2 inches above crest at MSP and hourly images

51
Q

What is the length of the large intestine?


A

Approximately 5 feet long

52
Q

What are the four main parts of the large intestine?


A

Cecum, colon, rectum, and anal canal

53
Q

What is a diverticulum?


A

An outpouching of the mucosal wall resulting from herniation of the inner wall of the colon

54
Q

What appearance does a volvulus have on a single contrast barium enema?


A

A tapered or beak appearance with an air-filled distended region of the intestine

55
Q

How do polyps differ from diverticula?


A

Polyps project inward into the lumen, while diverticula project outward

56
Q

What does intussusception look like on a contrast enema?


A

A mushroom-shaped dilation at the distal aspect with little barium or gas passing beyond it

57
Q

What imaging methods are recommended for detecting neoplasms?


A

Double contrast barium enema, CT, and sonography

58
Q

What is the significance of the apple core or napkin ring appearance in barium enema imaging?


A

It indicates carcinoma with a filling defect, narrowness, or tapering of the lumen

59
Q

What imaging modalities are preferred for appendicitis?


A

Ultrasound and CT

60
Q

What are the technical considerations for lower gastrointestinal imaging?


A

Patient care and preparation
Enema tip insertion
Single contrast barium enema
Double contrast barium enema
Evacuative proctography (defecography)

61
Q

What are the preparation steps for a barium enema?


A

Light evening meal prior to exam
Bowel cleaning cathartics
NPO after midnight (8 hours minimum)
No gum chewing or smoking
Enema morning of exam

62
Q

What are cathartics?


A

Substances that produce frequent, soft, or liquid bowel movements

63
Q

What are the two types of cathartics?


A

Irritant and saline

64
Q

What are the contraindications for using cathartics?


A

Gross bleeding, severe diarrhea, obstruction, and inflammatory lesions

65
Q

What are the two methods of barium enema examination?


A

Single Contrast: Barium fills the entire colon
Double Contrast: Barium and air administered simultaneously or in two stages

66
Q

What are the components of the contrast media for barium enema?


A

Single use-closed system kit
Room temperature water
Colloidal suspension (mix well before use)
Optional IV glucagon for spasms
Optional topical anesthetic

67
Q

Why is the large intestine required to be completely emptied before a barium enema?


A

Retained fecal matter can simulate small masses

Pathology RS (2 decks)

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