Test 3: Biliary tract and GI systems Flashcards
which organs are part of the RUQ?
liver
gallbladder
right colic (hepatic) flexure
duodenum
Which organs are part of the LUQ?
spleen
stomach
left colic (splenic) flexure
Which organs are part of the RLQ?
ascending colon
appendix
cecum
ileocecal valve
Which organs are part of the LLQ?
descending colon
sigmoid colon
What are the names of the 4 lobes of the liver?
left and right (major)
caudate and quadrate (minor)
what is the function of bile?
breakdown and emulsify fat
what is an examination of the bile ducts referred to as?
cholangiogram
which of the following terms describes the condition of having gallstones?
cholecystitis
cholelithiasis
cholecystectomy
choleliths
cholelithiasis
Which three pairs of salivary glands are associated with the mouth?
parotid
submandibular
sublingual
the trachea is __________ to the esophagus
anterior
wavelike involuntary contractions that propel food down the esophagus:
what other thing helps propel food?
peristalsis; gravity
term for the mucosal folds of the stomach:
rugae
what are the subdivisions of the stomach?
fundus
body
pylorus
What is part of the medial border of the stomach?
What is part of the lateral border of the stomach?
lesser curvature; greater curvature
Which aspect of the stomach fills with air when the pt is prone during a double-contrast upper GI series?
fundus
which aspects of the upper GI tract will be filled with barium in the PA (prone) projection?
body and pylorus of stomach and duodenal bulb
Which aspect of the stomach does barium gravitate in the supine position?
fundus
Which term describes food after it is mixed with gastric secretions in the stomach?
chyme
The churning or mixing activity of chyme in the SI is called:
rhythmic segmentation
Which two structures create the romance of the abdomen?
head of pancreas and C-loop of duodenum
define mastication:
define deglutition:
chewing; swallowing
a J-shaped stomach that is more vertical and lower in the abdomen and pelvic region would be found in what kind of body habitus?
asthenic
a high and transverse stomach would be found in what kind of body habitus?
hypersthenic
where are water, vitamins, and minerals absorbed?
small intestine
series of mucosal folds in the cystic duct is known as:
spiral valves
what is barium sulfate?
what kind of contrast is it?
a colloidal suspension that is inert
positive (radiopaque)
do we prep pts for receiving barium sulfate?
no, never
what kind of contrast can cause reactions?
ionic iodine
when should water-soluble iodinated contrast be used?
if there’s perforation of bowels
what condition may prevent the use of water-soluble contrast agents for a geriatric pt?
dehydration
what upper GI method is used to best visualize any diverticulum in the stomach?
give an example
double contrast, negative (radiolucent) agent such as air or fizzies
what is the minimum lead equivalency of protective aprons that must be worn during fluoro?
the bucky slot cover should be how much lead equivalency?
both .5 mm
list the three cardinal principles of radiation protection:
time
distance (most effective)
shielding
what is zenker diverticulum?
large outpouching of the esophagus
what is achalasia/cardiospasm?
what is dysphagia?
narrowing of the esophagus
difficulty swallowing
what is Barrett esophagus?
what modality is preferred?
replacement of tissue in esophagus
nuclear medicine
define trichobezoar:
define phytobezoar:
mass of hair in stomach
trapped vegetable fiber in stomach
what is a hiatal hernia?
what position best shows it?
part of stomach herniates through diaphragm;
Trendelenburg
what is the older term for GERD?
esophageal reflux
what appears as “wormlike” or “cobblestone” during an esophagram?
esophageal varices
for detecting early signs of GERD and detecting esophageal varices, what is used?
endoscopy
why is it important to increase collimation and make the field smaller?
reduces pt dose and increases image contrast
what is the pt prep for an esophogram?
what is the techs job during it?
no prep;
set up room, explain procedure to pt and assess pt clinical history, hand things to pt, wipe mouth
what are 3 separate ways to show/detect GERD (reflux) and what are the pt positions for them?
water test: LPO
compression paddle: prone
toe touch maneuver: erect
a breathing technique where the pt takes in a deep breath and bears down is called the:
Valsalva maneuver
what is the pt prep for an upper GI series?
what is the techs job?
NPO at least 8 hours before and no smoking cigarettes or chewing gum
similar to esophagram
Why should the tech review the pt’s chart before the beginning of an upper GI?
A. to identify any known allergies
B. to ensure that the proper study has been ordered
C. to look for pertinent clinical history
D. all the above
all the above
what is the minimum amount of time that the pt should be NPO before an upper GI or an esophagogram?
8 hours
CR for esophagram:
obliquity:
at T6; RAO 35-40°
why is the RAO preferred than the LAO for esophagrams?
places the esophagus between vertebral column and heart
CR for AP (PA) esophogram:
1” inf. to sternal angle or 3” inf. to jugular notch
Why is the AP projection of the esophagus not a preferred projection for the esophagography series?
majority of esophagus is superimposed over the spine
If a foreign object is stuck in a pediatric pt’s throat, what should be done?
esophagram with barium-soaked cotton ball
what procedure best demonstrates a gastric ulcer?
double contrast upper GI series
Which position visualizes the pylorus and duodenal bulb?
LPO
a radiograph of an upper GI was taken, but the student tech is unsure of the position. The radiograph demonstrates that the fundus is filled with barium, but the duodenal bulb is air filled and is seen in profile. Which position does this radiograph represent?
LPO (recumbent)
Which of the following technical/positioning factors does not apply to a water soluble oral contrast media upper GI study?
A. 125 kVp
B. exposure made on expiration
C. 40” SID
D. erect and recumbent positions formed
125 kVp
During esophagography, the radiologist remarks that Schatzki ring is present. Which condition or disease process is indicated by the presence of this sign?
sliding hiatal hernia
for an anterior tumor on the stomach, what projection is used?
lateral
what part of the small intestine is the shortest and widest?
which part is the longest and thinnest?
duodenum; ileum
what is part of the large intestine?
cecum, colon, rectum, and anal canal
What are the parts of the colon?
Which two aspects of the large intestine are not considered part of the colon?
ascending colon, left and right colic flexure, transverse colon, descending colon
cecum and rectum
What is the term for the three bands of muscle that pull the large intestine into pouches?
what are these pouches called?
Taeniae coli
haustra
when a pt is supine during enema, air rises into the:
barium sinks to fill the:
transverse colon and loops of sigmoid colon;
ascending and descending colon
when a pt is prone, air fills the:
barium is in the:
rectum, ascending colon, and descending colon;
transverse colon and loops of sigmoid colon
define dynamic (mechanical obstruction) and what it’s caused by:
adynamic ileus and what it’s caused by:
blockage of the bowel caused by tumors, adhesions, or hernia;
bowel unable to propel contents forward caused by infection, certain drugs, or postsurgical complications
which aspect of the GI tract is responsible for synthesis and absorption of vitamins B and K and amino acids?
large intestine
what structures are intraperitoneal?
cecum, transverse colon, sigmoid colon, jejunum, and ileum
what structures are retroperitoneal?
ascending colon, descending colon, upper rectum
what structures are infraperitoneal?
lower rectum
list the two conditions that may prevent the use of barium during a small bowel series:
perforated bowel or obstruction
the term enteroclysis describes what type of a small bowel series?
what pathologic conditions are best evaluated through this?
double contrast method;
regional enteritis and adenocarcinoma
define adenocarcinoma:
what is its radiographic appearance?
malignant tumors of the small intestine
apple core sign
what condition has a radiographic appearance of a stovepipe colon due to a lack of haustra and shows up as cobblestone on a BE?
ulcerative colitis (severe form of colitis)
what condition appears as “cobblestone” or a string sign?
regional enteritis (Chrohn’s)
define diverticulosis:
define volvulus:
having numerous diverticula (defects projecting out of colon)
twisting of the intestine on its own mesentery
define intussusception:
what procedure would diagnose it?
telescoping of bowel into another aspect of it
BE
what are the two types of laxatives? give an example:
irritant (castor oil)
saline (magnesium citrate/sulfate)
what position is the pt in for a barium enema?
how is the procedure performed?
Sims
pt history is taken and exam explained, then tip insertion.
the flow of barium or air is controlled by tech and tech helps pt with changing positions
the initial insertion of the rectal enema tip should be pointed toward the:
A. symphysis pubis
B. bladder
C. umbilicus
D. tip of coccyx
umbilicus
if there is resistance to an enema insertion, do you force it? What do you do?
no
get radiologist to do it under fluoroscopic supervision
what kind of catheter is used for a barium enema on an infant?
10F flexible silicon catheter
for an immediate (15 min.) small bowel where is the CR?
1 hour?
2” above crest
at crest
What position is preferred when doing a small bowel series and why?
PA (prone) bc compressing separates the bowel loops
what is the recommended kVp range for oblique projection taken during a double-contrast study?
90-100
which projection for BE has the greatest amount of gonadal dose to male and female pts?
lateral rectum
What is an alternative to the lateral rectum?
ventral decub
When is the sigmoid better visualized and why?
upshot; spreads it out
The RAO projection best demonstrates the ______ colic flexure with CR centered _____________.
The LAO projection best demonstrates the ______ colic flexure with CR centered ______________.
right, at crest;
left, 2” above crest
pt position for lateral rectum:
lateral recumbent with knees flexed and arms up in front of head
what is another term describing the AP axial projection?
what is the CR angle and centering for the AP axial
butterfly projection
30-40° cephalad 2” inf to ASIS
what is the average length of time in a routine small bowel series for the barium to pass through the ileocecal sphincter?
2 hrs
