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Positioning Lecture Material > Test 4 Biliary, UGI, Lower GI Systems > Flashcards

Test 4 Biliary, UGI, Lower GI Systems Flashcards

1
Q

Where is the barium in the stomach when prone?

A

Body

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2
Q

Where is the barium located in the stomach when errect?

A

Pylorus region

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3
Q

What is peristalsis?

A

Movement of gastric contents towards the pylorus

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4
Q

What is mastication?

A

The mechanical part of digestion. Chewing, reduces size of food particles and mixes with saliva.

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5
Q

What is deglutition?

A

Swallowing

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6
Q

What are the 3 functions of the digestive system?

A

Intake and digestion of food, water, vitamins and minerals, absorption of digested nutrients into the blood or lymphatic capillaries, and elimination of unused intake from the body

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7
Q

When is barium contraindicated? What can be substituted?

A

If perforation is suspected or if the patient is going to surgery. May substitute with a water soluble iodinated contrast such as gastrografin.

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8
Q

Where is the barium located in the stomach when supine?

A

Fundus

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9
Q

What is a positive contrast medium used?

A

Barium sulfate (BaSO4) radiopaque

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10
Q

What is a Negative contrast medium used?

A

Swallowed air, CO2 gas crystals and naturally present gas bubble in the stomach

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11
Q

What does thick barium do that thin doesn’t?

A

Descends slowly down the esophagus and coats the mucosal lining.

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12
Q

What is the reason to do a double contrast study versus a single contrast?

A

Double will demonstrate potential polyps, diverticulae, and ulcers

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13
Q

What is Barrets esophagus?

A

Ulcerative tissue, lower esophagus may cause stricture

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14
Q

What are esophageal varices and what causes them?

A

Displayed veins causing worm like or cobblestone appearance. Caused by acute liver disease such as cirrhosis.

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15
Q

What is achalasia?

A

Cardiospasm motor disorder with reduced peristalsis, dilation

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16
Q

What is zenkers diverticulum?

A

Large out pouching just above upper esophageal sphincter. Symptoms include dysphagia, aspiration and regurgitation.

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17
Q

Hypersthenic organ locations:

A

Lungs: short
Stomach: high and transverse, center 1” below zyphoid process
Transverse colon: high
Large bowel: extends to the periphery of abdominal cavity

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18
Q

Sthenic organ locations:

A

Stomach: J shaped and lower.

Left colic flexure is high resting under left diaphragm

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19
Q

Hyposthenic and Asthenic organ locations:

A

Stomach: J shaped and low, very near the midline.
Lungs: long and narrow
Diaphragm: low
Large intestine is low in the abdomen

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20
Q

What things might the patient have to swallow during an esophagram?

A

Liquid barium, cotton balls soaked in barium, barium tablets, marshmallows followed by thin barium.

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21
Q

Routine patient prep for an UGI?

A

NPO from midnight or at least 8 hours before exam. No smoking or gum chewing bc it increases gastric secretions. 0-1years: NPO 4hrs
+1year: NPO 6 hours
LMP

22
Q

What is the Valsalva maneuver?

A

Demonstrates reflux. Patient takes in deep breath while beating down as if making a bowel movement. Forces air against the closed glottis.

23
Q

What is the modified Valsalva maneuver?

A

Demonstrates reflux. Patient pinches nose, closes mouth, and tries to blow nose. Cheeks expanded

24
Q

What is the Mueller Maneuver?

A

Demonstrates reflux. Patient exhales and then tries to inhale against closed glottis.

25
Q

What is the water test?

A

Demonstrates reflux. Patient swallows water and the radiologist observes the esophagogastric junction for regurgitation under fluoro.

26
Q

What is the compression technique?

A

Demonstrates reflux. Paddle is placed under prone patient and inflated to provide pressure to the stomach to demonstrate the esophagogastric junction.

27
Q

What is the toe touch maneuver?

A

Demonstrates reflux. The esophagogastric junction is observed as the patient bends over and touches their toes. Also may demonstrate hiatal hernias.

28
Q

Explain the enteroclysis procedure:

A
  • double contrast study of the small bowel.
  • Pt intubated under fluoro w/ an enteroclysis catheter that is passed thru the stomach into the duodenum. A bilbao or sellnik catheter is advanced to the duodenojejunal flexure. high density barium is injected 100mL/min, followed by either air or methyl cellulose to distend the bowel.
29
Q

what does adding the two types of contrast in the enteroclysis procedure do?

A
  • dilate the loops of SB

- increase visibility in the mucosa

30
Q

what are the indications of enteroclysis?

A

SB ileus
regional enteritis (crohns)
malabsorbtion syndrome

31
Q

what is the kvp for single contrast barium studies?

A

100-125 kvp

32
Q

what is the kvp for double contrast barium studies?

A

90 kvp

33
Q

how can small and large intestine be differentiated radiographically?

A
  • the large intestine has a greater diameter.

- the presence of haustra indicates large intestine.

34
Q

what is the large intestine made up of?

A

3 external bands of muscle fibers from the taeniae coli, which pull the large intestine into sacculations called haustra.

35
Q

what are the contraindications of a BE?

A
  • suspected perforated hollow viscus
  • possible LB obstruction
  • if a biopsy had been performed recently
  • pregnancy
36
Q

what is the CR for BE RAO and LPO?

A

IC and 1” lateral to the upside of MSP

37
Q

what is the CR for BE LAO and RPO?

A

1-2” above IC and 1” lateral to the upside of MSP

38
Q

what is the CR of the right and left lateral decubitus?

A

asis and MSP

39
Q

what is a colostomy?

A

surgical formation of an anastomosis between two portions of the large bowel. Part of the bowel may be removed and an artificial opening is created brining the intestine to the surface of the abdomen at a stoma.

40
Q

How is a BR performed on a colostomy patient?

A

contrast is administered into the stoma and the rectum. the stoma has no sphincter so must use a colostomy BE kit that includes adhesive to hold the barium in the stoma.

41
Q

Patient prep for a BE:

A
  • light evening meal
  • cleansing cathartics
  • NPO 8 hours
42
Q

BE procedure:

A
  • drain air from tip
  • insert tip towards umbilicus and then slightly anterior, then superior
  • BE bag 24” above table
43
Q

BE film sequence:

A 
PA or AP
RAO and LAO
LPO and/or RPO
lateral rectum
R and L lateral decubitus (for double contrast)
44
Q

what are the special projections of the BE?

A

AP axial
AP axial oblique
PA axial
PA axial oblique

45
Q

why is a PA projection preferred over an AP in a BE?

A

compression of the abdomen in the PA results in a more uniform density of entire abdomen.

46
Q

what are indications of a BE?

A

ulcerative collitis, diverticulosis, diverticulitis, neaplasms, volvulus, intussusception, appendicitis.

47
Q

what are the indications of SBS?

A

enteritis or gastroenteritis, meckels diverticulum, neoplasm, malabsortion syndrome, ileus obstruction, whipples disease, lymphoma adencarcinoma

48
Q

what are the pathological indications of the upper GI system?

A 
peptic ulcer
hiatal hernia
diverticula 
gastritis
tumor
bezoar
49
Q

what is the CR for RAO esophogram?

A

T5-T6 and 1” inferior to sternal angle

50
Q

where is the CR for the upper GI series?

A

L1

Positioning Lecture Material (10 decks)

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