Upper Gastrointestinal System: Flashcards by Lan Chau

Positioning for upper GI

RAO
PA
RIGHT LATERAL 
LPO
AP

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Describe what is visualized for RAO for upper GI series

To visualize polyps and ulcers of the pylorus, duodenal bulb, and the c-loop of the duodenum

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Retrogastric space? Where is that

Space behind the stomach

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RAO: which part of the stomach is barium filled and air filled

fundus (air filled)
Pylorus (barium filled)
Duodenal bulb (barium filled)

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What clinical indication is visualized on a PA projection of upper GI series

Polyps, diverticula, bezoar psych and signs of gastric in the body and the pylorus of the stomach

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What are the accessory organs of the GI system?

Liver
Gallbladder
Pancreas
Salivary glands

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Ratio of thin barium.

1 part barium and one part water.

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Ratio of thick barium.

3 or 4 parts barium to 1 part water.

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Which lobe of the liver is the larger lobe?

Right lobe of the liver

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The liver is held in place by what?

Falciform ligament

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Main function of the liver?

Production of bile

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Function of bile

Aides in the digestion of fats by emulsifying fat globules and the absorption of fat following its digestion.

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Extra hepatic duct belongs to which organ

Liver

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Cystic duct belongs to which organ

Gallbladder

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Bile route

Lt. and rt. Hepatic duct, common hepatic duct, then temporarily stored in gallbladder via the cystic duct OR secreted directly to duodenum via the common bile duct. From there it joins w/pancreatic duct at the hepatopancreatic sphincter before emptying into the duodenum via the duodenal papilla.

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Another name for the pancreatic duct

Duct of Wirsung

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Another name for hepatopancreatic sphincter

Sphincter of Oddi

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Three parts of the gallbladder

Fundus, body, neck

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The most distal end and broadest part of the gallbladder

Fundus part of the gallbladder

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What’s the difference b/w the cystic duct to all the other ducts

It contains SPIRAL VALVE, membranous folds, that functions to prevent distention or collapse of the cystic duct.

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How much bile can a normal gallbladder typically holds

30-40 mL of bile.

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Three primary functions of the gallbladder

To store bile
To concentrate bile
To contract when stimulated

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When does the gallbladder contract

When fatty foods and fatty acids are in the duodenum, theses foods stimulate the duodenal mucosa to secrete the hormone CHOLECYSTOKININ (CCK) and as CCK increases in blood, the gallbladder contracts

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What is Chloelithiasis

Stones in gallbladder

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What is cholecystitis

Inflammation of gallbladder

Another name for the digestive system proper

Alimentary canal

Where does the alimentary canal begins and its route through the body

Begins at the oral cavity (mouth) and continues as the pharynx, esophagus, stomach and small intestine. Ends at the large intestines which terminates at the anus.

Three function of the digestive system

Intake/digestion of food Absorption of food particles, water, vitamins, etc Eliminate waste products

Esophagogram aka BA Swallow is done to evaluate what

This studies the form and function of the swallowing aspect of the pharynx and esophagus

Upper GI series is done to evaluate what

To study the distal esophagus, stomach, and duodenum.

What are the three parts of the pharynx

Nasopharynx (behind nose) Oropharynx (behind mouth) Laryngopharynx (above larynx but below oro)

What is the first part of digestion

Mastication (chewing)

What is the termed for swallowing

Deglutition

What are the three saliva secretion glands and where are they located

Parotid (near ear) Submandibular (below mandible) Sublingual (below tongue)

What happens to the epiglottis during degutition

The epiglottis is depressed to cover the laryngeal opening. The closing of the epiglottis prevents food and fluids from being aspirated into the larynx, trachea, and bronchi.

Where does the esophagus start and stop

From C5/C6 to T-11 roughly.

What are the two indentations of the esophagus

1. Aortic arch | 2. Left primary bronchus

Another term for the abdominal segment of the esophagus

Cardiac Antrum

What are the three things that passes through the diaphragm

Esophagus (cardiac Antrum) Aorta Inferior vena cava

The opening between the esophagus and the stomach is termed?

Esophagastric junction aka cardiac orifice

What is the termed for a wavelike series of involuntary muscular contractions that propel solid and semisolid materials through the tubular alimentary canal?

Peristalsis

Where is the stomach located

Between the esophagus and small intestine

What does the stomach serves as

As a reservoir for swallowed food and fluid

Another name for cardiac notch

Incisura cardiaca

Another name for angular notch

Incisura angularis

Mucosal folds within the stomach is termed

Rugae

What does the Rugae do within the stomach

Assist in mechanical digestion of food within the stomach

What is the function of the gastric canal within the stomach

It funnels fluids directly from the body of the stomach to the pylorus.

Location of the fundus in the body

Posterior of the body of the stomach

In supine position how is the barium orientated

Barium in the fundus | Air in the body and pulorus

RAO position how is the barium orientated

Air in fundus | Barium in body and pylorus

Prone position how is the barium orientated

Air in fundus | Barium in body and pylorus

The four parts of the duodenum

1. Duodenal bulb 2. Descending duodenum 3. Transverse/horizontal duodenum 4. Ascending duodenum

What's the connection point between the duodenum and the jejunum

Duodenojejunal flex urge

What's the ligament that holds the duodenum in placed termed

Ligament of Treitz

What are two ways of getting contents from the mouth to the stomach.

Peristalsis and gravity

Why would gastrografin be used sometimes instead of barium sulfate for a fluoroscopic procedure

If there is a definite known obstruction or/and for post-op because if there is, the barium will escape into the peritoneal cavity and cause intestinal infarcts or peritonitis

What is double contrast

Barium and air or CO2 gas

What is termed positive contrast

Barium or radiopaque

What is termed negative contrast

Air or gas or radiolucent

What kind of contrast is gastrografin

Water soluble iodinated contrary

Where should the technologist NOT be standing during a fluoroscopic procedure

NOT at either ends of the table. Instead by patient belly or the middle of the table

Instructions for patient for preparation for Upper GI

NPO 4-6 hrs prior to procedure

Instructions for patients for preparation for BA swallow

No specific instructions because the esophagus is always emptying involuntarily.

What's the purpose of the valsalva and mueller maneuver

To create intrabdominal pressure to check for reflux. Other testing is the water test and toe touching test.

What condition in which a portion of the stomach goes through the diaphragmatic opening

Hiatal hernia

What is hypertrophic pyloric stenosis

Most common gastric obstruction in infants that causes an obstruction at the pylorus

What are ulcers

Erosions of the stomach or duodenal mucosa that are caused by diet, smoking, stress

What position places the entire esophagus between the thoracic spine and heart in a BA Swallow

Lateral

CR for esophagogram aka BA swallow

T5/T6 which is 2-3" below jugular notch

Breathing instruction for BA swallow

Expiration

CR difference between sthentic, asthenic, and hyper sthentic patients.

Sthentic is at level of L1 Asthenic is 2" below L1 Hyper sthentic is 2" above L1

Clinical indication purpose for RAO for upper GI

To visualize the C-loop of the duodenum

Clinical indication purpose of PA of upper GI

Polyps, diverticula, bezoar a and gastritis in the body or pylorus of the stomach

Clinical indication purpose for right lateral of upper GI

To visualize the retrogastric space (space behind stomach)

LPO purpose of upper GI

Demonstrates signs of gastritis and ulcers

PA PURPOSE for upper GI

To check for possible hiatal hernia