Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fluoro > Upper GI > Flashcards

Upper GI Flashcards

1
Q

Anatomy of Esophagus

A

Anterior to the vertebra and posterior to the trachea
Passes through the diaphragm at level T10
At the bottom of the esophagus there is a widening called the cardiac Antrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Esophogram

Contraindications and exam prep

A
  • Contrast should to be used if the patient has a sensitivity or allergy to it or has a chance of perforated bowel which would allow the contrast to escape into the peritoneal cavity
  • no exam prep for esophagus but will need to be prepped if a upper GI series is involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

AP esophagus

A

CR 1” inferior to sternal angle T5 and along MSP
Barium filled esophagus superimposed over the spine
Recumbent position allows for more complete filling of esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

RAO or LPO Esophagus

  • where to CR
  • Which position if preferred
A

CR at T5-T6 (sternal angle) and approximately 5cm lateral to the MSP on the elevated side
Rotate the body 35-40 degrees depending on body habitus
RAO is preferred over the LPO b/c is has a lower OID
LPO is done if the patients mobility is limited
Esophagus should be demonstrated b/w heart and spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lateral Esophagus

  • pt position
  • what structures are visualized
A

True lateral position ensure no rotation
Keep patient arms forward, off the chest
Perpendicular to T5-T6 and along MCP
Ribs posterior to the vertebra superimposed
Esophagus b/w the spine and heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Valsalva Maneuver

A

For esophageal varices the patient is instructed to draw barium into mouth but don’t swallow it. Now inhale fully and swallow barium bolus then “bare it”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Stomach Anatomy

A

Fundus is most superior and posterior portion of the stomach
Important for air fluid levels
Ragae are visible when the stomach is empty, the internal lining if through into numerous longitudinal mucosal folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Air-Barium Distribution

-spine, prone, and erect

A

Supine - Fundus is posterior and barium filled
- pyloric portion if anterior and air filled
Prone - Fundus is posterior and air filled
- pyloric region is lowest and bowel filled
Erect - Air rises to fill the Fundus
- barium descends by gravity to fill the pyloric portion
- air barium line tends to be a straight one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Stomach and Duodenum contraindications and exam prep

A

Contrast should not be used it the patient has a sensitivity to it or their is a chance they have a perforated bowel (a water soluble contrast may be used if query perforation)
No food the from midnight till exam time, no smoking or chewing gum b/c this can increase gastric secretions which prevent proper coating of barium to the mucosa lining of the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Upper GI or Stomach and Duodenum

A

Usually performed as a double contrast study - both a negative and positive contrast agent used
Can be combined with small bowel for follow through
All the walls of the stomach need to be coated with barium so the patient must do a 360 degree log roll
Images often obtained in both erect and supine positions, exam usually begins in RAO position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

RAO Position of Stomach and Duodenum

A

Patient is erect or recumbent rotated 30-70 degrees from prone
Sthenic - CR a L1 and midway b/w spine and upside lateral border of the abdomen
Asthenic - CR 5cm below level of L1 and oblique body 40 degrees
Hypersthenic - CR 5cm above L1 and oblique body 70 degrees
* will give you the best image of the pyloric canal and duodenal bulb in profile* duodenal bulb and c-loop in profile and Fundus is air filled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Names for Upper Digestive Tract Exams

A 
UGI - upper gastrointestinal series 
Barium meal 
Barium swallow 
SBFT - small bowel follow through 
Enteroclysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PA Projection of the Stomach

A

Done erect or recumbent, usually supine but end up prone
Sthenic - CR at the level of L1 and 2.5cm left of the vertebral column
Asthenic - CR 5cm below L1 (L3)
Hypersthenic - CR 5cm above L1 nearer to the midline
barium filled stomach spreads more horizontally in the PA position and see the pylorus in profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lateral Position of the Stomach

A

Ensure no rotation by having hips and shoulders stacked
Sthenic - CR at L1 and 2.5cm anterior to the MCP
Asthenic - CR 5cm below L1
Hypersthenic - CR 5cm above L1
stomach moves lower if the patient is erect compared to recumbent
See the retrogastric space and entire stomach and duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

LPO position of the Stomach

A

Recumbent, rotate the body 30-60 degrees depending on habitus (more for a hypersthenic person less for a hyposthenic person)
Sthenic - CR at the level of L1 and midway b/w the midline of the body and the left lateral margin of abdomen, oblique 45 degrees
Asthenic - CR 5cm below L1 and oblique 30 degrees
Hypersthenic - CR 5cm above L1 and oblique 60 degrees
Body, pylorus, and duodenal bulb will be air filled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AP projection of the Stomach

A

Sthenic - CR at the level of L1 and along the MSP
Asthenic - CR 5cm below L1 and along the MSP
Hypersthenic - CR 5cm above L1 and along the MSP
AP partial trendelenburg used to fill fundus on asthenic pt
See the pylorus in profile
Barium filled stomach spreads more horizontally

17
Q

Modified Barium Swallow

A

Performed to asses the patients ability to swallow
Patient is observed while swallowing food of various consistencies, from thin fluids to thick barium paste
The is often performed on stroke or other patients who have recently experienced hemi paralysis

18
Q

Anatomy of small bowel

A

Extends from the pyloric sphincter to the ileocecal valve, where it joins the large intestine
Mucosa contain vili which result in a feathery appearance when filled with barium
Duodenum - RUQ and LUQ, shortest, widest, and most fixed portion of small bowel
Jejunum - LUQ and LLQ, contains numerous mucosal folds which increase the SA to aid in the absorption of nutrients (feathery appearance)
Ileum - RLQ and LLQ, longest portion of the small intestine, terminal ileum joins the large bowel at the cecum via the ileocecal valve

19
Q

SBFT patient prep and views

A

Patient prep NPO for 8 hrs before exam
Test may take from 2-4 hours to complete but is completely patient dependent
Time intervals decided by Rad (0, 15, 30, 1, 1 1/2….)
Each film must have a time marker and be shown to the Rad
At the end of the exam the rad takes additional images of the terminal ileum
Patient should drink lots of water post exam to flush barium out the system (can cause constipation if left to harden in bowel)

20
Q

SBFT Initial Image

A

Taken 15 min after barium swallow must have time marker
CR is about 10cm above iliac crests (L4) and include the entire stomach
Can be taken PA or AP (PA is preferred b/c more compression and separation of the bowel and less gonadal dose) it’s patient condition dependent

21
Q

Remainder of SBFT images

A

Interval images are taken at 30 min to 1hr
CR at the level of the iliac crests and on MSP
Exam is completed once the contrast reaches the cecum and large bowel

22
Q

Enterocylsis

A

Injection of a nutrient or medical liquid into the bowel by a special catheter passing through the nose to the duodenojejunal junction. Barium is injected flowed by methylcellulose or air. Methylcellulose is preferred b/c it adheres and distends the bowel enhancing visibility of the mucosa. Preformed under fluoro, may take 2-3 hrs

23
Q

Enteroclysis Disadvantages and Indications

A

Disadvantages
- increased pt discomfort, possbility of perforation, potential for high dose of radiation
Indications
- pt w/ history of small bowel obstructions, celiac, or Crohn’s disease (usually done on patients w/ inflammatory diseases)

24
Q

Routine for Esophagus

A
  • RAO (35-40 degrees)
  • Lateral
  • AP or PA (Usually AP)
25
Q

Routine Upper GI or stomach and duodenum

A 
RAO
PA
Right Lateral 
LPO 
AP
26
Q

Enteroclysis best demonstrate what anatomy

A

Enhances the visibility of the mucosa in the small intestine
Is usually done on patient with inflammatory disease like Crohn’s

Fluoro (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions