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MRAD2220 - Outcome 4 > Upper GI studies > Flashcards

Upper GI studies Flashcards

1
Q

What is the position of the esophagus in the body?

A

Lies posteriorly at MSP

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2
Q

What is the name of the end of the esophagus (connection to stomach)

A

Cardiac antrum

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3
Q

Whats the function of the esophagus?

A

Move saliva and food from laryngopharynx to stomach

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4
Q

What are the 4 parts of the stomach?

A
  • cardia
  • fundus
  • body
  • pylorus
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5
Q

What are the longitudinal folds in the stomach called?

A

Rugae

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6
Q

Whats the position of the fundus in the body?

A

Lies most posterior and superior

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7
Q

Whats the position of the Body of the stomach in the body?

A

Anterior and inferior to the fundus

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8
Q

Whats the position of the pylorus in the body?

A

posterior and distal to the body

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9
Q

Stomach appears higher and more horizontal in patients who have a _________ body habitus

A

hypersthenic

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10
Q

Stomach appears lower and more midline in patients who have an _________ body habitus

A

Asthenic

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11
Q

Where does the duodenal bulb sit in hypersthenic patients

A
  • to the right of the midline
  • At the level of T11-T12
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12
Q

Where does the duodenal bulb sit in sthenic patients

A
  • slightly to the right of the midline
  • at the level of L1-L2
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13
Q

Where does the duodenal bulb sit in Hypo/Asthenic patients

A
  • At the midline
  • at the level of L3-L4
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14
Q

What are the functions of the stomach?

A
  • food storage during digestion
  • secretes chemicals for chemical digestion
  • Mechanically digests vie churning and peristalsis
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15
Q

What is chyme?

A

chemically and mechanically altered food that leaves the stomach

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16
Q

Why do we use fluoroscopy during GI studies?

A

For functional evaluation (movement)

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17
Q

What is the contrast used for GI studies (usually)?

A
  • Barium sulfate, radiopaque
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18
Q

What is a colloidal suspension?

A

A type of mixture
- never dissolves in water
- rate of separation depends on the brand

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19
Q

When are colloidal suspensions contraindicated?

A
  • Perforation, or presurgical procedure
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20
Q

What must you do before giving a patient a colloidal suspension of contrast?

A
  • Make sure it’s shaken well because it can settle
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21
Q

Whats the ratio of barium to water for thick barium?

A

3:1 or 4:1 ratio of barium to water

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22
Q

Whats the ratio of barium to water for thin barium

A

1:1

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23
Q

When barium is contraindicated, what is used instead?

A

Water-soluble iodinated CM

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24
Q

When is water-soluble iodinated cm contraindicated?

A

If there is history of iodine hypersensitivity

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25
What is a barium swallow procedure?
Using contrast to visualize and evaluate the esophagus
26
True or false: Barium swallow procedures can be single or double contrast
True
27
What prep is done for barium swallow?
- no prep like laxatives or cleansing enemas needed - Just NPO after midnight
28
Whats the CR and patient position for AP/PA projection for barium swallow?
- Patient is erect OR recumbent - CR: T5/T6 @ MSP
29
Whats the CR and patient position for AP/PA OBLIQUE projection for barium swallow?
- rotate body 35-40 degrees RAO or LPO - CR: T5/T6, 2" laterally from MSP of elevated side
30
What position is preferred for AP/PA OBLIQUE projection for barium swallow and why?
- preferred position is RAO - because esophagus is viewed between vertebrae and heart, and heart lies more to the left. RAO provides a wider area of visualization
31
Whats the CR and patient position for LATERAL projection for barium swallow?
- Pt is erect or recumbent w/ arms raised - R OR L side down - CR: T5/T6 - Top of IR placed above the mouth to see flow of CM
32
What is the cause for esophageal varices?
Portal hypertension
33
What is done to increase visualization for esophageal varices?
- Valsalva Maneuver - Trendelenburg position
34
What is the Valsalva maneuver?
- Patient takes a deep breath, and pushes their abdomen like they're trying to poop to increase abdominal pressure
35
What is the stomach & duodenum(S&D) procedure?
Using contrast to visualize and evaluate the stomach and duodenum - also called S&D, UGI, Barium meal
36
How is contrast used during S&D?
- Single = used for small children, elderly, or very ill patients - Double = barium sulfate and gas granules (preferred)
37
Patient prep for S&D:
NPO from midnight, 8-9hrs before exam
38
PA projection for S&D:
- patient prone - CR at MSP, at the level of L1/L2 (lower if patient is upright)
39
Whats the air-barium distribution during PA S&D
- Body and pyloric portion filled with barium - because these are more anterior
40
AP projection for S&D:
- Patient prone - CR is the same as PA
41
Whats the air-barium distribution during AP S&D
- Fundus is filled with barium cuz its more posterior - S&D is still well visualized/filled
42
what should we include for an AP S&D?
diaphragm and lower lung field to detect hiatal hernia
43
right anterior oblique projection for S&D:
- Pt prone, rotated 40-70 degrees - CR is still @ MSP, @ L1/L2 (lower if pt's upright)
44
Whats the air-barium distribution during RIGHT ANTERIOR OBLIQUE S&D
- Pyloric portion filled with barium - Fundus filled with air
45
Gastric peristalsis is more active in what position?
- right anterior oblique
46
emptying the stomach is easier in what position?
- Right lateral
47
left posterior oblique projection for S&D:
- Pt supine, rotated 30-60 degrees - CR is once again, still the same - Duodenal valve should be seen without SI of pylorus
48
Whats the air-barium distribution during LEFT POSTERIOR OBLIQUE S&D
- Fundus is filled w/ barium - Body and Pyloric portion are seen with double contrast
49
What does the right lateral projection demonstrate?
- Right retrogastric space - pyloric canal - duodenal bulb - barium into pylorus and duodenal bulb
50
What does the left lateral projection demonstrate?
- Left retrogastric space - air into the pylorus and duodenal bulb
51
How long is the small intestine?
an average of 22 ft in adults
52
What are the three portions of the small intestine?
- duodenum - jejunum - ileum
53
Whats the widest, and shortest part of the small intestine?
- Duodenum
54
What part of the small intestine appears feather-like?
- Jejunum
55
When are small intestine studies considered complete?
When we reach the ileocecal valve
56
What does small bowel follow through (SBFT) provide for us?
Visualization and evaluation of the function of the small bowel
57
What contrast is most often used for small bowel follow through?
Barium sulfate
58
When are small bowel follow through procedures performed?
Frequently right after an S&D exam
59
Whats the prep for small bowel follow through?
Same as S&D, NPO after midnight
60
AP/PA projection for SBFT:
- Patient supine OR prone - Images taken with time intervals (15 mins, 30 mins etc) - MAKE SURE YOU USE TIME MARKERS or annotate
61
Why are AP/PA projections for SBFT taken with time intervals?
because movement within the small bowel takes time, this also differs from all patients
62
If small bowel movement is too slow, what can we ask the patient to do?
Walk/move around or drink ice cold water
63
what is the CR for AP/PA projections for SBFT?
Changes as the exam progresses, starts above the crest, ends at the crest (approximately)
64
What does a compression paddle do?
Used to separate loops of bowel
65
When a suspicious area is spotted, what do we do?
We take spot images of that specific area

MRAD2220 - Outcome 4 (4 decks)

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