Precancerous saclike projections that project INWARD into the lumen of the bowel Show May appear radiographically as an "apple core" lesion Telescoping of one part of the intestine into another. Blind pouch of the rectum best demonstrated by defecography Infected OUTPOUCHINGS of the mucosal wall due to herniation Im what position will you find Barium in the fundus of the stomach? Where will air be? Supine position- fundus is superior and posterior to the body. Air will be in the body In what position will you find Barium in the body of the stomach? Where will the air be? Prone position - because the body is more anterior. Air with be in the fundus
Functions of the digestive system
Type of Barium that is: Type of barium that is: Contraindications to Barium
What can you substitute Barium with if it is contraindicated? Water-soluble iodinated contrast- Gastrografin
KV range for water-soluble contrast
"Heartburn" aka cardiospasm.reduced peristalsis, inability of esophagogastic sphincter to relax Stricture or streaking at the distal esophagus Dilation of veins of distal esophagus. Often with cirrhosis of liver. Large outpouching of the esophagus just above the esophagogastric sphincter Gastroesophageal Reflux Disease
-Contrast (thin) prepped and ready Mass of undigested material trapped in the stomach
What side of the body is viewed in Anterior Oblique positions? Downside anatomy What side of the body is viewed in Posterior Oblique
positions? Upside anatomy Common birth defect in the ileum.
Two parts of the large intestine that are not included in the colon Contraindications for barium enema
Pt placed in what position for insertion of enema tip? The taeniae coli pull the large intestine into sacculations called ___ Two positions that are required for a double contrast BE that are not required when performing a single contrast BE The RPO BE position should be centered (CR location) ___ to best demonstrate the ___ 1" left of MSP, 2" above iliac crest; What is the importance of the bowel prep prior to the BE study? Make sure bowels are clear;
Can a BE be performed immediately following a colonoscopy?
Why? Yes (if biopsy had not been performed) Recommended KVP for Single contrast barium enema? Double contrast? Sng = 110-120KV Disease
process that may result in the loss of haustal markings and a "stovepipe" appearance to the colon Explain Defecography, also called Evacuative Proctography procedure
What special type of barium enema is performed to assess an anastomosis? A surgical connection between two hollow or tubular structures What position requires the central ray to be angled 30-40° cephalad and enters 2" medial and 2" inferior to the right ASIS? LPO double angle What anatomy is demonstrated on the Right lateral decubitus radiograph?
What anatomic structure is located on the posteromedial
aspect of the cecum? Postoperative (T-tube or delayed) Cholangiogram procedure
Endoscopic Retrograde
Cholangiopancreatography
Pathologic indications of ERCP
Cutting the muscular sphincter to enlarge the opening Using a basket or balloon catheter to remove stones from a duct Stretching of a partial blockage or stenosis and the placement of a small tube in the duct to keep it patent Duct dilation and stenting Ingestion and/or digestion takes place in: (5)
Absorption takes place in: Small intestine and stomach Elimination takes place in: Exam performed to study the form and function of the pharynx and the esophagus Exam performed to study the form and function of the distal esophagus, stomach and duodenum Radiographic exam of the small intestine Radiographic examination of the large intestine The distal end of the gallbladder is termed the ___ The valves found
within the cystic duct are termed ___ Another term for the hepatopancreatic sphincter is the ___ Condition of having gallstones Inflammation of the parotid gland results in ___ Preferred view to demonstrate the esophagus If a patient lies supine during an upper GI series, where would most of the barium settle within the stomach? What structures help create the romance of the abdomen? head of the pancreas and C-loop of the duodenum What pathologic condition is often secondary to acute liver disease such as cirrhosis? Which upper GU projection will best demonstrate the retrogastric space What is the degree of obliquity on UGI obliques? Indications for UGI radiography (9)
Maneuvers for diagnosing Esophageal reflux (6)
Maneuver for diagnosis of esophageal reflux: bearing down as if having a bowel movement Maneuver for diagnosis of esophageal reflux: pinches off nose,
closes mouth, tries to blow mose Modified valsalva maneuver Maneuver for diagnosis of esophageal reflux: Exhales and then inhales against a closed glottis Maneuver for diagnosis of esophageal reflux: swallows water, radiologist observes for regurgitation of Ba into esophagus from stomach Maneuver for diagnosis of esophageal reflux: inflated paddle placed under prone patient to demonstrate esophagastric junction Maneuver for diagnosis of esophageal reflux: Esophagastric junction observed as pt touches toes. May demonstrate reflux and hiatal hernias
Why no smoking or chewing gum during the NPO period of Upper and Lower GI exam prep? Increase gastric secretions and salivation - prevents proper coating of the gastric mucosa The typical
adult's small intestine (intact) measures ___ What is the longest segment of the small intestine? Pouches or sacculations found along the mucosal wall of the large intestine are termed ___ Which regions of the large intestine would be barium filled during a double contrast BE with the patient lying prone? May present with cobblestone appearance and a string sign Crohn's disease Methylcellulose and barium is introduced via nasoduodeno tube during a(n) ___
Indications for Lower GI (9)
A-bnormal passage from a hallow organ to the surface or from one organ to another Functional study of the anus and rectum during the evacuation and rest phases of defecation Evacuative proctogram
(Defecography) Clinical indications for Evacuative proctogram
Surgical anastomosis between two portions of the large bowel Opening created on the
surface of the abdomen Colostomy performed to assess for: (4)
What types of contrast are used for the enteroclysis procedure? high density barium (methylcellulose) Type of digestion (movement) that takes place in the stomach Hormone that causes the gallbladder to contract Effect of residual Barium in the GI tract How can the technologist
speed up the small bowel procedure? 5 routine UGI projections (not counting AP scout)
Routine projections for a BAS
Routine projections for the SBS
Routine projections for a BE
Routine projections for ACBE
Stricture or narrowing of esophagus A - Left hepatic
duct Shows as irregular filling within stomach on x-ray Appears with absense of rugae, thin gastric wall, and "speckled" appearance of mucosa with acute cases Gastric bubble or protruding aspect of stomach above diaphragm or Schlatzki's ring Distention of stomach owing to obstruction of pylorus Hypertrophic pyloric stenosis Punctate collection of barium and "halo" sign in stomach Thickening of mucosal folds and poor definition of circular folds in small intestine Inflammatory condition of the large intestine. Chronic inflammation and spasm give the intestinal wall a "saw-tooth" or jagged appearance Mechanical part of digestion - chewing. Reduces size of food particles and mixes them with saliva Positive = radiopaque Negative = radiolucent Location of biliary and GI organs for a Hypersthenic patient
Location of Biliary and GI organs for a Hyposthenic/Asthenic patient
When the pt is in the PRONE position, where is the barium located in the stomach? When the pt is in the SUPINE position, where is the barium located in the stomach? When the pt is in the ERECT position, where is the barium located in the stomach? Pylorus (flat line between barium and air) When the pt is in the PRONE position, where is the barium located in the Large Intestine? Transverse and Sigmoid colon When the pt is in the SUPINE position, where is the barium located in the Large Intestine? Rectum, ascending colon, descending colon How may the radiologist induce esophageal reflux?
Indications for a barium swallow? 1.) suspected esophegal malignancy 2.) Dysphagia 3.) Congenital defects 4.) Gastric reflux
Indications for barium enema alteration in bowel habit What's the kVp range for iodinated contrast? Intestine twists on it's own mesentary, leading to mechanical obstruction. 1. Cardiac notch 2. Fundus 3. Body A - Common bile duct A. Nasal cavity B. Soft palate C. Tongue 1. Nasopharynx PA esophagram
(slight RAO obl) Distinctive ring caused when portion of the stomach herniates through a weakened part of the esophageal sphincter. Hiatal hernia - Schatzki's ring Which aspect of the small intestine is considered the longest?Ileum: This last section is the longest part of your small intestine. The ileum is where most of the nutrients from your food are absorbed before emptying into the large intestine.
Which aspect of the large intestine is located highest or most superior in the abdomen?Digestive System-- LGI. Which part of the small intestine has a feathery appearance when filled with barium?Which part of the small intestine has a feathery appearance when filled with barium? pg. 489: The jejunum contains numerous mucosal folds (plicae circulares), which increase the surface area to aid with absorption of nutrients. These numerous mucosal folds produce the "feathery appearance of the jejunum".
Which of the following structures is intraperitoneal quizlet?The intraperitoneal organs are the stomach, spleen, liver, bulb of the duodenum, jejunum, ileum, transverse colon, and sigmoid colon.
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Which region of the large intestine may be visualized during an Evacuative Proctogram study?
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