Bontrager ch. 15
Where is the suspensory muscle (ligament of Treitz) found?
Between the duodenum and jejunum
What is the difference between Adynamic/paralytic ileus and mechanical obstruction ileus?
Adynamic/paralytic = due to cessation of peristalsis Mechanical = blockage of bowel due to tumors, adhesions, or hernia
Section of the colon which is found between the cecum and transverse colon:
Ascending colon
Which one of the following digestive movements occurs in the small intestine? A. Haustral churning B. Rhythmic segmentation C. Mass peristalsis D. Mastication
B. Rhythmic segmentation
Which aspect of the large intestine is best demonstrated with the RAO projection? A. Cecum B. Right colic flexure C. Left colic flexure D. Descending colon
B. Right colic flexure
Name the procedure which would best demonstrate the following pathologic conditions: Colitis (ulcerative) Diverticulosis/diverticulitis Neoplasms (apple core or napkin ring lesions) Volvulus
Barium Enema
Four conditions which would prevent the use of a laxative cathartic before a barium enema procedure are:
Bleeding Diarrhea Obstructions Lessions
What is another term for describing the AP and PA axial projections?
Butterfly
What type of CR angle is required for the AP axial "butterfly" projection? A. 10°-15° cephalad B. 20°-30° caudad C. 30°-40° cephalad D. 35°-45° caudad
C. 30°-40° cephalad
Name the procedure which would best demonstrate the following: 1. Rectoceles 2. Rectal intussusception 3. Prolapse of rectum
Evacuative proctogram (defecography)
A new growth extending from mucosal wall (inward):
Polyp
A BE studies what?
Large Intestine
Cathartic is synonymous with:
Laxative
The LAO position best demonstrates the _________ colic flexure with the CR at the level of _________.
Left 1-2 inches above crest
This is sometimes added to the contrast medium to minimize spasm during a B.E.:
Lidocaine
Patient with lactose or sucrose sensitivities:
Malabsorption syndrome
A common birth defect found in the ileum:
Meckel's diverticulum
Outpouchings located in distal ileum:
Meckel's diverticulum
Apple-core lesion
Neoplasm
Looks like an "apple core":
Neoplasm
What CR angle is required for the AP axial? How about for the PA axial?
30-40 degrees cephalad (AP) 30-40 degrees caudad (PA)
How much midline does (also female gonadal dose) is acquired for a PA small bowel or BE projection of a small-to-average-size patient?
30-50 mrad
How much body rotation is required for oblique barium enema projections?
35-45 degrees
The average length of the large intestine is:
5 ft
A patient must be NPO for how long prior to a small bowel series?
8 hours
What is the recommended kV range when a water-soluble contrast agent is used?
80-90 kV
Define cathartics.
A substance that produces soft/liquid bowel movements
The most common type of colon cancer is _____.
Adenocarcinoma
This is also called the iliac colon:
Descending colon
What does methylcellulose during an enteroclysis do?
Dilates intestinal lumen for a more diagnostic study
A condition of numerous herniations of the mucosal wall of the large intestine is called:
Diverticulosis
Jagged or sawtooth appearance of the intestinal wall
Diverticulosis
During an enteroclysis, the tip of the catheter is advanced to the:
Duodenojejunal flexure (suspensory ligament)
Name and describe the 3 sections of the small intestine. (Length, quadrant location, etc.)
Duodenum - RUQ & LUQ - Shortest (10 in, largest diameter) Jejunum - LUQ & LLQ - 2/5ths Ileum - RLQ & LLQ - 3/5ths (longest but smallest in diameter)
Inflammation of the small intestine:
Enteritis
Crohn's disease and malabsorption syndromes are best evaluated through what procedure?
Enteroclysis
Name the procedure which would best demonstrate the following: small bowel obstruction, Crohn's disease, malabsorption syndrome
Enteroclysis
Looks like a "herringbone" or "circular staircase":
Ileus
Obstruction of the small intestine:
Ileus
For a small bowel procedure a scout image is first taken in which the CR is centered to the __________. The first film after ingestion (15-30 mins later) is taken at what level and why?
Iliac crest 2 in higher than crest - to show stomach
Enteritis is:
Inflammation of the intestine
Mushroom-shaped dilation with a small amount of barium extending beyond it
Intussusception
This makes up 40% of the small intestine:
Jejunum
Which division of the small bowel has a feathery or coiled-spring appearance during a small bowel series?
Jejunum
What structures does an LAO position demonstrate?
L colic flexure & Descending colon
In which two abdominal quadrants would the majority of the jejunum be found?
LLQ & LUQ
Volvulus is _______________ and a classic sign of it looks like __________.
Twisting of the intestine "beak" sign or tapered narrowing
Has a "cobblestone" or "stovepipe" appearance in colon:
Ulcerative Colitis
"cobblestone" sign may be due to:
Ulcerative colitis
Chronic inflammatory condition of the large intestine:
Ulcerative colitis
Severe form of colitis (inflammation of large intestine) is called:
Ulcerative colitis
Stove-pipe appearance of colon
Ulcerative colitis
Does volvulus occur more frequently in males than in females?
Yes it does
What type of patients should be given extra care when using a water-soluble contrast media?
Young/Dehydrated or patients with iodine sensitivity
The transverse colon and sigmoid colon will fill with air during a double-contrast barium enema when the patient is in what position?
supine
The initial insertion of the rectal enema tip should be pointed toward the:
umbilicus
Another name for appendix
vermiform appendix
"tapered or corkscrew" sign may be due to:
volvulus
A twisting of a portion of the intestine on its own mesentery is called:
volvulus
The IV pole/enema bag is no farther than ___ above the table for the beginning of a barium enema procedure.
24 in.
What kV is recommended for a small bowel series (single contrast)?
100-125 kV
In a person with good muscle tone, the length of the entire small bowel is:
15-18 ft
How much barium sulfate is generally given to an adult patient for a small-bowel-only series?
2 cups (16 oz)
How long does it usually take to complete an adult small bowel series?
2 hours
The skin dose range for a lateral rectum position on an average-size patient is:
2000-3000 mrad
How long is the average small bowel if removed and stretched out during autopsy?
23 ft
How long does it take the barium (given orally) to reach the rectum?
24 hours
Widest portion of the large intestine:
Cecum
A form of sprue:
Celiac disease
Intussusception is most common in _____.
Children under 2 years old
An inflammatory condition of the large intestine:
Colitis
Regional enteritis is also known as _____.
Crohn's Disease
Chronic inflammatory condition of the small intestine:
Crohn's disease
A small bowel series is complete when the contrast passes through what?
Ileocecal valve
Whipple's diease is a rare disorder of the:
Proximal small intestine
What structures does an RAO position demonstrate?
R colic flexure & Ascending colon
Which position(s) taken during a barium enema will best demonstrate the right colic flexure?
RAO/LPO
In which quadrant does the terminal ileum connect with the large intestine?
RLQ
Where are the ileocecal valve and the appendix located?
RLQ
Has a "cobblestone"/ "string sign" appearance:
Regional Enteritis (segmental enteritis or Crohn's disease)
Form of inflammatory disease of the GI tract:
Regional enteritis
The RAO position best demonstrates the _________ colic flexure with the CR at the level of ________.
Right iliac crest
This part of the colon lies in the pelvis but possesses a wide freedom of motion:
Sigmoid colon
The position the patient must be in for rectal tip insertion:
Sim's
A small bowel series studies what?
Small Intestine
An exam which is a combination of an SBS and a UGI is:
Small bowel follow-through
SBS is
Small bowel series - a study of the small intestine
Which 2 aspects of the large intestine are not considered part of the colon?
cecum & rectum
What type of small bowel study is an enteroclysis?
double-contrast
Where the enteroclysis catheter goes:
duodenojejunal junction/ligament of Treitz (terminal duodenum)
