CH 17: Workbook - Part 2
what two recumbent oblique positions can be used to best demonstrate an unobstructed image of a barium filled esophagus between the vertebrae and heart
RAO, LPO
What acronym refers to the upper gastrointestinal series
UGI
what is a biphasic GI exam
UGi exam with double contrast then single
With which body habitus does the greates visceral movement occur between prone and upright
asthenic
what body habitus produces the greatest visceral movement when a pt is moved from the prone to upright position
asthenic
What type of radiopaque contrast medium usually is used routine UGI studes
barium sulfate 30% to 50% weight per volumn
What two types of contrast media are used for doule-contrast esophageal studies
high density barium and carbon dioxide crystals
What are the two types of contrast media used in double contrast procedures
high density barium fulfate suspension and gas producing substance
In which body habitus type is the stomach almost horizontal and high in the abdomen
hypersthenic
which types of body habitus requires the most rotation
hypersthenic
what opening is at the distal end of the small intestine
ileocecal valve
what structure is the distal part of the small intestine
ileum
Where in the large intestine is the sigmoid located
between descending and rectum
Where in the large intestines is the l. colic flexure located
between transverese and descednign colon
what two imaging modalities are most commonly used to examine the alimentary canal after the introduction of barium
flouro and xray
which curvature is located on the R. medial border of the stomach
lesser
In radiographs of a contrast filled esophagus with the pt in the RAO position, how does the esophagus appear in relation to the surrounding structures when rotation of the pt was insufficient
partially obscurred by throacic vertebrae
Describe how and to where the CR should be directed to the IR and the pt
perpendicualar between coronal plane
how and to where should the CR be directed
perpendicular to the IR
As part of pt preparation, why should the pt maintain a soft, low residue diet for 2 days
reduce production of gas and fecal materal
what is the purpose of useing glucagon during double contrast exams
relax gastric tract
what part of the large intestine is located between the acsending and desending parts of the colon
transverse colon
A barium sulfate mixture is the preferred contrast medium for esophagus
true
For the average pt, the PA oblique projection, RAO positoin produces the best imageof the pyloric canal and the duodenal bulb filled with barium. T/F
true
Other imaging modalities such as sonography and CT have larely replaced hypotonic duodneography. T/F
true
Single contrast and double contrast studies can be used to demonstrate the esophagus. T/F
true
The PA projection with the pt in the pronce position demonstrates the contour of the barium filled stomach. T/F
true
The PA projection with the pt in the upright position shows the size, shape, and relative position of hte barium filled stomach. T/F
true
The barium sulfate suspension used for double contrat exams should have a higher weight per volumn ratio than the barium sulfate suspension used for single contrast exams. T/F
true
approximately how long does it usually take a barium meal to reach the ileocecal valve
two to three hours
How should the prone position of the pt be adjusted to prevent the full weight of the abdomen from causing the stomach and duodenum to press against the vertebral column
under cushions
to best demonstrate the swallowing function in what position should the pt be placed to being the fluoro phase of single contrast exams of the esophagus
upright
when examinint R. lateral projection radiographs which osteologic structes should be examined to determine whether the pt was rotated
vertebrea
what are the two methods of performing hypotonic duodenography
with and without intubation
approximatly how long does it take a barium meal to reach the rectum
24 hours
Approximatly how many inches above the lower rib margin should the IR be centered to the recumbent pt
1 to 2
what is the range of weight per volumn concentration for the barium sulfate suspension usually used for single contrast exams
30-50%
For radiographs with the pt int he RAO position, the pt should be rotated approximatly __ to __ degrees
35-40
how many degrees should the pt be rotated from the prone position
40-70
List projections that comprise the typical esophageal study
AP RAO, LPO lateral
for the double contrast UGI exam, which projection produces the best image of a gas filled duodenal bulb and pyloric canal
AP oblique projection, recumbent LPO position
to what level of the pt should the CR be directed for the PA oblique projection, RAO position as part of the UGI exam
L1, L2
when performing the pa projection on a prone pt, to what level of the pt should the R be centered
L1, L2
At which vertebral leel should the CR enter the pt if the pts is in the recumbent position
L1,L2
at which certebral levelshould the CR enter the pt if the pt is moved from the recumbent position to the upright lateral position
L3
What two oblique positions can be used to demonstrate the entire esophagus effectively
RAO, LPO
for the single contrast UGI exam with the pt recumbent, which projection produces the best image of a barium filled pyloric canal and duodenal bulb in pts whose habitus approximates the sthenic types
PA oblique projection, RAO position
for the double contrast UGI exams with the pt recumbent, what projection produces the best image of a gas filled fundus
PA oblqiue RAO
For the UGI exam with the pt recumbent which projection best stimulates gastric peristalsis to better demonstrate the pyloric canal and duodenal bulb
PA oblque projection, RAO
When demonstrating the entire esophagus to what level of the pt should the iamge receptor be centered
T5, T6
what refers to the biphasic exam
a combination of single and double contrast study of the UGI
What type of contrast medium is most commonly used for examining the upper GI tract
a barium sulfate suspension
The distal esophagus empties its contents into the
cardiac antrum
The esophagus should be clearly seen from the lower neck to the __
cardiac oriface
what structue is the pouchlike part of the large intestine situated below the junction of the ileum and the colon
cecum
what structure ist he proximal part of the large intestine
cecum
How should the centering of the IR be adjuected if the pt is repositoined fromt he prone to upright position
center IT 3-6 in lower
why should pts undergoing double contrast exams turn from side to side or roll over a few times during a procedure
coat lining of stomach
How can the UGI study be affected if the pt smokes cigarettes shortly before the exam
coating ability of barium diminished
for the PA projection as part of the UGI exam why should the lower lung fields be included on a 14x17 inch
demonstrate a possible hiatal hernia
during double contrast exams, what instructions should be given to the pta fter the pt swallows the carbon diaoxide crystals or tablests to ensure a double contrast effect
do not burp
which method of exams is perforemed fist as part of biphsic exam
double contrast
what structure is the proximal part of the small intestine
duodenum
A compression band may be placed across the pts abdomen to immobilize the pt and reduce involuntary movement of the visera. T/F
false
THe msot importamt requirement for the contrast medium is that the weight per volum should be rated greater than 50%. T/F
false
The AP oblique projection, LPO position, demonstrates the __ portion of the stomach filled with barium
fundic
which area is the most superior part of the stomach
fundus
Why is the recumbent RAO position preferred over upright
it allows more complete contrast filling of esophagus
how should the pts position be adjusted to center the stomach over the midline of the table
midsagittal plane
To what level of the pt should the IR be centered
midway between xiphoid process and lower costal margin
In the lateral projection radiograph, what structures are used to determine whether the pt was rotated? how should theses structuers appear
posterior ribs superimposed
What opening is located between the stomach and small intestine
pyloric oriface
which area is the most inferior part of the stomach
pylorus
what struture is located between ascending and transverse colon
r. colic flexure
For the UGI exam with the pt recumbent what projection best demonstrates the R. retrogastric space
r. lateral projection
Which radiographic body position should be used to best demonstrate the duodenal loop and duodenaljejunal junction filled with contrast medium
recumbent R. lateral position
in which abdomincal region does the large intestine originate
right iliac
The AP oblique projection, LPO position, requires the pts __ side be elevateda away from the table __ degrees
right, 45
Describe how the pt should be adjuestedfrom the rpone to the RAO positoin
roll to the l. elevating th l side
list the two general GI exams routinetly used to examine the stomach
single and double contrast xams
List two advantages of performing the double-contrast examination
small lesions demonstrated and mucosal linng visualized
what is a major advantage of the double contrast UGI exam over the single contrast UGI exam
small lesions on the mucosal lining are better demonstrated
Which body positoin is to be used on AP
supine
What btreathing instructions should be given to the pt when making the exposure
suspend respiration after expireation
what breathing procedure should th pt perform when UGI radiographs are exposed
suspended expiration
Why is the PA oblique projection, LAO position, not included in the typical esophgeal study
the LAO may superimpose vertebreal shadows with distal esophagus
FOr AP or PA projections, how is it determined that the selection of exposure factors was acceptable
the esophagus should be accuratly demonstrated through the superimposed thoracic vertebrea
for the AP projection with the pt supine what procedure should be performed to best demonstrate a diaphragmatic herniation(hiatal hernia)
tilt the table and the pt into a full trendelenburg position
which procedure should be performed to help demonstrate a diaphragmatic herniation
tilt the table to the trendelenburn angulation
In relation to the surrounding structures, where should the esophagus appear in images with the pt in the RAO position
to the left of spine between the thoracic certebrea and heart