Chapter 12: Biliary Tract and Upper Gastrointestinal System

The average adult gallbladder is ____ cm long and ____ cm wide. A) 7 to 10; 3 B) 4 to 6; 2 C) 12 to 15; 5 to 6 D) 2 to 3; 1

A) 7 to 10; 3 pg. 447: the normal gallbladder is 7 to 10 cm long and approximately 3 cm wide. It generally holds 30 to 40 mL of bile.

Toward which aspect(s) of the stomach will barium gravitate with the patient in a prone position? A) Body and pylorus B) Fundus C) Cardiac D) Fundus and body

A) Body and pylorus pg. 455: fig. 12.29: Air/gas = black, barium = white Supine position = the fundus is the most posterior portion and is where barium settles. RAO recumbent position (Pt is prone) = the fundus is in the highest position, causing gas to fill this portion of the stomach. The barium settles in the anterior body & pylorus. Erect = air/gas rises to fill the fundus, whereas barium descends to fill the pyloric portion of the stomach.

Which of the following technical factors will best enhance a digital image taken during an upper GI series? A) Collimation B) Low kV techniques C) Long SID D) Use of compensation (wedge) filter

A) Collimation pg. 476: Because of the proximity of the spine, without accurate collimation the imaging system may rescale the image to display a longer than optimal scale of contrast.. This could lead to certain soft tissue structures and pathology being obscured during the image reconstruction process. Careful collimation to the organs of interest minimizes this possibility.

Which biliary structure is labeled 4? A) Cystic duct B) Common bile duct C) Common hepatic duct D) Right hepatic duct

A) Cystic duct pg. 447: figures 12.5, 12.6, and 12.7

The dilated portion of the distal esophagus is termed the: A) cardiac antrum B) cardiac notch. C) fundus. D) incisura cardiaca.

cardiac antrum. pg. 452-453: the esophagus pierces the diaphragm at the level of T10. Just before passing through the diaphragm, the esophagus presents a distinct dilation ... the abdominal segment of the esophagus is termed the cardiac antrum.

What type of contrast media is ideal for demonstrating a diverticulum within the stomach? A) Double-contrast barium/negative contrast agent B) Single-contrast barium sulfate C) Water soluble D) Radiolucent

A) Double-contrast barium/negative contrast agent pg. 462: potential polyps, diverticula, and ulcers are better demonstrated with a double-contrast technique.

What is an older term for the pancreatic duct? A) Duct of Wirsung B) Hepatopancreatic duct C) Duct of Langerhans D) Ampulla of Vater

A) Duct of Wirsung pg. 447: pancreatic duct (Duct of Wirsung)

Where is cholecystokinin produced? A) Duodenal mucosa B) Liver C) Gallbladder D) Pancreas

A) Duodenal mucosa pg. 447: Food stimulates the duodenal mucosa to secrete the hormone cholecystokinin (CCK).

What is the most common radiographic procedure performed to diagnose GERD? A) Endoscopy B) Esophagogram C) Upper GI series D) CT

A) Endoscopy pg. 467: endoscopy is often performed to detect early signs of GERD.

Which of the following conditions involves dilated veins in the distal aspect of the esophagus, which in some cases can lead to internal bleeding? A) Esophageal varices B) Esophageal reflux C) Esophageal hypertension D) Esophageal thrombosis

A) Esophageal varices pg. 467: Esophageal varices = characterized by dilation of the veins in the wall of the distal esophagus

Which division of the duodenum contains the duodenal bulb or cap? A) First (superior) B) Third (horizontal) C) Second (descending) D) Fourth (ascending)

A) First (superior) pg. 456: the duodenum is shaped like the letter "C" and consists of four parts. The first (superior) portion begins at the pylorus of the stomach. The first part of the superior portion is termed the duodenal bulb.

A radiograph taken during an esophagogram using thin barium mixture demonstrates that there is very little contrast media in the esophagus. Which of the following points will improve filling of the esophagus? (The exposure was made on inspiration after the last swallow.) A) Have the patient drink during the exposure. B) Have the patient perform the Valsalva maneuver during the exposure. C) Have the patient perform the Müller maneuver during the exposure. D) Shorten the exposure time.

A) Have the patient drink during the exposure. pg. 478: thin barium = for complete filling of the esophagus with thin barium, the patient may have to drink through a straw, with continuous swallowing and exposure made after 3 or four swallows without suspending respiration.

Which of the following substances are not digested chemically? A) Minerals B) Carbohydrates C) Proteins D) Lipids

A) Minerals pg. 457: Only carbohydrates, proteins, and lipids must be chemically digested to be absorbed.

Which of the following imaging modalities is ideal for demonstrating signs of Barrett esophagus? A) Nuclear medicine B) MRI C) Sonography D) CT

A) Nuclear medicine pg. 477: NM is very effective in demonstrating Barrett esophagus.

Which structure is labeled 9? A) Pancreatic duct B) Common bile duct C) Cystic duct D) Common hepatic duct

A) Pancreatic duct pg. 447: figures 12.5, 12.6, and 12.7

Which two forces or processes propel food down the esophagus? A) Peristalsis and gravity B) Peristalsis and rhythmic segmentation C) Gravity and deglutition D) Deglutition and mastication

A) Peristalsis and gravity pg. 453: fluids tend to pass from the mouth and pharynx to the stomach, primarily by gravity. A bolus of solid material tends to pass both by gravity and by peristalsis.

What is the classification of barium sulfate as a contrast media? A) Radiopaque B) Radiolucent C) Isodense D) Negative contrast media

A) Radiopaque pg. 461: the most common positive, or radiopaque, contrast medium used to visualize the gastrointestinal system is barium sulfate (BaS04).

Which of the following imaging modalities is an alternative to an esophagogram for detecting esophageal varices? A) Sonography B) CT C) Nuclear medicine D) MRI

A) Sonography pg. 477: intraesophageal sonography for esophageal varices and carcinoma of the esophagus is becoming an alternative to the esophagram.

Part iii refers to the: A) nasopharynx. B) laryngopharynx. C) oropharynx. D) nasal cavity.

A) nasopharynx. pg. 451: figure 12.15

Part ii refers to the: A) soft palate. B) tonsils. C) hard palate. D) epiglottis.

A) soft palate. pg. 451: figure 12.15

Saliva contains certain enzymes to begin the digestion of: A) starch. B) minerals. C) proteins. D) lipids.

A) starch pg. 451: saliva dissolves foods to begin the digestion process. It also contains the enzyme amylase, which breaks down starches.

Protective aprons worn during fluoroscopy must possess at least ____ mm lead equivalency (Pb/Eq.). A) 0.25 B) 0.5 C) 0.75 D) 1

B) 0.5 pg. 465: protective aprons of 0.5 mm lead equivalency must always be worn during fluoroscopy.

A PA radiograph taken on a hypersthenic patient during an upper GI series reveals that the pylorus and duodenal bulb are superimposed. Which of the following modifications will best eliminate the superimposition between these structures? A) Roll the patient into a slight RAO position. B) Angle the CR 35° to 45° cephalad. C) Place a rolled towel or a filled compression paddle under the patient's abdomen before exposure. D) Increase the kV.

B) Angle the CR 35° to 45° cephalad. pg. 483: an alternative PA axial position may be used = a 35° to 45° cephalad CR angle separates the duodenal bulb and pyloric region of the stomach.

Which part of the stomach is labeled 9? A) Cardiac notch B) Angular notch C) Pyloric orifice D) Incisura cardiaca

B) Angular notch pg. 454: Fig. 12.23

Which part of the stomach is labeled 3? A) Angular notch B) Cardiac notch C) Incisura angularis D) Esophagogastric junction

B) Cardiac notch pg. 454: Fig. 12.23

Which of the following is not a main subdivision of the stomach? A) Fundus B) Cardium C) Pylorus D) Body

B) Cardium pg. 454: the stomach is composed of three main subdivisions (1) the fundus, (2) the body, (3) the pylorus.

Which one of the following cardinal principles of radiation protection is most effective in reducing the dose to the technologist during fluoroscopy? A) Time B) Distance C) Intensity D) Shielding

B) Distance pg. 465: the most effective method of reducing dose during fluoroscopy procedures is to increase the distance between the x-ray tube and the technologist.

Which aspect of the gallbladder is labeled 1? A) Neck B) Fundus C) Body D) Apex

B) Fundus pg. 447: figures 12.5, 12.6, and 12.7

At what level should the CR and image receptor be centered for the RAO or PA upper GI projection and/or position on a sthenic body type of patient? A) Lower costal margin B) L1 C) L3-4 D) iliac crest

B) L1 pg. 482: Sthenic = CR @ L1 Asthenic = CR 2" below L1 Hypersthenic = CR 2" above L1

Other than the esophagogram, what imaging modality is performed to diagnose Barrett's esophagus? A) Computed tomography B) Nuclear medicine C) Magnetic resonance D) Sonography

B) Nuclear medicine pg. 468: table 12.5 = esophagram or NM

Which aspect of the gastrointestinal (GI) tract is primarily responsible for the absorption of digestive end products along with water, vitamins, and minerals? A) Stomach B) Small intestine C) Large intestine D) Pancreas

B) Small intestine pg. 457: most of the absorption of digestive end products occurs in the small intestine. Simple sugars, amino acids, fatty acids, glycerol, water, and most salts & vitamins are absorbed into the bloodstream or the lymphatic system through the the lining of the small intestine.

What structure indicates the junction between the duodenum and jejunum? A) Duodenal cap B) Suspensory muscle of the duodenum C) Valvulae conniventes D) C-loop of the duodenum

B) Suspensory muscle of the duodenum pg. 456: the junction of the duodenum with the second portion of the small intestine, the jejunum is termed the duodenojejunal flexure. This portion is relatively fixed and is held in place by a fibrous muscular band, the ligament of Treitz (suspensory muscle of the duodenum). This structure is a significant radiographic reference point.

Which of the following patient care concerns would prevent the use of an oral, water-soluble contrast medium? A) The patient has a possible ulcer. B) The patient is sensitive to iodine. C) The patient has esophageal reflux. D) The patient has dysphasia.

B) The patient is sensitive to iodine. pg. 462: water-soluble iodinated contrast media should not be used if the patient is sensitive to iodine, or if the patient is experiencing severe dehydration.

Why would a patient undergo Valsalva maneuver during an esophagogram? A) To demonstrate possible esophageal varices B) To demonstrate possible esophageal reflux C) To demonstrate possible esophagitis D) To demonstrate a possible bezoar

B) To demonstrate possible esophageal reflux pg. 470: various breathing exercises (Valsalva maneuver, Mueller maneuver) are designed to increase both intrathoracic and intra-abdominal pressures. The increase in intra-abdominal pressure may produce the reflux of ingested barium that would confirm the presence of esophageal reflux.

Research suggests that peptic ulcers may be caused by: A) smoking. B) bacteria. C) alcohol. D) antibiotics.

B) bacteria. pg. 437: some more recent studies suggest that ulcers may be caused by bacteria and can be treated with antibiotics.

Enzymes that aid in chemical digestion are classified as: A) lipids. B) biologic catalysts. C) digestive acids. D) amino acids.

B) biologic catalysts. pg. 457: chemical digestion is sped up by various enzymes. Enzymes are biologic catalysts.

Radiographic examination of the biliary ducts only is termed: A) cholecystography. B) cholangiography. C) cholelithiasis. D) cholecystocholangiography.

B) cholangiography. pg. 448: table 12.1 cholangiography = radiographic examination of biliary ducts.

The main function of bile is to: A) break down cholesterol. B) emulsify fats. C) begin the digestion of proteins. D) begin the digestion of complex sugars.

B) emulsify fats. pg. 446: the major functions of bile are to aid in the digestion of fats by emulsifying (breaking down) fat globules, and aid in the absorption of fat following its digestion.

Most esophagograms begin with the patient: A) recumbent-supine. B) erect. C) recumbent-prone. D) in a left lateral decubitus position.

B) erect. pg. 469: because esophagram studies begin with the table in the vertical position, the footboard should be in place.

The liver is divided into ____ major and minor lobes. A) three B) four C) two D) six

B) four pg. 446: the liver is divided into 2 major lobes and 2 minor lobes. 2 major = right & left lobes 2 minor = quadrate lobe & caudate lobe

The RAO position of the esophagus is preferred over the left anterior oblique (LAO) because it: A) is a more comfortable position for the patient. B) increases the visibility of the esophagus between the vertebrae and heart. C) reduces thyroid exposure to the patient. D) is easier for the patient to hold the cup of barium in his or her left hand.

B) increases the visibility of the esophagus between the vertebrae and heart. pg. 478: RAO provides better visibility of pertinent anatomy between vertebrae and heart.

The aortic arch and the _____ create a normal indentation seen along the lateral border of the esophagus. A) pulmonary artery B) left primary bronchus C) pulmonary veins D) superior vena cava

B) left primary bronchus pg. 452: as the esophagus descends within the posterior aspect of the mediastinum, two indentations are present. One indentation occurs at the aortic arch, and the second is found where the esophagus crosses the left primary bronchus.

The esophagus is located ____ to the larynx. A) anterior B) posterior C) inferior D) proximal

B) posterior pg. 452: the esophagus is located posterior to the larynx and trachea.

Gastric emptying studies are performed using: A) intraesophageal sonography. B) radionuclides. C) MRI. D) CT.

B) radionuclides. pg. 477: with the use of radionuclides, nuclear medicine scans demonstrate cirrhosis of the live, splenic tumors, gastrointestinal bleeding, and gastric emptying studies.

Part vii refers to the: A) esophagus. B) trachea. C) spinal cord. D) larynx.

B) trachea. pg. 451: figure 12.15

Which of the following kV ranges should be used for an upper GI series using barium sulfate (single-contrast study)? A) 80 to 90 kV B) 90 to 100 kV C) 110 to 125 kV D) 125 to 140 kV

C) 110 to 125 kV pg. 476: high kV of 110 to 125 is required to penetrate adequately and increase visibility of barium-filled structures. A kV les than 100 would not provide visibility of mucosa of the esophagus, stomach, or duodenum.

How much obliquity is required for the RAO position for the esophagus? A) 10° to 15° B) 20° to 30° C) 35° to 40° D) 45° to 60°

C) 35° to 40° pg. 478: rotate 35° to 40° from prone position, with right anterior body against IR.

How much barium is typically given to a 3- to 10-year-old child during an upper GI series? A) 4 to 6 ounces B) 14 to 16 ounces C) 6 to 12 ounces D) 1 cup

C) 6 to 12 ounces pg. 475: barium volume guidelines... Newborn to 1 year = 2 to 4 oz. 1 to 3 years = 4 to 6 oz. 3 to 10 years = 6 to 12 oz. Older than 10 years = 12 to 16 oz.

The liver secretes approximately ____ mL of bile per day. A) 100 to 250 B) 500 to 700 C) 800 to 1000 D) 1200 to 1500

C) 800 to 1000 pg. 446: The liver performs more than 100 different functions, but the function most applicable to radiographic study is the production of large amounts of bile. It secretes 800 to 1000 ml, or about 1 quart of bile per day.

Which of the following devices reduces scatter exposure during fluoroscopy from the fluoroscopy tube? A) Compression paddle B) Bucky tray C) Bucky slot shield D) Lead gloves

C) Bucky slot shield pg. 465: bucky slot shield - this shield significantly reduces scatter radiation resulting from the fluoroscopy x-ray tube located under the table.

What is a potential risk associated with the use of water-soluble contrast agents, especially for geriatric patients? A) Bowel obstruction B) Cardiac arrest C) Dehydration D) Shock

C) Dehydration pg. 475: the risk of dehydration during GI studies is a concern for geriatric patients. The use of water soluble contrast agents such as Gastrographin or MD-Gastroview may increase the risk of dehydration further.

Which of the following conditions is an example of GERD? A) Esophageal varices B) Gastric carcinoma C) Esophageal reflux D) Bezoar

C) Esophageal reflux pg. 467: Gastroesophageal reflux disease (GERD), or esophageal reflux, is the entry of gastric contents into the esophagus, irritating the lining of the esophagus.

Which specific part of the pancreas is adjacent to the C-loop of the duodenum? A) Tail B) Body C) Head D) Neck

C) Head pg. 456: the head of the pancreas is nestled in the C-loop of the duodenum.

Which of the following is not one of the cardinal principles of radiation protection? A) Time B) Distance C) Intensity D) Shielding

C) Intensity pg. 465: cardinal principles of radiation protection = time, distance, shielding.

Which of the following statements is true about barium sulfate? A) It should be discarded if not used within an hour after mixing. B) The patient may become ill if it is not prepared with sterile water. C) It rarely produces an allergic reaction. D) It is soluble in water.

C) It rarely produces an allergic reaction pg. 461: this particular compound, which is a salt of barium, is relatively inert because of its extreme insolubility in water and other aqueous solutions, such as acids. Because it does not interact chemically with the body, it rarely produces an allergic reaction.

Where is bile formed? A) Gallbladder B) Duodenal mucosa C) Liver D) Pancreas

C) Liver pg. 447: bile is formed in small lobules of the liver .

Which of the following definitions would describe a bezoar? A) Inflammation of the gastric lining B) Outpouching of the stomach wall C) Mass of undigested material D) Stomach neoplasm

C) Mass of undigested material pg. 471: bezoar describes a mass of undigested material that becomes trapped in the stomach.

Patient preparation for an adult upper GI series includes: A) nothing; no patient preparation is required. B) NPO 4 hours before the procedure. C) NPO 8 hours before the procedure. D) NPO 24 hours before the procedure.

C) NPO 8 hours before the procedure. pg. 474: food and fluids should be withheld for at least 8 hours before the examination.

Which aspect of the gallbladder is located most posterior within the abdomen? A) Fundus B) Body C) Neck D) Apex

C) Neck pg. 447: The fundus is the distal end of the broadest part of the gallbladder. The body is the main section of the gallbladder. The neck is the narrow proximal end.

Which of the following clinical indications would mandate the use of an oral, water-soluble contrast agent? A) Patient with esophageal reflux B) Patient with a bezoar C) Patient with a possible perforated bowel D) Patient with a possible peptic ulcer

C) Patient with a possible perforated bowel pg. 462: barium sulfate mixtures are contraindicated (not used) if there is any chance that the mixture might escape into the peritoneal cavity.

Which part of the stomach is labeled 6? A) Body B) Pyloric portion C) Pyloric antrum D) Pyloric canal

C) Pyloric antrum pg. 454: Fig. 12.23

Which aspect of the stomach is attached to the duodenum? A) Fundus B) Body C) Pylorus D) Cardiac

C) Pylorus pg. 455: the first (superior) portion of the duodenum begins at the pylorus of the stomach.

The liver is located primarily in the ____ of the abdomen. A) LLQ B) RLQ C) RUQ D) LUQ

C) RUQ pg. 446: the liver occupies most of the right upper quadrant.

Which of the following procedures will not demonstrate possible esophageal reflux? A) Toe-touch maneuver B) Water test C) Reverse Trendelenburg method D) Compression technique

C) Reverse Trendelenburg method pg. 470: one or more of the following procedures may be performed to detect esophageal reflux: (1) breathing exercises, (2) water test, (3) compression paddle technique, (4) toe-touch maneuver.

A patient comes to radiology for an upper GI series. Her clinical history indicates that there may be a tumor posterior to the stomach. Which one of the following projections and/or positions will best demonstrate this condition? A) RAO B) PA C) Right lateral D) LPO

C) Right lateral pg. 484: Right lateral clinical indications = patholigc processes of the retrogastric space (space behind the stomach) ... demonstrates diverticula, tumors, gastric ulcers and trauma.

What type of breathing instructions should be given to the patient during an esophagogram using a thin barium mixture? A) Suspended respiration while continuing to swallow B) Suspended inspiration after the last swallow C) Shallow breathing and continued swallowing during exposure D) Exposure immediately after last bolus is swallowed (patient will not be breathing immediately after swallow)

C) Shallow breathing and continued swallowing during exposure pg. 478: thin barium = for complete filling of the esophagus with thin barium, the patient may have to drink through a straw, with continuous swallowing and exposure made after 3 or four swallows without suspending respiration.

What is a primary function of cholecystokinin? A) Serves as an enzyme to break down certain food nutrients B) Stimulates the production of bile C) Stimulates the gallbladder to contract D) Inhibits the formation of gallstones.

C) Stimulates the gallbladder to contract pg. 447: Food stimulates the duodenal mucosa to secrete the hormone cholecystokinin (CCK). Increased levels of CCK in the blood cause the gallbladder to contract and the terminal opening of the common bile duct to relax.

CR centering for an esophagogram should be to the vertebral level of: A) the sternal angle. B) T3 or T4. C) T5 or T6. D) T7.

C) T5 or T6. pg. 478: position = CR is centered at level of T5 and T6 to include entire esophagus.

"Chole-" is a prefix for terms pertaining to the: A) gallbladder. B) ducts. C) bile. D) liver.

C) bile. pg. 448: table 12.1 "Chole-" = prefix denoting relationship to bile

Once food enters the stomach and is mixed with gastric secretions, it is termed: A) bile. B) lipids. C) chyme. D) biologic catalysts.

C) chyme pg. 457: the stomach contents are churned or mixed with stomach fluids into a semifluid mass term chyme.

The act of swallowing is termed: A) mastication. B) digestion. C) deglutition. D) aphasia.

C) deglutition. pg. 451: the act of swallowing is termed deglutition.

The opening between the stomach and esophagus is termed the: A) cardiac antrum. B) cardiac notch. C) esophagogastric junction. D) esophagocardiac junction.

C) esophagogastric junction. pg. 453: the opening between the esophagus and the stomach is termed the esophagogastric junction.

Achalasia is generally defined as: A) difficulty in swallowing. B) a common malignancy of the esophagus. C) motor disorder of the esophagus. D) large outpouching of the esophagus.

C) motor disorder of the esophagus. pg. 466: Achalasia = also termed cardiospasm, is a motor disorder of the esophagus in which peristalsis is reduced along the distal two-thirds of the esophagus.

Part i refers to the: A) nasal sinus. B) maxillary sinus. C) nasal cavity D) upper oral cavity.

C) nasal cavity pg. 451: figure 12.15

Part iv refers to the: A) laryngopharynx. B) nasopharynx. C) oropharynx. D) posterior oral cavity.

C) oropharynx. pg. 451: figure 12.15

Lipids (fats) are broken down into fatty acids and glycerol as they are digested and absorbed by the: A) stomach and small bowel. B) stomach only. C) small bowel only. D) None of the above (are not digested).

C) small bowel only. pg. 457: lipid, or fat, digestion essentially occurs only in the small bowel, although small amounts of the enzyme necessary for fat digestion are found in the stomach.

A stomach with the duodenal bulb at the level of L1-2 would be found in a(n) ____ patient. A) hyposthenic B) asthenic C) sthenic D) hypersthenic

C) sthenic pg. 458: sthenic = the dueodenal bulb is at the approximate level of L1 to L2.

Which of the following functions are performed by the gallbladder? A) Storage of bile B) Concentration of bile C) Contraction and release of bile D) All of the above

D) All of the above pg. 447: three primary functions of the gallbladder are (1) to store bile, (2) to concentrate bile, (3) contract when stimulated.

Which of the following structures is not one of the salivary glands? A) Parotid B) Sublingual C) Submandibular D) All of the above are salivary glands.

D) All of the above are salivary glands. pg. 451: three pairs of glands secrete most of the saliva in the oral cavity. These glands are the (1) parotid, (2) submandibular, (3) sublingual.

Which of the following positions is not normally considered to be part of the esophagogram basic routine? A) Posteroanterior (PA) B) Left lateral C) Right anterior oblique (RAO) D) Anteroposterior (AP)

D) Anteroposterior (AP)

Which part of the stomach is labeled 2? A) Esophagogastric junction B) Incisura angularis C) Incisura cardiaca D) Cardiac antrum

D) Cardiac antrum pg. 454: Fig. 12.23

What type of solution is formed when barium is mixed with water? A) Water-soluble solution B) Isotonic solution C) Hypotonic solution D) Colloidal suspension

D) Colloidal suspension pg. 461: a mixture of barium sulfate and water forms a colloidal suspension.

Which term describes the outer, lateral border of the stomach? A) Lesser curvature B) Incisura angularis C) Gastric border D) Greater curvature

D) Greater curvature pg. 454: the greater curvature is found along the lateral border of the stomach.

Which region of the biliary system is labeled 10? A) Duct of Vater B) Hepatopancreatic ampulla C) Duct of Wirsung D) Hepatopancreatic sphincter

D) Hepatopancreatic sphincter pg. 447: figures 12.5, 12.6, and 12.7

A radiograph taken during an upper GI series demonstrates poor visibility of the gastric mucosa. The following factors were used: 80 kV, 30 mAs, and 1/40-second exposure time. Barium sulfate was used during the procedure. Which of the following factors needs to be modified during the repeat exposure? A) Use of detail-speed screens (adjust mAs accordingly) B) Shortened exposure time (increase mAs accordingly) C) Use of a water-soluble contrast medium D) Increased kV (decrease mAs as needed)

D) Increased kV (decrease mAs as needed) pg. 476: high kV of 110 to 125 is required to penetrate adequately and increase visibility of barium-filled structures. A kV les than 100 would not provide visibility of mucosa of the esophagus, stomach, or duodenum.

Which of the following structures is not considered to be an accessory organ of digestion? A) Liver B) Pancreas C) Salivary glands D) Kidneys

D) Kidneys pg 450: accessory organs of digestion include the salivary glands, pancreas, liver, and gallbladder.

Which of the following upper GI projections and/or positions will best demonstrate the pylorus and duodenal bulb in profile during a double-contrast study? A) AP B) LAO C) PA D) LPO

D) LPO pg. 485: unobstructed view of duodenal bulb without superimposition of pylorus.

Which structure is labeled 6? A) Cystic duct B) Pancreatic duct C) Right hepatic duct D) Left hepatic duct

D) Left hepatic duct pg. 447: figures 12.5, 12.6, and 12.7

Patient preparation for an esophagogram includes NPO _____ before the procedure. A) 4 to 6 hours B) 30 minutes to 1 hour C) 4 to 6 hours and no gum chewing or smoking D) None of the above; patient preparation is not needed as long as an upper GI series is not scheduled to follow.

D) None of the above; patient preparation is not needed as long as an upper GI series is not scheduled to follow. pg. 469: because the esophagus is empty most of the time, patient need no preparation for an esophagram unless an upper GI series is to follow.

Which of the following upper GI projections and/or positions will best fill the body and pylorus with barium? A) AP B) Right lateral C) Left posterior oblique (LPO) D) PA

D) PA pg. 483: PA = body and pylorus of the stomach are filled with barium.

What is the primary purpose of the membranous folds located within the cystic duct? A) Produces cholecystokinin B) Prevents gallstones from entering the gallbladder C) Provides blood supply to the gallbladder D) Prevents distention or collapse of the cystic duct

D) Prevents distention or collapse of the cystic duct pg. 447: the cystic duct is 3 to 4 cm long and contains several membranous folds along its length. These folds are called the spiral valve, which functions to prevent distention or collapse of the cystic duct.

What is the term for the longitudinal mucosal folds found within the stomach? A) Gastric canal B) Valvulae conniventes C) Haustra D) Rugae

D) Rugae pg. 455: when the stomach is empty, the internal lining is thrown into numerous longitudinal mucosal folds terms rugae.

What is an older term for the hepatopancreatic sphincter? A) Duodenal papilla B) Sphincter of Vater C) Duodenal sphincter D) Sphincter of Oddi

D) Sphincter of Oddi pg. 447: hepatopancreatic sphincter (Sphincter of Oddi)

Which of the imaging modalities or procedures is most effective and preferred in diagnosing HPS? A) Nuclear medicine B) CT C) Upper GI series D) Ultrasound

D) Ultrasound pg. 472: hypertrophic pyloric stenosis (HPS) is the most common gastric obstruction in infants ... Sonography has become the modality of choice in diagnosing (HPS).

A large outpouching of the proximal esophagus above the upper esophageal sphincter is termed: A) Barrett esophagus. B) esophageal varices. C) esophageal reflux. D) Zenker diverticulum.

D) Zenker diverticulum. pg. 467: Zenker diverticulum = characterized by a large outpouching of the esophagus just above the upper esophageal sphincter.

Part ix refers to the: A) soft palate. B) tonsils. C) uvula. D) epiglottis.

D) epiglottis. pg. 451: figure 12.15

A high and transverse stomach would be found in a(n) ____ patient. A) hyposthenic B) asthenic C) sthenic D) hypersthenic

D) hypersthenic pg. 458: the stomach is very high and assumes a transverse position.

Part v refers to the: A) nasopharynx. B) larynx. C) oropharynx. D) laryngopharynx.

D) laryngopharynx. pg. 451: figure 12.15

When using computed radiography (CR), inadequate kV or mAs will produce a ____ image. A) dark B) light C) blurry D) mottled

D) mottled pg. 476: inadequate kV or mAs produces a "mottled" image.

Gastritis is defined as inflammation of the: A) pancreas. B) large intestine. C) small intestine. D) stomach.

D) stomach. pg. 471: Gastritis = inflammation of the lining of the mucosa of the stomach.