RAD112 - Chapter 17
ASIS
For the lateral projection of the large intestine, at what level is the IR centered and the CR enters
hypersthenic
For which body habitus is the stomach almost horizontal?
AP oblique
For which projection of the stomach would a positioning sponge be used?
asthenic
For which type of body habitus is the large intestine bunched together and positioned very low in the abdomen?
asthenic
For which type of body habitus is the stomach nearly vertical?
cardiac notch
Found along the superior aspect of fundus
ascending portion of the duodenum
Fourth portion of the duodenum
storage of food and chemical breakdown of food
Functions of the stomach include: 1) storage of food 2) absorption of food products 3) chemical breakdown of food
18-24 inches
How far above the anus is the enema bag placed during a barium enema?
no more than 4 inches
How far is the enema tip inserted into the rectum for a colon examination?
Aligned with the LUQ, centered 1-2 inches above lower rib margin, LRM is level of L1-L2
How is the IR centered for a recumbent AP or PA projection of the stomach?
24 hrs
How long does it take barium to go through the alimentary canal and reach the rectum?
30 feet
How long is the entire alimentary canal?
40-70 degrees
How much is the body rotated for the PA oblique projection of the stomach and duodenum?
3-6 inches
How much lower should the IR be positioned when the upright position is used for projections of the stomach?
calcium
In order to be radiopaque, gallstones must contain
polyp
Inward growth from the lumen of the intestinal wall
single-stage and two-stage procedures
Methods of performing a double-contrast barium enema include: 1) enteroclysis 2) single-stage procedure 3) two-stage procedure
single contrast and double contrast
Methods of radiographically examining the colon include: 1) enteroclysis 2) single contrast 3) double contrast
body
Middle aspect of the stomach
pylorus
Most anterior portion of the stomach
fundus
Most posterior aspect of the stomach
rugae
Mucosal folds in stomach
elimination of movement
One of the most important technical considerations in gastrointestinal radiography is
esophagogastric junction
Opening between esophagus and stomach
pyloric sphincter
Opening leaving the stomach
diverticulum
Outpouching of the mucosal wall
laxatives, dietary restrictions and cleansing enemas
Prep of the intestinal tract for exam of the colon includes: 1) laxatives 2) dietary restrictions 3) cleansing enemas
intussusception
Telescoping of one part of the intestine into another
30-40 cephalad
The CR angulation for the AP axial projection of the large intestine is?
descending colon
The PA oblique projection of the colon done in the LAO position clearly demonstrates the
stomach contour and duodenal bulb
The PA projection of the stomach best demonstrates the:
hepatic flexure
The ___________ is formed by the junction of ascending and transverse colon
pyloric portion
The area identified in the figure below is the
cardiac antrum
The area identified in the figure is the
fundus
The area identified in the figure is the
cecum
The area of the colon identified in the figure is
ascending colon
The area of the colon identified in the figure is the
sigmoid colon
The area of the colon identified in the figure is the
right colic flexure
The ascending portion of the colon joins the transverse colon at the
hepatopancreatic ampulla
The common bile duct and the pancreatic duct usually unite to form the
peristalsis
The contraction waves by which the digestive tube moves its contents towards the rectum are called
35-45 degrees
The degree of body rotation for an AP oblique projection of the large intestine is
30-60 degrees
The degree of body rotation for an AP oblique stomach radiograph ranges from
35-45 degrees
The degree of body rotation for the PA oblique projection of the large intestine is
hypersthenic
The degree of body rotation for the PA oblique projection of the stomach will depend on the body habitus. The greatest degree of rotation would be used for which body habitus?
duodenojejunal flexure
The duodenum joins the jejunum at a sharp curve called the
PA or AP
The entire colon is best demonstrated in which projection?
cardiac orifice
The esophagus joins the stomach through an opening called the
midsagittal
The esophagus lies in the __________ plane
produce and secrete digestive juices
The exocrine cells of the pancreas function to
cardiac antrum
The expanded portion of the terminal esophagus is called the
15 minutes
The first small intestine radiograph is taken how many minutes after the pt drinks barium?
rugae
The folds of the thick inner lining of the stomach are termed the
store and concentrate bile
The gallbladder functions to
hypersthenic
The gallbladder is generally positioned most superior in pts of what body habitus
enterostomy
The general term used to describe the surgical procedure of forming an artificial opening to the intestine for the passage of fecal material is
pointed toward the umbilicus
The initial insertion of the rectal enema tip should be
mesentery
The jejunum and ileum are attached to the posterior wall of the abdomen by the
haustra
The large intestine is made up of a series of pouches called the
liver
The largest gland in the body is the
reabsorption of fluids and elimination of waste products
The main functions of the large intestines are: 1) digestion of food 2) reabsorption of fluids 3) elimination of waste products
digestion of food and absorption of food
The main functions of the small bowel are 1) digestion of food 2) absorption of food 3) storage of food
iliac crests
The majority of AP, PA, and oblique radiographs taken during a barium enema are done on 14x17 inch IRs. Where is the IR centered on sthenic pts for the majority of these projections?
barium sulfate
The most common contrast medium used for radiologic examination of the gastrointestinal tract is
ileum
The most distal portion of the small intestine is the
villi
The mucosa of the small intestine contains a series of fingerlike projections called
pyloric sphincter
The muscle controlling the opening between the stomach and the duodenum is termed the
cholecystokinin
The muscular contractions of the gallbladder is activated by
ileocecal valve
The opening between the small intestine and the large intestine is called the
pyloric orifice
The opening between the stomach and the small intestine is termed the
greater duodenal papilla
The opening inside the duodenum where pancreatic enzymes and bile enter is called the
pyloric antrum
The part of the stomach identified in the figure is the
cecum
The pouchlike portion of the large intestine that is situated below the junction of the ileum and colon is the:
nothing after midnight
The pt "prep" for a morning stomach exam is
nothing after evening meal, no breakfast
The pt prep for a small intestine exam is
suspended
The respiration phase for all projections of the large intestine is
single contrast and double contrast
The routinely used methods of examining the stomach include: 1) no contrast 2) single contrast 3) double contrast
3
The small intestine is divided into how many distinct portions?
LUQ
The spleen is located in the __________ of the abdomen
4
The stomach wall is composed of how many layers?
portal vein and hepatic artery
The two vessels that supply blood to the liver are the
cecum
The vermiform appendix of the colon is attached to the
4
The wall of the colon is composed of how many layers?
4
The wall of the esophagus is composed of how many layers of tissues?
4
The wall of the small intestine is composed of how many coats?
duodenum
The widest portion of the small bowel is the
horizontal portion of the duodenum
Third portion of the duodenum
upright
To best demonstrate the swallowing function, in which position should the patient be placed to begin the fluoroscopic phase of single-contrast examination of the esophagus?
30-40 degrees caudal
What is the CR angulation for the PA axial projection of the large intestine
45 degrees
What is the average degree of body rotation for an AP oblique projection of the stomach and duodenum?
35-40 degrees
What is the degree of body rotation for the PA oblique projection of the esophagus?
22 feet
What is the length of the average adult small intestine?
5 feet
What is the length of the large intestine?
rectum, sigmoid, descending colon, transverse colon and ascending colon
What is the proper sequence for filling the large intestine with barium when performing a BE?
recumbent
What is the recommended general body position for a radiographic series of the esophagus?
PA, RAO
What is the recommended oblique projection and position for the best demonstration of the esophagus?
expiration
What is the respiration phase for all radiographs of the stomach and intestines?
85%
What percentage of the population will have a combination of sthenic and hyposthenic body habitus?
When performed upright the projection is performed as a left lateral and when performed recumbent the projection is performed as a right lateral
When performing lateral projections of the stomach/duodenum which of the following are true?
a parasagittal plane approximately 2 inches lateral to the MSP on the elevated (left) side
When positioning a PA oblique esophagus in the RAO position, the IR is centered left-to-right (and where the CR enters) with
Between the transverse and descending colon
Where in the large intestine is the left colic flexure located?
iliac crests
Where is the IR centered for all decubitus projections of the large intestines
at the level of the iliac crests
Where is the IR centered for delayed radiographs of the small intestine?
2 inches above the iliac crests
Where is the IR centered for radiographs of the small intestine that are taken within 30 minutes of drinking the barium?
RAO and LPO
Which 2 recumbent positions can be used to demonstrate an unobstructed image of a barium filled esophagus between the vertebrae and the heart?
lesser
Which curvature is located on the medial border of the stomach?
a combination single-contrast and double-contrast study of the GI tract
Which description refers to the biphasic GI exam
glucagon
Which drug may be given to the pt before a double contrast exam of the stomach to relax the GI tract?
by mouth, reflex filling and enteroclysis
Which methods are used to administer barium for a radiographic exam of the small intestine? 1) by mouth 2) reflex filling 3) enteroclysis
small lesions are not obscured and the mucosal lining of the stomach can be more clearly visualized
Which of the following are advantages of using the double contrast technique for examination of the stomach? 1) fewer radiographs are required 2) small lesions are not obscured 3) the mucosal lining of the stomach can be more clearly visualized
varices are filled better and more complete contrast filling, especially proximal part
Which of the following are advantages of using the recumbent position for radiographs of the esophagus? 1) varices are filled better 2) easier to swallow barium 3) more complete contrast filling, especially proximal part
mouth and pharynx, stomach and intestine
Which of the following are components of the alimentary canal? 1) mouth and pharynx 2) stomach and intestine 3) liver and pancreas
AP and PA
Which of the following are essential projections for examination of the small intestine? 1) AP 2) PA 3) lateral
anus, colon, esophagus
Which of the following are included as components of the alimentary canal? 1) anus 2) colon 3) esophagus
AP, LPO and PA, RAO
Which of the following are oblique projections of the stomach and duodenum? 1) AP, LPO 2) PA, RAO 3) PA, LAO
AP or PA, lateral and PA oblique
Which of the following are the essential projections for an esophagus series? 1) AP or PA 2) lateral 3) PA oblique
exhale, swallow the barium, hold breath out
Which of the following best describes the administration of barium for an esophagram being performed for esophageal varices
produces lymphocytes and stores and removes dead red blood cells
Which of the following best describes the function of the spleen? 1) produces glucagon 2) produces lymphocytes 3) stores and removes dead red blood cells
TV, cine and video recorders
Which of the following can be used to record the fluoro image? 1) TV 2) cine 3) video recorders
air, barium sulfate and water-soluble iodinated solution
Which of the following contrast media are used for exams of the GI tract? 1) air 2) barium sulfate 3) water-soluble iodinated solution
Chassard-Lapine method
Which of the following demonstrates the rectum and rectosigmoid area in a true axial projection? 1) AP axial 2) left lateral decubitus 3) Chassard-Lapine method
small intestine only
Which of the following examination requires the use of time markers on the radiographs? 1) stomach 2) small intestine 3) large intestine
it should be inflated by the radiologist using fluoro
Which of the following is true regarding inflation of the retention balloon for a barium enema? 1) it should be inflated by the radiographer using fluoro 2) it should be inflated by the radiologist using fluoro 3) it should be inflated by the radiologist without using fluoro
a longitudinal plane midway between the vertebrae and the lateral border of the elevated side
Which of the following planes is centered to the grid for the PA oblique projection of the stomach and duodenum?
midcoronal plane
Which of the following planes is centered to the grid for the lateral projection of the esophagus?
a plane passing midway between the midcoronal plane and the anterior surface of the abdomen
Which of the following planes is positioned to the center of the grid for the lateral projection of the stomach and duodenum?
AP oblique, LPO
Which of the following projections will best demonstrate the fundus of the stomach?
filled colon radiographs and postevacuation radiographs
Which of the following radiographs are taken during a single-contrast barium enema? 1) spot radiographs 2) filled colon radiographs 3) postevacuation radiographs
PA oblique, RAO
Which of the following will demonstrate the duodenal bulb and loop in profile?
transverse
Which part of the large intestine is located between the ascending and descending parts of the colon?
midcoronal plane
Which plane is centered to the grid for a lateral projection of the large intestine?
sims
Which position should the pt be placed in to insert the enema tip for a barium enema?
supine and trendelenburg
Which positions will best demonstrate the retrogastric portion of the duodenum and jejunum on an AP projection of the stomach? 1) supine 2) trendelenburg 3) standing
PA oblique, LAO
Which projection best demonstrates the left colic flexure?
lateral
Which projection is used for radiographs made during defecography?
PA oblique, RAO
Which projection of the colon best demonstrates the ascending colon?
AP, left lateral decubitus
Which projection of the colon best demonstrates the lateral aspect of the ascending colon and the medial aspect of the descending colon, when the colon is inflated with air?
lateral, ventral decubitus
Which projection of the colon best demonstrates the posterior portions of the colon?
PA oblique, RAO
Which projection of the colon best demonstrates the right colic flexure?
AP, right lateral decubitus
Which projection of the colon will best demonstrate the medial aspect of the ascending colon and the lateral aspect of the descending colon when the colon is inflated with air?
lateral
Which projection of the stomach demonstrates its anterior and posterior surfaces?
AP, trendelenburg
Which projection of the stomach would best demonstrate a diaphragmatic herniation?
lateral, PA axial, AP axial
Which projections taken during a barium enema will demonstrate the rectosigmoid area? 1) lateral 2) PA axial 3) AP axial
PA oblique,LAO and AP oblilque RPO
Which projections will clearly demonstrate the descending colon? 1) PA oblique, LAO 2) AP oblique, RPO 3) left lateral
AP oblique, LPO and PA oblique, RAO
Which projections will clearly demonstrate the right colic flexure? 1) right lateral 2) AP oblique, LPO 3) PA oblique, RAO
Right hypochondrium and epigastrium
Which two regions of the abdomen are almost entirely occupied by the liver?
double-contrast intestine exams
"High-density" barium sulfate is used primarily for: 1) enteroclysis intestine exams 2) single-contrast intestine exams 3) double-contrast intestine exams
a sagittal plane passing halfway between the midline and the lateral border of the abdomen
A PA projection of the stomach and duodenum can be performed using a 10x12 inch IR. Which of the following describes the plane that is centered to the grid for this projection?
midsagittal plane
A PA projection of the stomach and duodenum is often performed using a 14x17 inch IR. Which of the following describes the plane that is centered to the grid for this projection?
cholangiography
A specific radiographic exam of the biliary duct is termed
volvulus
A twisting of a portion of the intestine on its own mesentery
Coffee bean sign
A volvulus is identified on barium studies when a _________________ is seen.
Crohn's Disease
An inflammatory bowel disease that affects the ilieum and the cecum is termed
Crohn's disease
An inflammatory disease of the distal ileum
Ulcerative colitis
An inflammatory disease of the large intestine
distance
As a tech assisting during fluoro, which of the cardinal principles of radiation protection is the most effective in reducing your occupational dose
ASIS
At what level is the center of the IR positioned for a lateral projection of the rectosigmoid area?
L1/L2
At which level is the IR centered for a PA projection of the stomach and duodenum?
L1/L2
At which level is the IR centered for an AP or PA oblique stomach and duodenum?
a longitudinal plane 1-2 inches lateral to the midline of the body on the elevated side
At which plane is the CR positioned for the PA oblique projections of the large intestine?
anteriorly and superiorly
BC of the anatomy of the rectum, an enema tip should be inserted ________ to prevent injury
ampulla of vater
Common bile and pancreatic duct meets to form the
statement 1 is FALSE and statement 2 is TRUE
Consider the following statements about the biliary system: 1) The gallbladder serves as the major production site of bile 2) The function of bile is to emulsify fat for easier digestion
BOTH statement 1 and 2 are TRUE
Consider the following statements: 1) For BE, the temp of the suspension should be lower than the pt's body temp 2) During BE, the colon is slowly filled w contrast to keep cramping to a minimum
Statement 1 is TRUE and statement 2 is FALSE
Consider these statements about percutaneous transhepatic cholangiography. 1) PTC is performed on pts with jaundice when the ductal system has been demonstrated as dilated by CT or sonography 2) PTC is performed with the PT in the prone position
cystic duct
Duct that leaves the gallbladder carrying bile
hepatic duct
Duct that leaves the liver carrying bile
1-swallowing of barium, 2-imaging/spot films, 3-swallowing of sodium bicarbonate, 4-imaging/spot films, 5-imaging/overhead films
During a biphasic UGI procedure, what is the correct sequence of events?
pancreatic duct and common bile duct
During an ERCP, an endoscope is passed into the duodenum under fluoro control. "Spot" radiographs are usually taken of the: 1) pancreatic duct 2) hepatic duct 3) common bile duct
AP and AP oblique, RPO
During an operative cholangiogram, the surgeon injects the contrast medium directly into the billary system. Which of the following projections are typically done during this procedure in surgery? 1) AP 2) AP oblique, RPO 3) AP oblique, LPO
BOTH statement 1 and 2 are FALSE
Evaluate the following statements 1) if a PT is cooperative with breathing instructions, motion on GI tract studies is not an issue BC peristalsis is completely suspended when respiration is suspended 2) When positioning pts for identical projections, the CR is centered higher if the PT is in an upright position
statement 1 is FALSE and statement 2 is TRUE
Evaluate the following statements about contrast media used in the UGI tract: 1) Barium suspensions are preferred over iodinated solutions if bowel perforation is suspected 2) Barium suspensions are less likely to produce anaphylactic reactions than iodinated solutions
BOTH statement 1 and 2 are FALSE
Evaluate the following statements about contrast media used in the UGI tract: 1) Barium suspensions move thru the GI tract quicker than iodinated solutions 2) Barium suspensions do not adhere as well to the mucosa of the esophagus and stomach as iodinated solutions
8 hrs
Food and fluid should be withheld for how many hours before a stomach examination?
the level of the mouth
For all projections of the esophagus, the top of the IR is positioned at
To demonstrate a possible hiatal hernia
For the PA projection as part of the UGI examination, why should the lower lung fields be included on a 14x17 IR?
PA oblique projection, RAO position
For the UGI exam with the pt recumbent, which projection best stimulates gastric peristalsis to better demonstrate the pyloric canal and duodenal bulb?
PA oblique projection, RAO position
For the double-contrast UGI exam with the pt recumbent, which projection produces the best image of a gas-filled fundus?