Digestive System (Alimentary Canal)

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Body of the stomach

descedning from the fundus and beginning at the level of the cardiac notch.

Stomach

dilated, salike portion of the digestive tract extending between the esophagus and the small intestine.

Duodenum

8-10 inches in length, and is the widest portion of the small intestine. It is retroperitoneal and relatively fixed in position.

to demonstrate a possible hital hernia

Fo the PA projection as part of the UGI exmination, why should the lower lung fields be included on a 14X17 inch IR?

Iliac Crests

For delayed AP projections demonstrating the small intestine of a sthenic patient, to which level of the patient should the IR be centered?

35-40

For images with the patient in the RAO (Esophagus) position, the patient should be rotated approximately _________ to ________ degrees.

Support patient on radiolucent sponge

For lateral decub positons, what should be accomplished to ensure that the dependent side of the patient is demonstrated?

Right

For the AP oblique projection, LPO position which sie of the patient should be elevated away from the x-ray table

35-45

For the AP oblique projection, LPO position, the patient should be rotated __________ to _________ degrees

35-45 degrees

How many degrees should the pateints be rotated from the supine position for the AP oblique projection, RPO position

40-70

How many degrees should the patient be rotated from the prone position?

peristalsis is accelerated

How might the oral method of small bowl examination be affected by giving the patient a cup of cold water after the administration of the contrast medium?

Flexures to rectum

How much of the colon should be demonstrated in the image of a lateral decub position?

Center the IR 3-6 inches lower

How should the center of the IR be adjusted if the patient is repositioned from the prone position to the upright position?

Perpendicularly

How should the central ray be directed for the PA projection?

Angled caudally (30-40)

How should the central say be directed for the PA axial Projection?

Prone

How should the patient be placed for the PA projection?

Prone

How should the patient be placed for timed images when compression of the abdominal contents is desired?

Supine

How should the patient be positioned when the small intestine is to be filled by the complete reflux method?

Center over the midline of the grid a sagittal plane passing halfway between the vertebral column and the left lateral border of the abdomen.

How should the patients positions be adjusted to center the stomach over the midline of the table?

weight supported by cushion under thorax and pelvis

How should the prone position of the patient be adjusted to prevent the full weight of the abdomen from causing the stomach and duodenum to press against the vertebral column.

LAO

What other oblique positions produces an iage receptor similar to the AP oblique projection, RPO position

Oral

What small bowel series is most common?

RAO (preferred) and LPO

What two oblique positions can be used to demonstrate the entire esophagus effectively?

A high-density barium product and carbon dioxide crystals

What two types of contrast media are used for double- contrast esophageal studies?

A barium sulfate product of 30% to 50% weight per volume concentration

What type of radiopaque contrast medium usually is used in routine UGI studies?

post evacuation image

What wording refers to the last image usually performed as part of a BE examination

to indicate the interval between the exposure of the image and the ingestion of the barium

Why is a time marker displayed on each images made during oral method small bowel series?

The LAO position may superimpose vertebral shadows with the distal esophagus.

Why is the PA oblique projection, left anterior oblique (LAO) position, not included in the typical esophageal study?

It allows more complete contrast filling of the esophagus.

Why is the recumbent right anterior oblique (RAO) position preferred over the upright position?

obtain better coating of the lumen

Why should a high-density barium product be used as the contrast medium for double contrast barium enema?

To coat the mucosal lining of the stomach

Why should patients undergoing double-contrast examinations turn from side to side or roll over a few times during a procedure?

Asthenic

With which body habitus does the greatest visceral movement occur between the prone position and the upright position?

Small intestine

extends from the pyoric sphincter of the the stomach to the ileocecal valve.

Rectum

extends from the sigmoids colon to the anal canal.

Villi

fingerlike projections, which assist the processes of digestions and absorption.

Chyme

food that has been mechanically and chemically altered in the stomach is transported to the duodenum as a material called

instruct patient to drink a glass of ice water

for a small bowel series of a patient with hypomotility of the small intestine, which procedure shoud be performed to accelerate peristalsis

2 inches below ASIS

for the AP axial projection, where on the patients anterior surface should the central ray enter when a 14X17 inch IR is used?

PA oblique porjection, RAO position

for the single contrast UGI examination with the patient recumbent, which projection produces the best image of a barium-filled pyloric canal and duodenal bulb in patients whose habitus approximates teh sthenc type?

right iliac

in which abdominal region does the large intesting originate?

Ileocecal Valve

valve projects into the lumen of the cecum and gaurds the opening between the ileum and the cecum

Fluoro and x-ray

what 2 imaging modalities are most commoly used to examne the alimentary canal after the introduction of a barium product?

storage, where food is broken down

what are the 2 main functions of the stomach?

single and double contrast

what are the two basic methods for performing a barium enema?

examined first with double contrast, then with single contrast

what is a biphasic GI examination?

no fecal matter present

what is considered the most important aspect of patient preparation for the BE?

24 inches

what is the maximum height above the level of the anus that a BE bag may be place on an IV stand?

barium sulfate

what is the most common type of contrast medium used for a barium enema?

Restrictive diet, laxatives, and cleansing enema

what should be included in the instructions generally given to a patient in preparation for a BE

85-90 degrees

what should the temp of the barium be when the administration of a warm barium solution is desirable?

Air and Carbon dioxide

what two radiolucent contrast media can be used during the double contrast BE study

RAO and LPO

what two recumbent oblique poistions can be used to demonstrate best an unobstructed image of a barium-filled esophagus between the vertebrae and the heart?

Barium Sulfate

what type of contrast is used to visualize the alimentary canal.

patient cant tolerate retrograde filling of the colon

when might an orally administered, water-soluble, iodinated contrast medium be used in place of a barium sulfate mixture for a BE?

6th cervical vertebrae, T11

where does the esophagus originates? And where does it terminate?

between the descedning colon and the rectum

where in the large intestin is the sigmoid located?

between the transverse colon and the descending colon

where in the large intestine is the left colic flexure located?

Enterolysis

which method of preforming a small bowel series does not use a cleansing enema as part of patient preparation?

Rectum and sigmoid

which portions of the large intestine are of prime interest with the left lateral portion

PA axial projection

which projection produces an image similar to the AP axial projection?

Complete Reflux

which small bowel series method often requires the administration of glucagon or diazepam to relax the intestine and reduce patient discomfort during the initial filling of the small intestine

cecum

which structure, when visualized on an image as part of a small bowel series usually indicates the completion of the examination

Hypersthenic

Which type of body habitus requires the most rotation?

ASIS

To which level of the patient should the central ray be directed for the PA axial projection?

True

True of False: A barium sulfate mixture is the preferred contrast medium for esophagrams.

True

True of False: For the average patient, the PA oblique projection, RAO position, produces the vest images of the pyloric canal and the duodenal bulb filled with barium.

True

True of False: The PA projection with the patient in the prone position demonstrates the contour of the barium filled stomach and duodenal bulb.

True

True of False: The barium sulfate suspension sue for double contrast examinations should have a higher weight per volume ration then the barium sulfate suspension sued for single contrast examinations

False

True of False: The most important requirement for the contrast medium is that the weight per volume should be rated greater than 50%

False

True of False: A compression band may be placed across the patients abdomen to immobilize the patient and reduce involuntary movement of the viscera.

True

True of False: The patient should suspend respiration for the exposure for the AP projection

True

True or False: For the PA oblique projection RAO position, the patient should be rotated 35-45 degrees from the prone position

False

True or False: For the PA oblique projections RAO position, the central ray should be directed 35-45 degrees caudally

True

True or False: Other imaging modalities such as sonography and computed tomography have largely replaced hypotonic dudenography

True

True or False: The PA oblique projections, RAO position, is performed primarily to demonstrate the right colic flexure.

True

True or False: The PA projections with the patient in the upright position shows the size, shape, and relative position of the barium- filled stomach.

True

True or False: The entire colon should be demonstrated for the AP projection

True

True or False: Both colic flexures should be seen in the RAO positon image.

False

True or False: Both colic flexures should be seen with the PA axial projection

True

True or False: Single or Double contrast studies can be sued to demonstrate the esophagus.

UGI

What acronym refers to the Upper Gastrointestinal Series?

reabsorption of fluids and eliminate waste

What are the 2 main functions of the large intestine?

Digestion and absorption

What are the 2 main functions of the small intestine?

High-density barium sulfate suspension and gas producing substance

What are the two types of contrast media used in double contrast procedures

With intubation and without intubation

What are two methods of performing hypotonic duodenography?

Suspended inspiration after expiration

What breathing instructions should be given to the patient when making the exposure? (UGI)

Haustra?

What do the cicles represent?

Jejunum

What is B

Illeum

What is C

Duodenum

What is letter A

Lesser Curvature

What is letter B

Cardia

What is letter C

Fundus of the stomach

What is letter E

Greater Curvature

What is letter H

Pyloric Sphincter

What is letter H

Pyloric Antrum

What is number 10

Pyloric Canal

What is number 10

Angular Notch

What is number 9

Taeniae Coli

What is the Arrow pointing to?

22 feet

What is the length of the small intestine?

2-3 hours

What is the normal emptying time of a normal stomach?

To relax the gastric tract, enabling gastric structures to expand and be better demonstrated

What is the purpose of using glucagon during the double contrast examination?

3 1/2- 4 inches

Approximately how far into the rectum should an enema tip be inserted?

15-30 minutes

Approximately how long after the exposure of the first image should subsequent images be exposed.

1 to 2

Approximately how many inches above the lower rib margin should the IR be centered to the recumbent patient? (Right Lateral)

Reduce production of gas and fecal matter

As part of patient preparation, why should the patient maintain a soft, low-residue diet for 2 days?

L1-L2

At which vertebral level should the central ray enter the patient if the patient is in the recumbent position (Right Lateral)

L3

At which vertebral level should the central ray enter the patient if the patient is moved from the recumbent position to the upright lateral position?

Perpendicular to the center of the IR and midway between the midcoronal plane and the anterior surface of the abdomen

Describe how and where the central ray should be directed to the IR and the patient

Instructed not to belch

During double contrast examinations, what instructions should be given to the patient after the patient swallows the carbon dioxide crystals or tablets to ensures a double contrast effect?

the esophagus was demonstrated through the superimposed thoracic vertebrae

For the AP or PA projections for the esophagus, how is it determined that the selections of exposure factors were acceptable

L2

For the AP projection demonstrating the small intestine of a sthenic patient within 30 minutes after the administration of contrast medium, to which level of the patient should the IR be centered?

At the end of expiration

For the AP projection demonstrating the small intestine, when should the exposure be made?

prependicularly

For the AP projection demonstrating the small intestine, where should the central ray be directed?

Midsagittal

For the AP projection demonstrating the small intestine, which plane of the body should be centered to the grid.

Tilit the table and patient into a full trendelenburg position

For the AP projection with the patient supine, which procedure should be performed to demonstrate best a diaphragmatic herniation

Midsagittal

For the PA axial projection, which plane of the body should be centered to the midline of the table?

Right lateral projection

For the UGI examination with the patient recumbent, which projection best demonstrates the right retogastric space?

at level of ASIS

For the lateral rectum projectio, to what level of the patient should the IR that is 10X12 inch be centered?

midcoronal

For the left lateral projection, which plane of the body should be centered to the midline of the table

2-3 inches lower; gravitational effect

For upright frontal, oblqie, and lateral projections how is the centering of the IR adjsted from that sed for the recumbent positions? Why is the compensation necessary?

Perpendicular to the center of the IR

How and where should the central ray be direct for the RAO UGI projection?

The coating ability of the barium could be diminished because the secretion of gastric juices may be stimulated.

How can the UGI study be affected if the patient smokes cigarettes shortly before the examination?

produce irritation and injure internal tissues

How could the patient be affected if the barium solution is too warm

10 inches

How long is the adult esophagus

6 inches long

How long is the anus?

5 Feet

How long is the large intestine?

partially obscured by thoracic vertebrae

In images of a contrast filled esophagus with the patient in the RAO position, how does the esophagus appear in relation to the surrounding structures when rotation of the patient was insufficient.

between the thoracic vertebrae and the heart

In relation to the surrounding structures, where should the esophagus appear in images with the patient in the RAO position.

Hips and femurs superimposed

In the image of the left lateral projections, how is it determined that the patient was not rotated?

Posterior ribs, they should be superimposed

In the lateral projection (esophagus), what structures are used to determine whether the patient was rotated? How should these structures appear?

Cephalically 30-40 degrees

In which directions and how many degrees should the central ray be directed for the AP axial projection?

Lesser Curvature

Known as the right border of the stomach

Greater Curvature

Left and inferior borders of the stomach

Single and double contrast

List the two general GI studies routinely used to examine the stomach

Small lesions are readily demonstrated, and the mucosal lining of the stomach can be more clearly visualized.

Name 2 advantages of performing the doubles contrast examinations for the UGI

Fundus

Superior portion of the stomach that expands superiorly and fills the dome of the left hemidiaphragm.

PA oblique, RAO

The AP oblique projection, LPO position, produces an image similar to the ___________________________ projection ( __________________________ position)

Right, 45

The AP oblique projection, LPO require the patients ________________ side be elevated away from the table _________________ degrees.

Fundus

The AP oblique projections, LPO position, demonstrates the _________ portion of the stomach filled with barium.

30-50%

What is the range of weight per volume concentration for the barium sulfate suspension usually used for single-contrast examinations.

Cardiac Sphincter

The muscle controlling the cardiac orifice is called the

Upright

To demonstrate swallowing function best, in which position should the patient be placed to begin the fluorocopic phase of a single-contrast examinations of the esophagus.

Inferior margin of the pubic symphsis

To produce coned-down image of the AP axial projection on an IR that is 10X12 inches where on the patient should the central ray enter?

midway between xipoid process and the lower lateral margins of ribs.

To what level of the patient should the IR be centered for the AP oblique projections?

Iliac Crests

To what level of the patient should the IR be centered for the AP projection?

Iliac Crests

To which level of the patient should the IR be centered for the PA oblique projections, LAO position?

Iliac Crests

To which level of the patient should the IR be centered?

AP, Right lateral Decub

Whcih BE projection requires that the patient be placed in the right lateral recumbent positions and that a horizontal central ray be directed to the mid-line of the patient at the level of the iliac crests?

T5-T6

When demonstrating the entire esophagus, to what level of the patient should the IR be centered?

cecum

When examining images of a small bowel series, which structure usually indicates adequate demonstration of the entire small bowel?

Vertebrae

When examining images of the right lateral projection, which osteologic structures should be examined to determine rotation?

1-2 inches above lower rib margin

When performing the PA projection on a prone patient, to what level of the patient should the IR be centered?

Gas

When the patient is in the upright position, the fundus is usually filled with?

midway between xipoid process and the lower lateral margins of ribs.

Where exactly should the central ray enter the patient

duodenum

Where in the small intestine should the tube be inserted for the enterolysis method of performing a small bowel series

Rectosigmoid

Which are of the large intestine is best demonstrated with the PA axial projection?

Pylorus

Which area is the most inferior pat of the stomach?

Fundus

Which area is the most superior part of the stomach?

Supine

Which body position should be used for the AP projection?

right colic flexure

Which colic flexure should be well demonstrated with the AP oblique projections, LPO position?

Smal bowerl series

Which examination of the alimentary canal requires that a series of images be taken at specific time intervals after the ingestion of barium

Left colic

Which flexure should be well demonstrated with the AP oblique projection, RPO position?

double contrast

Which method of examination (single of double) is performed first as part of a biphasic examination?

Midsagittal

Which plane of the body should be centered to the grid for the AP projection?

tilt the table to the trendelenburg angulation

Which procedure should be performed to help demonstrate a diaphragmatic herniation (Hiatal hernia)

Recumbent Right Lateral Position

Which radiographic position should be used to demonstrate best the duodenal loop and the duodenojejunal junction filled with contrast medium?

Enterolysis

Which small bowel series method injects contrast medium through an intestinal tube?

Left colic flexure and descending colon

Which two structures of the large intestine are demonstrated primarily with the PA oblique projection LAO position?

15 Minutes

approximately how long after the patient swallows the barium sulfate mixture should the first images be made

Large Intestine

begins in the right iliac region, where is joins the ileum of the samll intestine, forms an arch surronding the loops of the small intestines, and ends at the anus

Peristalsis

contractions of waves by which the digesive tubes propels its contents toward the rectum

Orally, reflux filling, and intubation

list the 3 common methods by which a barium sulfate mixture can be administered for a small bowel series

AP, RAO, and Lateral Projection

list the projections that comprise the typical esophageal study.

Esophagus

long muscular tube that carries food and saliva from the laryngopharynx to the stomach

Transverse colon

longest and most moveable part of the colon, crosses the abdomen to the undersurface of the spleen, makes a sharp curve into the left clic flexure

Right lateral decub

name the lateral decub position that demonstrates the left colic flexures

left lateral decub

name the lateral decub position that demonstrates the right colic flexures

descending colon

passes inferiorly and medially to its junction with the sigmoid portions at the suprior aperture of the lesser pelvis

ascending colon

passes superiorly from its junction with the cecum to the undersurface of the live, where is joins the transverse colon at an angle called the right colic flexure

Cardia

section immediately surronding the esophageal opening

Hypersthenic

stomach is horizontal and is high, with most dependent portion well above the umbilicus

Asthenic

stomach is vertical and occupies a low positions, with the most dependent portion well below the transpyloric line.

24 Hours

the barium usually reaches the rectum within how many hours?

cardiac antrum

the distal esophagus empties its contents into

Cardiac Orifice

the esophagus joins the stomach at the esophagogastric junction through the opening termed

Cardiac Orifice

the esophagus should be clearly see from the lower neck to the _____________________

Cardiac Antrum

the expanded portion of the terminal esophagus which lies in the abdomen is called the

4-5 hours

the last portion of bariums reaches the ileocecal valve in how many hours?

Pyloric Sphincter

the muscle controlling the pyloric orifice is called the

Pyloric Orifice

the opening between the stomach and the small intestine is called the

Cardia, Fundus, Body, Pylorus

the stomach is divided into four parts. What are those four parts.

Rugae

this is known as the inner mucosal layer of the body of the stomach.

ileocecal orifice

this opening is at the distal end of the small intestine

pyloric orifice

this opening is located between the stomach and the small intestine

Transverse colon

this part of the large intestine is located between the ascending colon and the desceding parts of the colon

right colic flexure

this structure is located between the ascending colon and the transverse colon

cecum

this structure is the proximal part of the large intestines

duodenum

this structure is the proximal part of the small intestine

ileum

this strucutre is the distal part of the small intestine


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