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