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  1. differentiate between thin and thick barium
    • thin 1:1 ratio
    • thick barium 3-4:1(3 or 4 tbsps of barium against one cup of water)
  2. what are the contraindications to barium
    • it sohuld not be used if the patient has a history of perforations or lacerations in the body (viscus)
    • if the patient is pre surgical for surgery
    • or if they are allergic to barium
  3. what should be used if the patient is allergic to barium
    what happens if they allergic to iodine
    • water soluble iodine contrast
    • if allergic idoine do not use a water soluble iodine contrast
  4. does barium dissolve in water or is it water soluble
  5. when should you not use water soluble iodinated contrast
    if the patient is allergic to iodine and has a history of dehydration
  6. what is an example of an iodinated contrast media
  7. what is the purpose of a double contrast UGI
    to visualize gastric mucosa
  8. where is the most amt of radiation when flouoring
    at the patients head and feet are
  9. where must the bucky be when doing the fluoro
    must be moved all the way to the head end of the table
  10. what is the purpose of a charged couple device
    it changes an analog signal intoa digital signal
  11. Fluoroscopy exposure patterns are aka
    isodose curves
  12. what three positions visualize barium in the pylorus region of the stomach
    which position is best to view the duodenal bulb filled w/barium
    • ap rao and right lateral
    • RAO = best or RT lateral
  13. what is the patient prep for an upper GI
    the patient must be ___
    • do not eat drink smoke or chew gum the midnight before the exam
    • any antispasmodic medications should be discontinued 24 before the exam
    • NPO 8 hrs prior
  14. what is the patient prep for an esophagram
    there is no prep for the patient except during the exam the patient must wear a hospital gown and remove all metal from the waist up
  15. how should we begin the introduction for an esophagram exam and what is the room prep
    • introduce yourself (what exam is about)
    • get history allergies and pregnancy
    • explain the exam
    • scout films
    • Room:
    • should be clean
    • Fluoro timer set to 5 mins
    • lead aprons available for everyone
    • bucky tray at the end of the table
    • foot rest test for security
    • tissue towels emesis basins straws and a waste receptacle if needed
  16. what is the scout film for a Upper gi and esophogram
    • upper gi: ap abdomen
    • esophagram: pa chest
  17. what are the instructions for administering a double contrast agent to the patient how should we do it
    • First have the barium in one cup already mixed with water
    • then have the patient drink the gas crystals first mix the gas crystals w/2tbsps of water and pour crystals in cup and give to patient immediately to drink
    • then give the pt the barium cup
    • then lie patient in an ap
  18. what are the routine positions for the UGI
    what is the special position for the UGI
    • AP LPO PA RAO RT Lateral
    • Ap trendelenberg
  19. how much kv do we need for an esophagram, STL, UGI
    double and single contrast
    • esophagram:
    • Single:100-125
    • double:100-125

    STL: 60-70

    • UGI
    • single:100-125
    • double: 80-100
  20. In an RAO prone of the UGI the air is in the _____ and the barium is filled where
    • fundus
    • barium is in pylorus region and barium filled in the duodenal bulb
  21. what size cassette do we use for a PA UGI
    when would you need a 14x17
    • 10x12 or 11x14
    • if the small bowel is to be included
  22. the breathing technique for all UGI positions is what
    suspend respiration on expiration
  23. how would you do a pa if you had a hypersthenic patient and theirĀ  stomach was more transverse and higher in position
    angle the tube 35-45 deg cephalad
  24. where is the CR for all positions of the UGI except the right lateral
    at level of 1 (2 inches above lower lateral rib margin & 1 inch to the left of the vertebral column
  25. where is the CR for a right lateral UGI
    still centered at l1 (2 inches above lower lateral rib margin) & 1.5 in anterior to midcoronal plane
  26. why do you need less kvp in double contrast examination
    because there is less barium and it is mixed with air so it is not as thick and needs less penetration
  27. what is the degree of obliquity for an RAO UGI
    if the patient was hypersthenic, asthenic or average what is the degree of obliquity for each
    • 40-70 degrees for anterior obliques
    • hypersthenic = 70
    • asthenic = 40
    • average (sthenic) =45
  28. what is the rule of thumb when obliquing the patient in and RAO or LPO position of the UGI in regards to body habitus (hypersthenic and asthenic)
    • if the patient is hypersthenic the pt needs more oblique rotation
    • if the patient is asthenic (really thin long) the pt needs less oblique rotation
  29. what is the degree of obliquity for an LPO UGI if the patient was hypersthenic asthenic or average list the obliquity for each
    • 30-60 deg oblique for posterior obliques
    • hypersthenic 60 deg
    • asthenic 30 deg
    • average 45 deg
  30. in any position of the UGI where would you center if the patient was either hypersthenic (broad short or fat) or asthenic (tall skinny)
    • hypersthenic: 2'' higher around level of t12 because there stomach is more transverse
    • asthenic: 2'' lower at level of L2 because there stomach extends downwards towards the bladder because of the height
  31. what is the only position of the stomach where you see the pyloric region posterior to the stomach
    RT lateral UGI
  32. with most positions of the UGI the bottom of the cassette can be place where when centering
    at the crests
  33. when would you use the alternative trendelenberg position on an AP UGI
    when it is necessary to fill the fundus with barium on a thin asthenic patient
  34. the jejunum has an appearance of what
    feathery apperance with barium in it
  35. what position is this
    Image Upload
  36. what position is this
    Image Upload
    RAO prone b/c notice obliquity of the spine
  37. what position is this
    Image Upload
    ap barium in the fundus air in pylorus regions
  38. what position is this
    Image Upload
    LPO b/c the barium is in the fundus and the spine is rotated indicating it is not an ap and air is filled in the duodenal bulb and pylorus regions
  39. what position is this
    Image Upload
    right lateral b.c of position of spine and barium in the pyloric and duodenal regions air in the fundus
  40. what is the choice of barium for a UGI
    thin barium mainly but you can use thick
  41. what is the choice of barium for an esophagram
    thick and thin barium
  42. what is AIDET
    • A - acknowledge patient
    • I -introduce yourself
    • D - discuss duration of procedure
    • E - explain procedure
    • T -thank the patient
  43. a full trendelenberg position when doing an upper GI is used to demonstrate what pathology
    hiatal hernia
Card Set:
2014-06-21 16:18:17

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