RAD-146 BARIUM ENEMA & SBS POSITIONS & PREP ONLY

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anatomy12
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276128
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RAD-146 BARIUM ENEMA & SBS POSITIONS & PREP ONLY
Updated:
2014-06-21 13:35:12
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    • C= cecum
    • A = ascending colon
    • H = right (hepatic) flexure
    • U = Haustra
    • T = transversve colon
    • S = left splenic flexure
    • D = descending colon
    • G = sigmoid colon
    • R = rectum and anal canal
  1. in a supine position the barium and air are where
    barium in ascending and descending colon air in recto sigmoid colon and transverse colon
  2. in the prone position where is the barium and air
    air ascending and descending colonbarium in rectosigmoid and transverse colon
  3. list the four Small bowel procedures
    • Upper GI/small bowel combination
    • SBS alone
    • Enteroclysis (radiographic or CT)
    • Intubation method
  4. One more what are the contraindications to using barium and water soluble iodinated contrast media like gastroview
    • barium:
    • presurgical pts
    • pts with perforated hollow viscus
    • large intestine obstructions
    • sensitivity

    • Iodinated contrast:
    • pts with history of sever dehydration or young pts
    • sensitivity (allergy) to iodine
  5. how much barium is needed for a SBS
    16oz
  6. what is the pt prep for SBS, enteroclysis and intubation procedure
    • NPO - 8hrs
    • low residue diet for 48 hrs (jello)
    • no gum chewing
    • no smoking
    • and ask abt pregnancy
  7. what is the pt prep for a BE
    • light evening meal prior to exam - jello
    • bowel cleansing cathartics
    • NPO aftermidnight 8 hrs minimum
    • no gum chewing
    • no smoking
  8. what are cathartics
    list examples
    what are the two types
    • substance that produces frequent soft liquid bowel movements
    • dulcolax mirolax
    • irritant (rarely used)
    • saline
  9. what are the contraindications to using cathartics
    • gross bleeding
    • severe diarrhea
    • obstruction
    • inflammatory lesions
  10. how much barium is needed for a BE single and double contrast
    • single 1500ml
    • double 500 ml
  11. what is the position of the pt for a BE procedure
    sims position lying on left side with right leg flexed to expose the rectum
  12. what four things must we keep in mind when inserting the tip in the rectum
    • 1.communicate with patient
    • 2.ear gloves
    • 3.drain air from enema tubing
    • 4.lubricate enema tip
  13. what barium is used for a double contrast BE
    thick barium (1:1 ratio) and room air temp for air administered
  14. what are the 5 safety concerns of a BE procedure
    • 1. review chart history
    • 2.never for an enema tip it should be sucked in once inserted 
    • 3.height of enema bag should be no higher than 2 in above the table
    • 4.verify the water temp of the contrast media
    • 5.escort pt to the restroom
  15. what is the routine and special procedures for an SBS
    • routine: PA
    • special: Intubation method, enteroclysis
  16. why is a pa the routine for a SBS
    b/c it helps compress the intestines and spread them when pt is lying on their stomach
  17. where is the CR for SBS pa projection for a 15-30min radiographs
    and hourly radiographs?
    • 2in above iliac crests
    • iliac crests
  18. what is the routine and specials positions for a BE
    • pa and/or ap
    • RAO and LAO
    • LPO and/or RPO
    • LAt. rectum
    • R and L lat. decubs (double contrast study)
    • PA post evac

    • Special:
    • ap axial or ap axial oblique
    • Pa axial or pa axial oblique
  19. where is CR for a PA and/or AP BE
    iliac crest
  20. where is the CR what is the obliquity for an RAO BE
    • CR to iliac crests and 1inch to left of MSP
    • 35-45 oblique
  21. the RAO position of a BE demonstrates what anatomy
    what other position will demonstrate the right colic flexure in profile as the RAO
    right hepatic flexure in profile ascending and descending colon are open w/o superimposition splenic flexure is not viewed

    LPO b/c it is opposite
  22. where is the CR what is the obliquity for an LAO BE
    what other position visualizes the same thing
    • CR at 1-2 in above crests and 1in to the right
    • 35-45 deg
    • RPO
  23. Bag of contrast should be suspended at what height to prevent faster flow of barium into rectum causing pt discomfort
    24-30in above the table
  24. all BE radiographs except for the what 2 projections are take on a 14x17
    for hypersthenic pts what must be done to include appropriate anatomy
    • lateral rectum and butterfly positions 
    • 2 14x17 crosswise cassettes
  25. what are the technical factors for a single contrast and double
    what is the breating
    what cells should be selected when using AEC
    • 100-125 single contrast
    • 80-90 kvp for a double contrast
    • Suspend respiration and expose on expiration
    • all cells selected when using aec
  26. why must we or could we use two films on an ap or pa of the colon
    to make sure we include the splenic flexure b/c it is located higher up and rectal ampulla (area where feces is stored)
  27. what structures are best shown in a PA/AP BE
    transverse colon and portion of sigmoid colon BA filled
  28. what structures are best visualized in an LAO or RPO BE
    the splenic flexure should be seen w/o superimposition
  29. where is the CR for a RPO BE
    1-2in above crests and 1in to the left of MSP
  30. where is the CR for a LPO BE
    • cr to level of iliac crests cr 1in to right of MSP
    • visualizes the right hepatic flexure as an RAO would
  31. where is the CR for a lateral rectum
    what casette would you use
    • CR to level of ASIS and midcoronal plane (midway between asis and posterior sacrum)
    • 10x12 length wise
  32. what is the alternative position to the lateral rectum
    why is the position done for
    • ventral decub (cross table or xtable lateral)
    • to visualize air in the rectum in a double contrast study
  33. what structure does the right lateral decub position show
    entire colon and an air filled splenic flexure and descending colon
  34. where is the CR for a right lateral decub BE (only for a double contrast study)
    1-2 in above crests because splenic flexure is located higher in abdomen
  35. if we are doing a single contrast BE are decubs R & L necessary
    no
  36. which position in a double contrast study visualizes the an air filled hepatic flexure and ascending colon and cecum
    where is the CR for this position
    • left lateral decub BE
    • at level of crests
  37. what size cassette is needed for a ap axial or ap axial oblique (LPO) Butterfly positions
    what is the tube angle ap axial
    where is the CR for the ap axial and ap axial oblique
    what is the obliquity of the LPO
    • 11x14
    • 30-40 deg cephalad
    • AP axial: 2" inferior to ASIS at MSP
    • LPO:2'' inferior and 2in medial to right ASIS
    • 30-40
  38. what size cassette is needed for a pa axial or pa axial oblique (RAO) Butterfly positions
    what is the tube angle for pa axial
    where is the CR for the pa axial and pa axial oblique
    what is the obliquity of the RAO
    • 11x14 lengthwise
    • angle cr 30-40 caudal
    • PA: at ASIS at MSP
    • RAO:cr at level of asis and 2in to left of spinous process
    • 35-45 deg
  39. a pa post evac use what IR and where is the cr
    do we need more or less penetration
    • 14x17
    • cr at the crests
    • less penetration because there is less barium
  40. what is the follow up care for BE
    pt should increase their intake of fluids and increase fiber intake

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