RAD-146 FINAL PT.1
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what are the accessory glands of digestion
- salivary glands
What are the three primary functions the digestive system performs?
intake and digestion (intake of water, vitamins and minerals plus the intake and digestion)
absorption (absorption of food particles water vitamins and essential elements into the blood or lymphatic capillaries)
elimination: eliminates any unused material in the form of semisolid waste
A radiographic examination of the pharynx and the esophagus is termed
esophagram or barium swallow
The three pairs of gland that secret most of the saliva in the oral cavity are
- parotid gland - near the ear
- submandibular - under the mandible
- sublingual - under the tongue
During swallowing the _____ closes off the nasopharynx the ______ prevents material from reentering the mouth and the ______ is depressed to cover the laryngeal opening
- soft palate
The esophagus is approx. ______ cm long and begins posterior to the level of the lower border of the _______
- cricoid cartilage of larynx (C5-C6)
The esophagus terminates its connection to the stomach, at the level of ________ vertebrae
The most proximal indentation occurs at the _______ the second is found where the esophagus crosses the _______
- aortic arch
- left primary bronchus
what is a wavelike series of involuntary contraction
The ________ is the aperture or opening between the esophagus and the stomach.
the opening or orifice leaving the distal stomach is termed the
esophogastric junction (cardiac orifice)
The stomach is composed of three main subdivisions, they are
Gastric folds are commonly called
The section of the stomach closest to the posterior abdominal wall is
The ligament of Treitz signifies the end of the
after is what part of the small intestine
Stomach contents are churned or mixed with stomach fluids into a semifluid mass termed
Chemical digestion is speed up by _______ which are biological catalysts found in various digestive juices.
Digested substances and resultant by-products:
_________simple sugars (mouth and stomach)
__________amino acids (stomach and small bowel)
___________fatty acids and glycerol (small bowel only)
List the term for each body habitus
Explain an Esophagram
What is the prep
It is the study of your esophagus while you are drinking contrast solution
Explain an UGI series (w/ SBS)
it is the study of the entire small intestines, the stomach the distal esophagus duodenum
Why are double contrast studies done?
to visualize and enhance structures of the organs and lining
Why use both thick and thin barium?
thick barium is used with air in doub contrast studies coat the lining of the stomach easier
thin barium allows you to give pt more barium to fully fill the small bowel up into the ileocecal valve or cecum
What contrast media is considered negative or radiolucent?
room air or C02
What are contraindications to barium sulfate?
- if there is any chance barium mixture can escape into the peritoneal cavity
- if patient is pre surgical
- or sensitivity to barium
What are contraindications to water-soluble iodinated contrast media?
- if the patient is allergic to iodine and has a history of dehydration
- pt is really young or really old
What is the pt. prep for a UGI?
- 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
What procedures can be done to test for esophageal reflux? (4)
- breathing exercises (valsalva maneuver and mueller)
- water test
- compression paddle technique
- toe touch maneuver
What are the three routine projections for an esophagram?
CR for above positions
- RAO (35-40)
- Ap (PA)
perp to t5-t6
What are the optional positions for an esophagram?
What are the routine positions for an
State the CR for all positions of the UGI
what must we adjust if the patient is hypersthenic or asthenic
- Ap pa = level of l1 (midway between xiphoid tip and lower rib margin)
- RAO 40-70deg = @ l1(1-2in above lower rib margin) midway between spine and later border of abdomen
- hypersthenic = 70 deg asthenic 40deg
- LPO 30-60 deg oblique = @ l1 same cr but center midway between midline of body and left lateral margin
- RT LAT = @ l1 and 1.5 inch anterior to MCP
How does the CR vary regarding different body habitus?
hypersthenic patients require the CR to be higher while taller patients (asthenic) require CR to be lower 2in
What degree of obliquity is necessary for oblique position of the stomach? LPO and RAO
How does the obliquity differ regarding different body habitué’s in exams of the stomach?
- a hypersthenic patient requires more rotation the maximum
- LPO UGI hypersthenic pt = 60 deg oblique
- and the asthenic patient requires less or the least rotation depending on the position RAO UGI for asthenic pt. = 40 deg oblique
What radiograph will show the bulb in profile filled with contrast media?
What radiograph will show the bulb in profile filled with air?
What radiograph will show the retrogastric space?
What is achalasia?
neuromuscular disorder where the gastroesophageal sphincter fails to relax.
What is atresia?
- esophageal atresia is an abnormal condition characterized by the incomplete development of the esophagus
- It is almost always associated with a fistulous tract that communicates with the trachea.
What is esophageal varices?
are dilated tortous veins in the distal esophagus
What is GERD?
gastroesophageal reflux disease
it is the backwards flow of gastric and sometimes duodenal contents into the esophagus
What is gastritis?
What is the definition of emesis?
- an inflammation of the lining of the stomach
- the act of vomiting
What is a bezor?
What is hiatal hernia?
a mass of undigested material that becomes trapped in the stomach
is characterized by herniation or protrusion of the stomach through an incompetent cardiac sphincter in the left hemidiaphragm
State the three sections of the small intestine
how do the three portions of the small intestine differ radiographically
- jejunum = feathery appearnace
- ileum = smoother lining less feathery
- duodenum = c shaped
Which is the longest segment?
What flexure is located between the ascending and transverse colon?
What flexure is located higher is the abdominal cavity?
- right colic (hepatic) flexure
- left colic (splenic) flexure
What another name for the appendix?
Where is the appendix located?
the ileum joins the cecum
What is the function of the above answer? (2 functions)
- ileocecal valve
- acts a sphincter to rpevent the contents of the ileum from passing too quickly into the cecum and prevents reflux of large intestine content into the ileum
What two parts of the large intestine possess the widest freedom of motion?(3)
cecum sigmoid transverse
the ______ presents two anteroposterior curves
The longitudinal muscle fibers of the large bowel from three bands of muscle called ______ which tend to pull the large intestines into pouches called _________
taeniae coli; haustra
What are the most anterior portions of the large intestines?
- transverse colon
- sigmoid colon
Barium sulfate by mouth is contraindicated in patients with… (2 things)
presurgical patients and patients suspected to have a perforated hollow viscus
large bowel obstruction
State four procedures done specifically for the small bowel.
- Upper GI
- Small bowel only series
- intubation method
What procedure is done when air or methylcellulose is injected into the bowel to distend it and provide a double contrast study?
What is the pt. prep for a BE?
- light evening meal prior to exam - jello
- bowel cleansing cathartics (laxative)
- NPO aftermidnight 8 hrs minimum
- no gum chewing
- no smoking
What are the contraindications for cathartics?(4)
- gross bleeding
- severe diarrhea
- inflammatory lesions
Retention tips (most common) are used to …
for double contrast studies and administration of barium and air and to keep the tip within the rectum during a BE
Glucagon is a drug given intravenously to … (2)
- to minimize the possibility of colonic spasms due to cold water mixture with barium or tech can use topical anesthetic (lidocaine)
- slows down peristalsis
What temp. water is said to have an anesthetic effect on the colon and aids to increase the retention of contrast media?
- room temperature water
The _____ position is used to relax the abdominal muscles so tip insertion can be performed.
Before the tip insertion the patient should be instructed to
not to push the tip out of the rectum by bearing down once the tip is inserted
relax abdominal muscles to prevent increased intra abdominal pressure
concentrate on breathing by the mouth to reduce spasms and cramping
the initial insertion toward the _____. After the initial insertion the rectal tube is directed _____ and slightly _______ to follow the normal curvature of the rectum
- superior and anteriorly
The height of the enema bag should not exceed ________ inches above the table
24-32inches or else it will flow to fast
What projection/position is routine for the SBS…? (Why?)?
how much barium is needed for a SBS
what is the pt prep for SBS, enteroclysis and intubation procedure
PA = it compresses the intestines and spreads them out more evenly
- NPO - 8hrs
- low residue diet for 48 hrs (jello)
- no gum chewing
- no smoking
- and ask abt pregnancy
where is the CR for SBS pa projection for a 15-30min radiographs
and hourly radiographs?
- 2in above iliac crests
- iliac crests
When does timing beginning for a SBS?
@ moment of ingestion of barium
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