Stomach and Esophagus – Flashcards
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| patient prep for barium swallow esophagus |
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| no preliminary prep is necessary |
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| difference between a single contrast exam and a double contrast exam |
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| single-barium only double- high density barium and carbon dioxide crystals |
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| what the IR must be positioned to include |
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| the mouth |
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| which oblique is preferred for the barium swallow and why? |
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| RAO. LAO- the esophagus is obstructed more by other structures |
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| degree of obliquity for esophagus |
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| 35 to 40 degrees |
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| which general position the patient is in for the esophagus radiographs |
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| recumbent |
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| which position is used to demonstrate esophageal varices |
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| upright |
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| CR for oblique esophagus projection |
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| 2 inches lateral to elevated side and centered to IR |
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| patient position for lateral esophagus |
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| lying on right or left side with arms placed in front of patient |
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| evaluation criteria for oblique esophagus projection |
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| esophagus between the vertebra and the heart |
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| how barium is administered to the patient for barium swallow |
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| through a straw |
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| how to demonstrate the entire esophagus full of barium on a radiograph |
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| make exposure while patient is swallowing |
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| why barium tablet is used |
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| evaluate the lumen narrowing within the esophagus |
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| what swallowing dysfunction study is done |
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| evaluates swallowing of patient due to stroke, trauma, etc |
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| what UGI evaluates |
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| distal esophagus, stomach, and some or all of the small intestine |
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| why nicotine and chewing gum is also restricted when patient is to be NPO (nothing by mouth)? |
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| stimulates gastric secretions |
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| 2 general procedures routinely done to examine the stomach |
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| single and double contrast exams |
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| What the single UGI demonstrates |
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| - size, shape, position of stomach - examine the changing contour of the stomach during peristalsis |
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| When overhead radiographs should be obtained |
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| immediately after fluoro before any considerable amount of barium passes into the jejunum |
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| how patient is positioned when hiatal hernia is suspected |
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| the head of the table may be lowered 25-30 degrees |
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| advantages of double contrast UGI vs single |
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| small lesions are less easily obscured and the muscosal lining of stomach can be more clearly visualized |
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| why patient must not belch during double contrast exam |
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| to ensure optimum amount of gas remains throughout the exam |
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| what might be given to patient to relax GI tract |
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| glucagon intravenously or intramuscularly |
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| where is IR centered for PA UGI projection |
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| 1-2 inches above angle of the ribs appx L1-L2 |
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| why immobilization bands are contraindicated for UGI |
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| interferes with the emptying and filling of the duodenal bulb |
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| respiration for UGI images |
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| suspend at end of expiration |
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| structures shown on PA UGI image |
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| contour of the barium filled stomach and duodenal bulb |
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| 2 body positions for the obliques of the stomach |
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| RAO and LPO |
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| degree of rotation for PA oblique UGI |
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| 40-70 degrees with hypersthenic patients requiring greater rotation |
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| what patient require the greater degree of rotation in PA oblique projection? |
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| hypersthenic |
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| structures shown on PA oblique UGI image |
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| pyloric canal duodenal bulb and loop in profile |
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| what is placed under patient on the ap oblique ugi projection for immobilization of patient? |
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| positioning sponge |
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| where is the body of the stomach located in AP oblique projection |
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| a point midway between xiphoid process and lower margin of ribs |
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| degree of obliquity for AP oblique UGI on the average sized patient |
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| 45 degrees |
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| structures shown on AP oblique UGI image |
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| the fundus of the stomach, barium in the fundus |
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| what the right lateral UGI projection demonstrates |
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| right retrogastric space, duodenal loop, duodenojejunal |
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| CR for right lateral UGI in the upright and recumbent positions |
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| perpendicular to the center of IR at the level of L1-L2 (1-2" above lower rib margin) for recumbent and L3 for upright |
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| how to check on the radiograph of the lateral UGI if patient is in true lateral |
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| look at the vertebrae |
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| where ir is centered for AP ugi projection |
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| between the xiphoid and lower rib margin L1-L2 |
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| 3 ways barium can be administered into the small bowel |
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| -mouth -complete reflux filling with large volume of barium -direct injection into the bowel through intestinal tube called enteroclysis or small intestine enema |
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| common patient prep for exam of small intestine |
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| soft or low-residue diet for 2 days before the study; food and fluid withheld after the evening meal and pateint must remain NPO; cleansing enema may be done to clear the colon |
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| what 2 positions patient is radiographed in for small bowel series |
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| supine or prone |
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| what supine and prone positions each demonstrate in exam for small intestine |
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| supine-prevent possible overlapping of the loops of the intestine prone-compresses abdominal contents which increases radiographic quality |
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| when is 1st image taken after small bowel |
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| 15 minutes after pateint has drank and finished barium |
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| time intervals of small bowel series images |
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| 15-30 minutes |
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| why coffee or tea is sometimes given to small bowel patients reaching 3-4 hour mark? |
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| stimulates peristalsis |
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| centering for preliminary and delayed images of small bowel series |
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| -a little high than crest for 1st image -delayed- center @ the crest |
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| What PA/AP small bowel projection demonstrates |
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| small intesting progressively filling until barium reaches ileocecal valve |
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| when a small bowel series is over |
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| once barium reaches the ileocecal valve and starts to enter into the cecum of lg intestine |
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| what enteroclysis means |
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| injection of nutrient or medicinal liquid into the bowel |
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| describe the bowel enterocylsis exam including what is used to perform it |
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| -the enteroclysis catheter with a stiff guidewire is advanced to the end of duodenum @ the duodenojejunal flexure |
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| type of catheter used on enterocylsis exams |
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| retention balloon type of catheter |
