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RAD 370 - Anatomy > Fluoro + GI + Digestive > Flashcards

Fluoro + GI + Digestive Flashcards

1
Q

Fluoroscopy is a ____ radiation

A

continuous

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2
Q

During the examination, what can fluoroscopy do?

A

record or produce radiograph

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3
Q

What is the benefit of digital fluoro?

A

decrease the need for post-fluoroscopic image

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4
Q

5 ways to protect yourself when performing a fluoro exam

A

-wear lead
-thyroid shield
-gloves
-glasses
-stand behind radiologist

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5
Q

What are the responsibility for tech fluoro

A

verify orders
obtain clinical history
make sure the equipment works
have all equipment ready

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6
Q

Which contrast media is negative? what does it do?

A

Air or CO2
expands organs for coating

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7
Q

Air or CO2 is radio___

A

radiolucent

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8
Q

Which contrast media is positive? Mixing it with water will form _____

A

Barium Sulfate
colloidal suspension

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9
Q

What is the consistency for barium sulfate

A

thick & thin

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10
Q

Thin barium is used for ____
Thick barium is used for _____

A

studying of entire GI tract
studying of esophagus

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11
Q

Does colloidal suspension dissolve in water?

A

NO

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12
Q

When not to use Barium for contrast media ?

A

bowel perforation
allergic reaction

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13
Q

If contraindications happen with Barium, what is the alternative positive contrast media?

A

Iodinated contrast

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14
Q

Gastroview/Gastrografin is ____ contrast medium

A

radiopaque

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15
Q

Which contrast media can escape into peritoneal cavity without causing pertonitis?

A

Iodinated contrast

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16
Q

Which contrast is more water-soluble?

A

Iodinated contrast

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17
Q

Which contrast travel faster through the GI tract

A

Iodinated contrast

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18
Q

Iodinated contrast should not be used if patient experiences ____

A

dehydration

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19
Q

[FLUORO] What is the kVp for
single contrast: ?
double contrast: ?
water-soluble contrast: ?

A

110+
100
90

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20
Q

Thick Barium contrast media ____

A

coats internal organs (esophagus & stomach)

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21
Q

Thin Barium contrast media _____

A

fills internal organs (stomach)

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22
Q

What are the 4 lobes of liver?

A

Right
Left
Caudate
Quadrate

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23
Q

terminology for bile

A

Chole

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24
Q

terminology for sac/bladder

A

cysto

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25
Q

-Lith means

A

Stone

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26
Q

-Ectomy means

A

removal

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27
Q

-Gram means

A

Picture

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28
Q

The liver is in which quadrant

A

RUQ

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29
Q

What separate the left and right lobe

A

falciform ligament

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30
Q

What is the main function of liver that makes it applicable to radiographic study

A

production of biles

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31
Q

What is the function of biles

A

emulsify (break down) fat

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32
Q

What are 3 anatomic parts of the gallbladder

A

neck
body
fundus

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33
Q

what are the 3 functions of gallbladder

A

store bile
concentrate bile
contracts when stimulated by CCK

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34
Q

What happens to gallbladder when there is food in the duodenum

A

gallbladder contracted by the stimulation of food to secrete hormone CCK

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35
Q

Left and Right hepatic duct join to form ____

A

common hepatic duct

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36
Q

Bile is carried to the gallbladder through ___

A

cystic duct

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37
Q

Bile secreted into the duodenum through

A

common bile duct

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38
Q

what 2 biliary ducts joined at the hepatopancreatic sphincter

A

common bile duct & pancreatic duct

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39
Q

What is the passageway that formed by the pancreatic duct and common bile duct into duodenum?

A

Hepatopancreatic ampulla
(ampulla of Vater)

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40
Q

What is the muscle surround the opening of ampulla of Vater called?

A

Hepatopancreatic sphincter
(Sphincter of Oddi)

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41
Q

What is the protrusion into the lumen of duodenum called?

A

Duodenal papilla
(papilla of Vater)

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42
Q

What are the surgical radiographic procedure for biliary duct

A

Operative cholangiogram
T-tube
Endoscopic Retrograde Cholangiopanreatography(ERCP)

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43
Q

Which surgical radiographic procedure use C-arm in OR

A

operative cholangiogram

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44
Q

The T-tube is placed into the ____ during ____

A

common bile duct
cholecystectomy

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45
Q

What is the purpose of T-tube?

A

determine location of stones & remove them

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46
Q

What is an endoscope

A

medical equipment that allows illumination of internal lining of an organ

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47
Q

The injection process through endoscope for ERCP

A

mouth –> duodenum –> duodenal papilla –> insert catheter into hepatopancreatic ampulla –> inject contrast to fill CBD

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48
Q

Which specialist mainly performed the ERCP procedure

A

gastroenterologist

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49
Q

Who are involved in ERCP procedure

A

gastroenterologist
ED tech
ED nurse
Anesthesiologist

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50
Q

A scout method is done in which position

A

high KUB

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51
Q

A cystogram is ___

A

taken picture of the bile sac/gallbladder

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52
Q

What is cholecystectomy

A

removal of gallbladder

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53
Q

Gallbladder store and secrete bile through process of ____

A

hydrolysis

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54
Q

What is the function of CCK

A

contract gallbladder to secrete bile

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55
Q

From the liver, bile is filtered from ___ to____

A

RT & LT hepatic duct

common hepatic duct

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56
Q

Which duct provides the border between the common hepatic and common bile duct?

A

cystic duct

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57
Q

Superior to cystic duct is ____
Inferior to cystic duct is ____

A

common hepatic duct

common bile duct (CBD)

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58
Q

When doing an ERCP, which structure does the doctor first look for?

A

papilla of vater

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59
Q

What stimulates the Sphincter of Oddi to open?

A

CCK

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60
Q

What structure of distal CBD can be seen on endoscopy

A

duodenal papilla

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61
Q

which part of the duodenum is directly connect to papilla of Vater

A

descending

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62
Q

What is cholangiogram

A

taking picture of the vessels of the biliary ducts

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63
Q

What is laparoscopic Cholecystectomy (Lap Chole)

A

removal of gallbladder

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64
Q

What is Cholangiopancreatography?

A

taken picture of Bile + vessels + pancreatic duct

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65
Q

When are rad tech needed while doing lap chole? to do what?

A

at the end of the procedure

to make sure the CBD is intact and bile is not leaking

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66
Q

T-Tube is post ____

A

cholecystectomy

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67
Q

Which procedure has drainage bag outside the patient

A

T-tube

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68
Q

T-tube is placed in ____ duct

A

common bile

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69
Q

ERCP is done in which position

A

SCOUT (HIGH KUB)
OR
RAO or LAO

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70
Q

If gastroenterologist wants to look at proximal CBD, where do we go

A

up the common bile duct

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71
Q

The digestive system includes ____ & ____

A

alimentary canal
accessory organs

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72
Q

What organs are involved in the alimentary canal (7)

A

oral cavity
pharynx
esophagus
stomach
small intestine
large intestine
anus

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73
Q

What organs are accessory organs (4)

A

Salivary glands
Pancreas
Liver
Gallbladder

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74
Q

Medical term for chewing

A

mastication

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75
Q

medical term for swallowing

A

deglutition

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76
Q

medical term for involuntary muscle contraction

A

peristalsis

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77
Q

What is the function of digestive system

A

intake & digest
absorption
elimination

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78
Q

Anatomy of oral cavity

A

Teeth
Hard & Soft Palate
Uvula
Tongue

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79
Q

what are the 3 glands that secrete saliva

A

Parotid
Submandibular
Sublingual

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80
Q

Where does each salivary gland located?

A

parotid - anterior to external ear

submandibular - below mandible

sublingual - below the tongue

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81
Q

Location of pharynx in aspect to oral cavity

A

pharynx is posterior to oral cavity

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82
Q

what are the 3 parts of pharynx (from superior to inferior)

A

nasopharynx
oropharynx
laryngopharynx

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83
Q

which part of the pharynx is not a part of digestive system

A

nasopharynx

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84
Q

The Nasopharynx is posterior to _____

A

bony nasal septum, nasal cavities, and soft palate

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85
Q

Oropharynx extends from _____ to _____

A

soft palate

epiglottis

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86
Q

Epiglottis cover the opening of _____ during ___

A

larynx

swallowing

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87
Q

Which part of the pharynx continues as the esophagus

A

laryngopharynx

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88
Q

Trachea is ____ to esophagus

A

anterior

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89
Q

During deglutition, bolus moves ______ to oral cavity

A

posterior

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90
Q

Process of deglutition (4)

A
  1. bolus moves posterior oral cavity
  2. soft palate closes off nasopharynx as we swallow
  3. Trachea elevates and epiglottis folds over
  4. Food enters esophagus
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91
Q

_____ has specific nerves that can be affected if there is a stroke.

A

epiglottis

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92
Q

what do radiologist look for when doing MBS if a patient has a stroke?

A

see if epiglottis folds over –> danger if not fold as it can go the lungs.

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93
Q

During deglutition, what action can prevent swallowed substance to go up to the nose

A

soft palate closes off nasopharynx

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94
Q

During deglutition, what are the 3 main thing that happened?

A

soft palate closes off nasopharynx

Trachea elevate and epiglottis is folded to cover laryngeal opening

food enters esophagus

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95
Q

What is inhibited during deglutition to prevent swallowed substance from entering the trachea and lungs

A

respiration

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96
Q

If swallowed substance pass into larynx and trachea during deglutition, what happened?

A

coughing

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97
Q

Esophagus extends from _____ to ____?

A

cricoid cartilage(C5-C6)

stomach (T11)

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98
Q

what are the topographic landmark help to determine the start and end of esophagus?

A

C7

xiphoid process (T9-10)

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99
Q

Esophagus is located ____ to trachea & Heart

A

posteriorly

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100
Q

Esophagus is located ____ to vertebrae

A

anteriorly

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101
Q

Esophagus crosses over _____ & _____

A

aortic arch

left primary bronchus

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102
Q

Esophagus passes thru diaphragm at ___

A

esophagus hiatus

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103
Q

What are the 3 indentations when the esophagus cross over?

A

aortic arch
left primary bronchus
Left atrium

104
Q

The abdominal segment of esophagus is called ___

A

cardiac antrum

105
Q

What is hiatal hernia

A

portion of stomach go through diaphragm opening.

106
Q

What is the esophagogastric junction (cardiac orifice)

A

opening between esophagus and stomach

107
Q

What is MBS? its purpose?

A

modified barium swallow
evaluate deglutition

108
Q

Where is the focus for MBS

A

proximal esophagus at the area of the laryngopharynx

109
Q

What do you need to watch for when doing MBS

A

aspiration with different consistencies

110
Q

Swallowing of barium is observed in which position

A

PA
RAO
Lateral
Recumbent or Erect

111
Q

What is the kVp for esophagus imaging

A

90

112
Q

When do we expose for esophagus imaging

A

during 3rd swallow of barium

113
Q

Why do we expose during 3rd swallow of barium

A

make sure entire esophagus is seen

114
Q

Where is CR for PA Esophagus

A

mid-sagittal at T5-6

115
Q

What is collimation for PA Esophagus

A

4” transverse field

116
Q

Why position pt 35-40 RAO to image esophagus

A

so esophagus is between vertebra and heart

117
Q

Where is CR for RAO Esophagus

A

T5-T6

118
Q

Where is CR for RAO Esophagus

A

T5-T6
1-2” left of spine

119
Q

Where is CR for Lateral Esophagus

A

T5-T6

120
Q

What is collimation for Lateral Esophagus

A

5-6” transverse field

121
Q

Stomach is located between ____ and ___

A

esophagus

small intestine

122
Q

esophagogastric junction is also called __

A

cardiac orifice

123
Q

cardiac orifice refers to the relationship of ___

A

diaphragm near the heart

124
Q

Cardia consists of which parts?
They are ___ to the heart

A

cardiac orifice
cardiac sphincter
cardiac notch

proximal

125
Q

SUperior to cardiac orifice is ___

A

cardiac notch

126
Q

What is pyloric orifice

A

opening of distal stomach

127
Q

The lesser curvature is ____
The greater curvature is ___

A

medial border
lateral border

128
Q

The angular notch separated ___ from ____

A

body of stomach
pyloric portion of stomach

129
Q

what is the chain of actions that push food along the GI tract down the pharynx to esophagus

A

Mastication –> Deglutition –> peristalsis

130
Q

Food and air enters which part of the pharynx

A

oropharynx –> laryngopharynx –> esophagus

131
Q

What are the parts of the stomach? (6)

A

Rugae
Fundus
Body
Pylorus
Lesser Curvature
Greater Curvature

132
Q

What is the function of rugae

A

allow stomach to contract & expand

133
Q

The fundus is most ___ & ___ portion of stomach

A

superior
posterior

134
Q

Contents of the stomach go through ___ to reach duodenum

A

pylorus

135
Q

distal to angular notch is ___

A

pyloric antrum

136
Q

____ ends at the pyloric sphincter

A

pyloric canal

137
Q

angular notch separates ___ from ___

A

stomach body from pyloric

138
Q

What separates stomach body from pyloric

A

angular notch

139
Q

What structure of the stomach is important for radiologists to look at

A

duodenal bulb

140
Q

In SUPINE position, the fundus is _____. Therefore, ___ settles in there

A

most posterior

barium

141
Q

In PRONE position, the fundus is _____. Therefore, ___ settles in there

A

most ANTERIOR

air

142
Q

In supine position, barium settles in ___, air in ___

A

fundus
body/pylorus of stomach

143
Q

in which position does barium settles in the fundus

A

supine

144
Q

in which position does barium settle in the body/pylorus of the stomach?

A

prone, RAO

145
Q

In erect position,
air is ____
barium is ___ in ___

A

filling fundus
leveling off in body/pylorus

146
Q

Difference between substracted and non-substracted image. Which is our routine image?

A

subtracted image: positive contrast (barium) is black

non-substracted image: barium is white

routine: non-subtracted image

147
Q

What is substraction in fluoro?

A

Radiopaque structures such as bones are eliminated (“subtracted”) digitally from the image, thus allowing for an accurate depiction of the blood vessels.

148
Q

Position of stomach for each body habitus:
hypersthenic: ____
sthenic: _____
hyposthenic: _____

A

higher stomach ( T9-12)
mid (T10-L2)
lower (T11-L4)

149
Q

Which body habitus has a stomach that is more transverse

A

hypersthenic

150
Q

Which body habitus has a stomach that is more longitudinal

A

hyposthenic

151
Q

The location of duodenal bulb in each body habitus?
hypersthenic: ____
sthenic: _____
hyposthenic: _____

A

T11-12
L1-L2
L3-4

152
Q

the first portion of the small intestine is ____

A

duodenum

153
Q

C-shaped duodenum is closely related to the head of ____

A

pancreas

154
Q

C-loop of duodenum & pancreas are ____ structures

A

retroperitoneal

155
Q

the superior portion of the duodenum is ____

A

duodenal bulb

156
Q

What are the 3 portions of the small bowel? (list in order from beginning to end)

A

duodenum
jejunum
ileum

157
Q

____ is the junction between duodenum and jejunum

A

duodenojejunal flexture

158
Q

The ileum ends at _____

A

Ileocecal valve

159
Q

The ileum ends at ileocecal valve in which quadrant

A

RLQ

160
Q

the duodenum is divided into 4 parts: ____

A
  1. duodenal bulb
    2.descending portion
  2. horizontal portion
  3. ascending portion
161
Q

which portion of the duodenum receive bile and pancreatic enzymes

A

descending portion

162
Q

The duodenal papilla is in which portion of the duodenum? what is its function

A

descending portion

opening for common bile and pancreatic ducts into duodenum

163
Q

Which portion of the duodenum form the C-loop ?

A

horizontal and ascending portion

164
Q

which portion of the duodenum is most important for ERCP ?

A

descending portion

165
Q

How do you prep patient for UGI?

A

NPO 8 hours
Pt undressed in gown

166
Q

Why NPO 8 hours for UGI?

A

prevent filling defect that can be confused with pathology

167
Q

UGI is radiographic examination of ____ (3)

A

distal esophagus, stomach, and duodenum

168
Q

for UGI, patient starts ____

A

upright

169
Q

if dual contrast for UGI, patient _____

A

swallows negative contrast

170
Q

What is the important instruction when doing dual contrast for UGI

A

instruct patient not to burp (belch)

171
Q

For UGI, we start with ___ barium which ____ the esophagus & stomach until we see the _____ opens. Then we give _____ barium on the radiologist’s instruction to ___ stomach

A

thick
coats
esopharyngeal sphincter

thin
fill

172
Q

when patient drinking thin barium, its important that _____

A

they take big gulp

173
Q

which barium is used for UGI with NG?

A

thin

174
Q

What is the important step to do after UGI with NG? why?

A

flush NG with water
barium can dry out in the NG –> NG replacement –> hassle –> nurse get mad !

175
Q

what are the routines for UGI imaging (4)

A

AP Scout (high KUB)
PA
RAO (slight vs steep)
RT Lateral

176
Q

kVp for UGI; SID?

A

100; 40

177
Q

Purpose of scout film?

A

gives overview prior to barium (before fluoro procedure) to make sure there are no obstructions

178
Q

[BE] Position patient for AP & Scout (HIGH KUB)
CR?
expose?

A

supine
CR: MSP & iliac crest
expiration

179
Q

how to position patient for PA UGI
CR?
expose?

A

prone
duodenal bulb (L1-2)
2” left of midline
Expiration

180
Q

what kind of projection is slight RAO

A

PA

181
Q

Position patient for slight RAO
CR?

A

15-20 RAO
CR: L1-L2 (duodenal bulb area)
halfway bw spine & left lateral aspect of body

182
Q

Position patient for steep RAO
CR?
purpose?

A

45-70 RAO
CR same as slight RAO

to see different profile of stomach & duodenum

183
Q

how to distinguish STEEP RAO from Lateral

A

rib superimpose vertebral

184
Q

Why we do RIGHT lateral instead of LEFT lateral [UGI]

A

normal progression of emptying the stomach starts from the right

185
Q

CR for RT lateral [UGI]

A

1-2” anterior to MCP

186
Q

Patient prep for SMALL BOWEL SERIES without UGI

A

NPO 8hrs
bowel prep
2 cups of thin barium

187
Q

Patient prep for SMALL BOWEL SERIES with UGI

A

1 additional thin barium ready

188
Q

what is timed PA

A

procedure after UGI overheads

189
Q

Timed PA starts after ____

A

pt drinks 2 cups of thin barium

190
Q

What are the “typical time” films for Timed PA

A

15min, 30min every 30min

191
Q

time films continues until contrast reached

A

large bowel

192
Q

Spot film is used to take image of _____

A

ileocecal valve

193
Q

Duodenum located in ____ quadrant and extends to ____ quadrant

A

RUQ
LUQ

194
Q

first portion of large intestine is called ____

A

cecum

195
Q

function of ileocecal valve

A

allow contents from small intestine to cecum

196
Q

___ is the area we look at for final image on SBS

A

terminal ileum (TI)

197
Q

routine for SBS

A

PA KUB

198
Q

position pt for PA KUB [SBS]

A

prone

199
Q

CR for PA KUB [SBS]

A

early film (15-30min): 2” above iliac crest

late films (after 30min): at iliac crest

200
Q

ileocecal valve is in which quadrant

A

RLQ

201
Q

After terminal ileum, the next structure of large intestine is ___

A

cecum

202
Q

What structure coming off of the cecum?

A

appendix

203
Q

Appendix isnt influenced by ____

A

peristalisis

204
Q

Pain in RLQ indicated ___

A

appendicitis

205
Q

what are the 4 sections of the colon?

A

ascending
transverse
descending
sigmoid

206
Q

the cecum is in which quadrant

A

RLQ

207
Q

name the flexure from right to left

A

hepatic –> splenic

208
Q

Which colic is lower? [LARGE INTESTINE]

A

right

209
Q

What is the role of ileocecal valve?

A

acts as a sphincter to prevent contents of ileum from passing too quickly into the cecum

prevent reflux into TI

210
Q

How does appendicitis happen?

A

Appendix has no exit. When infectious agents enter, it cannot empty itself.

211
Q

If appendicitis not treated before rupture, it can cause ___

A

peritonitis

212
Q

If appendicitis is not treated before rupture, it can cause ___

A

peritonitis

213
Q

___ is a control muscle that surrounds the anal canal

A

anal sphincter

214
Q

___ are the pockets within the large intestine

A

haustrum

215
Q

most of the large intestine possess haustrum, except for ___

A

rectum

216
Q

what is the band of longitudinal muscle of large bowel?

A

taeniae coli

217
Q

What structures distinguish the large intestine from small intestine

A

taeniae coli
haustrum

218
Q

4 purposes of intestine

A

digestion
absorption
reabsorption
elimination

219
Q

Small intestine’s purpose: ___
Large intestine’s purpose: ____

A

digestion/absorption/reabsorption
elimination

220
Q

[GI] Small in diameter, longer in length is ____

A

small intestine

221
Q

[GI] large in diameter, short in length is ___

A

large intestine

222
Q

medical term for elimination [large intestine]

A

defecation

223
Q

Which parts of colon are anterior?

A

transverse & sigmoid

224
Q

which parts of colon are posterior

A

ascending, descending, rectum

225
Q

[LARGE INTESTINE] in supine, air rises in ___, barium settles in ___

A

transverse & sigmoid
rectum, ascending, descending

226
Q

[LARGE INTESTINE] in prone, air rises in ___, barium settles in ___

A

rectum, ascending, descending
transverse & sigmoid

227
Q

Patient prep for BE of Large Intestine

A

NPO full day prior
Bowel prep

228
Q

the importance of bowel prep for BE of Large Intestine

A

avoid confusing bw polyps and stools

229
Q

What are used for BE bowel prep

A

laxatives/cathartics

230
Q

What are the condition that contraindicate the use of laxative?

A

gross bleeding
severe diarrhea
obstruction
appendicitis

231
Q

What is the temperature for barium used in BE

A

room temperature

232
Q

for BE tip insertion, patient is placed in which position

A

Sim’s

233
Q

insert enema tip on ___ into anal canal

A

expiration

234
Q

enema tip is inserted toward ___ then ___

A

umbilicus
superior

235
Q

It’s important enema tip inserted do not exceed ___

A

1 1/2”

236
Q

Tech’s role during BE exam

A

assist radiologist
control barium flow
assist paient

237
Q

Tech’s role after exam

A

obtain & overhead needed
check with radiologist
drain barium into bag
remove tip
assist patient to restroom

238
Q

BE is not performed in case of ___

A

acute appendicitis because of perforation

239
Q

[BE] kVp for Scout

A

75 - 80

240
Q

[BE] We can see flexure of large intestine in which position

A

RPO (LAO)
LPO (RAO)

241
Q

kVp for routine BE

A

100

242
Q

kVp for BE postevac

A

75-80

243
Q

[BE] how do you know if scout image is PA or AP

A

AP: wide pelvis
PA: narrow pelvis

244
Q

[BE] Which positions both show splenic flexure?
CR?

A

RPO & LAO
CR: mid body and at crest or higher

245
Q

[BE] CR?
LAO: ___
RAO: ___

A

RAO: at iliac crest & MSP
LAO: at crest or 1-2” above iliac rest & MSP

246
Q

[BE] Which positions both show hepatic flexure?
CR?

A

LPO & RAO

247
Q

[BE] If doing lateral rectum, which side the patient lies on

A

LEFT

248
Q

[BE] lateral decub
CR?

A

horizontal & perpendicular
Iliac crest & MSP

249
Q

[BE] lateral rectum
CR?

A

CR: MCP & ASIS

250
Q

[BE] AP axial
CR?

A

30-40 cephalad
MSP & 2” inferior to ASIS

251
Q

[BE] PA axial
CR?

A

30-40 caudal
exit ASIS & MSP

252
Q

[BE] which position is done for Postevac

A

KUB ( AP or PA)

253
Q

Position for air contrast BE

A

routines + RT/LT decub

254
Q

Alternative position to routine abdomen decub for air contrast BE

A

X-table rectum

255
Q

[DOUBLE CONTRAST BE]
PA: transverse colon is ___ filled
AP: transverse colon is ___ filled

A

barium
air

256
Q

[LAO/RPO] Ala of left ilium is ___
[RAO/LPO] Ala of right ilium is

A

foreshortened
foreshortened

RAD 370 - Anatomy (5 decks)

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