Ch.17 Lesson 2 : Anatomy and Procedures of the small intestine

Question 1

Extends from pyloric sphincter to ileocecal valve

Answer 1

Small Intestine

Question 2

How long is the average adult length of the small intestine

Answer 2

22 feet

Question 3

Three portions of the Small Intestines:

Answer 3

Three portions:
*Duodenum
*Jejunum
*Illeum

Question 4

Is 8 to 10 inches long and C shaped

Answer 4

Duodenum

Question 5

What is the first portion of the duodenum called

Answer 5

Duodenal bulb

Question 6

Portion that joins jejunum is a sharp curve called:

Answer 6

duodenojejunal flexure

Question 7

What is supported by the suspensory muscle of the duodenum (ligament of Treitz)

Answer 7

Flexure

Question 8

Functions of the small intestine:

Answer 8

Digestion and absorption of food

Question 9

contraction waves by which the
digestive tube propels contents toward the
rectum

Answer 9

Peristalsis

Question 10

Average transit time to ileocecal valve

Answer 10

2 to
3 hours

Question 11

What is the most common contrast for the alimentary canal ?

Answer 11

Barium sulfate
but water soluable iodinated contrast media may also be used

Question 12

Why are iodinated solutions not typically used for the alimentary canal ?

Answer 12

Iodinated solutions become diluted in the small intestines, so clear anatomic detail cannot be seen and it absorbs too quickly

Question 13

Before beginning examination, the
radiographer should

Answer 13

*Describe the contrast media and administration
(i.e., taste, enema tip insertion).
* Inform the patient that the room will be darkened
during the procedure.
* Introduce the patient and fluoroscopist to each
other.

Question 14

where is peristalsis greater in ?

Answer 14

*Peristalsis greatest in stomach and duodenum
* Slows in distal part of GI tract

Question 15

What is peristalsis affected by :

Answer 15

body habitus,
pathology, use of narcotic pain medicine,
body position, and respiration

Question 16

normal peristaltic activity

Answer 16

exposure time no longer than 0.2 seconds and never longer than 0.5 s

Question 17

what do you want for your time and kvp

Answer 17

fast exposure
high kvp

Question 18

how much time does hypermotility require

Answer 18

0.1 seconds or less

Question 19

when are exposures made :

Answer 19

on expiration

Question 20

Barium or other opaque contrast
administered one of three ways

Answer 20

 Orally
 Reflux filling via large-volume barium enema
 Direct injection via a tube placed into the small
bowel, termed enteroclysis

Question 21

What is the most common way that barium or other opaque contrast is given

Answer 21

Oral method most common

Question 22

Patient Prep for Small Intestine
Examination

Answer 22

*Soft or low-residue diet for 2 days before
study
*Food and fluid withheld after evening meal on
day before examination
* Breakfast withheld on day of examination
* Cleansing enema for colon may be
administered

Question 23

what two exams are timed

Answer 23

*IVU
*Small bowel

Question 24

• Termed small bowel series because several
  identical images are produced at timed
  intervals
• Each image identified with time marker
  indicating interval since ingestion of barium
• Images obtained with patient in either supine
  or prone position*

Answer 24

Oral method of examination

Question 25

Why is supine used for oral method of examination

Answer 25

 To take advantage of superior and lateral shift of
stomach, which improves visualization of
duodenum and jejunum
 To prevent compression of overlapping loops of
intestine

Question 26

why is prone used for oral method of examination

Answer 26

To compress abdomen and increase image quality

Question 27

When are the images usually taken for the oral method of examination

Answer 27

First image usually taken 15 minutes after
ingestion of barium
* Next interval varies between 15 and 30
minutes
* Radiologist inspects each image
* Varies procedures according to individual
*When barium reaches ileocecal region, uses
fluoroscopy to obtain compression radiographs

Question 28

When is the oral method of examination complete

Answer 28

Examination complete when barium seen in
cecum
* Typically 2 hours after ingestion in patients with
normal motility

Question 29

Essential projections for small intestine

Answer 29

PA or AP

Question 30

Patient position for PA or AP small intestine

Answer 30

Supine or prone

Question 31

Part position for PA or AP small intestine

Answer 31

Part position
 MSP centered
 For 30-minute interval, center IR at level of L2
 For delayed images, center IR at iliac crests

Question 32

Criteria for AP/PA small intestine

Answer 32

*Entire small intestine on each image
* Stomach on initial image
* Time marker
*Vertebral column centered
* Complete examination when barium reaches
cecum