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SPRING 2024: Advanced Procedures > UNIT 3: Esophagram > Flashcards

UNIT 3: Esophagram Flashcards

1
Q

Functions of the Digestive System

A

-INGESTION: taking in food and drink
-PERISTALSIS: contractual waves used to move food along digestive tract
-DIGESTION: convert food into chemical substances
-ABSORPTION: intake of chemical substances
-Ex: simple sugars, amino acids
-DEFACATION: elimination of indigestible solid substances

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2
Q

INGESTION

A

taking in food and drink

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3
Q

PERISTALSIS

A

contractual waves used to move food along digestive tract

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4
Q

DIGESTION

A

convert food into chemical substances

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5
Q

ABSORPTION

A

intake of chemical substances

Ex: simple sugars, amino acids

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6
Q

DEFACATION

A

elimination of indigestible solid substances

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7
Q

Key points about the oral cavity

A

-Teeth: 32 (molars, premolars, canine, incisors)
-Tongue: muscle with taste receptors for sweet, sour, salty
-Roof of oral cavity: hard and soft palate
-Mastication: chewing and grinding food into small pieces
-Salivary Glands: produce saliva that moistens and breaks down food:
-parotid
-sublingual
-submandibular

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8
Q

Mastication

A

chewing and grinding food into small pieces

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9
Q

Deglutition

A

act of swallowing

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10
Q

Pharynx

A

passageway for air and food

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11
Q

Valves that control passage of food

A

-Uvula
-Epiglottis

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12
Q

The esophagus is also known as

A

the gullet

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13
Q

The esophagus

A

-Hollow, muscular tube
-10 inches long, 3/4 Inch in diameter
-Extends from the pharynx (C6) to the stomach (T11)
-Transports food by gravity and peristalsis

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14
Q

Normal dents in the esophagus

A
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15
Q

Distal Esophagus

A

-Esophagus passes through the diaphragm at the esophageal hiatus (T10) and joins the stomach (T11)
-Cardiac antrum: expanded portion of the distal esophagus
-Cardiac orifice: opening between esophagus and stomach
-Cardiac sphincter: muscle controlling cardiac orifice

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16
Q

Pathology

A

-ESOPHAGEAL STRICTURE: Narrowing of the esophagus. Barium tablet can be given to demonstrate site of lumen narrowing.
-ESOPHAGEAL VARICES: Enlarged tortuous veins. Patients with liver disease.
-ACHALASIA: Failure of esophageal peristalsis. Lower esophageal sphincter does not relax. Dilation of the distal esophagus. Bird beak appearance.
-SCHATZKI RING: Narrowing of the lower part of the esophagus due to changes in the mucosa. Associated with hiatal hernias.
-ZEN KER’ S DIVERTICULUM: Hypopharyngeal diverticulum. Pouch forms at the junction of the pharynx and esophagus. Patients complain of difficulty swallowing, feeling lump or fullness in throat, regurgitation of food.

17
Q

Dysphagia vs Disphasia

A

-Dysphagia: difficulty swallowing
-Disphasia: difficulty speaking

18
Q

Fluoroscopic Procedure

A

-Fluoroscopy Needed
-Slide bucky to foot of table
-If overheads are requested, they can be done recumbent or erect
-Recumbent is routine (It allows for more complete filling of esophagus, especially in the proximal portion)
-No formal preparation needed for routine esophagus/barium swallow
-Patient prep only needed if UPPER GASTOINTESTINAL SERIES to follow

19
Q

Single vs Double Contrast media

A

-SINGLE CONTRAST: consists of a high density barium (BaSO4) only
-DOUBLE CONTRAST: consists of barium & carbon dioxide (CO2) crystals
-CO2 administered before barium
-Ask them NOT to belch(burp)

20
Q

During imaging

A

-Instructions: “DRINK, DRINK, DRINK”
-After positioning, patient should begin drinking barium, continuously
-Make exposure after 3 – 4 swallows.
-Allows more complete filling of esophagus
-RESPIRATION is inhibited approx 2 secs after swallowing. The patient does NOT need to be instructed to hold his/her breath.

21
Q

Esophagus PA positioning

A

-SID: 40”
-IR: 14”x17” LW in Table Bucky
-Top of IR at level of chin
-Position: Prone
-MSP centered
-Turn head to facilitate drinking
-CR: ⟂ to center of IR at T5-T6
-Collimation: 12”x17”
-Marker in light field, Shield patient
-Instructions: Drink, Drink, Drink

22
Q

Esophagus AP Positioning

A

-SID: 40”
-IR: 14”x17” LW in Table Bucky
-Top of IR at level of chin
-Position: Supine
-MSP centered
-Turn head to facilitate drinking
-CR: ⟂ to center of IR at T5-T6
-Collimation: 12”x17”
-Marker in light field, Shield patient
-Instructions: Drink, Drink, Drink

23
Q

PA/AP Esophagus Evaluation Criteria

A

-Evidence of proper collimation
-Esophagus from lower neck to its entrance in the stomach
-Esophagus filled with barium
-Penetration of barium
-Brightness and contrast to visualize esophagus through spine
-No rotation of patient

24
Q

Esophagus PA Oblique (RAO) Positioning

A

-SID: 40”
-IR: 14”x17” LW in Table Bucky
-Top of IR at level of chin
-Position: RAO
-Rotate patient 35-40º
-Right arm down, Left arm up
-CR: ⟂ to center of IR at T5-T6, 2” lateral to MSP on elevated side
-Collimation: 12”x17”
-Marker in light field, Shield patient
-Instructions: Drink, Drink, Drink
-RAO preferred over LAO

25
Q

Oblique Esophagus Evaluation Criteria

A

-Evidence of proper collimation
-Esophagus from lower neck to its entrance in the stomach
-Esophagus filled with barium
-Penetration of barium
-Esophagus between heart and vertebrae

26
Q

Right Lateral positioning

A

-S.I.D: 40”
-IR SIZE: 14 x 17 (LW)
-C.R: Perpendicular to midpoint of IR (approx. T5-T6)
-Place top of IR to approx level of chin.
-PATIENT POSITION: Right lateral recumbent so you can watch them drink (left lateral if they are upright)
-Shield patient if possible
-PART POSITION:
-Center MCP to IR
-Be sure arms are up and out of the way, near face
-Holding cup of barium with straw

27
Q

Barium swallow Esophagram Lateral Evaluation Criteria

A

-STRUCTURES DEMONSTRATED:
-Entire esophagus filled with barium from the neck to gastro-esophageal junction

-EVALUATION CRITERIA:
-Proximal esophagus without superimposition of the patient’s arm
-Ribs posterior to the vertebrae superimposed to show true lateral position

28
Q

MBS – MODIFIED BARIUM SWALLOW WITH SPEECH THERAPIST

A

-Soft palate, pharynx, larynx, and cervical esophagus
-Swallowing dysfunction study
-Performed in conjunction with a speech therapist
-Fluoroscopy only
-No overheads
-Typically done in lateral position

29
Q

Esophagram normal indentations in anatomy

A

Aortic arch, Left main stem bronchus, Left atrium

SPRING 2024: Advanced Procedures (25 decks)

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