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301 MEDIMAGE > 6. Fluoroscopy 1 > Flashcards

6. Fluoroscopy 1 Flashcards

1
Q

what area of the body is barium used to visualise

A

GI tract

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2
Q

what area of the body is urografin used to visualise

A

urinary system

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3
Q

what area of the body is gastrografin used to visualise

A

GI tract

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4
Q

what area of the body is lipiodol used to visualise

A

tear ducts

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5
Q

what is barium made of

A

barium sulphate

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6
Q

what is the atomic number of barium

A

56

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7
Q

what must be a condition of barium particles and why

A

must be small enough to make them more stable in suspension

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8
Q

what is the relative cost of barium

A

low cost

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9
Q

why is barium better than water soluble CM

A

better muscosal detail as its better at coating

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10
Q

what is needed if CT is needed after Barium

A

if CR is needed a period of time - up to 2wk - may be required to allow clearance of barium

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11
Q

if there is a perforation of the bowel what can happen with barium use

A

barium escapes into the gut and can cause peritonitis

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12
Q

what are the 2 concentrations of omnipaque

A

300 and 350

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13
Q

what is the base of omnipaque

A

iodine

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14
Q

what is the atomic number of iodine

A

53

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15
Q

what are the 3 administration methods for omnipaque

A

intravenously, orally and rectally

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16
Q

what are the 2 administration methods for gastrografin

A

oral and rectal

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17
Q

when is gastrographic indicated

A

when barium is unsuitable such as when there is a threatening perforation, suspected partial or complete stenosis

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18
Q

is gastrografin or barium superior in mucosal coating

A

barium

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19
Q

what is the treatment for minor adverse reaction to ICM

A

close observation and reassurance

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20
Q

what is the treatment for moderate adverse reaction to ICM

A

prompt treatment with close observation

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21
Q

what is the treatment for severe adverse reaction to ICM

A

immediate treatment

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22
Q

what is the effect of body type on positioning

A

different body habitus have different bowel and stomach orientation

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23
Q

what is the difference in bowel position for slender and large patients

A

slender patient bowel sits more medially

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24
Q

where is the stomach located for hypersthenic patients

A

high and transverse

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25
Q

where is the stomach located for sthenic patients

A

j shaped

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26
Q

where is the stomach located for hyposthenic patients

A

J shaped and low

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27
Q

where is the duodenal located for hypersthenic patients in terms of vertebral level

A

T11-12

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28
Q

where is the duodenal located for sthenic patients in terms of vertebral level

A

L1-2

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29
Q

where is the duodenal located for hyposthenic patients in terms of vertebral level

A

L3-4

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30
Q

what is the distribution of the large intestine for hypersthenic patients

A

widely distributed

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31
Q

what is the distribution of the large intestine for sthenic patients

A

L colic flexure high

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32
Q

what is the distribution of the large intestine for hyposthenic patients

A

low near pelvis

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33
Q

what area of the GI tract is barium swallow used to study

A

from lips to gastric fundus

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34
Q

what are the 2 instances where barium swallows are required

A

SLT or post op

35
Q

what are the 4 types of barium related studies of the GI tract

A

barium swallow
barium meal/follow through
gastrografin enema
defaecating proctogram

36
Q

what is oesophageal varicies

A

bleeding varicies - varicose veins

Swollen veins on lining of oesophagus

37
Q

what is the risk of oseophageal varicies

A

Life threatening if they break open

Almost like holes In oesophagus

38
Q

what is hiatus hernia

A

stomach protrudes out of diaphragm

39
Q

what is schatzki ring in terms of what the patient presents with

A

dysphagia and chest pain secondary to food impaction

40
Q

what is schatzki ring commonly seen with and what are they assocaited with

A

sliding hiatal hernia and both are associated with peptic oesophagitis

41
Q

what is dysphagia

A

difficulty swallowing

42
Q

what is an apple core lesion of the GI tract

A

cancer on large bowel

constriction of lumen of colon associated caused by stenosis due to carcinoma

43
Q

what is diverticular disease

A

small pouches stick out from the walls of the colon and can become inflammed and infected

44
Q

what are the 4 clinical indications for a barium swallow

A

dysphagia
foreign body
haematemesis
oesophageal varices

45
Q

what is modified barium swallow performed for in terms of dysfunction

A

oropharyngeal dysfunction

46
Q

what does a modified barium swallow involve in terms of staff

A

Speech and language therapist

47
Q

what is given to patients in a modified barium swallow

A

substances of a variety of consistencies

48
Q

how is a patient positioned for SLT swallow

A

erect, right ant oblique projection

49
Q

why is a right ant oblique projection used for SLT swallow

A

positions the oesophagus clear of the spine

50
Q

what views are taken for the modified barium SLT swallow

A

AP, lateral and coned

51
Q

what is the aftercare for barium swallows

4 things

A

give patient cloth to wipe mouth

patient can eat/drink normally

warn patient about pale/white stools

encourage patient to drink extra fluid

52
Q

what are double contrast barium enemas

A

both air and barium are put into the large bowel rectally

53
Q

how was a double contrast barium enema set up

A

Tube placed in rectum and bag of barium from drip pole drip into bowel and once reached transverse colon they drop bag to allow gravity to let barium move back down and coat mucosa

Air pumped in to push barium through to caecum and provide double contrast look

54
Q

why are gastrografin enemas done

A

query anastomotic leak following low resecton

55
Q

what part of the colon does gastrografin enema investigate

A

signoid colon

56
Q

how much gastrografin is used for enemas in volume

A

50-60mLs

57
Q

what are the 4 projections taken for gastrografin enema

A

AP
LAO30
RAO30
Lateral

58
Q

what was the small bowel studied with previously

A

enteroclysis

59
Q

where is the NJ tube placed in enteroclysis

A

placed at DJ flexure or just beyond

60
Q

how is the small bowel investigated now without fluro

A

patient drinks approx 100ml of gastrografin followed by pain xray 4-6hrs post introduction of CM

61
Q

what is small bowel xray with CM used to assess

A

small intestine for abnormalities in size and shape and evaluate transit of CM

62
Q

what is a defecating proctogram

A

contrast placed into rectum and have to defecate during procedure

63
Q

why are defecating proctograms taken

A

functional study of anus and the rectum during the evacuation and rest phases of defecation

64
Q

what are the 2 clinical inidications of defecating proctogram

A

prolapses and rectal intussusception

65
Q

what are 2 types of prolapses

A

rectocoeles and enterocoeles

66
Q

what is rectocele

A

rectum lower part of large bowel bulges into back of vaginal wall due to weakening of supporting tissues such as the ant/post wall

67
Q

what is rectal intussusception

A

bowel telescopes in on itself

68
Q

anorectum functions as what

A

coordinated unit to maintain faecal continence and facilitate defecation

69
Q

faecal continence is the result of what

A

complex combo of concious and unconcious control

70
Q

what is patient preparation for defecating proctogram

A

patient required to insert a suppository one hr prior

they must retain it for 10-15mins

71
Q

what does the suppository ensure in defecating proctogram preparation

A

makes sure that part of bowel is as clean as possible

72
Q

what is the procedure for defecating proctogram in terms of how many catethers are needed

A

2 x 50ml catheter tip syringes containing thick barium paste

73
Q

what is the procedure for defecating proctogram in terms of patient positioning

A

patient placed in lateral position and the barium is introduced into rectum

74
Q

where else is barium placed in for females in a defecating proctogram and why

A

in the vagina to see if there is a gap between the vagina and rectum

75
Q

in a defecating proctogram when is an image taken and what position is the patient in

A

taken after barium is administered and patient is in slightly oblique position

76
Q

when are images taken during defecating proctograms x 3 times

A

during patient resting and straining and post evacuation image is taken

77
Q

what is the pelvic coccygeal line in terms of where it is

A

runs from base of symphysis to tip of coccyx

78
Q

what is the pelvic coccygeal line used for

A

equate to the anatomical location of the pelvic floor

79
Q

what lies at 90 degree to the pelvi-coccygeal line

A

rectoanal canal

80
Q

when straining the pelvic floor muscles do what and the rectum should not drop more than how much below what when straining

A

pelvic floor muscles contract and hold everything in place

rectum should not drop more than 2cm below the pelvi-coccygeal line when straining

81
Q

if the pelvic floor muscles are weak the rectum does what during straining

A

rectum is pushed down during straining

82
Q

in the defecating proctogram the post evacuation image is taken for what

A

to see how far the rectum drops below the pelvi-coccygeal line during straining when the bowel is not loaded

83
Q

in the defecating proctogram what is measurement calibration and what does this allow

A

radio opaque ruler is placed between the buttocks and this allows for all measurements taken from the images to be calibrated so that image magnification is not a factor

301 MEDIMAGE (18 decks)

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