biliary tract and upper GI Flashcards
(141 cards)
1
Q
radiographic examination of the biliary system involves ?
A
studying the manufacture, transport, and storage of bile
2
Q
liver
A
large wedge shaped organ
inferior to the diaphragm
largest solid organ
3
Q
what are the 2 major lobes of the liver
A
right lobe
left lobe
4
Q
what are the 2 major lobes divided by
A
falciform ligament
5
Q
what are the 2 minor lobes
A
quadrate lobe
caudate lobe
6
Q
what is located between the 2 minor lobes
A
the hilum
7
Q
what is the function of the liver most applicable to radiography
A
the production of bile
8
Q
how much bile does the liver secrete in a day
A
800-1000mL or 1 quart of bile per day
9
Q
what is the major function of bile
A
to aid in the digestion of fats by emulsifying fat globules and the absorption of fat following its digestion
10
Q
what is bile
A
a liquid substance composed mainly of bile salts, bile pigments, cholesterol and water
11
Q
what can cause gallstones
A
if bile contains either insufficient bile salts or excessive cholesterol the cholesterol may crystallize to form gallstones
12
Q
bile is formed where and then travels to
A
in the liver and travels to the R&L hepatic ducts
13
Q
the hepatic ducts join to form
A
the common hepatic duct
14
Q
gallbladder
A
pear shaped sac
7-10 cm long
15
Q
how much bile does the gallbladder hold
A
30-40 mL
16
Q
what are the 3 parts of the gallbladder
A
Fundus
Body
Neck
17
Q
cystic duct
A
3-4 cm long
contains folds called spiral valve
18
Q
what is the function of the spiral valve
A
to prevent distention or collapse of cystic duct
19
Q
what are the 3 primary functions of the gallbladder
A
- store bile
- concentrate bile
- contract when stimulated
20
Q
T or F
if bile is not needed for digestive purposes, it is stored for future use in the gallbladder
A
TRUE
21
Q
what forms the most common type of gallstones?
A
cholesterol coming out of solution
22
Q
the gallbladder contracts when fatty acids or fats are in the duodenum. these foods stimulate the mucosa of the duodenum and secrete a hormone called:
A
cholecystokinin (CCK)
23
Q
Cholecystokinin does what
A
causes the Gallbladder to contract and the terminal opening of the common bile duct to relax
also causes increased exocrine activity by the pancreas
24
Q
common bile duct
A
about 7.5 cm long
diameter is about the size of a straw
enters the duodenum
25
the common bile duct joins what to enter where
joins the pancreatic duct and enter the hepatopancreatic ampulla
26
what is a common site for impaction of gallstones
hepatopancreatic ampulla
27
the ampulla is controlled by a circular muscle called
hepatopancreatic sphincter
| or sphincter of oddi
28
the presence of the hepatopancreatic sphincter causes a protrusion into the lumen of the duodenum known as
the duodenal papilla
29
what does the prone position do to the gallbladder
places it closer to the IR
30
why would the supine position be used
if the primary purpose is to drain the gallbladder into the duct system
31
oral cholecystogram
| OCG
contrast medium was ingested orally
| ultrasound has replaced this
32
sonography of gallbladder
non invasive means of studying gallbladder and biliary ducts
33
what are the 4 advantages of sonography over OCG
1. no ionizing radiation
2. able to detect small calculi
3. no contrast medium
4. less patient prep
34
chole
relationship with bile
35
cysto
bag or sac
36
choledocho
common bile duct
37
cholangio
bile ducts
38
cholecyst
gallbladder
39
cholangiogram
radiographic exam of the biliary duct
40
cholecystocholangiogram
study of both the gallbladder and the biliary ducts
41
choleliths
gallstones
42
cholelithiasis
condition of having gallstones
43
cholecystitis
inflammation of the gallbladder
44
choledocholithiasis
the presence of stones in the biliary ducts
45
1. biliary calculi (gallstones)
```
these stones can produce a blockage in the ducts
symptoms:
pain
tenderness in RUQ
jaundice
```
46
who is at high risk for developing gallstones
females and obese patients
| four F's Fat, Female, near Forty, and Fertile
47
what percentage of gallstones are radiolucent
85-90%
48
what percentage of gallstones are radiopaque
10-15% can be visible on plain radiographs
49
pathologic indications for gallbladder and biliary ducts
1. biliary calculi
2. cholecystitis
3. neoplasms
4. biliary stenosis
50
2. cholecystitis
inflammation of the gallbladder
| can be acute or chronic
51
3. neoplasms
growths that can be benign or malignant
| cancer of gallbladder can be aggressive
52
4. biliary stenosis
narrowing of one of the biliary ducts
may restrict flow of bile leading to an obstruction
may lead to cholecystitis and jaundice
53
mastication
chewing
54
deglutition
swallowing
55
dysphagia
difficulty swallowing
56
dysphasia
difficulty speaking
57
emesis
vomit
58
hematemesis
blood in vomit
59
cathartic
an agent causing active movement of the bowels
60
alimentary canal
from the mouth to the anus
61
how long is the GI tract from the esophagus to the end of the large intestine
about 30 feet long
62
how long would the small intestine average
23 feet
63
what are the 3 primary functions of the digestive system
1. intake and digestion
2. absorption
3. elimination
64
what are the common radiographic procedures for the upper gastrointestinal system
esophagram (barium swallow)
| upper GI series
65
what are the common radiographic procedures for the upper gastrointestinal system
esophagram (barium swallow)
| upper GI series
66
what is the purpose of the upper GI
to study the form and function of the distal esophagus, stomach, and duodenum
67
mouth (oral cavity)
beginning of GI tract where mastication of food occurs
68
what are the 3 pairs of salivary glands
1. parotid salivary glands
2. submandibular (submaxillary)
3. sublingual glands
69
saliva consists of
99.5% water and 0.5% salts
70
how much saliva is excreted daily
1000 to 1500mL
71
mumps
inflammation and enlargement of the parotid glands
72
pharynx
common passageway for foods liquids and air
73
what are the 3 parts of the pharynx
nasopharynx
oropharynx
laryngopharynx
74
7 cavities that communicate with the pharynx
```
2 tympanic cavities
2 nasal cavities
1 oral cavity
1 larynx
1 esophagus
```
75
what is the function of the esophagus
transport food and fluids from the pharynx to the stomach
76
how long is the esophagus and where does it start/end
10 inches long 3/4 inches in diameter
| extends from cricoid cartilage C5/C6 to stomach at T11
77
4 layers of the esophagus
fibrous
muscular
submucosal
mucosal
78
what are the 2 indentations on the esophagus
1. aortic arch
| 2. left primary bronchus
79
esophageal hiatus
where the esophagus passes through the diaphragm
| at the level of T10
80
hiatal hernia
a condition where the upper portion of the stomach protrudes through the esophageal hiatus
81
cardiac antrum
abdominal segment of the esophagus
82
esophogastric junction (cardiac orifice)
openin between esophagus and stomach
83
esophogastric junction (cardiac orifice)
opening between esophagus and stomach at approximately T11
84
peristalsis
wavelike series of involuntary muscular contractions
| propels solid and semisolid material through the entire alimentary canal
85
cardiac sphincter
muscle that controls the esophagogastric junction
86
cardiac notch
notch located superior to esophagogastric junction
87
cardiac antrum
slightly expanded portion of the terminal esophagus
88
pyloric orifice
opening leaving the stomach
89
pyloric sphincter
muscle that controls the pyloric orifice
90
pylorus is divided into 2 parts
1. pyloric antrum
| 2. pyloric canal
91
in the supine position where is the barium and air
barium is in the fundus
| air is in bottom
92
in the prone position where is the barium and air
air in fundus
| barium is in body/ pyloric region
93
in the erect position where is the barium and air
air rises to the fudus
| barium is in pyloric porttion
94
in the erect position where is the barium and air
air rises to the fudus
| barium is in pyloric portion
95
in the erect position where is the barium and air
air rises to the fundus
| barium is in pyloric portion
96
in the erect position where is the barium and air
air rises to the fundus
| barium is in pyloric portion
97
duodenum
1st portion of small intestine
8-10 inches long
head of pancreas sits in c loop
98
T or F
| most of duodenum and pancreas are retroperitoneal
TRUE
99
what are the 4 parts of the duodenum
1. first (superior) portion
2. second (descending portion)
3. third (horizontal) portion
4. fourth (ascending) portion
100
ligament of treitz
separates the duodenum to jejunum
101
ligament of treitz
separates the duodenum to jejunum
102
what are the 2 types of digestion
1. mechanical
| 2. chemical
103
where is the stomach in a hypersthenic patient
high and horizontal
104
where is the stomach in a hyposthenic/ asthenic patient
vertical and J shaped, low
105
where is the duodenal bulb/GB in a hypersthenic pt.
T11/T12
106
where is the duodenal bulb/GB in a hyposthenic/asthenic pt.
L3/L4
107
where is the duodenal bulb/GB in a sthenic pt.
L1/L2
108
what are contraindications to an esophagogram
no major ones except possible sensitivity to contrast media
109
pathologic indications for esophagogram
```
achalasia
anatomic anomalies
barrett/s esophagus
carcinoma of the esophagus
dysphagia
esophageal varices
foreign bodies
GERD
zenker's diverticulum
```
110
achalasia
cardiospasm
| motor disorder of esophagus where peristalsis is reduced
111
achalasia
cardiospasm
| motor disorder of esophagus where peristalsis is reduced
112
barretts's esophagus
replacement of normal squamous epithelium with columnar lined epithelium ulcer tissue in lower esophagus
113
esophageal varices
dilation of veins in the distal esophagus
114
GERD
when the contents of the stomach go into retrograde
115
zenker's diverticulum
large outpouching of esophagus
| caused by weakening of muscle wall
116
demonstration of esophageal reflux 4 ways
1. breathing exercises
a. valsalva maneuver
b. mueller manuever
2. water test
3. compression paddle technique
4. toe touch test
117
valsalva maneuver
pt. takes a deep breath and holds breath while bearing down as trying to move bowels
118
mueller nameuver
pt. exhales and tries to inhale against closed glottis
119
water test
pt. swallows water while in LPO and if barium regurgitates into the esophagus then its a positive test
120
UGI
radiographic exam to study the function and form of distal esophagus stomach and duodenum
121
UGI contraindications
history of bowel perforation, laceration, or viscus rupture
122
UGI contraindications
history of bowel perforation, laceration, or viscus rupture
123
UGI pathologic indications
```
bezoar
diverticula
emesis
gastric carcinoma
gastritis
hiatal hernia
schatzki's ring
hypertrophic pyloric stenosis HSP
ulcers
```
124
bezoar
mass of undigested material that becomes trapped in the stomach
125
trichobezoars
hair balls
126
phytobezoars
composed of food material non digestible by humans
127
diverticula
pouchlike herniations of a portion of mucosal wall
128
what is best demonstrated on a double contrast UGI study
gastric carcinoma
gastritis
ulcers
129
gastritis
inflammation of mucosa
130
hiatal hernia
portion of stomach herniates through diaphragmatic opening
131
schatzki's ring
ringlike constriction at the distal esophagus
132
hypertrophic pyloric stenosis HPS
caused by hypertrophy of the antral muscle at pyloric orifice
produces an obstruction at the pylorus
133
what is the most common type of gastric obstruction in infants
hypertrophic pyloric stenosis HPS
134
ulcers
erosions of stomach or duodenal mucosa
135
ulcers
erosions of stomach or duodenal mucosa
136
UGI patient prep
NPO 8 hours prior to study
no gum chewing
no smoking
137
4 part summary of positioning and procedures tips for UGI
1. clinical history
2. body habitus
3. fluorosocopy
4. high kV short exposure
138
when would CT be used as the modality of choice
for demonstrating trauma and tumors of GI tract
139
hemocromatosis
iron overload due to genetics or multiple blood transfusions
well visualized on MRI
140
medical sonography is useful for
seeing HSP in infants
141
nuclear med is useful for
diagnosing esophageal reflux and barrett's esophagus
