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Rad Positioning I > Chapter 12 > Flashcards

Chapter 12 Flashcards

1
Q

Where is the liver located

A

RUQ, extends below the 10th rib

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2
Q

How much does the liver weigh?

A

3-4 pounds

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3
Q

What does the liver produce? Where is it stored? How much is produced?

A

Produces bile
Stored in the gallbladder
1 quart/day

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4
Q

How many lobes are in the liver?

A

2 major
2 minor

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5
Q

What are the two major lobes? Which is bigger?

A

Left and right; right is bigger

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6
Q

What separates the two major lobes?

A

Falciform ligament

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7
Q

What are the two minor lobes? Where are they located?

A

Quadrate - between the gallbladder and falciform ligament

Caudate - posterior to the quadrate lobe

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8
Q

What contours over the surface of the caudate lobe

A

Inferior vena cava

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9
Q

From the liver, bile travels to the _______ or directly to the _______

A

Gallbladder
Duodenum

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10
Q

What duct is formed from the right and left hepatic ducts combining

A

Common hepatic duct

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11
Q

What does the common hepatic duct turn into?

A

The common bile duct

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12
Q

The common bile duct joins the pancreatic duct before it empties into the duodenum through the:

A

Hepatopancreatic sphincter (sphincter of Oddi)

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13
Q

What percentage of people have a separate opening for the common bile duct and pancreatic duct?

A

40%

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14
Q

How long is the common bile duct?

A

3 in (7.5cm)

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15
Q

Where is the common bile duct located

A

Behind the superior portion of the duodenum and head of the pancreas

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16
Q

Where does the common bile duct empty after connecting with the pancreatic duct

A

Descending portion of the duodenum

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17
Q

What is the appoximate size of a gallbladder

A

3-4 in (7-10 cm) long and 1 in (3 cm) wide

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18
Q

What are the 3 parts of the gallbladder

A

Fundus
Body
Neck

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19
Q

What is the distal end of the gallbladder

A

Fundus

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20
Q

What is the narrow proximal end of the gallbladder and what duct does it make?

A

Neck; cystic duct

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21
Q

How much bile is stored in the gallbladder

A

30-40 CC’s (2-2.5 tbsp)

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22
Q

What is the best position to empty the gallbladder

A

Supine

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23
Q

What are the 3 functions of the gallbladder

A

Store bile
Concentrate bile
Contract

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24
Q

How is bile concentrated in the gallbladder

A

Removal of water - hydrolysis

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25
Q

When does the gallbladder contract

A

When fats or fatty acids are in the duodenum

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26
Q

What hormone causes the gallbladder to contract and the bile duct to open

A

Cholecystokinin (CCK)

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27
Q

How long is the cystic duct?

A

1.5 in (3-4 cm)

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28
Q

What is the spiral valve?

A

Several membranous folds along the length of the cystic duct

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29
Q

What does the spiral valve prevent

A

Distention or collapse of the cystic duct

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30
Q

Where is the gallbladder located for an asthenic person?

A

Near the iliac crest and close to the midline

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31
Q

What position does an asthenic person need to be in to best visualize the gallbladder

A

35-40 LAO (move spine away from gallbladder)

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32
Q

Where is the gallbladder located for a sthenic/hyposthenic person?

A

Between xiphoid tip and lower lateral rib margin

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33
Q

What position does an sthenic/hyposthenic person need to be in to best visualize the gallbladder

A

20-25 degree LAO

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34
Q

Where is the gallbladder located for a hypersthenic person?

A

Located high and more lateral

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35
Q

What position does an hypersthenic person need to be in to best visualize the gallbladder

A

15-20 degree LAO

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36
Q

What modality is the best way to visualize the gallbladder

A

Ultrasound

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37
Q

The gallbladder and biliary ducts cannot be seen on a diagnostic radiograph unless the patient has:

A

Contrast media

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38
Q

What is an OCG?

A

Oral cholecystogram

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39
Q

What are possible reasons to have an OCG?

A

Nausea
Heartburn
Vomitting

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40
Q

What forms gallstones?

A

Increased levels of bilirubin, calcium, or cholestrol

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41
Q

Who is at a greater risk of getting gallstones?

A

Women, especially pregnant women

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42
Q

When is milk calcium bile best demonstrated?

A

Right lateral decub

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43
Q

How long is the esophagus

A

10 in; 2 cm in diameter

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44
Q

Where does the esophagus start and end

A

Starts behind the cricoid cartilage (C5-C6)
Stops at the connection to the stomach

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45
Q

Where is the esophagus in relation to the spine

A

Anterior to the spine

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46
Q

What lies between the t-spine and the distal esophagus

A

Thoracic aorta

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47
Q

The esophagus and aorta switch position at:

A

T10

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48
Q

At what level does the esophagus go through the stomach

A

T10

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49
Q

What is the junction where the esophagus enters the diaphragm

A

Esophagogastric junction

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50
Q

What are the two indentations in the esophagus

A

Superior at the aortic arch
Inferior to that at the left primary bronchus

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51
Q

What is the greek term for stomach

A

Gaster

52
Q

What is the small, circular muscle called in the esophagogastric junction

A

Cardiac sphincter

53
Q

Where is located slighly superior to the esophagogastric junction

A

Cardiac notch

54
Q

The opening at the distal stomach is called the:

A

Pyloric orifice

55
Q

What are the subdivisions of the stomach

A

Fundus
Body (corpus)
Pyloric portion

56
Q

What is the fundus of the stomach

A

Upper portion, often filled with a bubble of swallowed air called the gastric bubble in the erect position

57
Q

Where does the body of the stomach start and end

A

Middle portion of the stomach; ends at with the angular notch

58
Q

What are the two portions of the pyloric portion of the stomach

A

Pyloric antrum - located directly after the angular notch

Pyloric canal - ends at the pyloric sphincter

59
Q

What is the purpose of rugae

A

Aid in digestion
Help to streamline fluids to the pylorus via the gastric canal

60
Q

Laterally, the fundus is more ______ than the body, and the pylorus is more _______ than the body

A

Posterior
Posterior

61
Q

What positions puts barium in the fundus

A

AP
LPO

62
Q

What positions puts air in the fundus

A

PA
RAO
Erect

63
Q

What is the first part of the small intestines

A

Duodenum

64
Q

How long is the duodenum

A

8-10 inches

65
Q

What are the 4 parts of the duodenum

A

Duodenal bulb or cap
Descending portion
Horizontal portion
Ascending portion

66
Q

Where does the 4th part of the duodenum end

A

At the duodenaljejunal flexure

67
Q

What ligament holds the duodenaljejunal flexure

A

Ligament of Treitz

68
Q

What percent of the population is hypersthenic

A

5%

69
Q

How does the stomach look in hypersthentic people

A

Almost transverse

70
Q

How does the stomach look in asthenic/hyposthenic people?

A

“j” shaped, located in lower abdomen

71
Q

What percent of the population is sthenic?

A

50%

72
Q

What is radiolucent contrast and how does it show up on an image?

A

Negative contrast; black

73
Q

What is used to produce negative contrast

A

Air, CO2, gas crystals

74
Q

What are the crystals composed of create gas bubbles in the stomach

A

Calcium and magnesium citrate

75
Q

What is the atomic number for barium

A

56

76
Q

What is radiopaque contrast and how does it appear on an image?

A

Positive contrast; white

77
Q

What is the compound formula for barium sulfate

A

BaSO4

78
Q

Barium sulfate is mixed with water to form a:

A

Colloidal suspension

79
Q

What is the water to barium ratio for thin barium

A

1:1

80
Q

What is the water to barium ratio for thick barium

A

4:1

81
Q

What contrast should be used if a perforation is suspected

A

Water-soluble iodinated contrast (often called Gastrografin or gastroview)

82
Q

What is the difference between ionic and non-ionic contrast

A

Ionic breaks apart in the bloodstream

83
Q

When is single vs double contrast used

A

Single - functions and structures

Double - Polyps, diverticula, and ulcers

84
Q

What does the alimentary canal include

A

Oral cavity (mouth)
Pharynx
Esophagus
Stomach
Duodenum and small intestine
Large intestine
Anus

85
Q

Accessory organs of the alimentary canal

A

Salivary glands
Pancreas
Liver
Gallbladder

86
Q

Functions of the alimentary canal

A

Intake and digestion
Absorption
Elimination

87
Q

What are the salivary glands associated with the mouth

A

Parotid
Submandibular
Sublingual

88
Q

What is saliva composed of

A

99.5% water
.5% solutes or salts

89
Q

How much saliva does the salivary glands produce daily

A

1000 to 1500mL

90
Q

What are the cavities that communicate with the pharyx

A

Two nasal cavities
Two tympanic cavities
Oral cavity
Larynx
Esophagus

91
Q

What is used to stop spasms in the abdomen

A

Glucagon

92
Q

During swallowing, the soft palate closes off the:

A

Nasopharynx

93
Q

During swallowing, the epiglottis is depressed to cover the:

A

Laryngeal opening

94
Q

What type of muscle is throughout the esophagus to help with swallowing

A

Upper 1/3 - skeletal muscle (circular and longitudinal)

Middle 1/3 - skeletal and smooth

Lower 1/3 - smooth

95
Q

Mechanical digestion that happens in the oral cavity

A

Mastication
Deglutition

96
Q

Mechanical digestion that happens in the pharynx

A

Deglutition

97
Q

Mechanical digestion that happens in the esophagus

A

Deglutition
Peristalsis (1 second for liquids; 4-8 seconds for solids)

98
Q

Mechanical digestion that happens in the stomach

A

Mixing (chyme)
Peristalsis (2-6 hours)

99
Q

Mechanical digestion that happens in the small intestine

A

Rhythmic segmentation (churning)
Perstalsis (3-5 hours)

100
Q

What substances are ingested through chemical digestion

A

Carbs
Proteins
Fats
Vitamins
Minerals
Water

101
Q

Substances ingested, digested, and absorbed. Where does digestion take place?

A

Carbs (mouth and stomach)
Proteins (stomach and small bowel)
Lipids (small bowel only)

102
Q

The end products of digestion of carbs (complex sugars) is

A

Simple sugars

103
Q

The end products of digestion of proteins

A

Amino acids

104
Q

The end product of digestion of lipids

A

Fatty acids and glycerol

105
Q

Substances ingested but not digested

A

Vitamins
Minerals
Water

106
Q

Protocol for OCG

A

Scout film (prone)
LAO
Right lateral decub
Fluoro
Spot films

107
Q

Protocol for Esophagography

A

RAO
Lateral
AP

108
Q

Protocol for Upper GI

A

RAO
PA
Right lateral
LPO
AP

109
Q

Breathing exercises for esophageal reflux

A

Valsalva maneuver - hold breath in while bearing down or pinches the nose, closes the mouth and blows out

Mueller maneuver - exhales and inhales against a closed glottis

110
Q

Water test for esophageal reflux

A

Patient in supine position and turned up slightly on left side - fills fundus with barium

Swallow water through a straw to see if barium comes back up

111
Q

Compression technique for esophageal reflux

A

Patient prone and the paddle is inflated as needed to put pressure on the stomach

112
Q

Toe-touch maneuver for esophageal reflux

A

Cardiac orifice is observed as patient bends over to touch toes

Reflux and hernias are sometimes demonstrated

113
Q

What is choledocholithiasis?

A

Stones in the bilary ducts

114
Q

AP Supine - where is barium?

A

Fundus and pylorus

115
Q

RAO - where is barium?

A

Body and pylorus

116
Q

What two things affect contrast resolution?

A

Beam restriction
Grids

117
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangiopancreatogram

118
Q

For an ERCP - what position is the patient?

A

RAO

119
Q

Does negative contrast have a low or high atomic number?

A

Low

120
Q

Does positive contrast have a low or high atomic number?

A

High

121
Q

What is osmolarity?

A

Ability to draw water out of cells

122
Q

What type of water-soluble contrast has a higher osmolarity (ionic or non-ionic?

A

Ionic

123
Q

LPO - where is barium?

A

Fundus

124
Q

RT Lat - where is barium?

A

Pylorus

125
Q

PA - where is barium?

A

Body

126
Q

What is extravasation?

A

Leakage of contrast outside the vessel

Rad Positioning I (33 decks)

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