Chapter 13 Flashcards by Rachel Brenner

Length of small bowel

15-23 feet (4.5-5.5 m)

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Shortest, widest, and most fixed part of the small intestine

Duodenum

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Makes up 2/5’s of the small bowel

Jejunum

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Where is the duodenojejunal flexure located

LUQ

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What causes the jejunum to have a feathery appearance?

Villi

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Where is the ileum located

RUQ, mostly in the LLQ and RLQ

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How long is the ileum?

3/5’s of the small bowel

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Where is the ileocecal valve located

RLQ

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The circumference of the ileum is _____________ than the rest of the small intestine

Smaller

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Function of the ileocecal valve

Controls the dumping of it’s contents into the cecum; somewhat prevents reflux

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Large intestine has 3 bands of muscle called:

Taeniae coli

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Function of taeniae coli

Pull the colon up like drapes or pouches called haustra

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The large intestine is located around the:

Periphery of the abdomen

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A large pouch located inferior to the ileocecal valve

Cecum

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True/false - the cecum is free floating and very movable

True

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What is attached to the cecum

Appendix

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4 parts of the colon

Ascending
Transverse
Descending
Sigmoid

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Part that ascends towards the liver, ends at the hepatic flexure

Ascending

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Located transverse or horizontal from the hepatic flexure to the splenic flexure

Transverse

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Located from the splenic flexure and travels down to sigmoid colon

Descending

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Lart part of the colon which turns into the rectum

Sigmoid

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Final 1.5 inch of the intestine which terminates at the anus

Anal canal

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What is the direction of the rectum

Starts inferior and posterior along sacrum.. curves to inferior and anterior along rectal ampulla.. curves inferior and posterior along anal canal

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Barium location in supine position

Ascending & descending colon
Aspects of sigmoid

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Barium location in prone position (intestines)

Transverse colon Sigmoid

What part of the colon is the most anterior

Transverse Sigmoid

Functions of the small intestine

Chemical and mechancial digestion

Functions of duodenum and jejunum

Absorption of nutrients, H2O, salts and proteins Reabsorption of H2O and salts

Function of large intestine

Reabsorption of H2O and inorganic salts, vitamins B & K, amino acids Elimination

Digestive movements of small intestine

Peristalsis Rhythmic segmentation

Digestive movements of large intestine

Peristalsis Haustral churring Mass Peristalsis Defecation

What does the term vermiform mean?

Worm like

The small bowel series is what type of procedure?

Timed Sequence

Contraindications for a small bowel series

Pre-surgery patients Perforation Obstruction Pregnancy

How much barium is ingested for a small bowel series

2 cups

When does the small bowel series end?

When barium has reached the ileocecal valve

Films taken for a small bowel series are mostly:

Chabdomen/high abdominal

What is IR size and orientation for small bowel series?

14x17 LW

How is a patient positioned for small bowel series? Why?

Prone - to separate the bowels

What does it mean if the order says "colonoscopy or sigmoidoscopy"?

Possible perf - let rad know about it

Contraindications for BE/Lower GI

Perforated bowel Obstruction Pregnancy

What is a single contrast BE used for?

Function and patentcy

Patient prep for BE

Laxative or tap water enema NPO

Contraindications for laxative

Severe diarrhea Gross bleeding Bowel obstruction Appendicitis

What is the first image taken for a BE? Why?

Full abdominal prelim. Rad may change the single contrast to double or vice versa

How is single contrast mixed?

Barium is mixed in the bag with warm water to about 2200-2500cc's (2/3-3/4ths). Make sure the flow is clamped off

What should you do after barium is mixed?

Let it flow through the tube until it almost reaches the enema tip, then clamp the tube off and hang on the IV pole

How many times should the balloon be checked on the enema tip?

At least 2 times

How many tubes are on the enema tip for a single contrast BE?

Two - one for barium, one to pump up balloon

After mixing the barium, what position do you put the patient in?

Sims

How do you enter the enema tip?

Have patient breathe deeply, put tube in on third exhale, inflate balloon, clamp everything

What is the next step after tipping the patient?

Put on your lead, put the patient in the starting position, and turn on the fluoro, go get the doc

Before the postevac picture, you will need to:

Drain the barium from the patient

Images for a single contrast BE

AP LPO RPO LT LAT Rectum Erect Post void

Images for a double contrast BE?

AP R decub L decub Ventral and/or Dorsal decub (with or without tip) Sigmoid Erect

In a double contrast BE, what side is best visualized?

Side with air

How much do you fill the bag for a double contrast BE?

1/2 to 2/3 full

What level does the rectum start?

What is the rectal ampulla?

Dilated portion of the rectum located anterior to the coccyx

What is enteroclysis?

A double contrast study An injection of nutrients or medicinal liquid into the duodenum

What is the standard height of the IV pole for the bag?

18-24 inches

How many tubes lead to the tip of the enema for a double contrast BE?

3, 1 for balloon pump, 1 for barium, and 1 for air

What is a Defecogram

Functional study of the anus and rectum

For a left lateral decub where is the barium and air?

Barium: lateral border of descending and medial border of ascending Air: medial border of the descending and lateral border of the ascending

For the right lateral decub where are the barium and air?

Barium: medial border of the descending and the lateral border of the ascending, the Air: lateral border of the descending and the medial border of the ascending

Widest part of large intestine

Cecum

Another name for descending colon

Iliac colon

Part of the colon that lies in the pelvis but posseses a wide freedom of motion

Sigmoid

What two types of contrast are used for enteroclysis?

High-density barium Air/methylcellulose

What two pathologic conditions are best evaluated through enteroclysis?

Crohn's disease Malabsorption

What water temp is recommended for BE mixtures?

85-90 degrees

What are the four parts of the large intestine

Cecum Colon Rectum Anal canal

What is the w/v % for single-contrast barium

15-25%

What is the w/v % for double-contrast barium

75-95%

What is the w/v % for evacuative proctogram?

100%

Chapter 13 Flashcards

(75 cards)