Endterm Flashcards
(147 cards)
1
Q
Radiographic examination which includes the distal part of esophagus, stomach, duodenum and proximal part of jejunum with the use of barium sulfate.
A
UPPER GI SERIES
2
Q
11 Indications for UGIS
A
Diverticulum, gastritis, gastric outlet obstruction, sol, abdominal new growth, peptic ulcer, duodenal atresia, hiatal hernia, tumor, polps, bezoar
3
Q
Remember (UGIS)
A
Activities of the stomach, stomach habitus, regions of abdomen, quadrants of abdomen, stomach habitus, variation of stomach, and structures adjacent to stomach
4
Q
3-6 inches inferiorly esp. distal and pyloric portion with pylorus moving as high a T12 and as low as the sacrum
A
Erect
5
Q
Best depiction of relationship of stomach to the spine which measurements indicates the depth of retro-gastric space
A
Left lat erect
6
Q
offer most superior displacement of stomach in this the gastric contents tends to flow into the fundus with some air within the stomach while fluid gravitates to the most dependent portion of the stomach. Best demonstrate the DCS of the body of stomach and pylorus.
A
Supine
7
Q
greater tendency for a lower position of the stomach than in supine and to fall obliquely. Forward and downward. Barium tends to gravitates and fills up the distal end of the body of stomach, pylorus, bulb, and C-loop while there is usually mixtures of air and barium and BA. Coated mucosa of the fundus, thus DCS is achieved in the fundus
A
Prone
8
Q
Llr swing backwards
A
Rlr
9
Q
Dcs of body of stomach
A
Oblique/lao
10
Q
Caused of barium retention in the stomach
A
Hypoacidity and emotional stress
11
Q
Things to do?
A
Bowel preparation
Patient preparation
12
Q
Two methods of administering the cm
A
Double meal and single meal
13
Q
Methods of the study
A
Fluoroscopy
Overhead/conventional method
14
Q
Conventional
1. Scout film-
2. Esophagus-
A
- Ap supine
- Ap,lao,rpo,pa recumbent, rt lateral,
15
Q
Fluoroscopy/conventional
1. Esophagus-
2. Stomach-
A
- Rpo up.
- Rpo up, ap recumbent, lao recumbent, pa recumbent, spot fil 4:1 bulb
16
Q
Ways of producing air in the stomach?
A
Two straw one outside one inside, breath thru his/her mouth of swallow air after ingestion of barium, Gas producing tablet- gastroluft, ez gas, ans alka seltzer, carbonated drinks
17
Q
Pylorus and bulb for hypersthenic (45* cranially)
A
Gordon’s modification
18
Q
Infants (35* cranially)
A
Gugliantini modification
19
Q
Demonstrate a leaf like pattern of pylorus and bulb
A
Hamptons modification
20
Q
Retro-gastric space to evaluate pancreatic mass
A
Popple’s method
21
Q
35* hiatal hernia
A
Sommer-foegelle method
22
Q
Rao
A
Wolf method
23
Q
Roentologic investigation of biliary system of liver by means of functioning radiopaque cm
A
Cholangiography/cholecystography
24
Q
Methods (cholangiography/cholecystography)
A
- Oral
- Iv
25
Indications (cholangiography/cholecystography)
1. Determine function of liver, ability to remove cm from blood stream and excrete it with bile
2. Determine patency of biliary ducts,
3.Conditions such as biliary calculi, papillomas,
4.Cholelithiasis
5.cholecystitis
6.neoplasm
7.biliary stenosis
8.congenital anomalies
26
Contra-indications (cholangiography/cholecystography)
1. Advance hepato renal disease
2. Active GI disease (V/D)
3. Hypersensitivity to iodine
27
Modification for cholangiography/cholecystography
Trendelenburg maneuver
Fleischner modification
28
Post motor meal for cholangiography/cholecystography
1.Determine contracting and emptying power of GB
2. ap/pa (recumbent or upright)
29
functional study of biliary system
IVC
30
Indications for IVC
1. Demonstrate biliary ducts of cholecystectomized subjects
2. Investigate biliary ducts and gb of non-cholecystectomized subjects
3. Incase of non-visualization of gb in oral method
4. Incase of vomiting and diarrhea
5. Physiology of GB
6. Hepatoma
7. Tumor
8 new growth
9 stones and biliary stenosis
31
Contraindications for ivc
Hepatitis
Cholangitis
Renal dysfunction
Multiple myeloma
Jaundice
32
Substitute for ivc
Us
Ptc
Ercp
33
Cm used for ivc
Biligrafin plain or forte
34
Projections for ivc
Scout film-
Injection phase 1cc-
__
Time interval-
_-_-_
Filling phase
Pa (__mins)
Lpo _mins/_mins
Rld
Motor phase
__ /__
Lpo _ mins
Rao_ mins
Rao _ mins- __
Ap
Sensitivity test
Fulldose
10,20,30,45,1hr,2hrs, until 12 hrs
Ap,pa,rao
20 mins
30/60 mins
Post motor/evacuation phase
20 mins
30 mins
60min- after meal
35
-same as oral chole
-px instructed to refrain from eating fatty foods for 4 days
-px may take 2 tabs of telepaque after each meal 4 days
Four day telepaque test
36
- Direct examination of biliary tract or pancreatic duct
- Non-functional study
- Invasive
- Oral/IV
- Px bring to RR
- Complication- PNM
Endoscopic retrograde cholangio-pancreatography
37
- Pre operative radiologic exploration of biliary tract
- Non-functional study/invasive method
Percutaneous transhepatic cholangiogram
38
Direct examination of GB and is done in operating room
Intraoperative cholangiogram
39
Indications for IOC
1. Investigation of patency of bile duct and status of sphincter of ODDI
2. Reveal presence of calculi that cannot be detected by palpation
3.demonstrate condition such as tumors, structures, or dilation of passage
4. Determine status of hepatopancreatic ampulla
40
Positioning for IOC
Ap,pa,rpo,lpo,ap fowlers and trendelenburg
41
Things to do in IOC
Necessary numbers of film and cassettes (with grid)- 10x12
Hangers and lead aprons goggles and thyroid shield
42
Positioning in IOC (2)
-ap, slightly rpo,lpo
ap fowlers- distal portion of biliary system and duodenum
43
Cm used in ercp
Meglumine salt (telebrix, conray, hypaque
44
In ercp we use?
Endoscopic/cannulate two portions of doudenum
45
In ptc we use __ "__" needles
Chiba "skinny"
46
Machines used in ptc
Fluoroscopy and US
47
Purpose in PTC
Obstructive jaundice/stone extraction/biliary drainage
48
Machine used in ercp
Fluoroscopy
49
Purpose of tube is for drainage of bile and remaining stones in the ducts, performs 1-3 days after surgery
T-tube cholangiography
50
Purpose in t-tube cholangiography
Visualized residuals or previous undetected cholelithis
evaluate status of biliary duct system
demonstrate lesion strictures or dilation within biliary ducts
51
Projections for t-tube
Scout film-
Injection phase-
Ap supine
Ap,rpo
52
Combination of GB and UGIS
Chole-gis
53
Preparation for chole-gis
-Fatty meal for lunch day before examination
-Evening meal non fatty foods
-Take cholecystopaque (telepaqu,biloptin,cistobil)
-usually double dose tablet 12 tablets (1-2 tablets every 5 mins intervals)
-npo
-no smoking, no breakfast
54
Modified to perform cholecystectomy and cholangiography
Lapascopic cholangiography
55
Advantages of lapascopic cholangiography
- can perform as outpatient
- less invasive
- reduced hospital time, can go home the same day
56
Non-functional study
Ercp,ptc,ioc, t-tube
57
Functional study
Oral chole, 4 day telepaque test, ivc, chole-gis
58
Radiologic examination of small bowel with administration of barium suspension
Small intestine series
59
Indication for small intestine series
-anatomy of small intestine
-to know physiology- transmit and emptying time
-pathology of small intestine
60
Things to do in small intestine series
- px prep
Method of study-
-ba prep-
-time interval
oral or indirect
33 to 50%
15 mins, 60 mins endpoint is when cecum begins to be filled up/14x17
61
Projection for small intestine series
Ap recumbent
62
Why supine?
-To avoid abdominal pressure thus preventing overlapping of loops of small intestine
- to avail superior movement of stomach thus demonstrating the C-loop and restrogastric better
63
Increase motility in small bowel and hasten gastric evacuation
Colonic saline method (cold isotonic saline)
64
Cases of obstruction (small bowel enema and therapeutic intubation)
Intubation period
65
One for intro and one for aspiration
Abbot-miller-double lumen (barrel)
66
same with intubation method
Enteroclysis (small intestine enema)
67
Projection used Enteroclysis (small intestine enema)
Pa, ap, oblique (sbo, chron, dse and malabsorption)
Complete reflux enema
Reflux filling enema
68
Done in UGIS with special emphasis to duodenal loop after administration of barium sulfate and gastruluft or my means of intubations, Studying both intraluminal and extraluminal disorders
Hypotonic doudenography
69
Indications for hypotonic doudenography
Duodenitis, pancreatitis, hepatitis and abdominal mass affecting c-loop
70
Things to do in hypotonic duodenography
Ba sulfate-
Ap/lao-
Probatine buscopan solution-
15 mins after injection take?
-
-
-
-
33 to 50%
Stomach
To relax duodenum
Projection of c-loop
Ap 2 exposure 8x10
Lao 2 exposure 8x10
Rpo 2 exposure 8x10
1 hr film may follow
71
Technique of water test
- Px in supine and oblique (LPO)
- Highly satisfactory for detection of gastro-esophageal reflux and reflux occuring under these circumstances, correlates well with pyrosis (heartburn) esp. px with hiatal hernia
72
Accelerate of barium meal
1. recommends IM/subcuataneous injection of 0.5mg noestigmine
2. recommends addition of 30mg of sorvitol to 400cc of water and 125-130g of barium
1. Marshar/linder
2. Sovenyl/Varro
73
Radiographic examination of large intestine
Barium enema
74
Indications for barium enema
Colitis, diverticulosis, neoplas, polyps, volvulus, intusussception, abdominal mass, LGI bleeding, fistula, ulcerative colitis, and tumor
75
Contra indications for barium enema
- Post sigmoidoscopy
- Post colonoscopy
- Diarrhea
76
Preliminary preparations for barium enema
- Laxatives (evacuate intestinal contents)
- Cleansing enema (evacuate fecaloid materials from large intestine)
77
Precaution in barium enema
- Active bleeding, definite obstruction, diarrhea and acute ap
78
Ba prep in barium enema
- 8 ounces of barium sulfate and 2 quartz of warm water, 1 and half or two ounces of powder gum acacia to sustain the suspension
79
Enema system
- Two of barium to allow complete filling of colon
- Should be at least 6 feet above tubing
- 18-24 inches above px anus for low pressure enema
80
How to clean enema system
Place soap suds and boil the system for 5 mins
81
Position in inserting the enema nozzle, relax pressure of abdominal muscle as well as the anal sphincter
Sim position
82
Procedures in barium enema
1. Scout phase-
2. Filling phase
-
-
Lld-
Rao-
Lao-
3. Post evacuation-
4.
Ap
Ap
Lao
Space between rectum and coccyx
Splenic flexure
Hepatic flexure
Ap
Mucosal study or double contrast study
83
Is an opening in the colon serving some or all of the function of anus
Colostomy
84
Replace the anus when the anus and rectum must be removed
Permanent colostomy
85
Anterior measure pending restoration of colonic continuity
Temporary colostomy
86
Creation of passage through abdomen into the ileum
Ileostomy
87
Invagination or indigestion of a portion of the intestine into the adjacent position
Intussusception
88
When ileum and ileocecal valve passed into the cecum and colon
Ileocecal
89
Large intestine is prolapsed into itself
Colic
90
Small intestine invaginated into itself
Ileal
91
Invagination of a lower part into higher part
Retrograde intussusception
92
Ileus to NB to blocking the bowel with thick meconium
Meconium ileus
93
recto-sigmoid
Trendelenburg position
94
Recto-sigmoid 35-45* cranially (prevent overlapping loop to separate sigmoid colon
Billing's modification
95
Recto-sigmoid (12* caudally)
Openheimer modification
96
Lao (30-35* rot) 30-45* cranially
Fletchers
97
Pre-sacral LL
Robins modification
98
Rectum and recto sigmoid junction
Chassard lapine modification/jack knife position
99
Method valuable in early diagnosis of the ff: ulcerative colitis, regional colitis and polyps
Welin technique
100
CM enters the kidney in normal directions
Antegrade filling
101
CM introduced against flow
Retrograde filling
102
BUN
8-25Mg/ml
103
Creatinine
0.6-1.5mg/100ml
104
General term applied to the radiologic examinations of excretory canals by means of CM
IVP
105
Types of kidney
Horshoe kidney, floating/wandering kidney-nephrotosis/renal ptosis, ptotic kidney, hydronephrosis
106
Indications for ivp
Trauma, flank pain, hematuria, renal hypertension,renal failure,pyelonephritis, tumor/cyst, UTI, scanty urination, new growth, hydronephrosis
107
Contraindication for IVP
multiple myeloma, sickle cell anemia, anuria, hypersensitive to iodine, dm, chf, severe hepatitis
108
Things to do in IVP
bun/creatinine, inform consent, cm prep and bowel prep
109
Examination procedure for IVP
* Scout film/kub-
* injection phase
-
Full dose
5 mins-
15 mins-
30 mins-
Post void/post micturation film-
Ap
Sensitvity test/test dose
Ap
Ap/pa
Ap-oblique
Ap upright
110
For hypersensitive patient or sometimes utilized for children, used drip infusion method 60-120 cc of cm
Hypersensitive IVP
111
Hypersensitive ivp can demonstrate?
1. Late appearance of CM indicating arterial obstruction
2. Hyper-concentration of CM is one kidney indicating ischimic kidney with higher rate of water reabsorption
3. Delayed execretion of CM indicating reduce function size differential
4. Non-functional kidney
5.irregular outine but normal calyces indicating renal dysfunction
112
Procedures for hypersensitive IVP
*
*
*
*
5 mins-
Scout film
Injection phase
1,2,3 mins after completion of injection
Ap
113
Intended for hypersensitive patients, increase clarity of which the collecting system and ureters may be indentified.
Drip infusion pyelography
114
Sequence filming may be made 2,3,5,15 mins until entire system is visualized
Wash out IVP
115
Hypertensive case
Rapid sequence IVP
116
Cm is injected to the skin and will be absorbed by the skin, site of injection (scapular region)
Subcutaneous pyelography
117
Inner and outer wall of the organ or outer contour of a relative solid organ to detect displacement or deformity in the shadow of kidney
Suprarenal air insufflation (perirenal) dual contrast
118
Direct non functional radiographic examination of pelvo-calyceal system, pre operative procedure, using cystoscope, renal washing
Retrograde pyelography (ascending pyelography)
119
Direct invasive non-functional radiographic examination of pelvo-calyceal system
Percutaneous translumbar neprostomy
120
Direct, non-functional/retrograde radiographic examination of UB
Cystography
121
Indication of cystography
Cystolithiases, trauma, BPH, extravasation, fistula
122
Procedure for cystography
Scout film, pa, raol/lao, ap/pa
123
Radiographic examination of prostate gland with the use of cm
Prostatography
124
Procedure for prostatography
Px is requested to empty his bladder, prep of px is the same as cystoscopy
125
Positioning and modification for prostatography
Pa
Tube shift technique (uretral calculus) 2 exposures
Rass and emmet (two technique)
126
5 degrees cranially
Rib cover kidney
127
Translateral and dorsal decubitus in IVP to investigate the utero-pelvis junction esp in case of hydronephrosis
Rolestone and relay
128
Bilateral projections of UB (popples method 1 UGIS)
Ilkins modification
129
Prone in IVP for demonstration of possible obstruction of ureter
Handle and schwarts
130
Px in lateral "knee chest"
Pre-scaral pneumography
131
Cm is introduced into the retro-peritoneal cavity
Peri-renal pneumography
132
Demonstrate masses, abscess, and cysts within or outside kidney
Percutaneous renal puncture
133
Employed for the investigation of the walls of the uterus to locate the site of the placenta in cases of possible placenta previa, ap and lateral
Placentograpy
134
Employed for the demonstration of fetus in utero, detect early pregnancy and later for determining age, condition, position and presentation of fetus, whether the pregnancy is single or multiple and to detect any abnormal conditipn (PA for early pregnancy)
Fetography
135
Radiographic examination of the fallopian tube and uterus using positive cm
Hysterosalphingography
136
Indication for hysterosalingography
Determine tubal patency, diagnosis of malformation of uterus and FT, post-operative visualization of tubal plastic surgery, detection of tubal and uterine pathology
137
Postion
* lithotomy postion-
Projections-
Insertion
Ap,pa,oblique, lateral
138
Radiographic examination of congenital malformation and pathologic condition such as vesicovaginal to lambi, robin and dall recommend the use of thin barium sulfate mixture for investigation of fistulous communications with intestine
Vaginography
139
Radiologic examination of the female pelvic organs by means of intraperitoneal gas insufflation, this now replaced by US for uterine fundus, ovaries, oviducts and broad ligaments (slowly inject 1000-2000 cc of gas (air,c02 and n20)
Pelvic pneumography, gynecography, and pangynecography
140
Perfomed to demonstrate the architecture of maternal pelvis and to compare the size of the maternal bony pelvic outlet. The purpose of this procedure is to determine whether the pelvic diameters are adequate for normal parturation or whether CS is necessary for the delivery
Pelvimetry
141
Indications for pelvimetry
Pseudopregnancy
Presence/absence of fetus
142
Spalding sign, massive gas formation, collapse of fetus, position
Fetal death
143
Types of fetal death
Colcher-sussman pelvimeter
Ball and thom
144
Projection for fetal death
Ap and lateral
145
Radiographic examination of amnion with the use of positive cm to determine the viability or non-viability of fetus
Amniography
146
Projections for amniography
Ap and lateral
147
Hazards for amniography
Induce premature laboring
Fetus received radiation
