fluoro Flashcards by Sydney Luella

acquiring a single image of a particular structure or structures with no movement involved

static imaging

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allows for the observation of movement

dynamic imaging

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ALARA is synonymous with the term ___________________________________

optimization for radiation protection (ORP)

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3 cardinal principles of radiation protection

time, distance, shielding

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abdomen regions right to left; most superior

right hypochondriac region, epigastric region, left hypochondriac region

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abdomen regions right to left; middle region

right lumbar region, umbilical region, left lumbar region

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abdomen regions right to left; most inferior

right iliac region, hypogastric region, left iliac region

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area where common bile duct and main pancreatic duct join together

Ampulla of Vater

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place where bile/pancreatic enzymes enter the proximal duodenum

Sphincter of Odi

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lower GI begins at ________

jejunum

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contrast agents affect _________________ so we can see the tissues of interest better and apart from the surrounding tissues

differential absorption

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types of contrast media

barium sulfate, iodinated media, air

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glucagon (is/is not) a contrast agent

is not

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glucagon is used to_____________ and constrict the gallbladder to ________________

slow stomach motility, increase bile flow

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Barium taste description…

-chalky
-consistency like liquid antacids such as Pepto-Bismol, Maalox, etc.

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Barium is ______, (organic/inorganic), ___________ and ____________

inert, inorganic, non-iodinated, non-soluble

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Barium is a ____________

colloidal suspension

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barium is a mixture of small particles distributed __________ throughout water

evenly

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water soluble iodinated contrast media (some not all)

Omnipaque
Gastrografin
Gastroview
Gadolinium

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_______ barium is good at coating linings of organs

thick

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iodinated contrast agents are usually classified by its ________: high or low __________

molality, osmolality

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esophagram (barium swallow) studies

form and function of swallowing aspect of pharynx and esophagus

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upper gastrointestinal series (UGI) looks at the _______________

distal esophagus, stomach, proximal duodenum in one exam

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UGI with SBFT

-same procedure as UGI, but exam continues until contrast agent reaches ileocecal juncture

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small bowel follow through is considered a ____________

lower GI tract study

with upper GI with small bowel follow through, do not let the floor nurse _________

turn on suction

small bowel will have a "____________" appearance compared to large bowel

feathery

no gum chewing and no smoking for ______ prior to exam

4 hours

BE pre-exam patient prep -________________prior to exam -Bowel-cleansing cathartics -NPO after ____________ (________ minimum except for pediatric patients) -No gum chewing -No smoking -Enema _________ exam

-light evening meal -midnight, 8 hours -morning of

ascending/descending colon are more posterior; transverse is more _______

with a BE exam, when a patient is prone, you are going to fill the _____________ (this will be white)

transverse colon with contrast

BE positioning visualization prone = _________ colon supine = _________ colon

prone = transverse colon supine = ascending/descending colon

how to visualize what position patient is in for a BE? Scotty dog faces the _________

downside

LPO visualizes __________ flexure in a BE

right colic flexure

RPO visualizes __________ flexure in a BE

left colic flexure

what is a t-tube check?

a “T” shaped catheter is inserted into the common bile duct after a cholecystectomy if there are concerns for residual or left over stones in the duct.

what does ERCP stand for?

endoscopic retrograde cholangiographic pancreatography

the use of a long snake like endoscope that allows for the internal illumination of an internal lining of an organ or cavity

ERCP exam

where does the t-tube terminate in a t-tube exam?

outside the patient's body

iodinated contrast studies in HSGs sometimes use ______; it is an oil based contrast rather than a water based one

Lipiodol

order of anatomy in duodenum

pyloric sphincter, duodenal bulb, D1, D2, D3, D4

where is the Papilla of Vater?

in the duodenum in the D2 section

what is the general collimation guidelines for esophragms?

5-6" wide, top of light field should be 2" above the patient's shoulders

esophagram SID for RAO if recumbent; if standing

SID 40 for recumbent SID 72 for standing

CR entrance for RAO esophragm

level at T-6 (2-3" below jugular notch)

what type of contrast should be used if a perforation is suspected?

not barium; water soluble contrast

SID for AP/PA esophagram; what is it for the lateral?

40 recumbent; 72 standing same for lateral

CR centering for lateral esophagram

T-6

respiration for AP/PA esophagram

exposure on full expiration

types of procedures to detect esophageal reflux

breathing exercises, water test, compression technique, toe-touch

what is the Vasalva Maneuver?

commonly used to detect reflux; patient is asked to take in a deep breath and then bear down is if trying to move their bowels while holding their breath

what is the Mueller Maneuver?

patient exhales and then tries to inhale against a closed glottis

what position is best for a water test?

LAO (per book), facing provider

how do you conduct a water test?

while supine, the patient drinks water through a straw. A positive test is indicated when barium/water refluxes back into the esophagus

toe-touch maneuver: while performing fluoroscopy, the ______________ is monitored while the patient bends over and touches their toes

cardiac orifice

rotation for LAO/RAO esophagram

35-40 degrees

a mass of undigested material trapped in the stomach

bezoars

pouch like herniations

diverticula

CR centering for AP/PA esophagram

T-5 or T-6

range of RAO obliquity Upper GI

40-70 degrees

for a small bowel series/follow through exam, how often do you take images?

Images taken 15 to 20 mins for the first hour and shown to the radiologist Follow up images are then taken at time intervals decided by the radiologist

respiration for small bowel series/follow through

expiration

CR entrance for small bowel series/follow through

midline at 2” above the iliac crest for the first hour, and then at the iliac crest after the first hour

inflammatory condition of the large intestine

colitis

outpouching of the mucosal walls

diverticula

telescoping of one part of the intestines into another

intussusception

abnormal masses of tissue

neoplasms

Most carcinomas encircle the lumen of the colon causing an irregular channel. These have been described as ______________ lesions

“apple core” or “napkin ring”

sac like projections that project into the lumen where diverticula project outward from the lumen wall

polyps

twisting of a portion of the intestine which leads to a mechanical obstruction

volvulus

respiration for all barium enema images

expiration

what is visualized in RAO barium enema image?

right colic flexure, ascending colon, sigmoid colon

what should be visualized in an RAO Upper GI?

entire stomach, C-loop of duodenum

what is visualized in LAO barium enema image?

left colic flexure, descending colon

what is visualized in LPO barium enema image?

right colic flexure, ascending colon, sigmoid colon

what is visualized in RPO barium enema image?

left colic flexure, descending colon

CR entrance for AP Axial barium enema image

at level 2" below the ASIS at MSP

CR angulation for AP Axial barium enema image

30-40 cephalic

RAO Upper GI centering and obliquity for sthenic body types

-45-55 degrees obliqued -CR enters level of L1 (1-2" above lower lateral rib margin between spinal column and upside lateral abdominal margin)

CR entering and obliquity for RAO Upper GI for asthenic body type

-40 degrees obliqued -CR enters 2" below level of L1

RAO Upper GI obliquity and CR centering for hypersthenic body type

-70 degrees obliqued -CR enters 2" above level of L1

CR entering PA Upper GI for sthenic body type

at level of L1 and 1" left of vertebral column

CR entering PA Upper GI for asthenic body type

2" below level of L1

CR entering PA Upper GI for hypersthenic body type

2” above the level of L1 (and more midline)

Right Lateral Upper GI for sthenic body type

At level of L1 at the lower lateral rib margin and 1” to 1.5” anterior to the MCP

Right Lateral Upper GI for asthenic body type

2" above level of L1

Right Lateral Upper GI for hypersthenic body type

2” below the level of L1

Angle and CR centering for LPO Upper GI for sthenic body type

-45 degrees obliqued -At level of L1 (between the lower lateral rib margin and xiphoid process and between midline of body and left lateral abdominal margin)

Degree and CR entering for LPO Upper GI for asthenic body type

-30 degrees obliqued -2" below level of L1 (and more midline)

Degree and CR centering for LPO Upper GI for hypersthenic body type

-60 degrees obliqued -2” above the level of L1

CR centering for AP Upper GI sthenic body type

At level of L1 (roughly midway between xiphoid process and lower rib margin) and between the midline and the left lateral margin of the abdomen

AP Upper GI for asthenic body type

2" below level of L1 (and more midline)

AP Upper GI for hypersthenic body type

2" above level of L1

order of pyloric portion of stomach

angular notch, pyloric antrum, pyloric canal, pyloric orifice (pylorus)

thick barium ratios

3-4 parts barium sulfate 1 part water cooked cereal consistency

thin barium ratio

1 part barium sulfate 1 part water thin milkshake consistency

what is the cecum and what are some characteristics?

proximal portion of large intestine; has ileocecal valve, widest portion of the large intestine

temperature of contrast for BE

85-90 degrees F

what sort of lubricant for a BE?

water soluble

what are double contrast BEs good for?

demonstrating polyps and diverticula

_________ are the pouches caused by ___________

haustra, taeniae coli

AP BE CR centering

iliac crest

RAO BE CR centering

iliac crest & 1" left of MSP

LAO BE CR centering

1-2" above iliac crest & 1" right of MSP

LPO/RPO BE CR centering

iliac crest & 1" to elevated side

lateral rectum BE CR centering

level of anterior ASIS

right lateral BE CR centering

iliac crest

left lateral BE CR centering

iliac crest

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