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RD1038 > GI tract > Flashcards

GI tract Flashcards

1
Q

patient preparation

A
  • 3 forms of ID
  • explanation
  • justification
  • remove artefacts
  • bowel prep
  • nil by mouth 6 hours prior
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2
Q

upper GIT

A
  • barium swallow
  • barium meal
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3
Q

lower GIT

A
  • small bowel meal
  • barium enema
  • CT colonography
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4
Q

equipment

A
  • fluoroscopic equipment
  • tilting table
  • lead rubber aprons
  • trolly
  • injection equip
  • emergency drugs
  • vomit bowl
  • oxygen
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5
Q

what does a contrast medium achieve

A

helps differentiate between different structures

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6
Q

positive contrast medium

A
  • barium sulphate solution
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7
Q

negative contrast medium

A
  • air, CO2
  • gas granules
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8
Q

intravenous buscopan

A

relaxes smooth muscles (reduce peristalsis)
- reduces motion artefact

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9
Q

how long and diameter of oesophagus

A
  • 25cm long
  • 2cm diameter
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10
Q

walls of oesophagus

A

lubricated by mucus to assist bolus movement

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11
Q

clinical indications

A
  • dysphagia
  • dyspepsia
  • goitre
  • oesophageal motility
  • stricture
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12
Q

outline the radiological procedure of barium swallow

A
  • patient stands and rapid image sequences taken while patient swallows barium sulphate solution
  • full length views of oesophagus in PA and lateral and right anterior oblique (RAO)
  • prone views to demonstrate oesophageal varices
  • ensure patients arms and drinking equipment kept clear of image field
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13
Q

patient aftercare

A
  • general reassurance
  • check patient knows how to get results
  • escort to changing area and check general condition
  • send home and advise to eat and drink normally
  • warn patient of possibilities of constipation
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14
Q

clinical indications of barium meal

A
  • peptic ulcer
  • duodenal ulcer
  • dyspepsia
  • weight loss
  • pain after meals
  • hiatus hernia
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15
Q

contrast medium and drugs for barium meal

A
  • barium sulphate solution
  • gas granules
  • intravenous buscopan
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16
Q

outline radiological procedure of barium meal

A
  • give buscopan
  • give gas granules (straight to back of mouth with little water)
  • vertical table (stand on step)
  • shake barium sulphate solution well
  • patient holds cup
  • images taken while patient swallowing
  • face table horizontally
  • patient rotates to coat stomach with barium
  • views of stomach taken
  • image taken while drinking with straw (check for reflux)
  • duodenal cap views
  • patient stands for erect fundus view
17
Q

pylorus function

A

acts as a valve regulating flow of gastric contents into duodenum

18
Q

small bowel sizes

A

6m long
2.5/3cm diameter

19
Q

anatomy of small bowel

A
  • duodenum curves around head of pancreas
  • jejenum
  • ileum
  • ends at ileo-caecal valve
20
Q

clinical indications causing for small bowel meal

A
  • pain
  • diarrhoea
  • bleeding per rectum
  • malabsorption
  • partial obstruction
  • extent of malignant or inflammatory disease
21
Q

patient prep before small bowel meal

A
  • whole GI tract should be clear
  • low residue diet for 48 hours prior
  • laxatives started 24 hrs prior
  • nil by mouth 6 hours prior
  • stop drugs that may inhibit peristalsis
22
Q

outline small barium meal procedure

A
  • ask patient to drink barium mixture
  • lie on right to encourage gastric emptying
  • prone abdomen after 15 mins
  • subsequent images at 30 min intervals
  • ## prone films to open bowel loops
23
Q

size of large intestine

A

1.5 metres long
3 bands of longitudinal muscle

24
Q

clinical indications needing barium enema

A
  • change in bowel habit
  • pain
  • meleana
  • mass in abdomen
  • malignant disease
  • obstruction
  • failed failed colonoscopy
25
Q

patient preparation for barium enema

A
  • low residue diet for 48 hours prior
  • laxatives 24 hours prior
  • no food 6 hours prior
  • iv buscopan immediately prior procedure
26
Q

radiographer prep for barium enema

A
  • prepare enema bag
  • gloves
  • lubricating gel
  • facilities for washing patient
  • prep of equipment and other requirements
  • radiation protection
  • control of fluoroscopic equipment
27
Q

outline barium enema procedure

A
  • patient on left side
  • rectal catheter inserted and taped
  • barium bag raised on drip stand
  • barium solution allowed to flow as far as mid transverse colon
  • fluoroscopy used to check
  • enema bag lowered and drained of most barium solution
  • buscopan given at this point
  • remaining barium pushed by air/ CO2
  • gives double contrast
  • images then taken
28
Q

patient aftercare after barium enema

A
  • directed to toilet
  • washed
  • warned of white bowel motions
  • drink plenty water
  • warned of blurred vision from buscopan
  • check ok and reassure
  • tell patient where to get results
29
Q

outline radiological procedure of CT colonography

A
  • same clinical indications and bowel prep as barium enema
  • trolley - insufflator, catheter, lubricating gel
  • buscopan
  • inflate large bowel with air prior to scan
  • topogram from sternal angle to symphysis pubis
  • supine and prone imaging - enhanced scan
  • post processing on specialist workstation

RD1038 (3 decks)

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