GI tract/Biliary system Flashcards by Pam Presley

3 pairs of salivary glands

Parotid-Lgst salivary gland

Submandibular

Sublingual-Smallest salivary gland

1 L of saliva is produced daily

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Opening of parotid duct

Stenson’s duct opens into oral vestiblue opposite the 2nd molar

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Larynx:

Voice organ

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Pharynx:

Passageway for food & air

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The liver is mostly located:

Upper right quadrant

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Biliary tree components:

L & R Hepatic Ducts

Common hepatic duct

cystic duct

Common bile ducct

pancreatic duct

hepatopancreatic ampulla

sphincter of oddi

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Identify cross sectional image of liver…

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An image of an abdomen should demonstrate…

Psoas muscles

lower boarder of liver

kidneys

ribs

transverse process of vertebrae

free air

air fluid levels

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Prime considerations for positioning a KUB

Hypersthenic pts require 2 CW abdomen projections

Taller pts may require a separate bladder shot

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Upright abdomen positioning, breathing instructions and “look for”

IR centered 2” above iliac crests

high enough to include the diaphragm

suspend on expiration

look for free air or hiatal hernia

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Horizontal beam placement for which ABD projections

Lataral dorsal decubitus

L Lateral decubitus

PA/AP upright

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What is the default position for a decub abd image if not specified & why?

L Lateral decubitus

Air fluid levels only see with right side up

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Pre exposure delays before imaging the abd for suspected large and small amounts of air/gas:

Patient in dorsal decubitus (supine) position at least 11-20 min for intraperitoneal gas & 5 min for lg amounts of gas

Page 89

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Name the organs in the pelvic cavity:

Rectum

Sigmoid

urinary bladder

reproducctive organs

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Peritoneum

2 parted sac that encloses the abdominopelvic cavity

inner layer-visceral (organs) peritoneum

outer layer-parietal peritoneum

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Which body plane is perpendicular to long axis of grid for lat abd?

MCP

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Space behind peritoneum where the kidneys & pancreas lie

retroperitoneum

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4 parts of the stomach

cardia-surrounds esophageal opening

fundus-fills L hemidiaphragm

Greater curvature is lateral

body-between fundus & pyloric portion

pyloric portion-between stomach & duodenum

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Contrast media for upper GI tract:

single & double contrast studies

double contrast-includes barius & fizzies (gas producing substance)

Biphasic exam-single & double contrast combination in single exam

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Respiration phase for imaging upper GI tract:

Quiet nasal breathing

pg 21

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Patient pret for UGI in the am:

Food & fluids withheld after midnight or 8-9 hrs prior to exam

empty stomach

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Body rotation for a PA Obl esophagus

what is the rotation degree

What does it demonstrate

RAO position rotated 35-40 degrees

Demonstrates esophagus between heart & spine

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Advantages of double contrast technique for UGI….

Small lesions are less likely obscured & mucosal lining of stomach is easily visualized

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What drug is given to relax the GI tract for a stomach exam?

Glucagon or other anticholinergenic meds are given to relax GI tract

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What is the sagittal plane placement for a PA stomach & duodenum...

Sagittal Plane passing 1/2 way between vertebral column & L lateral boarder of abdomen, collimating to stomach when using 24x30

What is the sagittal plane placement for a PA stomach & duodenum using 35x43 imaging field

Sagittal plane passing 1/2way between vertebral column & L lateral boarder of abd, collimating to stomach when using 35x43

PA obl rotation of the stomach & duodenum

RAO rotated 40-70 degrees demonstrates the pyloric canal, duodenall loop, & bulb

AP Obl rotation of stomach & duodenum What degrees? What does it demonstrate?

LPO rotated 30-60 degrees (45 is ave) demonstate the stomach, barium in fundus, duodenal loop & bulb

right lateral stomach & duodenum visualizes

the anterior & posterior aspects of stomach, pyloric canal, duodenal bulb

`AP stomach & duodenum demonstrates

stomach duodenal loop barium filled fundus body pylorus duodenal bulb double contrast viualization

Which projection of the stomach demonstrated its anterior and posterior surfaces?

R lateral

Protrusion of the stomach through the diaphragm...

hiatal hernia

The formula for W/V % in contrast is...

% W/V = g/ml x 100

MBS is used to dx:

aspiration

Breathing instructions for soft tissue neck...

Expose during slow inspiration near end of inhalation also known as quiet breathing

Who normally participates in BA swallow exam?

Radiologist & RT

Who normally participates in MBS exam?

Speech pathologist

What is the valsalva maneuver? What does it rule out?

forcible exhalation against a closed glottis also known as bearing down used for esophagram to r/out reflux

PA stomach & duodenum demonstrates..

Stomach (air in fundus) & duodenal loop

ERCP

gallbladder images by U/S

RAO esophagus

Demonstrates esophagus between heart & spine ![]()

PA Obl stomach

![]()RAO stomach (on stomach, prone) Fundus-dome shaped highest point of stomach filled with air Duodenal loop & bulb

PA stomach

Demonstrates stomach (air in fundus) & duodenal loop

R lat stomach

![]() Allows stomach to hang free look for cubed vertebrae R retrogastric space, duodenal loop & duodenaljejunal junction with air and gas in fundus

AP Obl Stomach

LPO Stomach Look for open z joints (scottie dog) Fundus filled with barium

AP stomach

![]() Look @ spinous processes (centered) fundus filled with contrast

What is respiration phase for imaging upper GI tract

Suspend expiration

Decubitus

Always a horizontal CR

3 portions of small bowel:

duodenum jejunum ileum

Majority of small bowel is attached to the abdominal wall by?

mesentery

functions of small bowel:

digestion & absorption of food

Functions of large bowel:

reabsorption of fluids & elimination of waste products

Layers of the colon wall:

fibrous muscular submucosal mucosal layers

The veriform appendix attaches to the:

posteromedial cecum

Opening/connection between small/lg intestine:

ileocecal valve

Sections of the colon

ascending transverse descending sigmoid

most common contrast medium used in the GI tract

single-barium sulfate double-barium then air

List 3 methods to record/display the fluoroscopic image

TV digital image camera spot film camera cine film

Patient prep for SBS:

Soft or low residue diet for 2 days before study food and fluid withheld after evening meal on day B4 exam breakfast withheld on day of exam AP or PA scout (KUB) image may be done cleansing enema for colon may be administered

How long (after patient drinks barium) until image #1 of the SBS:

First image taken 15 mins after ingestion

IR centering for delayed images on SBS:

center & iliac crests (KUB)

What do you do if there is excessive resistance or the patient experiences pain during enema tip insertion?

notify radiologist

It is recommended that the balloon is inflated by the

radiologist using fluoroscopy

patient position for enema tip insertion:

sims position (LAO)

Height of enema bag above table (anus):

no higher than 24" above level of anus

Centering of the 14x17 IR for AP/PA/OBL projections on a sthenic patient-BE exam:

IR centered @ iliac crests

Which projections best demonstrate the sigmoid colon region?

AP axial PA axial

Degree & direction of CR angle for the PA axial colon; AP axial:

30-40 cephalic (AP) Caudad (PA)

Degree of body rotation for OBL projections of the colon

35-45 degree RPO or LPO

What 3 projections best show the ascending colon

PA Obl (RAO) BEST AP PA

What projection normally best shows the right (hepatic)colic flexure

AP Obl (LPO) PA Obl (RAO)

The PA Obl (LAO) projection usually demonstrates which colic flexure:

Left colic flexure

IR centering for a Lat rectosigmoid area

Centered to ASIS

List 2 projections that should demonstrate the right colic flexure

AP Obl (LPO) PA Obl (RAO)

Define colostomy

piece of colon diverted to an opening in the abd to bypass damaged colon

Final images of the SBS may involve visualizing the:

ileocecal valve or terminal ileum

Define haustra:

series of pouches along lg intestine

Junction of ascending/transverse & transverse/descending colon regions:

R/L colic flexure

Know body habitus/colon location

Hyper-higher horizontal asthenic-lower more midline

Maximum insertion depth of tip for a BE:

no more than 4"

Best demonstration of entire colon (minimal superimpostion) is the ____ or \_\_\_\_?

AP/PA

Supine vs. prone for SBS:

Supine- Prone-supresses & improves image quality slide 72 pg 140

Anatomy best visualized on Lat decub images using air:

side up=side of interest R Lat decub=medial side of ascending colon & lat side of descending colon L Lat decub=Lat side of ascending colon & medial side of descending colon

Posterior colon est seenon which 2 projections:

L or R ventral decubitus

PA Projection

![]() Anterior view Prone position