Positioning Test 2

Question 1

What is the length of the small intestine in an average adult?

Answer 1

22 feet

Question 2

What are the three portions of the small intestine?

Answer 2

Duodenum, jejunum, ileum

Question 3

What are the primary functions of the small intestine?

Answer 3

Digestion and absorption of food

Question 4

What are the main functions of the small intestine?

Answer 4

Digestion
Absorption (nutrients, H2O, salts, proteins)
Reabsorption (95% of H2O and salts)
Elimination (defecation)

Question 5

What is the length of the duodenum?


Answer 5

8 to 10 inches long

Question 6

What is the duodenojejunal flexure?


Answer 6

It is the sharp curve where the duodenum joins the jejunum

Question 7

What supports the duodenojejunal flexure?


Answer 7

The suspensory muscle of the duodenum (ligament of Treitz)

Question 8

What are plicae circulares and their function?


Answer 8

They are mucosal folds in the jejunum that increase surface area for absorption

Question 9

Where does the terminal ileum join the large intestine?


Answer 9

At the ileocecal valve in the right lower quadrant (RLQ)

Question 10

What is the quadrant location of the small intestine portions?


Answer 10

Duodenum: RUQ and LUQ
Jejunum: LUQ and LLQ
Ileum: RUQ, RLQ, LLQ
Ileocecal valve: RLQ

Question 11

What are the two types of obstructions in the small intestine?


Answer 11

Adynamic/paralytic obstruction and mechanical obstruction

Question 12

How can small intestine obstructions be identified radiographically?


Answer 12

By observing extended air-filled loops

Question 13

What is Giardiasis?


Answer 13

A common intestinal illness caused by the microscopic parasite Giardia duodenales

Question 14

What is Meckel’s Diverticulum?


Answer 14

A small pouch in the wall of the intestine near the junction of the small and large intestines

Question 15

What is Crohn’s disease?


Answer 15

A chronic inflammatory bowel disease that can affect the entire digestive tract

Question 16

What should be done to prepare the examination room for a small intestine examination?


Answer 16

Room should be completely prepared before patient enters
Adjust equipment controls to correct settings
Have footboard and shoulder supports ready
Check filming devices and number of IRs available
Prepare type and amount of contrast

Question 17

What is peristalsis?


Answer 17

Contraction waves by which the digestive tube propels contents toward the rectum

Question 18

What is the average transit time to the ileocecal valve?


Answer 18

3 hours

Question 19

Why can clear anatomic detail not be seen in the small intestine?


Answer 19

Because iodinated solutions become diluted in the small intestine

Question 20

What is the challenge of GI radiography?


Answer 20

To eliminate motion

Question 21

How does peristalsis vary in the GI tract?


Answer 21

It is greatest in the stomach and duodenum, and slows in the distal part of the GI tract

Question 22

What factors affect peristalsis?

Answer 22

Body habitus, pathology, use of narcotic pain medicine, body position, and respiration

Question 23

What is the normal exposure time for peristaltic activity?


Answer 23

No longer than 0.2 seconds (never longer than 0.5 seconds)

Question 24

What exposure time is required for hypermotility?


Answer 24

0.1 seconds or less

Question 25

When should exposures be made during routine procedures?


Answer 25

At the end of expiration

Question 26

What are the radiation protection measures in GI radiography?


Answer 26

Close collimation Optimum technique factors Shielding

Question 27

What are the methods of administering barium or other opaque contrast for small intestine procedures?


Answer 27

Orally Reflux filling via large-volume barium enema Direct injection via a tube (enteroclysis)

Question 28

What is the recommended diet for patient preparation before a small intestine examination?


Answer 28

A soft or low-residue diet for 2 days before the study

Question 29

What should be done with food and fluid before the examination?


Answer 29

Withhold food and fluid after the evening meal on the day before the examination

Question 30

What are the pathologic indications for a small bowel series?


Answer 30

Enteritis, gastroenteritis, Meckel’s diverticulum, neoplasm, malabsorption syndrome, ileus

Question 31

What does enteritis indicate in a small bowel series?


Answer 31

Thickening of mucosal folds and poor definition of circular folds

Question 32

What is the appearance of Crohn’s disease in a small bowel series?


Answer 32

Segments of lumen narrowed with an irregular cobblestone appearance and string sign

Question 33

What does Giardiasis look like in a small bowel series?


Answer 33

Dilation of the intestine with thickening of circular folds

Question 34

What is the appearance of ileus in a small bowel series?


Answer 34

Abnormal gas patterns with dilated loops of bowel, showing a "circular staircase" or "herringbone" pattern

Question 35

What does malabsorption indicate in a small bowel series?


Answer 35

Thickening of mucosal folds and poor definition of normal feathery appearance

Question 36

What does a neoplasm look like in a small bowel series?


Answer 36

Narrowed segments of intestine with "apple core" or "napkin ring" sign

Question 37

What is Meckel’s Diverticulum in a small bowel series?


Answer 37

A large diverticulum of the ileum, proximal to the ileocecal valve

Question 38

What are the methods of examination for the small intestine?


Answer 38

Oral method (small bowel series) Enteroclysis Intubation method

Question 39

What is the oral method of examination for the small intestine?


Answer 39

It produces several identical images at timed intervals after ingestion of barium

Question 40

How are images obtained in the oral method of examination?


Answer 40

With the patient in either supine or prone position

Question 41

Why is the supine position used during the oral method of examination?


Answer 41

To take advantage of the superior and lateral shift of the stomach, improving visualization of the duodenum and jejunum

Question 42

Why is the prone position used during the oral method of examination?


Answer 42

To compress the abdomen and increase image quality

Question 43

When are the first images taken after ingestion of barium?


Answer 43

When are the first images taken after ingestion of barium?
 15 minutes after ingestion

Question 44

When is the examination complete during the oral method?


Answer 44

When barium is seen in the cecum

Question 45

What are the contraindications for using BaSO4?


Answer 45

Presurgical patients, perforated hollow viscera, large intestine obstruction

Question 46

What is the procedure for an upper GI/small bowel combination examination?


Answer 46

Routine upper GI first (note time of first cup ingestion) Ingest second cup 30-minute interval radiographs 1-hour interval radiographs (if needed) Spot ileocecal valve (optional)

Question 47

What is the procedure for a small bowel only series examination?


Answer 47

Scout radiograph 16 ounces of BaSO4 (note time) 15–30-minute radiographs (first) 30-minute interval radiographs Spot ileocecal valve (optional)

Question 48

What is the enteroclysis procedure?


Answer 48

A catheter is advanced to the duodenojejunal flexure, thin barium mixture is injected, and air or methylcellulose is instilled

Question 49

What is the purpose of the enteroclysis double contrast small bowel series?


Answer 49

To evaluate pathologic indications such as ileus, Crohn’s disease, and malabsorption syndrome

Question 50

What is the timing for PA projection in small bowel series?


Answer 50

15–30-minute radiographs, CR 2 inches above crest at MSP and hourly images

Question 51

What is the length of the large intestine?


Answer 51

Approximately 5 feet long

Question 52

What are the four main parts of the large intestine?


Answer 52

Cecum, colon, rectum, and anal canal

Question 53

What is a diverticulum?


Answer 53

An outpouching of the mucosal wall resulting from herniation of the inner wall of the colon

Question 54

What appearance does a volvulus have on a single contrast barium enema?


Answer 54

A tapered or beak appearance with an air-filled distended region of the intestine

Question 55

How do polyps differ from diverticula?


Answer 55

Polyps project inward into the lumen, while diverticula project outward

Question 56

What does intussusception look like on a contrast enema?


Answer 56

A mushroom-shaped dilation at the distal aspect with little barium or gas passing beyond it

Question 57

What imaging methods are recommended for detecting neoplasms?


Answer 57

Double contrast barium enema, CT, and sonography

Question 58

What is the significance of the apple core or napkin ring appearance in barium enema imaging?


Answer 58

It indicates carcinoma with a filling defect, narrowness, or tapering of the lumen

Question 59

What imaging modalities are preferred for appendicitis?


Answer 59

Ultrasound and CT

Question 60

What are the technical considerations for lower gastrointestinal imaging?


Answer 60

Patient care and preparation Enema tip insertion Single contrast barium enema Double contrast barium enema Evacuative proctography (defecography)

Question 61

What are the preparation steps for a barium enema?


Answer 61

Light evening meal prior to exam Bowel cleaning cathartics NPO after midnight (8 hours minimum) No gum chewing or smoking Enema morning of exam

Question 62

What are cathartics?


Answer 62

Substances that produce frequent, soft, or liquid bowel movements

Question 63

What are the two types of cathartics?


Answer 63

Irritant and saline

Question 64

What are the contraindications for using cathartics?


Answer 64

Gross bleeding, severe diarrhea, obstruction, and inflammatory lesions

Question 65

What are the two methods of barium enema examination?


Answer 65

Single Contrast: Barium fills the entire colon Double Contrast: Barium and air administered simultaneously or in two stages

Question 66

What are the components of the contrast media for barium enema?


Answer 66

Single use-closed system kit Room temperature water Colloidal suspension (mix well before use) Optional IV glucagon for spasms Optional topical anesthetic

Question 67

Why is the large intestine required to be completely emptied before a barium enema?


Answer 67

Retained fecal matter can simulate small masses