Study Guide Large Intestine Flashcards
1
Q
The large intestine begins in what region?
A
right iliac
2
Q
The large intestine has how many parts?
A
4
3
Q
What are the 4 parts of the large intestine?
A
cecum, colon, rectum, anal canal
4
Q
How long is the large intestine?
A
5 ft
5
Q
How many layers does the large intestine have?
A
4
6
Q
What is the external band of longitudinal muscle that forms into 3 thickened bands?
A
taeniae coli
7
Q
One band is positioned ____ and two are positioned_____.
A
anteriorly, posteriorly
8
Q
Taeniae Coli bands create a pulling muscle tone that creates pouches called?
A
haustra
9
Q
The main functions of large intestine are?
A
reabsorption of fluids and elimination of waste products
10
Q
What is a pouchlike portion of the large intestine that is below the ileum and colon?
A
Cecum
11
Q
What is attached to the posteromedial side of the cecum and is a wormlike narrow tube?
A
vermiform appendix
12
Q
What is below the junction of the ascending colon and cecum?
A
ileocecal valve
13
Q
The colon is subdivided into what sections?
A
ascending, transverse, descending, sigmoid
14
Q
What passes superiorly from its junction with the cecum to the undersurface of the liver and joins the transverse colon?
A
ascending colon
15
Q
What is the most movable, the longest portion of the colon?
A
transverse
16
Q
The ascending colon makes a right angle forming the?
A
right colic flexure
17
Q
The transverse colon makes a sharp curve forming the?
A
left colic flexure
18
Q
What part of the colon passes inferiorly and medially to its junction with the sigmoid portion?
A
descending colon
19
Q
What forms a S-shaped loop and ends in the rectum?
A
sigmoid
20
Q
The sigmoid ends at what level in the rectum?
A
3rd sacral segment
21
Q
What extends from the sigmoid colon to the anal canal?
A
Rectum
22
Q
What terminates at the anus?
A
anal canal
23
Q
What is above the anal canal and is a dilatation?
A
rectal ampulla
24
Q
How many curves do the rectum and anal canal have?
A
2 AP curves
25
In _____ patients large intestine is positioned around the periphery of the abdomen and may require more images to show entire length.
hypersthenic
26
In _____ patients the large intestine is bunched together and positioned low in the abdomen.
asthenic
27
What is the largest, irregularly wedge shape gland in the body?
liver
28
The deepest point of the liver is?
inferior aspect above the right kidney
29
The diaphragmatic surface of the liver is?
convex
30
The visceral surface of the liver is?
concave
31
What divides the liver into the right and left lobe?
falciform ligament
32
The posterior surface of the liver is?
caudate lobe
33
The inferior surface of the liver is?
quadrate lobe
34
The hilum of the liver is called?
porta hepatis
35
What conveys blood to the liver?
portal vein and hepatic artery
36
Where does the portal vein end in?
sinusoids
37
Where does the hepatic artery end in?
capillaries
38
Where does the liver receive blood from?
portal system
39
The blood circulating through these organs are rich in?
nutrients
40
The hepatic veins convey blood from the?
liver sinusoids
41
What are the functions of the liver?
formation of bile, elimination for waste products of RBC, emulsification of fats
42
The two main hepatic ducts emerge to form?
common hepatic duct
43
The common hepatic duct and cystic duct form?
Common bile duct
44
The common bile duct and the pancreatic duct form?
hepatopancreatic ampulla
45
The distal end of the common bile duct is controlled by?
Choledochal sphincter
46
The hepatopancreatic ampulla is controlled by?
sphincter of the hepatopancreatic ampulla
47
The gallbladder stores bile during?
interdigestive periods
48
The gallbladder evacuates bile during?
digestion
49
The hepatopancreatic ampulla opens on an elevation known as?
major duodenal papilla
50
What is a thin walled, pear shaped sac?
gallbladder
51
What is the capacity of the gallbladder?
2oz
52
The gallbladder concentrates bile through?
absorption of water content
53
The muscular contraction of the gallbladder is activated by a hormone called?
cholecystokinin
54
What does the gallbladder consist of?
narrow neck, body and fundus
55
In ____ patients the gallbladder is high and well away from the midline in?
hypersthenic
56
In _____ patients the gallbladder is low and near the spine in?
asthenic
57
What is an elongated gland situated across the posterior abdominal wall?
Pancreas
58
The pancreas consists of?
head, heck, body and tail
59
What portion is the broadest?
head
60
What kind of gland is the pancreas?
exocrine, endocrine
61
The exocrine portion of the pancreas produces?
pancreatic juices
62
The endocrine portion of the pancreas consist of?
islet cells
63
The pancreas produces the hormone ____ and ____?
insulin and glucagon
64
The digestive juices secreted by exocrine cells are conveyed into what duct?
pancreatic
65
Insulin and glucagon are responsible for?
glucose metabolism
66
The pancreatic duct and the common bile duct form?
hepatopancreatic ampulla
67
The spleen belongs to what system?
lymphatic
68
What is a ductless organ that produces lymphocytes and stores/removes dead RBC?
spleen
69
Where does the spleen sit?
obliquely in Left upper quadrant
70
What are two methods of examining large intestines?
single contrast and double-contrast
71
Single contrast is?
barium or water-soluble iodide only
72
Double-contrast is?
barium sulfate and air/gas substance
73
Which contrast allows for the demonstration of small intraluminal lesions?
Double-contrast/ air contrast
74
What procedure is used as a primary screening tool for colorectal cancer?
Virtual colonscopy or computed tomography colonography
75
What is useful for double contrast studies of the alimentary canal where coating of the lumen is required?
High density barium sulfate
76
When air is the gaseous medium used in a double contrast study this procedure is called?
air contrast study
77
When a leak or colon perforation is suspected what is used?
Water soluble iodide
78
What is a disadvantage of Water soluble iodide?
evacuation is insufficient for satisfactory double contrast visualization
79
When using oral agents transit time from ingestion to colonic filling is?
3-4 hrs
80
The preliminary preparation for large intestines includes?
dietary restrictions (clear liquids only) and bowel cleansing regimen
81
What are the bowel cleansing methods
intestinal tract cleaning kits
lavage preparations
enema
82
When are enema retention tips used?
when a patient has a relaxed anal sphincter or other condition
83
The reusable squeeze inflator is recommended to limit air capacity to?
90mL
84
For the safety of patient, any retention balloon must be?
inflated with caution using fluoroscopy just before the exam
85
Most BE exams require how much premixed liquid barium?
1000-2000mL
86
For single contrast exams what is recommended?
low density barium suspension
87
What is the volume/weight for low density barium?
15-20%
88
Optimal imaging in double contrast exams use?
high density barium
89
What is the volume/weight for high density barium?
80-100%
90
When water soluble contrast is required what is the percentage used?
60-76%
91
What do you instruct the patient to do?
keep anal sphincter tightly contracted
relax abdominal muscles
concentrate on deep oral breathing
92
What helps reduce the incidence of colonic spasms?
deep oral breathing
93
Patient will be turned how many degrees for insertion of enema tip?
35-40 degrees
94
How much would you adjust the IV pole?
24" above the level of the anus
95
What would you need to run a little of the barium mixture into a waste basin?
free the tubing of air
96
The tube is directed anteriorly how many inches?
1-1.5"
97
The tube is inserted no more than how many inches?
4"
98
What are the most commonly obtained projections for single contrast BE?
PA/AP, PA obliques, axial and lateral
99
What is the most important requirement for a single stage procedure?
colon must be clean
100
What barium product percentage should be used for single stage contrast studies?
80-100%
101
What is the most important criterion for single stage contrast studies?
barium flows sufficiently to coat the walls of the colon
102
Each portion of the colon has a minimum of how many images taken?
2
103
For all Large intestine projections the SID is?
40"
104
For all Large Intestine projections the breathing instructions are?
Suspend
105
For PA where is the IR centered?
@ the level of the iliac crest
106
For PA what cassette size used?
14x17
107
For PA where is the CR centered?
Perpendicular to the IR, enter the midline of the body at the level of the iliac crest
108
For PA what collimation is used?
14x`17, 1" sides
109
For PA why would you put the patient in Trendelenburg?
Helps separate the overlapping loops of the bowel by "spilling" them out
110
For AP/PA projections what two exposures would you get for crosswise plate?
1st centered high enough to get diaphragm
| 2nd centered low enough to include rectum
111
The PA projection shows what structures?
entire colon
112
For PA Axial the cassette size is?
10x12, 14x17 lengthwise
113
For PA Axial the IR position is?
@ the level of the iliac crest
114
For PA Axial the CR is directed?
30-40 degrees cuadad
| @ level of ASIS
115
For PA Axial the collimation is?
no larger than 14x17 or 10x12
116
For PA Axial the structures show is?
rectosigmoid area of colon
117
For PA Axial the patient is in what position?
RAO to reduce superimposition of rectosigmoid area
118
For PA Oblique RAO the cassette size is?
14x17 lengthwise
119
For the Obliques the patient is turned at how many degrees?
35-45 degree
120
For PA Oblique RAO the IR is positioned?
@ the level of the iliac crest
121
For PA Oblique RAO the CR is positioned?
1-2" lateral to the midline of the body on the elevated side at the level of the iliac crest
122
For PA Oblique RAO the collimation is?
14x17, 1" beyond
123
For PA Oblique RAO the structures shown are?
right colic flexure, ascending colon, sigmoid colon
124
For PA Oblique LAO the cassette size is?
14x17 lengthwise
125
For PA Oblique LAO the IR Is?
@ the level of the iliac crest
126
For PA Oblique LAO the CR position is?
1-2" lateral to the midline of the body on the elevated side at the level of the iliac crest
127
For PA Oblique LAO the collimation is?
14x17, 1" beyond
128
For PA Oblique LAO the structures shown are?
left colic flexure and descending colon
129
For Lateral the cassette size used?
10x12 lengthwise
130
For Lateral the IR is positioned?
center to the ASIS
131
For Lateral the CR is positioned?
enter the mcp at the level of the ASIS
132
For Lateral the collimation is?
10x12
133
For Lateral what structures are shown?
rectum, distal sigmoid portion
134
For AP what is the cassette size used?
14x`17 lengthwise
135
For AP what is the IR position?
@ level of the iliac crest
136
For AP what is the CR position?
enter the midline of the body at the level of the iliac crest
137
For AP what is the collimation?
14x17, 1" beyond
138
For AP what structures are shown?
entire colon
139
For AP Axial what is the cassette size used?
10x12 or 14x17 lengthwise
140
For AP Axial what is the IR position?
@ level 2" above the iliac crest
141
For AP Axial what is the CR position?
30-40 degree cephalad
| 2" below level of the ASIS
142
For AP Axial what is the collimation?
14x17 or 10x12
143
For AP Axial what is the structures shown?
rectosigmoid area
144
The AP Axial projection is sometimes performed with the patient in what position?
LPO
145
For AP Oblique LPO what is the cassette used?
14x17
146
For AP Oblique LPO how is the IR centered?
@ the level of the iliac crest
147
For AP Oblique LPO how is the CR positioned?
1-2" lateral to the midline of the body on the elevated side at the level of the iliac crest
148
For AP Oblique LPO what is the collimation?
14x17, 1" beyond
149
For AP Oblique LPO what structures are shown?
right colic flexure, ascending colon, sigmoid colon
150
For AP Oblique RPO what is the cassette size?
14x17 lengthwise
151
For AP Oblique RPO what is the IR position?
@ level of the iliac crest
152
For AP Oblique RPO what is the CR position?
1-2" lateral to the midline of the body on the elevated side at the level of the iliac crest
153
For AP Oblique RPO what is the collimation?
14x17, 1" beyond
154
For AP Oblique RPO what structures are shown?
left colic flexure and descending colon
155
For AP/PA Right lateral decub what is the cassette size?
14x17 lengthwise
156
For AP/PA Right lateral decub what is the IR position?
@ level of iliac crest
157
For AP/PA Right lateral decub what is the CR position?
horizontal and perp to IR
| Center to midline of the body at the level of iliac crest
158
For AP/PA Right lateral decub What is the collimation?
14x17,1" beyond
159
For AP/PA Right lateral decub what structures are shown?
up medial side of the ascending colon and lateral side of descending colon is with air
160
For PA/AP Left Lateral decub what is the cassette size
14x17
161
For PA/AP Left Lateral decub what is the IR position?
@ the level of the iliac crest
162
For PA/AP Left Lateral decub what is the CR position?
horizontal and perp to IR
| center to mdiline of the body at the level of the iliac crest
163
For PA/AP Left Lateral decub what is the collimation?
14x17, 1" beyond
164
For PA/AP Left Lateral decub what structures are shown?
up lateral side of ascending colon and medial side of descending colon is with air
165
For patients in decubitus position its crucial to use?
elevated radiolucent support
166
If patient in upright position the IR is placed?
at a lower level due to gravity
167
Two methods of Double contrast BE?
Closed system
| Welin
168
What is the closed system method?
Doesn’t require removal and reinsertion if enema tip
169
What is the welin method?
two-step method, Take the tip out and reinsert. Used for early detection of small lesions
170
What are the essential projections for large intestines?
```
PA/AP
PA/AP Axial
PA oblique RAO/LAO
AP oblique RPO/LPO
Lateral
AP/PA right/left lateral decub
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