1
Q
What structures make up the alimentary canal?
A
Oral cavity, pharynx, esophagus, stomach, small intestine, large intestine
2
Q
What are the accessory organs of digestion?
A
Salivary glands, pancreas, liver, and gallbladder.
3
Q
What is the role of the Mouth
A
Mastication, begins digestion
4
Q
What is the role of the Pharynx
A
Passageway for food & air
5
Q
What is the role of the Esophagus
A
Muscular tube for swallowing
6
Q
What is the role of the Stomach
A
Mechanical + chemical digestion
7
Q
What is the role of the Small intestine
A
Absorption of nutrients (digestion, absorption, reabsorption)
8
Q
What is the role of the Large intestine
A
Elimination of waste (defecation)
[some reabsorption]
9
Q
What are the three divisions of the pharynx?
A
Nasopharynx, Oropharynx, Laryngopharynx
10
Q
Role of nasopharynx?
A
Primarily respiratory
11
Q
Role of oropharynx?
A
Passageway for food and air
12
Q
Role of laryngopharynx?
A
Muscular area where swallowing reflex directs bolus into esophagus
13
Q
What is mastication?
A
The mechanical part of digestion (chewing). Reduces the size of food particles and mixes them with saliva
14
Q
What is deglutition?
A
Swallowing.
15
Q
What is peristalsis?
A
Wave-like series of involuntary muscle contractions that propel substances through the GI tract
16
Q
What are the three pairs of salivary glands (2 of each)?
A
Parotid, submandibular, and sublingual glands.
17
Q
What structures form the roof of the oral cavity?
A
The hard palate and soft palate.
18
Q
What forms the main part of the floor of the oral cavity?
A
The tongue
19
Q
What is the uvula and where is it located?
A
A small conical process hanging from the soft palate.
20
Q
What does the oral cavity connect posteriorly with?
A
The pharynx
21
Q
What is the composition and function of saliva?
A
Saliva is 99.5% water and 0.5% salts/enzymes; it dissolves food, lubricates it into a bolus, and begins digestion.
22
Q
How much saliva is secreted daily?
A
1000-1500 ml
23
Q
What is mumps?
A
An inflammation and enlargement of parotid glands
24
Q
How long is the pharynx?
A
12.5 cm in length
25
What is a sialogram and when is it used?
A radiographic examination of salivary ducts, typically performed when stones (sialoliths) are present.
26
What mechanisms prevent aspiration during swallowing?
Soft palate closes nasopharynx, tongue blocks mouth, epiglottis covers laryngeal opening, and vocal cords close. Respiration stops momentarily.
27
How long is the esophagus and where is it located?
About 10 inches (25 cm), running posterior to the trachea and anterior to the spine.
28
Where does the esophagus extend from?
The lower border of the cricoid cartilage to the stomach
29
What is posterior to the distal esophagus?
The thoracic aorta
30
Where is the heart in relation to the esophagus and diaphragm?
Anterior to the esophagus and superior to the diaphragm
31
What is the narrowest part of the alimentary canal?
The esophagus
32
Where is the esophagus most constricted?
The proximal end where it enters the thorax and at the level of T10 where it passes through the diaphragm
33
Where does the esophagus pass through the diaphragm at?
The esophageal hiatus
34
What is the cardiac antrum?
A short 1–2 cm segment of the abdominal esophagus just below the diaphragm, curving left to join the stomach.
35
What is the esophagogastric junction?
The opening between the esophagus and stomach, also known as the cardiac orifice.
36
What are the main divisions of the stomach?
Fundus, body (corpus), and pyloric portion (antrum, canal, sphincter).
37
How do fluid pass through the esophagus?
By gravity
38
How do solids pass through the esophagus?
By gravity and peristalsis
39
What does the stomach look like when empty?
Virtually collapses. It expands greatly when filled with food
40
What allows food/fluid to enter the stomach?
The cardiac sphincter
41
What is directly superior to the cardiac orifice?
The cardiac notch
42
What is the last portion of the stomach?
The pyloric orifice
43
What is a thickened muscular ring at the pyloric orifice that periodically relaxes to allow gastric contents to move into the duodenum?
The pyloric sphincter
44
What is the concave medical border of the stomach that extends between the cardiac and pyloric openings?
Lesser curvature
45
What forms the convex lateral border of the stomach?
Greater curvature
46
What are rugae and what is their function?
Longitudinal gastric folds that allow the stomach to expand.
47
What is the gastric bubble and where is it found?
Swallowed air that rises to the fundus, especially when erect.
48
Where is the fundus located?
Superior and posterior
49
What along the lesser curvature divides the stomach's body from the pyloric portion?
Angular notch- a constricted ring-like area
50
Pyloric antrum vs pyloric canal?
Antrum: slight dilation immediately distal to the angular notch
Canal: slightly narrowed region following the antrum, ends at pyloric sphincter
51
Where does barium settle in the stomach in the supine position ?
In the fundus (gravity-dependent when lying down).
52
Where does barium settle in the prone position (stomach)?
Air will rise into the fundus and barium will lie in the body and pylorus.
53
Where does barium settle in the erect position (stomach)?
Air rises to the fundus and barium falls to the pylorus. This creates an air fluid level.
54
What does an air-fluid level in the stomach indicate?
That the patient is upright.
55
What is the first portion of the small bowel?
The duodenum
56
How big is the duodenum
8-10" long (short and wide)
57
What's the duodenum's shape?
C-shaped (head of pancreas nestles in the C)
58
What are the duodenum and pancreas considered in relation to position in abdomen?
Retroperitoneal structures
59
What are the four segments of the duodenum?
Superior
Descending
Horizontal
Ascending
60
What is the duodenal bulb and why is it important?
The first portion of the duodenum; a common site for peptic ulcers and visualized in UGI exams.
61
What's the longest segment of the duodenum that receives the common bile duct and main pancreatic duct?
Descending portion
62
Where does the horizontal portion of the duodenum go?
Curves to the patient's left
63
What part of the duodenum contains the duodenjejunal flexure?
Ascending
64
What ducts empty into the descending duodenum?
The common bile duct and main pancreatic duct.
65
What procedure looks at the duodenum?
Upper GI
66
What is the ligament of Treitz?
A suspensory ligament that anchors the duodenojejunal flexure.
67
How long does it take for solid food vs liquids to go from the mouth to stomach?
Food: 4-8 seconds
Liquid: 1 second
68
What is chyme?
Semi-fluid mass formed when food is mixed with gastric juices (pyloric valve is closed, trapping contents in stomach)
69
How long does gastric emptying take?
Typically 2–6 hours after a meal
70
What is rhythmic segmentation?
Rhythmic, localized contractions of smooth muscles in the small intestine that mix and churn food with digestive juices, promoting efficient nutrient absorption
71
How long does it take for chyme to move through the small intestine?
1 cm/min (taking 3-5 hours to go through the whole small bowel)
72
Where does most nutrient absorption occur?
In the small intestine.
73
What are the end products of digestion for carbs, proteins, and fats?
Carbs → simple sugars
Proteins → amino acids
Fats → fatty acids + glycerol
74
How does stomach position vary in hypersthenic patients?
High and transverse, located between T9–T12; center 1" distal to xiphoid.
75
How does stomach position differ in hyposthenic/asthenic patients?
Low, J-shaped, extending from T11 to L5, often below crest.
76
What is the difference between thin and thick barium?
Thin: 1:1 ratio with water; resembles thin milkshake.
Thick: 3–4 parts barium to 1 part water; coats mucosa well, used especially for esophagus.
77
When is barium contraindicated?
When perforation is suspected or if the patient is going to surgery.
78
What contrast is used if barium cannot be given?
Water-soluble iodinated contrast (Gastrografin, Gastroview, Oral Hypaque).
79
What are negative (radiolucent) contrast agents?
Air, CO₂ gas crystals, and naturally occurring gastric gas.
80
What is a double-contrast UGI used for?
To demonstrate mucosal detail and detect polyps, ulcers, or diverticula.
81
Which sticks "in" vs "out"- polyps and diverticula?
Sticks in: polyps
Sticks out: diverticula
82
Where is the x-ray tube located in conventional fluoroscopy?
Under the table, with the image intensifier above.
83
What device converts analog images to digital in DF systems?
A charged-coupled device (CCD).
84
What radiation protection rules should be followed during fluoroscopy?
Stand back from the table
Ensure tower drape and bucky slot cover are in place
Wear lead apron (and thyroid shield when possible)
Observe time, distance, and shielding principles.
85
Where does carbohydrate digestion begin?
In the mouth.
86
Where does protein digestion begin?
In the stomach.
87
Where are lipids digested?
In the small intestine with the help of bile.
88
What nutrients are absorbed without chemical breakdown?
Water, vitamins, minerals.
89
How does body habitus affect stomach position?
It determines how high, low, transverse, or vertical the stomach sits in the abdomen.
90
Where is the stomach located in a hypersthenic patient?
High, transverse, and more horizontally oriented.
91
Where is the stomach located in a sthenic patient?
Mid-abdomen, slightly to the left, J-shaped.
92
Where is the stomach in a hyposthenic/asthenic patient?
Low and more vertical; almost reaches the pelvis.
93
Why must technologists assess body habitus before UGI?
To determine proper CR location and positioning.
94
What is thin barium used for?
Esophagus, motility studies, and single-contrast UGI.
95
What is thick barium used for?
Coating mucosa, double-contrast studies, and detailed gastric mucosal evaluation.
96
What is the function of carbonation crystals?
To create gas, distend the stomach, and enhance mucosal visualization.
97
What is a double-contrast UGI?
A study using barium + gas for detailed mucosal visualization.
98
When should barium NOT be used?
When perforation or obstruction is suspected.
99
What contrast should be used if perforation is possible?
Water-soluble iodinated contrast (Gastrografin/Omnipaque).
100
Why is water-soluble contrast preferred in perforation?
It is absorbed by the body and does not cause peritonitis.
101
What is a disadvantage of water-soluble contrast?
It has a bitter taste and can cause dehydration.
102
What is the purpose of fluoroscopy in UGI?
To visualize real-time function and anatomy of the esophagus, stomach, and duodenum.
103
What are the two kinds of fluoroscopy?
Conventional and digital.
104
What part of the fluoroscopy system converts x-rays to light?
The input phosphor of the image intensifier.
105
What converts electrons back to visible light for viewing?
The output phosphor.
106
What is the minimum source-to-table distance (STD) in fluoroscopy?
15 inches for fixed units; 12 inches for mobile units.
107
What are the cardinal principles of radiation protection?
Time, distance, and shielding.
108
How can time be minimized in fluoro?
Using pulsed fluoro and last-image hold.
109
How can distance be maximized in fluoro?
Standing back from the table when not assisting.
110
What shielding should be worn during fluoro?
Lead apron, thyroid shield, and possibly lead glasses.
111
How should the Bucky tray be positioned during fluoro?
At the foot of the table to reduce scatter exposure.
112
What is the primary purpose of an Upper GI (UGI) exam?
To visualize the stomach and duodenum for pathology or dysfunction.
(DISTAL
ESOPHAGUS, STOMACH, AND DOUDENUM)
113
What are typical patient prep instructions for UGI?
NPO for 8 hours; no smoking or gum chewing.
114
Why can't patients smoke or chew gum before a UGI?
It increases gastric secretions and affects results.
115
What type of substance is Barium?
A radiopaque contrast medium. Powdery/chalky, combined with water to form a colloidal suspension (NOT a solution)
116
What types of contrast are used during UGI?
Thin barium, thick barium, and gas crystals.
117
What are the endoscopic alternatives to a UGI?
EGD (esophagogastroduodenoscopy).
118
Why are multiple positions used in UGI?
To coat the stomach and duodenum thoroughly and show anatomy without overlap.
119
What position best shows the gastric bubbles?
Erect position — air rises into the fundus.
120
What position best demonstrates the duodenal bulb?
RAO.
121
What position best shows the retrogastric space?
Right lateral.
122
What position best demonstrates the pylorus and C-loop of duodenum?
LPO or RAO depending on purpose.
123
What views of the esophagus may be taken during UGI?
AP/PA, RAO, Lateral.
124
What position best demonstrates esophageal peristalsis?
RAO.
125
What is the main advantage of prone esophagus imaging?
Compresses the esophagus and improves coating.
126
What is a hiatal hernia?
Part of the stomach protruding through the diaphragm.
127
What is gastritis?
Inflammation of the stomach lining.
128
What is a gastric ulcer?
A mucosal erosion, often in the duodenal bulb or lesser curvature.
129
What is a Schatzki’s ring?
A narrowing at the distal esophagus, associated with hiatal hernia.
130
What is achalasia?
Failure of the esophagus to relax, causing dilation and distal narrowing ('bird beak').
131
What should patients be told after UGI?
Drink plenty of water; Stool will be white/light until barium passes; Contact provider for constipation or abdominal pain.
132
What can help prevent barium impaction?
Hydration and possibly mild laxatives as directed.
133
What is the purpose of an esophagram?
To study the form and function of the esophagus and detect pathological processes.
134
What contrast agents are used for the esophagus?
Thin barium, thick barium, or water-soluble iodinated contrast if perforation is suspected.
135
Why is thick barium helpful in esophagus studies?
It adheres to mucosa and demonstrates structural abnormalities.
136
Is patient preparation required for a routine esophagram?
No — NPO is not usually required.
137
What rotation is used for an RAO esophagus?
35–40° RAO.
138
What does the RAO esophagus position demonstrate best?
Esophagus between the vertebral column and the heart shadow.
139
Why is RAO preferred for esophagus?
It enhances peristalsis due to gravity and position.
140
Where is the CR for RAO esophagus?
T5–T6; 2–3" left of MSP.
141
What is demonstrated in the lateral esophagus?
Esophagus free from superimposition, between T spine and heart shadow.
142
Where is the CR for lateral esophagus?
T5–T6.
143
Why is the lateral esophagus view important?
Shows posterior pathology like strictures and fistulas.
144
What does the AP/PA esophagus show?
Entire esophagus superimposed over the spine.
145
Why is AP/PA less ideal than RAO?
Esophagus is superimposed over spine → less detail.
146
What does achalasia look like on barium?
Distal 'bird beak' narrowing with proximal dilation.
147
What does esophageal varices look like?
'Worm-like' or 'rosary bead' filling defects.
148
What does a Schatzki ring look like?
A thin circumferential narrowing near the EG junction.
149
What does Zenker’s diverticulum look like?
Posterior outpouching above the upper esophageal sphincter (UES)
150
What is the rotation for RAO UGI?
40–70° depending on habitus.
151
What does RAO UGI best demonstrate?
Entire stomach; Duodenal bulb and C-loop; Pylorus filled with barium.
152
Why is RAO the key view in UGI?
It opens the bulb and shows pathology such as ulcers.
153
What does the PA UGI show?
Barium in the body and pylorus, air in fundus.
154
Why is PA UGI helpful?
Natural compression improves visualization.
155
What does the right lateral UGI show?
Retrogastric space; Pyloric canal; Duodenal loop; Anterior/posterior walls.
156
What pathology is best shown in lateral UGI?
Gastric ulcers.
157
What degree of rotation is used for LPO UGI?
30–60°.
158
What does LPO UGI demonstrate?
Fundus filled with barium; Unobstructed view of stomach body, pylorus, and bulb.
159
Why use LPO UGI?
Opposite of RAO — demonstrates alternative air/barium distribution.
160
What does the AP UGI show?
Barium in fundus; Air in body and pylorus; Entire stomach and proximal duodenum.
161
What is the Valsalva maneuver?
Patient bears down to show reflux, varices, or hiatal hernia motion.
162
What is the Water Test?
Patient drinks water while prone; demonstrates reflux and hiatal hernia.
163
What does Trendelenburg position show?
Small hiatal hernias or reflux not otherwise visible.
164
What is most important for the patient after UGI?
Hydration.
165
What must the technologist warn about after an exam with Barium contrast?
Barium causes light/white stools temporarily. Hydrate
166
When should the patient call a provider?
If they develop constipation, abdominal pain, or cannot pass barium.
167
What is an esophagram (barium swallow)?
A study that demonstrates the pharynx and esophagus using contrast to evaluate form and function of swallowing.
168
What is the purpose of an esophagram?
To observe the form/function of the esophagus and swallowing mechanism.
169
What is dysphagia?
Difficulty swallowing.
170
What is esophageal reflux?
Gastric contents reflux into the esophagus; described by patients as 'heartburn.'
171
What condition may reflux lead to radiographically?
Esophagitis → ulcerative/irregular mucosa.
172
What is achalasia/cardiospasm?
Failure of the esophagogastric sphincter to relax → megaesophagus. Reduced peristalsis
173
What is Barrett’s esophagus?
A distal esophageal stricture; advanced cases may ulcerate.
174
What are signs of esophageal carcinoma?
Dysphagia, pain with meals, bleeding.
175
What are esophageal varices?
Dilated distal esophageal veins (often from cirrhosis) with rosary bead appearance
176
What is Zenker’s diverticulum?
A large outpouching above the esophagogastric sphincter.
177
What is GERD?
Gastroesophageal reflux disease—gastric contents irritate the esophageal lining. Can be caused by heartburn
178
What may increase incidence of GERD?
Smoking, caffeine, alcohol, aspirin.
179
Is patient preparation required for an esophagram?
Not unless an Upper GI follows or the lower esophagus is the area of interest.
180
What kVp is used for esophagrams?
110–120 kVp single contrast; 90–100 kVp double contrast.
181
How long should the fluoro timer be set?
5 minutes.
182
What items may be used to detect foreign body?
Cotton balls soaked in barium, Barium tablets, Marshmallows with thin barium.
183
How should the patient hold the barium cup for UGI procedures?
In their left hand, near the left shoulder.
184
When is the radiograph taken?
After the tech sees the patient take at least 3 big swallows.
185
What is the Valsalva maneuver?
Deep breath + bearing down like having a bowel movement.
186
What is the modified Valsalva?
Pinch nose, close mouth, 'blow out' → cheeks puff.
187
What is the Mueller maneuver?
Exhale, then inhale against a closed glottis.
188
What is the water test?
Patient drinks water under fluoro while radiologist checks for reflux at EG junction.
189
What is the compression technique?
Paddle is placed under a prone patient and inflated to provide pressure to the stomach and demonstrate esophagogastric junction
190
What does the toe-touch maneuver demonstrate?
Reflux and hiatal hernias.
191
What is a UGI?
Radiographic study of distal esophagus, stomach, and duodenum.
192
What is the purpose of a UGI?
To evaluate anatomy and function; detect pathology.
193
What is a contraindication to UGI?
Suspected bowel perforation (use gastro instead)
194
What is a bezoar?
Mass of undigested material appearing as a filling defect.
195
What are gastric diverticula?
Pouchlike herniations of the mucosal wall—benign unless inflamed (then could lead to perforation)
196
What is emesis?
Vomiting.
197
What is hematemesis?
Vomiting blood.
198
What is gastric carcinoma?
Stomach neoplasm. Radiographic signs include large irregular filling defect in the stomach and ulceration of mucosa
199
What is gastritis?
Inflammation of the stomach lining; best seen with double-contrast UGI. Can be acute or chronic
200
What are radiographic signs of gastritis?
Absence of rugae, thin gastric wall, 'speckled' mucosa.
201
What is a hiatal hernia?
Portion of stomach herniates through diaphragmatic opening.
202
What is a Schatzki’s ring?
Ring-like narrowing at distal esophagus seen with sliding hiatal hernia.
203
What is hypertrophic pyloric stenosis (HPS)?
Most common type of infant gastric obstruction causing projectile vomiting, pain, distension
204
What is an ulcer?
Erosions of the stomach or duodenal mucosa caused by excessive gastric secretions, stress, diet, and smoking. Can lead to perforation.
205
How do ulcers appear?
Punctate barium collection surrounded by a "lucent-halo"
206
What are the different types of ulcers?
Duodenal (in duo- rarely malignant), peptic (caused by gastric acid juice), gastric (gastric mucosa), perforating (creates opening)
207
What are peptic ulcers synonymous with?
Gastric and duodenal ulcers
208
What does a perforated ulcer show on x-ray?
Free air under diaphragm.
209
What is recommended for most ulcer studies?
Double contrast.
210
What is the standard NPO time before a UGI for adults?
NPO after midnight or 8 hours before the exam.
211
Why no smoking or chewing gum before UGI exam?
Increases secretions → prevents coating of mucosa with barium.
212
What is the standard NPO time before a UGI for infants and children?
Infants <1 year: 4 hours
Children >1 year: 6 hours
213
What contrast is prepared for a double-contrast UGI?
High-density barium + gas crystals.
214
How does body habitus affect stomach position?
Hypersthenic: high, transverse stomach; Hyposthenic: low, vertical stomach.
215
What are the routine positions for an esophagram?
RAO 35°, Right Lateral, AP.
216
What views are included in a UGI?
RAO 40–70°, Right Lateral, AP/PA, LPO.
217
What do obliques demonstrate in a UGI?
Duodenal bulb in profile.
218
How much rotation for a RAO UGI?
40–70° (more for hypersthenic, less for asthenic).
219
How much rotation for an LPO UGI?
30–60°.
220
What does the lateral UGI demonstrate?
Retrogastric space.
221
What are indications for water-soluble iodinated contrast media?
Perforated viscus
Presurgical procedure
222
What are contraindications to water-soluble iodinated contrast?
Allergy to iodine
223
What does Barrett's esophagus appear as?
Larger than normal esophagus
224
What are the major causes of esophageal varices?
Acute liver disease (ex. cirrhosis)
Dilated veins
225
What's the main liver function we care about in radiology?
Production of ~1 quart of bile per day
226
What's the gallbladder's function?
Stores and concentrates bile. Contracts when stimulated
227
What stimulates the GB?
The hormone cholecystokinin when fats are present in the duodenum
228
How does bile get from the liver to the GB?
Biliary ducts
229
What is the largest solid organ in the human body?
The liver.
230
How much does the liver weigh?
3–4 pounds.
231
In which quadrant is the liver located?
Right Upper Quadrant (RUQ).
232
What protects the liver from injury?
The lower right rib cage.
233
How many lobes does the liver have?
Four (2 major + 2 minor).
234
What divides the right and left lobes of the liver?
The falciform ligament.
235
Name the two minor lobes of the liver.
Caudate lobe and quadrate lobe.
236
What is the primary radiologic function of the liver?
Bile production.
237
How much bile does the liver secrete per day?
800–1000 mL.
238
What are the two main functions of bile?
Emulsifying fats and aiding absorption.
239
What makes cholesterol soluble in bile?
Bile salts.
240
What are the three parts of the gallbladder?
Fundus, body, and neck.
241
How long is the gallbladder?
3–4 inches.
242
How much bile can the gallbladder hold?
30–40 cc.
243
What structure connects the gallbladder to the biliary ducts?
The cystic duct.
244
What is the function of spiral valves in the cystic duct?
Prevent collapse or distension.
245
What are the primary functions of the gallbladder?
Store, concentrate, and release bile.
246
What causes the gallbladder to contract?
The hormone cholecystokinin (CCK).
247
What stimulates the release of CCK?
Fatty foods entering the duodenum.
248
What does CCK cause?
Gallbladder contraction and sphincter of Oddi relaxation.
249
Where does bile formation begin?
In the lobules of the liver.
250
What ducts drain the liver?
Right and left hepatic ducts.
251
What duct forms when the hepatic ducts unite?
The common hepatic duct.
252
What two ducts form the common bile duct (CBD)?
Common hepatic duct + cystic duct.
253
How long is the common bile duct?
Approximately 3 inches.
254
In what portion of the duodenum does the CBD terminate?
Second (descending) portion.
255
What percentage of the population has separate CBD and pancreatic ducts?
40%.
256
What percentage has a combined duct (ampulla of Vater)?
60%.
257
What is the ampulla of Vater?
The enlarged chamber where CBD and pancreatic duct unite.
258
What is the hepatopancreatic sphincter also called?
The sphincter of Oddi.
259
What is the duodenal papilla?
The projection into the duodenal lumen created by the sphincter of Oddi.
260
Where is the gallbladder located relative to the coronal plane?
Anterior to the mid-coronal plane.
261
How does gallbladder position vary by body habitus?
Hypersthenic: higher & more lateral; Sthenic/hyposthenic: between xiphoid and lower rib margin; Asthenic: lower & more medial.
262
What's the radiographic examination of the GB and its ducts?
Cholangiogram
263
What does “chole” mean?
Bile.
264
What does “cysto” mean?
Sac or bladder.
265
What is cholelithiasis?
The condition of having gallstones (choleliths)
266
What is cholecystectomy?
Surgical removal of the gallbladder.
267
What causes gallstones?
Excess cholesterol, bilirubin, or calcium.
268
What percentage of biliary disorders are due to gallstones?
About 90%.
269
Who is at increased risk for gallstones?
Female, obese patients.
270
What is “milk of calcium bile”?
Sludge-like sediment that layers on erect/decubitus images.
271
What is acute cholecystitis usually caused by?
Blocked cystic duct → inflammation, possible infection.
272
What are symptoms of acute cholecystitis?
RUQ pain, fever, tenderness.
273
What is chronic cholecystitis associated with?
Gallstones, pancreatitis, GB cancer.
274
Are most gallbladder tumors benign or malignant?
They may be either, but malignant tumors are aggressive.
275
Which modalities best demonstrate GB tumors?
Sonography and CT.
276
What imaging modality replaced the oral cholecystogram (OCG)?
Sonography.
277
Why is sonography or CT preferred for biliary exams?
No radiation, no contrast, detects small stones, quicker exam.
278
When is an operative cholangiogram performed?
During surgery after gallbladder removal.
279
Operative cholangiogram procedure
[Incision is made and GB removed]
-Endoscope is inserted to sever/suction out GB
-Contrast is injected and images taken w/ C-arm to look for residual stones
280
What is operative cholangiogram's purpose?
Check duct patency, Identify residual stones, Evaluate ampulla function.
281
When is a T-tube cholangiogram done?
Post-op, 1 day to 6 weeks after cholecystectomy.
282
Why is T-tube cholangiogram performed?
Detect retained stones, Check duct patency, Evaluate strictures or dilatations.
283
What must the technologist do before T-tube cholangiogram?
Take a scout and set up the tray (contrast, syringe, butterfly, etc.).
284
What is percutaneous transhepatic cholangiography (PTC) used for?
Obstructive jaundice, stone extraction, biliary drainage.
285
How is PTC performed?
Needle inserted directly through liver into biliary ducts.
286
What complication must be ruled out after PTC?
Pneumothorax.
287
What does ERCP examine?
Biliary and main pancreatic ducts.
288
What is the ERCP procedure?
Scope is advanced through the mouth to ampulla of Vater. Then scope accesses either the common bile duct or pancreatic duct from the hepatopancreatic ampulla
289
What are the diagnostic uses of ERCP?
Check duct patency, Detect stones, Identify strictures/dilations.
290
What are therapeutic uses of ERCP?
Remove stones, Place stents, Dilate strictures.
291
Why must the patient remain NPO after ERCP?
To prevent aspiration due to throat anesthesia.
292
What guidance is used in an ERCP?
Fluoroscopic guidance as they advance the scope
293
What is choledocholithiasis?
Stones in the biliary ducts.
294
What are symptoms of choledocholithiasis?
RUQ pain, jaundice, pancreatitis.
295
What is biliary stenosis?
Narrowing of bile ducts.
296
What may cause biliary stenosis?
Stones, surgery, malignancy.
297
How does the CBD appear with stenosis?
Narrow, tapered, elongated.
298
What is the "bile route"?
R/L hepatic ducts drain into Common hepatic duct.
Cystic duct from GB joins into the Common bile duct.
Pancreatic duct joins in.
Empties into duodenum
299
What position reduces OID for GB studies?
Prone (PA projection)
300
What position is best for GB drainage?
Supine (AP projection)
301
What divides the common hepatic duct from the common bile duct?
The cystic duct
302
What body habitus is associated with GB high and transverse?
Hypersthenic
303
What does ERCP stand for?
Endoscopic retrograde cholangiopancreatography
304
What does the alimentary canal continue as after the stomach?
The small bowel (small intestine).
305
How long is the small intestine in an average adult?
15–18 feet.
306
Where is the small intestine located?
Primarily in the central portion of the abdomen.
307
Where does the small intestine begin and end?
Begins at the pyloric valve of the stomach and ends at the ileocecal valve.
308
How does the internal diameter of the small bowel change along its length?
It progressively decreases from the duodenum to the ileum.
309
What are the three parts of the small intestine?
Duodenum, jejunum, and ileum.
310
What are the characteristics of the duodenum?
It is the shortest, widest, and most fixed part of the small intestine.
311
How long is the duodenum?
10 inches.
312
Where is the duodenum located compared to the jejunum and ileum?
More posterior, located in the RUQ and LUQ.
313
How is the duodenal bulb recognized radiographically?
As the C-shaped portion of the duodenum.
314
What is the duodenojejunal flexure?
The junction between the duodenum and the jejunum.
315
What structure holds the duodenojejunal flexure in place?
The ligament of Treitz.
316
Why is the DJ flexure a radiographic reference point?
It is a fixed location used for small bowel study evaluation.
317
What appearance do the duodenum and jejunum have when filled with AIR?
A coiled-spring appearance due to villi.
318
What appearance do they have when filled with BARIUM?
A feathery appearance.
319
How long is the jejunum?
About 6 feet.
320
Where is the jejunum located?
Primarily left of midline in LUQ and LLQ.
321
How long is the ileum?
Approximately 9 feet (longest portion).
322
Where is the ileum located?
Primarily in the right and mid abdomen and pelvis: RLQ and LLQ.
323
What is the internal lining of the ileum like?
Smoother, without feathery appearance.
324
How does the ileum diameter compare to other small bowel segments?
It is the smallest in diameter.
325
What is the terminal ileum?
The distal portion that ascends to join the large intestine at the ileocecal valve in the RLQ.
326
What does a small bowel series (SBS) demonstrate?
Timed study for the form and function of the small bowel and detects abnormalities.
(DOUDENUM, JEJUNUM, AND ILEUM)
327
What is the small bowel portion of a combined UGI called?
A small bowel follow-through (SBFT).
328
What contrast is typically used for an SBS?
Radiopaque contrast — usually barium.
329
Why is contrast needed for SBS?
Because a large amount of air/gas in the bowel is abnormal and contrast defines the loops.
330
How much thin barium must the patient drink?
At least 16 ounces.
331
What contrast is used when perforation is suspected?
Water-soluble iodinated contrast.
332
What can improve transit in hypomotility?
Ice water or adding iodine contrast to the barium.
333
How long should the patient follow a low-residue diet before a UGI/SBS?
48 hours.
334
What is the NPO requirement before UGI/SBS exam?
NPO for at least 8 hours.
335
What should the patient know before an UGI/SBS exam?
The exam is lengthy and may take several hours.
336
Why is knowing abdominal surgical history important prior to UGI/SBS?
Adhesions or resections may affect motility and anatomy.
337
What happens after the routine UGI?
Progress of barium is followed through the entire small bowel.
338
When does timing begin for the small bowel portion of UGI/SBS?
When patient drinks 8 ounces of barium.
339
What does the patient do immediately after the UGI portion of SBS?
Drinks a second cup of barium.
340
Is patient prep different for an SBS only exam?
No — same as UGI: NPO, history, gown.
341
What is taken before giving barium for UGI/SBS?
A scout abdomen radiograph.
342
How much barium is given for SBS-only?
2 cups (16 oz) thin barium; time is noted.
343
Why are PA radiographs preferred for SBS?
They place bowel closer to the IR and compress bowel loops → better detail.
344
What kVp is used for thin barium?
110–120 kVp.
345
What is the first PA image centered to for SBS?
High — to include the stomach.
346
Where are PA images centered for SBS after the initial high image that included the stomach?
To the iliac crest.
347
Why are time markers required for SBS?
To document bowel transit time accurately.
348
How often are images taken in SBS?
Every 15–30 minutes until barium passes the ileocecal valve.
349
What happens if the exam lasts more than 2 hours (SBS)?
Radiographs are then taken at 1-hour intervals.
350
What happens after each image is taken (SBS)?
It is shown to the radiologist for review.
351
What typically indicates completion of the exam (SBS)?
Fluoroscopic spot imaging of the terminal ileum.
352
What tools must be available for the radiologist (SBS)?
Compression paddle and lead gloves.
353
What is “spotting the TI”?
Fluoro evaluation of the terminal ileum during UGI/SBS
354
May delayed imaging be requested (SBS)?
Yes — to follow barium through the large intestine.
355
How long does it take for barium to reach the rectum from oral route?
About 24 hours.
356
What size IR is used in SBS?
14 × 17 inches, usually lengthwise (unless hypersthenic)
357
What should patients be warned about barium?
It causes constipation; drink extra fluids.
358
When is accelerating the SBS allowed?
Only when normal motility is NOT in question.
359
How can the SBS exam be accelerated?
- Mix barium with saline
Add 10 mL water-soluble iodine contrast (check for allergy)
Radiologist may give motility-increasing drugs
360
What drug is mentioned regarding SBS?
Glucagon (antispasmodic — but actually slows motility; used for other GI exams).
361
What are clinical indications of a SBS?
Enteritis or gastroenteritis
Meckle's diverticulum
Neoplasm
Malabsorption syndrome
Ileus
362
What conditions contraindicate an SBS?
- Suspected perforation
Scheduled abdominal surgery
Suspected large bowel obstruction
Pregnancy.
363
What is enteritis?
Inflammation of the small intestine.
364
What is gastroenteritis?
Inflammation involving both stomach and small intestine.
365
How does enteritis appear radiographically?
Thickened, irregular, and narrowed bowel lumen.
366
Where does Crohn’s disease most commonly affect?
The terminal ileum.
367
What are the radiographic signs of Crohn’s?
Cobblestone appearance
“String sign” (narrowed segments).
368
What complications are associated with Crohn’s disease?
Obstruction, fistulas, abscesses, and high recurrence rate.
369
What is ileus?
Obstruction of the small bowel with abnormal air accumulation.
370
What is adynamic/paralytic ileus?
Cessation of peristalsis due to infection (e.g., peritonitis, appendicitis), drugs, or post-surgical complications.
371
What is mechanical ileus?
Physical blockage caused by tumor, adhesions, or hernia.
372
What radiographic signs do lymphoma & adenocarcinoma produce?
“Stacked coin” sign
Narrowed, ulcerated segments
Adenocarcinoma may show “napkin ring” constriction
Can cause obstruction.
373
What characterizes malabsorption syndromes?
The GI tract’s inability to absorb certain nutrients.
374
What radiographic appearance is seen in malabsorption syndromes?
Swollen or thickened mucosa from chronic irritation.
375
What disease is a form of malabsorption?
Celiac disease (affects proximal small bowel).
376
What does Whipple’s disease show on SBS?
Dilation of proximal small intestine and distorted bowel loops.
377
What is giardiasis?
Dilated intestine with thick circular folds
378
What is enteroclysis?
A double-contrast study involving catheter insertion into the duodenum.
379
How is the catheter placed for enteroclysis?
Through the stomach into the duodenum under fluoro.
380
Where is the enteroclysis catheter advanced to?
The duodenojejunal flexure (Ligament of Treitz).
381
How fast is barium injected for enteroclysis procedure?
100 mL per minute.
382
What is injected after barium (enteroclysis)?
Air or methylcellulose (Metamucil) for double contrast.
383
What are advantages of enteroclysis?
Loops are distended and mucosa becomes highly visible.
384
What are disadvantages of enteroclysis?
Patient discomfort and risk of perforation during catheter placement.
385
What conditions indicate enteroclysis?
History of small bowel ileus, Crohn’s disease, or malabsorption.
386
What imaging is done during the procedure (enteroclysis)?
Fluoroscopy and possible overhead images.
387
What happens after the enteroclysis exam?
Catheter is removed and patient is told to increase fluid intake.
388
What is EnteroVu?
A barium product that creates double-contrast appearance without catheterization. It has replaced the need for enteroclysis procedures
389
How is an EnteroVu exam performed?
Like a standard SBS.
390
What kVp is used for EnteroVu?
80–90 kVp.
391
What is CT enteroclysis?
Contrast is instilled via duodenojejunal tube under fluoro, then patient undergoes CT scanning.
392
What does CT enteroclysis detect?
Obstructions or adhesions.
393
How is the intubation method performed?
A nasogastric tube is inserted through the nose into the jejunum.
394
What is injected through the NG tube?
Thin barium, and time is noted.
395
How often are images taken in intubation?
Every 15–30 minutes.
396
When is fluoro used in intubation?
If compression is needed or suspicion arises.
397
What is therapeutic intubation used for?
Relieving postoperative distention
Decompressing small bowel obstruction
Removing gas and fluid via catheter.
398
Where does the large intestine begin?
In the right lower quadrant (RLQ), just lateral to the ileocecal valve.
399
How does the large intestine travel through the abdomen?
It extends around the periphery of the abdominal cavity and ends at the anus.
400
How long and wide is the large intestine?
About 5 feet long and 2.5 inches in diameter in adults.
401
What structures make up the large intestine?
Cecum, ascending colon, right (hepatic) flexure, transverse colon, left (splenic) flexure, descending colon, sigmoid colon, rectum, and anus.
402
What structures does the colon include?
Ascending colon, right flexure, transverse colon, left flexure, descending colon, and sigmoid colon — but NOT the cecum or rectum.
403
What is the cecum?
A large blind pouch inferior to the ileocecal valve and the first/widest part of the large intestine.
404
What does the ileocecal valve do?
Acts as a sphincter preventing reflux from the large intestine into the small intestine.
405
Where is the cecum located?
RLQ; highly mobile.
406
What is the appendix?
A wormlike tube extending from the posteromedial aspect of the cecum.
407
What is appendicitis?
Inflammation of the appendix; requires surgery before rupture.
408
What can happen if the appendix ruptures?
Peritonitis.
409
What is the ascending colon?
Vertical portion of the colon superior to the cecum.
410
Is the ascending colon larger or smaller in diameter than the cecum?
Smaller.
411
Where is the ascending colon located?
Retroperitoneum.
412
What is the right colic (hepatic) flexure?
Junction of ascending and transverse colon.
413
Why does the right colic (hepatic) flexure lie lower than the left flexure?
Because the liver is large and sits above it.
414
What is special about the transverse colon?
It is the longest and most mobile part of the colon.
415
How does the transverse colon typically appear?
Loops downward beyond the right flexure as it crosses the anterior abdomen.
416
What is the left colic (splenic) flexure?
Junction of transverse and descending colon.
417
What is the left colic (splenic) flexure's anatomical level?
Near L1, under the spleen.
418
How is the sigmoid colon shaped?
S-shaped.
419
Where is the sigmoid colon located?
Usually in the pelvis with wide motion range.
420
Where does the sigmoid colon travel?
Posteriorly and inferiorly along the sacral curve to become the rectum.
421
What is the rectum?
Final segment of the large intestine from sigmoid colon to anus.
422
What spinal level does the rectum begin at?
S3.
423
How long is the rectum?
About 4.5 inches.
424
What curvatures does the rectum follow?
The sacrococcygeal curve.
425
What is the rectal ampulla?
Dilated portion anterior to the coccyx.
426
What is the anal canal?
Constricted distal 1–1.5 inches of rectum.
427
What is the anus?
Terminal opening of the large intestine to the exterior.
428
How many AP curves/directional changes does the rectum have? Where?
Two (in the region of the rectal ampulla and the region of the anal canal)
429
Why does the enema tip need to be angled correctly?
Incorrect angulation risks serious injury by puncturing rectal walls.
430
What is the correct angle for inserting an enema tip?
First anteriorly, then superiorly.
431
What forms haustra?
Taeniae coli — 3 bands of longitudinal muscle that pull the colon into sacculations.
432
What indicates the large intestine on radiographs?
Haustra.
433
How do the small and large intestines differ in internal diameter?
Large intestine = larger diameter
Small intestine = smaller diameter
434
Are haustra in the small or large intestine?
Haustra (taenia coli) are in the large intestine
(This is one of the main differences between the intestines)
435
How do the small and large intestines differ in location?
Large intestine = periphery; small intestine = central abdomen.
436
What is the primary function of the large intestine?
Defecation.
437
What substances are absorbed in the large intestine?
Water, salts, vitamin K, amino acids.
438
What produces intestinal gases (flatus)?
Bacterial action converting proteins to amino acids.
439
What movements occur in the large intestine?
Peristalsis, haustral churning, mass peristalsis, and defecation.
440
What is colitis?
Inflammation of the large intestine due to infection, diet, stress, etc.
441
Radiographic appearance of colitis?
Saw-tooth or jagged mucosal appearance.
442
What is ulcerative colitis?
Severe chronic colitis common in young adults.
443
What radiographic appearance does ulcerative colitis cause?
Cobblestone mucosa; loss of haustra → stovepipe colon.
444
What is a diverticulum?
Outpouching of mucosa due to herniation of the colon wall.
445
Where are diverticula most common?
Sigmoid colon.
446
Who is most affected by diverticula?
Adults over 40.
447
What is diverticulosis?
Multiple diverticula.
448
What is diverticulitis?
Infection of diverticula.
449
What happens if a diverticulum perforates?
Peritonitis.
450
How do diverticula appear on BE?
Small barium-filled outpouchings.
451
Most colon cancers occur where?
Rectosigmoid region.
452
What is the classic radiographic sign of colon cancer?
Apple-core lesion.
453
What is annular carcinoma?
Common colon cancer type causing apple-core narrowing.
454
What can annular carcinoma lead to?
Large bowel obstruction.
455
What are polyps?
Saclike projections into the bowel lumen.
456
Can polyps be malignant?
Yes — benign or malignant origins.
457
Best exam to visualize polyps?
Air-contrast BE.
458
What symptoms can polyps cause?
Bleeding; may require surgical removal.
459
What is a rectocele?
A blind pouch of the rectum caused by weakened rectal walls.
460
What is volvulus?
Twisting of the intestine on its mesentery → obstruction and necrosis.
461
Where does volvulus occur?
Jejunum, ileum, cecum, or sigmoid colon.
462
Who is most affected by volvulus?
Males age 20–50.
463
Radiographic sign of volvulus?
Beak sign.
464
What is intussusception?
Telescoping of one bowel segment into another.
465
Who is most affected by intussusception?
Infants under 2, but can occur in adults.
466
Can a BE fix intussusception?
Yes — may re-expand bowel.
467
Radiographic appearance of intussusception?
Mushroom-shaped dilation; little contrast beyond the site.
468
Why must intussusception be treated quickly?
To prevent necrosis and obstruction.
469
What is the most common large intestine radiographic study?
Barium enema (BE).
470
How is contrast administered in a BE?
Retrograde (through the rectum).
471
Other names for BE?
Lower GI, air contrast BE, double contrast BE, ACBE, BE with air.
472
What does a BE evaluate?
Form, function, and pathology of the LARGE INTESTINE
473
Do both single and double contrast exams visualize the entire colon?
Yes.
474
kVp for single contrast BE?
110–125 kVp.
475
What type of contrast is used for a BE?
Thin barium only.
476
How much water is added to the barium contrast bag?
1500–2000 mL.
477
What contrast is used for a BE if barium is contraindicated?
Water-soluble iodinated contrast.
478
kVp for double contrast BE?
90-100 kVp.
479
What is the two-stage method for a BE?
Fill colon with dense barium → drain → add air.
480
What is the single-stage method for a BE?
Instill thick barium → clamp → add air.
481
What brand of thick barium is commonly used for a single-stage BE?
Polibar Plus (heavy cream consistency).
482
What does defecography evaluate?
Functional exam of anus and rectum during rest + evacuation.
483
What does defecography diagnose?
Rectoceles, rectal intussusception, rectal prolapse.
484
What is patient prep for defecography?
Soap suds cleansing enema 2 hours prior to study
485
What equipment is required for defecography?
Special commode with filters, stretcher, Anatrast contrast. 2 BBs placed on either side of rectum
486
How is contrast administered in defecography?
Via mechanical caulk-gun applicator.
487
What extra contrast steps are required in defecography?
Patient drinks thin barium 1 hour prior so it can go into the small intestine (compare small vs large intestine); females receive vaginal contrast.
488
Why is contrast administered into the vagina of females for a defecogram?
To look for fistula (abnormal connection or passageway) between large intestine and vagina
489
What are the two phases in evacuative proctography two-phase study?
1. During strain or evacuation
2. Post-evacuation radiograph
490
What are BE clinical indications?
Colitis (ulcerative)
Diverticulosis/diverticulitis
Neoplasms
Volvulus
Intussusception
Appendicitis
491
What are contraindications to BE?
Suspected perforation, suspected large bowel obstruction, recent colon biopsy, pregnancy.
492
Why must the colon be empty for BE?
Fecal material may mimic pathology.
493
What is a cathartic?
A purgative that increases bowel movements.
494
Two types of cathartics?
Irritant (castor oil) and saline (mag citrate).
495
Contraindications for cathartics?
Gross bleeding, severe diarrhea, obstruction, appendicitis.
496
What temperature should barium be for a BE?
Room temperature or slightly warm.
497
Why should barium not be cold?
Cold barium may cause cramping.
498
Why should barium not be hot?
Hot barium can burn the patient.
499
What contrast is used for double-contrast BE?
Thick barium (such as Polibar Plus).
500
What contrast is used for single-contrast BE?
Thin barium.
501
What happens if too much water is added to thick barium for double contrast?
It becomes too thin to coat mucosa properly.
502
What is the most common BE bag size?
1500 mL bag.
503
What should you do before connecting the tubing to the enema tip?
Run barium through the tubing to remove air.
504
Why must the tubing be filled before BE tip insertion?
To avoid introducing air into the patient.
505
What must be attached to the enema tip for safety?
A retention balloon cuff with a syringe.
506
How much air is used to inflate the retention cuff in a BE?
Only enough air to seal — no more than one squeeze of the bulb.
507
Why must the retention balloon never be overinflated for a BE?
Overinflation can rupture the rectum.
508
What is the maximum safe height for the barium bag (BE)?
No more than 24 inches above the table.
509
Why is the barium bag kept low (BE)?
Higher pressure increases risk of cramping or perforation.
510
How should a patient be positioned for enema tip insertion?
Sim’s position (left side with right knee flexed).
511
Why is Sim’s position used for BE tip insertion?
It relaxes the abdominal muscles and straightens the rectosigmoid region.
512
What should be used to lubricate the enema tip?
Water-soluble lubricant.
513
Why must you NEVER use petroleum-based lubricant for a BE?
It can destroy latex and may cause balloon rupture.
514
In what direction is the enema tip initially inserted?
Toward the umbilicus (anteriorly).
515
After the first inch, how should the BE tip insertion be continued?
Superiorly, following the natural curve of the rectum.
516
How far is the enema tip inserted?
1–1.5 inches.
517
When do you inflate the enema tip retention balloon?
Only after the radiologist approves.
518
What should the technologist do if the patient reports sharp pain during enema tip insertion?
Stop immediately — could indicate perforation.
519
Who is responsible for enema tip insertion?
The technologist — unless policy requires otherwise.
520
What must be available in case of latex allergy for BE?
A latex-free enema tip.
521
What is the technologist’s primary responsibility during BE fluoro?
Assist the radiologist and monitor the patient.
522
What should the technologist watch for during the BE exam?
Cramping, discomfort, fainting, and over-inflation of tubing.
523
Why must the technologist monitor the barium bag level (BE)?
To prevent the bag from emptying or being too high.
524
What should be done if the patient begins cramping (BE)?
Lower the barium bag to decrease flow.
525
What should the technologist do with the patient’s movement (BE)?
Assist with turning and repositioning as needed.
526
What must always remain in clear communication during BE?
The radiologist and technologist — especially during air instillation.
527
What must the patient do immediately after the BE?
Use the restroom to evacuate as much barium as possible.
528
Why is evacuation important after a BE?
Retained barium can cause constipation or impaction.
529
What instructions must be given after BE exam?
Increase fluid intake
Expect white stools for 2–3 days
Call if no bowel movement occurs within 24 hours
530
When should the patient contact a physician after BE?
If they experience abdominal pain, bleeding, or cannot defecate.
531
What is the overhead sequence for a single-contrast BE?
PA
PA axial sigmoid
RAO
LAO
RPO
LPO
Lateral rectum
Post-evacuation KUB
532
Why is a post-evac image required (BE)?
To evaluate the mucosa after most barium is drained.
533
What is the overhead sequence for a double-contrast BE?
PA
RAO
LAO
LPO
RPO
Right lateral decubitus
Left lateral decubitus
PA axial
Lateral rectum
Post-evacuation film
534
Why are decubitus positions essential in double contrast?
They show air–barium contrast on both sides of the colon.
535
What does a PA or AP BE image show?
Entire large intestine including flexures.
536
What does RAO position best demonstrate for a BE?
The right colic flexure and ascending colon.
537
Why is RAO used instead of RPO (BE)?
RAO provides more natural abdominal compression.
538
What does LAO position demonstrate (BE)?
Left colic flexure and descending colon.
539
What does RPO demonstrate (BE)?
Left colic flexure and descending colon (same as LAO).
540
What does LPO demonstrate (BE)?
Right colic flexure and ascending colon (same as RAO).
541
What does the left lateral decubitus show (BE)?
Air-filled ascending colon and barium-filled descending colon.
542
What does the right lateral decubitus demonstrate (BE)?
Air-filled descending colon and barium in ascending colon.
543
What does the ventral decubitus show (BE)?
Air–barium levels in the rectum and sigmoid colon.
544
What does the lateral rectum demonstrate (BE)?
Rectosigmoid region.
545
What is important during lateral rectum imaging?
Ensuring hips are truly lateral and no rotation is present.
546
In the supine position, where is air located (ACBE)?
Transverse colon and sigmoid colon.
547
In the supine position, where is barium (ACBE)?
Ascending and descending colon.
548
In the prone position, where is air (ACBE)?
Ascending and descending colon, rectum
549
In the prone position, where is barium (ACBE)?
Transverse colon and sigmoid colon.
550
What is the purpose of a colostomy BE?
Evaluate the stoma site, check for obstruction, leaks, or strictures.
551
What equipment is needed for a colostomy BE?
Smaller enema bag
Soft-tipped catheter
Adhesive ostomy cone or wafer
552
How is the stoma catheter secured?
Using an ostomy wafer or patient assistance.
553
Must the radiologist perform fluoro on the stoma (BE)?
Yes — similar to a traditional BE.
554
When is water-soluble contrast used for a BE?
When perforation is suspected.
555
What is the kVp for water-soluble BE?
~80 kVp.
556
How is water-soluble contrast different from barium?
Does not coat as well
Absorbed by the body
Safer if perforation exists
557
When does a SBS often follow?
An upper GI series
558
What does the colon include vs the large intestine?
Colon does not include the cecum and rectum
559
What are commonly combined GI exams?
- BAS/UGI
- UGI/SBS (Known as a SBFT)
- BAS/UGI and SBFT
560
Can a BAS, UGI, SBS, and BE be done on the same day?
NO. Residual barium from one exam will obscure details in subsequent exams
561
If multiple GI studies are ordered, which should you do first?
Barium Enema (BE) should be done first if several are ordered because the
barium will clear the lower GI system faster than if the barium had to clear
the entire GI system
562
After the BE is done for a multi-exam day, what order should the rest of the GI exams be done in?
From superior to inferior (esophagram --> UGI etc.)
563
CR location for UGI (RAO, PA, LPO, AP, RT LAT)?
L1
564
What's the central ray for the PA BE?
At iliac crest and MSP
565
What's the central ray for the RAO BE?
At iliac crest and 1" lateral from MSP to the elevated side (Left)
566
What's the central ray for the LAO BE?
1-2" above iliac crest and 1" lateral from MSP to the elevated side (Right)
567
What's the central ray for the LPO/RPO BE?
At iliac crest and 1" lateral from MSP to the elevated side
568
What's the central ray for the Lateral/Ventral Decubitus BE?
At iliac crest and MSP
