Covers the UGI and biliary systems for radiographic positioning
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| Largest solid organ in the human body | liver
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| where is liver located? | RUQ
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| where is gallbladder located in relation to the liver? | inferior and posterior surfaces
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| two major lobes of the liver | Right and left
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| what divides the major lobes of the liver | falciform ligament
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| two minor lobes of the liver | caudate and quadrate
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| what function of the liver is important in radiographic study? | production of bile
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| how much bile is produced each day? | 800-1000 mL
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| what is bile's function? | emulsify fats
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| what structures drain bile from the liver? | right and left hepatic ducts
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| the right and left hepatic ducts join to form what? | common hepatic duct
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| how does bile get from the common hepatic duct to the gallbladder? | cystic duct
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| the cystic duct and common hepatic duct join to form what? | common bile duct
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| what are the three parts of the gallbladder | fundus body and neck
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| is the fundus at the proximal or distal end of the gallbladder | distal
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| how much bile will the gallbladder normally hold? | 30-40 mL
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| what are the three functions of the gallbladder? | store bile, concentrate bile, contract when stimulated
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| what forms the most common type of gallstones? | cholesterol
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| what hormone causes gallbladder to contract? | CCK
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| where does the common bile duct enter the digestive track? | descending portion of duodenum
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| in what percent of individuals do the pancreatic duct and common bile duct enter separately into the duodenum? | 40
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| In what percent of individuals do the pancreatic duct and common bile duct join before entering the digestive track? | 60
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| When the common bile duct and pancreatic duct join, what is the common passageway called? | ampulla
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| what are some names for the ampulla formed by the pancreatic and common bile duct? | hepatopancreatic ampulla or ampulla of Vater
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| what is the name of the circular muscle fiber at the opening of the hepatopancreatic ampulla? | hepatopancreatic sphincter or sphincter of Oddi
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| what causes the sphincter of Oddi to relax? | CCK
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| if you want to get the gallbladder as close to the IR as possible, what position would you place the patient? | prone
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| If you wanted to assist the gallbladder in draining, what position would you place the patient? | supine
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| what is an older radiographic study that involved the patient takin an oral contrast to study the gallbladder? | oral cholecystogram
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| what imaging modality is typically used today for imaging the gallbladder? | sonography
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| why would sonography be better for imaging the gallbladder compared to traditional radiographic imaging methods? | no radiation, can detect small calculi, no contrast necessary, less patient prep
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| chole | bile
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| cysto | bladder or sac
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| choledocho | common bile duct
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| cholangio | bile ducts
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| cholecyst | gallbladder
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| cholangiography | study of biliary ducts only
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| cholecystocholangiogram | study of both the gallbladder and biliar ducts
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| cholecystography | radiographic exam of the gallbladder
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| cholegraphy | radiographic exam of the biliary system
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| location of hypersthenic gallbladder | high and away from midline
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| location of an asthenic gallbladder | low and near spine
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| which part of the gallbladder is most posterior? | neck
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| choledocholithiasis | stones in ducts
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| cholelithiasis | stones in gallbladder
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| cholecystitis | inflammation of the gallbladder
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| what are the accessory organs for the digestive system? | salivary glands, pancreas, liver, gallbladder
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| what are the functions of the digestive system? | ingestion/digestion, absorption, elimination
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| what are the three salivary glands? | parotid, submandibular, and sublingual
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| where is the parotid gland located? | near the ear
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| where is the submandibular gland located? | below the mandible
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| where is the sublingual gland located? | below the tongue
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| how much saliva may be produced daily? | 1000-1500 mL
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| what enzyme in saliva begins the digestion of starches? | amylase
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| act of chewing | mastication
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| act of swallowing | deglutition
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| what covers the trachea during deglutition to prevent food from entering airway? | epiglottis
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| the motility through digestive system (wavelike series of involuntary muscular contractions that propel solid and semisolid material through alimentary canal) | peristalsis
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| trachea is located ______ to the esophagus | anterior
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| the esophagus is located _____to the larynx and _____ to the stomach | inferior; superior
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| at what vertebral level does the esophagus go through the diaphragm? | T10
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| at what vertebral level does the esophagus start | C5-6
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| what are the four layers of the esophagus | fibrous, muscular, submucosal, mucosal
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| three parts of the stomach | fundus, body, pylorus
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| where is the cardia of the esophagus? | area surrounding the esophageal opening
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| what are the longitudinal mucosal folds that line the inner layer of the stomach body? | rugae
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| what are the two curvatures of the stomach | greater and lesser
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| which curvature is on the lateral border of the stomach | greater
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| which curvature is on the right side or medial border of the stomach? | lesser
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| what are the sphincters in the stomach? | cardiac and pyloric
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| which sphincter is between the stomach and esophagus? | cardiac
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| which sphincter is between the stomach and small intestine | pyloric
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| food mixed with gastric secretions | chyme
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| what is the angular notch? | separates the body from the pyloric portion
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| compared to the body of the stomach, the fundus and pylorus are generally more _______. | posterior
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| air would fill the fundus in what radiographic position(s)? | prone, erect, anterior oblique
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| what position would demonstrate fundus filled with barium? | supine, posterior oblique
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| what are the 6 categories of ingested substances? | carbohydrates, proteins, lipids, viatmins, minerals, water
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| of the 6 categroies of ingested substances, what are not chemically digested? | vitamins, minerals, water
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| what is another name for enzymes? | biologic catalysts
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| what does the term biologic catalyst imply? | accelerate reactions to digest substances
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| what are the three parts of the pancreas | head, body, tail
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| what part of the pancrease is furthest from the duodenum? | tail
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| what type of contrast is barium (radiopaque/radiolucent)? | radiopaque
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| what does it mean that barium is a colloidal susspension? | it will not dissolve in water
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| Is barium a positive or negative contrast medium? | positive
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| barium is considered an _____ substance meaning that it does not react ehemically | inert
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| how does barium get out of the GI system? | expelled rectally
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| what type of contrast should be used if perforation is suspected? | water soluble
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| why is water soluble preferred over barium for patients who will be having surgery? | water soluble, if leaked into peritoneal cavity, can be reabsorbed
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| what are common forms of watersoluble contrast used? | gastrografin, gastroview
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| how is double contrast exams accomplished for UGI? | room air or carbon dioxide gas is ingested
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| why use double contrast for the GI system? | allows for visualization of mucosal walls
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| why do we need to encourage fluid intake following barium administration? | It can harden and have to be removed surgically
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| what is the purpose of the esophagram? | study the form and function of the pharynx and esophagus
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| what is the purpose of the UGI exam? | study the form and function of the distal esophagus, stomach, and duodenum
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| where is the stomach on a hypersthenic body type? | high and transverse; level T11-T12 and to right of midline
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| where is the stomach on an asthenic body type | J shaped and low; at midline level of L3-L4
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| what are the three cardinal principles of radiation protection in fluoroscopy? | time, distance, shielding
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| of the three cardinal principles of radiation protection, which is most effective at reducing dose in fluoroscopy? | distance
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| what are some other items of radiation protection consideration in fluoro? | bucky slot cover, protective drape, lead gloves, lead goggles, pulsed fluoro
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| condition where peristalsis is reduced along distal esophagus | achalasia
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| another name for achalasia | cardiospasm
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| chronic irritation from stomach acid that changes the lining of the esophagus and is considered pre-cancerous | barrett's esophagus
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| difficulty swallowing | dysphagia
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| condition in esophagus that correlates with cirrhosis of the liver and heart failure | esophageal varices
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| GERD stands for | gastroesophageal reflux disease
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| how is GERD commonly diagnosed? | endoscopy
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| a large outpouching of the esophagus just above the upper esophageal sphincter | zenker's diverticulum
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| what is the prep for esophagram? | none
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| How is your fluoro table positioned typically to start an esophagram | in the vertical position
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| what hand should the patient hold the barium cup in to start the esophagram procedure | left
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| what are some methods to demonstrate esophageal reflux? | valsalva maneuver, mueller maneuvar, water test, compression technique, toe-touch maneuver
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| what degree of obliquity is used for esophagrams? | 35-40
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| True/False: Gonadal shielding should be used on all esophagram and UGI procedures | true
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| what film size is used for esophagram? | 14x17 lengthwise
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| which oblique is preferred for esophagram studies? | RAO
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| why is one oblique preferred more than another? | the RAO increases visibility of the esophagus between the vertebrae and heart
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| how wide should you collimate your field size to for an esophagram? | 5-6"
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| what respiration is used on esophagram and UGI imaging? | expose on expiration
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| what is recommended for complete esophageal filling on radiographic images? | have patient continue drinking during exposure
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| what vertebral level is the CR centered for esophagram | T5-T6
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| why do a swimmer's lateral | better visualization of proximal esophagus
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| Why would AP or PA not be a preferred image for esophagus imaging? | projects majority of esophagus over spine
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| undigested material stuck in the stomach | bezoar
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| condition where part of the stomach protrudes through the diaphragmatic opening | hiatal hernia
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| outpouching of the mucosal wall | diverticula
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| the act of vomiting blood | hematemesis
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| the act of vomiting | emesis
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| creates large irregular filling defect within the stomach with marked or nodular edges of the stomach lining | carcinoma
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| inflammation of the linig of the stomach | gastritis
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| what does HPS stand for | Hypertrophic pyloric stenosis
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| what does HPS cause | gastric obstruction most commonly in infants
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| erosions of the stomach or duodenal mucosa that are caused by various physiologic or environmental conditions | ulcers
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| what is rapunzel syndrome? | trichobezoar that follows the intestinal track
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| what is schatzki's ring? | finglike constriction at the distal esophagus from a sliding hiatal hernia
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| what prep is necessary for UGI? | NPO after midnight
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| what vertebral level is the CR directed for a sthenic patient for most UGI positions? | L1
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| what vertebral level is the CR directed for a hypersthenic patient for most UGI positions? | 2" above L1
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| what vertebral level is the CR directed for an asthenic patient for most UGI positions? | 2" below L1
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| Placing the patient in a trendelenburg would demonstrate what on the finished radiograph? | barium filled fundus, hiatal hernia
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| what is the common IR sizes for UGI? | 10x12 or 11x14; PA axial uses 14x17 as well as any UGI position requiring visualization of the small bowel
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| for single contrast exams of the esophagus and ugi, what kv range is used? | 110-125
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| for double contrast exams of the esophagus and ugi, what kV range is used? | 90-100
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| what mAs is used for AP/PA esophagus | 3
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| what mAs is used for LAO/RAO esophagus | 3
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| what mAs is used for lateral esophagus | 4
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| what mAs is used for AP/PA stomach | 4
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| what mAs is used for PA Axial stomach | 4
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| what mAs is used for RAO/LAO stomach | 5
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| what mAs is used for lateral stomach | 7
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| what degree of obliquity is necessary for the RAO position for UGI? | 40-70
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| who would generally require more rotation for the RAO position for UGI - hypersthenic or asthenic? | hypersthenic
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| ideally what are you trying to get in profile on the RAO UGI position? | duodenal bulb
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| what patient types would the PA axial UGI position typcially be used on? | hypersthenic and infants
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| why is the PA axial UGI position performed? | to open up the high horizontal stomach
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| what might the lateral UGI position be used to demonstrate? | retrogastric space
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| what degree of obliquity may be necessary for the LPO UGI position? | 30-60
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| what patient type requires more rotation for the LPO UGI position? | hypersthenic
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