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Pos Chap 12
Biliary Tract and Upper GI
| Question | Answer |
|---|---|
| Upper GI LPO has how much Rotation? | 30-60 degrees |
| B/D Duodenal bulb in profile | RAO |
| B/D Proximal Esophagus | Swimmers Lateral |
| If you see the "scottie Dog" on a Radiograph which position will the pt be in. | An oblique Pos |
| Position that best demos Proximal Esophagus | Swimmers Lateral |
| ___% Radiation reduction on Breast in PA pos compared to AP | 90% |
| Chole refers to | Bile |
| "cysto" refers to | bladder |
| "angio" refers to | Vessel |
| "graphy" refers to | study of |
| Chole+cysto+graphy | study of gallbladder |
| Chole+angio+graphy | study of Bile ducts |
| Cholecystocholangiography | study of gallbladder + bile ducts |
| Oral cavity terms Mastication+ Deglutition | M-chewing . D- Swallowing |
| Wave like contraction | Peristalsis |
| The gallbladder is located in which margin of the liver | Posterior-Inferior . Hw Q. |
| How many lobes in liver? | 4 |
| Name the 4 lobes of the liver | Left + Right + Caudate+ Quadrate |
| What is manufactured by the Liver | Bile |
| Bile is stored in which organ | gallbladder |
| How much does the liver weigh | 3-4 lbs, or 1/36 of the total body weight in an average adult. |
| Of the 9 abdominal regions the liver occupies almost all of which | the right hypochondrium, major part of the epigastrium, and a significant part of the left hypochondrium |
| which border of the liver has the greatest vertical dimension? | the right aprox 6-7 inches in avg person |
| The right border of the liver extends from the diaphragm to which rib | just below body of the 10th rib |
| T/F The liver is protected by the upper rib cage | False lower rib cage |
| T/F The liver is highly vascular and easily lacerated, protection by the ribs is necessary | True |
| A much larger right lobe of the liver is seperated from the left lobe by which ligament | Falciform ligament . HW Q. |
| The 2 minor lobes caudate + quadrate can be found where | Posterior aspect of the right lobe |
| Which of the smaller lobes of the liver is located more superiorly. C or Q | caudate lobe which extends superiorly to diaphragmatic surface |
| T/F the liver performs more than 100 different functions | True |
| How much bile does the liver produce in a day | 800-1000ml or about 1 quart |
| In which quadrant is the liver located in the sthenic patient? | RUQ. HW Q |
| Soft tissue structure that seperates L+R Lobes of Liver | Falciform Ligament. HW Q |
| Aid's in the digestion of fats by emulsifying(breaking down) fat gobules in the absorption of fat following its digestion | This is the description of the function of bile . HW Question |
| Bile also contains Cholesterol which is made soluble in the bile by what | Bile Salts |
| From the liver, bile flows through the R+L hepatic ducts which join and continue as the __________ hepatic duct | Common hepatic Duct |
| Which duct carries bile from the cystic duct to the duodenum? | CBD common bile Duct. HW Q |
| Pear shaped sac composed of 3 parts. What is this sac and what are these parts | gallbladder. (3) parts Fundus, Body, and Neck |
| Distal End and broadest part of the gallbladder | Fundus |
| main section of gallbladder | Body |
| Narrow proximal end of gallbladder that contains the cystic duct | Neck |
| 3-4cm long and contains many folds | cystic duct |
| membranous folds that function to prevent distention or collapse of the cystic duct | Spiral Valve -located in cystic duct |
| The normal gallbladder is ___ cm to ___cm long and aprox ___ cm wide | 7to 10 cm long and 3cm wide |
| What is the Avg capacity of the gallbladder (ml) | 30-40ml of Bile . HW Q> TEST |
| 3 Primary Functions of the gallbladder | (1) store Bile (2) concentrate Bile (3) contract when stimulated |
| Which process leads to concentration of bile within the gallbladder? | Hydrolysis. HW Q |
| When too much water is absorbed or the cholesterol becomes too concentrated what will form? | gallstones (choleliths) |
| Which hormone leads to contraction of the gallbladder to release bile? | cholecystokinin. HW Q |
| The common bile duct avgs aprox. ___cm in length and has the internal diameter of about a drinking straw | 7.5 cm in length |
| Pancreatic duct also known as | duct of Wirsung |
| Circular muscle fibers adjacent to duodenal papilla | Hepatopancreatic sphincter |
| A protrusion into the duodenum | Duodenal papilla |
| Duct connected directly to gallbladder | cystic duct |
| x-ray procedure for diagnosing gallstones. pt takes iodine-containing tablets by mouth. Iodine is used. It outlines the gallstones that are radiolucent and that are usually invisible on x-ray | OCG - Oralcholecystogram. The failure to visualize the gallbladder on an OCG is evidence for a diseased gallbladder. The OCG is an excellent procedure for diagnosing gallstones when they are strongly suspected but cannot be seen by ultrasound. |
| For sonography of the gallbladder how long should the pt be NPO? | 8 hours |
| which term describes the condition of having gallstones | Cholelithiasis |
| T/F sonography provides a quick diagnosis of gallbladder disease, and the physician can make a decision in hours rather than days | True |
| 4 advantages of sonography over conventional imaging | (1) no ionizing Rad (2) detect small calculi(3) NO Contrast medium if pts are sensitive or allergic (4) Less Pt preparation |
| Cholelithiasis( stones in gallbladder) most common exam | sonography, choloescintigraphy- NM study |
| Cholelithiasis radiographic appearance | both radiolucent and radiopaque densities seen in the region of the gallbladder. Shadowing effect w/ ultrasound |
| T/F you have to adjust exposure factors for all gallbladder and biliary tract diseases | False No Adjustments needed |
| T/F OCG clinical indications include nausea, heartburn, and vomiting | True |
| Presence of stones in the biliary ducts | Choledocholithiasis |
| choledocholithiasis exams | sonography/ ERCP/ Operative cholangiography |
| choledocholithiasis radiographic appearance | narrowing or widening of biliary ducts |
| 2 types of biliary calculi (gallstones) | cholesterol + pigment stones |
| 75% of stones that occur are which type | cholesterol |
| Risk Factors for developing gall stones | family history, excessive weight, being over 40, being female |
| emulsion of biliary stones in the gallbladder | Milk calcium bile |
| laproscopic technique for removing the gallbladder | cholecystectomy |
| Narrowing of one the biliary ducts | biliary stenosis |
| This system includes The alimentary canal and several accessory organs | Digestive system |
| Another term for esophagogram | Barium swallow |
| Which of the following is NOT a salivary Gland? Parotid-Sublingual-Vallecula-Submandibuar | Vallecula- not salivary gland |
| T/F The lateral margin of the stomach is called the lesser curvature. | false - greater |
| Which of the following structures does not pass though the diaphragm? Esophagus-Trachea-aorta-Inferior vena cava | trachea |
| The esophagus extends from C5-C6 to? | T11 |
| Which structure in the pharynx prevents the aspiration of food and fluid into the larynx? | epiglottis |
| infection in the biggest salivary gland (parotid) | mumps |
| Which aspect of the stomach is defined as an indention between the body and the pylorus? | angular notch |
| Which aspect of the stomach will fill with air when the patient is prone during double- contrast UGi? | Fundus |
| Which aspect of the stomach will barium gravitate to when the patient is in a supine postion? | Fundus |
| Which 2 structures create the romance of the abdomen? | head of pancreas and C-loop of duodenum |
| Opening leaving stomach | Pyloric orifice |
| Mucosal folds in stomach | rugae |
| Middle aspect of stomach | Body |
| Which 3 nutrients are digested? | carbs, lipids, proteins |
| The churning or mixing activity of chyme in the small intestine is called? | rhythmic segmentation |
| older term for GERD | Esophageal reflux |
| What criterion is used with ultrasound in determining whether a patient has HPS? (Hantavirus Pulmonary Syndrome) | Antral muscle thickness exceeding 4 mm |
| Other than the esophagram, what other imaging modality is performed to diagnose Barrett's Esophagus? | Nuclear medicine |
| trapped mass in the gastrointestinal system, that consists of components of indigestible plant material, such as fibres, skins and seeds. | phytobezoar |
| The gallbladder is located more anterorly or post in the abdomen | anteriorly |
| T/F The body of the stomach curves inf and post from the fundus | False- Inf and Ant |
| 3 divisions of the pharynx | nasopharynx, oropharynx, laryngopharynx |
| c-Loop of duodenum and pancreas are (intraperitoneal or retroperitoneal) | RetroPeritoneal |
| T/F Acute Cholecystitis may produce a thickened gallbladder wall | True |
| Enlargement or narrowing of the biliary ducts because of the presence of stones | Choledocholithiasis |
| Narrowing of the biliary Ducts | Biliary stenosis |
| T/F Concentrated levels of cholesterol in bile may lead to gall stones | True |
| Common site for impaction, or lodging of gallstones | Duodenal papilla |
| T/F Older term for the main pancreatic duct is duct of vater | False- Sphincter of oddi |
| 4 accessory organs of digestion | salivary glands, Pancreas, Gallbladder, Liver |
| abdominal quadrant that contains the gallbladder | RUQ |
| T/F The average healthy adult liver produces 1 gal or 3000-4000mL of bile per day | false 800-1000ml of bile 1 quart |
| Imaging modality that produces cholescinigraphy | Nuclear medicine |
| If air is in the very top of fundus of the stomach and barium in the body the pt pos is? | Prone |
| If the whole fundus and some of body of stomach has air w/ barium inferiorly which pos is pt in | erect |
| barium in fundus | supine |
| high and transverse stomach would be found in what body habitus | hypersthenic |
| Term that describes food after it is mixed w/ gastric secretions in stomach | chyme |
| Peristalsis is an example of which type of digestion? | mechanical |
| of the 3 primary food substances which one does the digestion begin in the mouth? | carbohydrates |
| absorption of nutrients primarily takes place in the______ although some substances are absorbed through the lining of the _____ | small intestine, stomach |
| End product of digestion of carbohydrates | simple sugars |
| end product of digestion of lipids | fatty acids/glycerol |
| end product of digestion for proteins | amino acids |
| Biologic catalysts that speed up the process of digestion are called | Enzymes |
| Stomach contents are churned into a semi fluid mass called | Chyme |
| Peristaltic activity is not found in which structure? | Pharynx |
| T/F Mechanical digestion includes movements of the entire GI tract | True |
| In erect pos how much will abdominal organs drop | 1-2 inches |
| T/F Barium sulfate never dissolves in water | True |
| T/F Barium contrast studies require a pure sulfate salt of barium for human consumption during GI studies | True |
| T/F w/ the use of digital fluoroscopy, the number of post fluoroscopy radiographs orderd has greatly diminished | True |
| What is the ratio of water to barium for a thin mixture of barium sulfate? | 1-1 |
| chemical symbol for barium sulfate | BaSO and a small 4 |
| Another term for a negative contrast medium is | Radiolucent |
| The speed woth which barium sulfate passes through the GI tract is called gastric | Motilty |
| What is the purpose of the gas w/ a double-contrast media technique? | forces barium sulfate against mucosa for better coating |
| What pt condition prevents the use of a water-soluble contrast medium for an upper GI series? | Sensitivity to Iodine |
| When is the use of barium sulfate contraindicated? | When the mixture escapes into the peritoneal cavity |
| Which device on a digital fluoroscopy system converts the analog into a digital signal? | CCD- Charged coupled device |
| minimum level of protective apron worn during fluoroscopy? | 0.5 mm Pb/Eq apron |
| what is the major benefit of using a compression paddle during an upper GI study? | Reduced exposure to arms and hands of radiologist or fluoroscopist |
| Device found beneath the x-ray table that greatly reduces exposure to the technologist from the fluoroscopic x-ray tube? | bucky slot shield |
| A patient comes to radiology with a clinical history of a possible trichobezoar. What is a trichobezoar and which radiographic procedure will best diagnose it? | A massive hair trapped in the stomach. An upper GI |
| What are the Digestive systems 3 primary Functions | 1. Intake or digestion of food. 2. absorb digested food particles. 3. Eiminate any unused material in the form of semisolid waste products. |
| Esophagogram or Barium Swallow is the study of ? | Study of the form and function of the swallowing aspect of the pharynx and the Esophagus |
| Procedure designed to study the distal esophagus, stomach, and duodenum in one examination is termed | Upper Gastrointestinal series |
| Negative density area on radiograph appears black or white? | White, think opposite of density or blackness |
| The alimentary canal is a continuous hollow tube beginning with the | Oral cavity(mouth) |
| The roof of the oral cavity is formed by | the Hard and Soft palates |
| What small process hangs from the mid posterior aspect of the soft palate | A conical process termed the Palatine uvula |
| During swallowing, the soft palate and the uvula move ________ to close off the nasopharynx, preventing food from entering the nasal cavity. | Superirorly |
| The oral cavity is bordered anteriorly and Bilaterally by the inner surfaces of the | upper and lower teeth |
| Most of the floor of the oral cavity is formed by the | Tongue |
| The oral cavity connects ant or post w/ the pharynx | Posteriorly |
| accessory organ of digestion associated with the mouth | Salivary glands |
| Initiates the mechanical part of digestion | Mastication-(chewing movements) |
| Meaning "near the ear" largest of the salivary glands located just anterior to the external ear | Parotid |
| Sometimes called "submaxillary" meaning below mandible or maxilla | Submandibular |
| Meaning below the tongue | sublingual |
| Saliva is ___% water and _____% solutes or salts and certain digestive enzymes. | 99.5% water and 0.5% solutes or salts and certain digestive enzymes |
| How much ml of saliva does the salivary glands secrete daily | 1000ml to 1500ml |
| What enzyme is contained in saliva and what does it do. | amylase - breaks down starches |
| inflammation and Enlargement of the parotid glands caused by a paramyxovirus, which can result in inflammation of the testes in aprox ____% of infected males | Mumps. 30% |
| Is about 12.5cm long and is the part of the digestive tube found posterior to the nasal cavity, mouth, an larynx | pharynx |
| Posterior to the bony nasal septum, nasal cavities, and soft palate. This portion of the pharynx is not part of the digestive system | Nasopharynx |
| Directly posterior to the oral cavity proper. extends from the soft palate to the epiglottis. | Oropharynx |
| 3rd portion of pharynx AKA hypopharynx extends from level of epiglottis to level of ____ | Laryngopharynx. C6 |
| T/F The trachea is posterior to the esophagus | false the trachea is anterior to esophagus |
| 7 major components of the alimentary canal | Mouth, pharynx, esophagus, stomach, small intestine, large intestine, anus. |
| A high and transverse stomach indicates a ___________ body habitus w/ the duodenal bulb at the vertebral level of ______ | Hypersthenic, T11 or T12 |
| Which body habitus would put the stomach low and vertical with the duodenal bulb at the vertebral level of L3 or L4 | Hyposthenic or Asthenic |
| What is the most common radiopaque contrast media used in the GI system? | Barium Sulfate |
| What is the ratio of barium to water for a thick mixture of barium sulfate? | 3 or 4 parts barium to 1 part water |
| During an upper GI, when should a water soluble contrast medium be used rather than barium sulfate? | For a perforated bowel |
| Which of the following conditions may prevent the use of water-soluble contrast agents for a geriatric patient? | Dehydration |
| T/F Water soluble contrast agents pass through the GI tract faster than barium sulfate. | True |
| T/F Digital fluoroscopy does not require the use of image receptor cassettes | False |
| A large outpouching of the mid to upper esophagus is termed? | Zenker's diverticulum |
| What can be added to barium sulfate and swallowed to detect a radiolucent foreign body lodged in the esophagus? | Shredded cotton or marshmallows |
| A gastric canal is formed by rugae in the stomach along which curvature? | lesser curvature- gastric canal . Greater curvature= Rugae |
| funnels fluids directly from the body of the stomach to the pylorus | Gastric canal |
| In the supine position the fundus of the stomach is the most ______ portion of the stomach and is where the ______ settles | Posterior/ Barium |
| In the RAO recumbent pos the fundus is in the ______ position causing the ____ to fill this portion of the stomach. | Highest / gas |
Created by:
superwillybones