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Outline Unit 2

RAD 112

What is the function of the esophagus? To convey food and saliva from largopharynx to stomach
Where does the esophagus originate? C5/C6
Where does the esophagus join the stomach? T11
Where does the esophagus pass through the diagphragm? T10
What is the expanded terminal end of the esophagus called? cardiac antrum
Describe the stomach. A dilated, saclike portion of the digestive tract extending between the esophagus and small intestine.
Describe the four parts of the stomach. CARDIA: section surrounding esophageal opening FUNDUS: superior portion fills left hemidiaphragm BODY: located btwn fundus/pylorus, interior surface covered numerous longitudinal folds called RUGAE PYLORUS: narrow end (pyloric antrum/pyloric canal)
What is the lesser curvature? the right border
What is the greater curvature? the left border
What is the cardiac notch? sharp angle at the esophagogastric junction
What controls the entrance and exit of material in/out of stomach? Cardiac (Esophageal) sphincter and pyloric sphincter
What are the openings in/out of the stomach called? cardiac orifice and pyloric orifice
What affects the position of the stomach? body habitus - hypersthenic (high and transverse) asthenic ( low and more midline)
What is the function of the stomach? storage area for food during digestion; also processes food bolus into material called chyme
What does the stomach do? secretes acids, enzymes and other chemicals to break down food
What is the chemically and mechanically altered food called that leaves the stomach? CHYME
What is peristalsis? involuntary contraction waves that propel contents toward rectum
How often does peristalsis occur in the stomach? 3 to 4 waves per minute in full stomach
How long to empty stomach? 2 - 3 hours
How long is transit from stomach to ileocecal valve? 2 - 3 hours
What is contrast media? allows radiographic demonstration of alimentary canal
What is most common contrast media for gastro studies? What is the alternative? Barium sulfate; water soluble iodinated contrast media
Why is water soluble iodinated contrast media used as alternative to Barium? 1) clears stomach 1-2 hrs 2) do not adhere to esophageal mucosa as well 3) provide good exams of stomach, duodenum and large intestine 4) easily removed before/during surgery 5) readily absorbed by body, excreted by kidneys (perforation)
What are the essential projections of the esophagus? AP or PA AP or PA oblique Lateral
What are the essential projections of the stomach and duodenum? PA PA oblique AP oblique Lateral (right preferred) AP
What is the lower gastrointestinal tract? a musculomembranous tube that extends from mouth to anus
What are the components of the lower GI? - mouth - pharynx - esophagus - stomach - small intestine - large intestine (terminates at anus)
Describe the small intestine. - a musculomembranous tube that extends from pyloric sphincter to ileocecal valve - consists of duodenum, jejunem, ileum
Describe the duodenum. - from pyloric sphincter to jejunem - 8 to 10 inches and C shaped - first portion called duodenal bulb - joins jejunem at duodenojejunal flexure - flexure is supported by suspensory muscle called LIGAMENT OF TRIETZ
What is the function of the small intestine? 1) digests and absorbs food 2) gastrointestinal transit 3) uses peristalsis 4) average transit time to ileocecal valve 2 -3 hours
Describe radiation protection during GI studies. - use shielding, but do not compromise clinical objectives of exam - use close collimation - use optimum technique factors
How is contrast administered? 1) orally 2) reflux filling via large-volume barium enema 3) direct injection via tube placed into small bowel (enteroclysis)
What is the most common method of administering contrast? orally
What is patient prep for small intestine orally administered exam? 1) soft/low residue diet for 2 days 2) FAST 8 hours prior to exam 3) may need cleansing enema for colon
Why is it called small bowel series? - Several identical images are produced at timed intervals - images notated with time since ingestion of barium - patient in PRONE or SUPINE position
Why is supine used? - to view superior and lateral shift of stomach, improving visualization of duodenum and jejunum - prevent compression of overlapping loops of intestine
Why is prone used? To compress abdomen and increase image quality
How does technologist determine time intervals between images? having radiologist inspect each image and giving next time frame
When is the exam considered completed? When barium moves through ileocecal valve
Describe the large intestine. a musculomembranous tube that extends from ileocecal valve to anus
What is the position of the large intestine? An arch around small intestine
What are the four main parts of the large intestine. - cecum - colon - rectum - anal canal
How long is the large intestine? about 5 feet
What are the series of pouches along the colon called? haustra
What are the muscular bands that form the haustra? taeniae coli
What is the cecum? pouch-like portion below the junction of the ileum and colon
What is the outpouching attached to the posteromedial side of cecum called? vermiform appendix
What are the four portions of the colon? Ascending Transverse Descending Sigmoid
What is the first sharp angle at ascending/transverse colon called? right colic flexure (hepatic)
What is the second sharp angle at transverse/descending colon called? left colic flexure (splenic)
Describe the sigmoid portion. an S shaped loop that ends at rectum at level of 3rd sacral segment
What extends from sigmoid to anal canal? Rectum
What is the final portion that terminates at the anus? anal canal
What is the function of the large intestine? reabsorption of fluids elimination of waste products
Why is carbon dioxide used most commonly in double contrast studies? absorbed more rapidly
When are water soluble contrast agents used? when retrograde filling is contraindicated usually not satisfactory for double contrast studies because doesn't adhere as well to mucosa
Why must the large intestine be completely empty prior to exam? retained fecal matter can simulate small masses
What conditions limit patient preparation for large bowel study? - severe diarrhea - gross bleeding - obstruction
Describe large bowel cleansing methods. - complete intestinal cleaning kit - GI lavage preparations - cleansing enema
Created by: Larobbins