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AP 2 Book

lecture 7 Exam Study - UGI

QuestionAnswer
A radiographic and fluoroscopic procedure of the form and function of the distal Esophagus, Stomach and Duodenum using contrast medium - also referred to as an Upper GI Series or Stomach Exam Upper Gastrointestinal (UGI)
An erosion of the Stomach lining caused by excessive hydrochloric acid secretions - commonly formed in the body of the stomach, pyloric region, or in the duodenal bulb Ulcers
Ulcers radiographically may appear as what when the stomach is filled with barium during a single column UGI Negative contrast defects
A cork shaped bacteria that is commonly found in the stomach Helicobacter pylori
ulcerations in the esophagus, stomach, or duodenum Peptic Ulcers
ulcers located in the mucosal lining of the stomach Gastric Ulcers
A portion of the stomach herniates through the Esophageal Hiatus - two types, congenital and sliding Hiatal Hernia
Most common type of cancer found in the stomach? Adenocarcinoma
Pouch-like herniation of a portion of the mucosal wall, most arising at the posterior aspect of the Fundus Diverticula
An inflammation of the lining or mucosa of the Stomach Gastritis
(Gastric obstruction in infants) caused by hypertrophy of the muscles at the pyloric orifice, causing an obstruction Hypertrophic Pyloric Stenosis
Clinical indications for performing an Upper GI exam: 1-7 1. Gastric ulcers 2. hiatal hernia 3. intrinsic or extrinsic masses or tumors 4. polyps 5. Diverticuli 6. Gastritis 7. Hypertrophic Pyloric stenosis
What can happen to ulcers causing harmful gastric contents to spill out into the peritoneum? bleed and/or perforate
In the event of contraindications to Barium Sulfate, what contrast medium is used instead? Water-soluble iodinated contrast medium
Oral Water-Soluble Contrast Media contains what percent of organically bound iodine? 37%
When preparing the equipment for an UGI, how is the x-ray table placed to begin the examination? In the upright position with the footboard attached
A weakening of the esophageal sphincter located between the terminal esophagus and the diaphragm, resulting from obesity, aging or smoking. Sliding Hiatal Hernia
Radiographically a sliding hiatal hernia may appear as a what? ring-like constriction at the distal esophagus called a Schatzki's ring
kV used for an UGI 90-125 for Barium Examinations to adequately penetrate barium filled structures
SCOUT imaging performed prior to the UGI examination and CR placement? Typically none - if requested, AP Projection of the Abdomen, CR directed 2 inches above Iliac Crest
What position is utilized during the UGI exam to increase peristalsis, allowing barium to flow into the duodenal bulb? RAO
If the patient's peristaltic contractions are limited during the UGI exam as a result of nervousness or loss of appetite, what two things can be done and why? 1. Radiologist may begin to discuss food - to activate peristalsis 2. Administer Glucagon - to relax the pyloric sphincter
Routine OVERHEADS for an UGI: 1 2 3 4 5 1. PA Projection 2. 30-60 degree RAO 3. Right Lateral Position 4. 30-60 degree LPO 5. AP Projection
Positioning adjustment For a PA Projection on a Hypersthenic patient? A PA Axial Projection - angle CR 35-40 degrees Cephalad to open up Greater/Lesser Curvatures, Pyloric Canal and Duodenal Bulb
Degree of obliquity (30-60 degrees) depends upon body habitus: Sthenic: Hypersthenic: Asthenic/Hyposthenic: Sthenic: 45 degrees Hypersthenic: 50-60 degrees Asthenic/Hyposthenic: 30 degrees
Positions to place air in the fundus of the Stomach, Barium sulfate in the body of the stomach: 1 2 3 1. Upright position 2. RAO position 3. PA projection
Positions to place Barium in the Fundus of the Stomach, Air in the Body of the Stomach: 1 2 1. LPO Position 2. AP Projection
What is the Location of the Duodenal Bulb? L2
CR location for Overheads for a Hypersthenic patient? CR 2 inches below the Xiphoid Process
CR location for Overheads for a Sthenic patient? Center at L2 by directing the CR above Iliac Crest
CR location for Overheads for a Asthenic/Hyposthenic patient? Center 1 inch above Iliac Crest
Structures Best demonstrated on an LPO Overhead (UGI) The Duodenal Bulb, with air in the body of the stomach and barium in the fundus
Structures Best demonstrated on an RAO Overhead (UGI) The Duodenal Bulb, with barium in the body of the stomach and air in the fundus
Structures Best demonstrated on a Right Lateral Overhead (UGI) The Pylorus of the Stomach and the C-Loop of the Duodenum; the retro-gastric space (behind stomach) should be visible to demonstrate a Gastric Diverticula
A fluoroscopic procedure to determine if there are complications from Bariatric surgery or performed as a 24-hour postoperative examination for detection of leaks Bariatric UGI
Clinical indications for a bariatric UGI: 1 2 3 4 5 6 1. Symptoms of "dumping syndrome" 2. Suspect leakage or slippage of gastric band 3. infection 4. ulcerations around the band 5. obstruction 6. inadequate weight loss
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