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AP 2 Book
Lecture 9 exam study - BE
| Question | Answer |
|---|---|
| A radiographic and fluoroscopic procedure to demonstrate radiographically the form and function of the Large Intestine - also referred to as a lower GI or Colon examination | Barium Enema (BE) |
| A BE is performed what two ways? | Single column: Barium only or Double column: with both air and barium (ACBE or double-contrast barium enema) |
| An inflammation of the wall of the Large Intestine | Colitis |
| How does Colitis appear radiographically? | as a loss of haustral markings |
| A severe form of colitis that is common in young adults - one of the most common forms of inflammatory bowel disease ulcers | Ulcerative Colitis |
| How do Ulcers appear radiographically? | As multiple filling defects that create an "cobblestone" appearance along the mucosa |
| What is "stovepipe" colon? | Haustral markings and flexures are absent |
| Common in the Large Intestine, begin as a polyp and commonly found in the Rectosigmoid area, may be visualized by a Barium Enema | Benign and Malignant Neoplasms |
| A small growth extending inward from the wall of the intestine | Polyp |
| The third leading cause of cancer in males and fourth in females in the U.S. Risk factors include heredity and colon polyps, often this encircles the lumen of the colon and will appear radiographically like an "apple core" lesion | Colorectal Cancer |
| An outpouching of the mucosal wall of the Large Intestine | Diverticulum |
| Condition with numerous diverticula | Diverticulosis |
| Diverticula become inflamed or infected and may cause bleeding | Diverticulitis |
| Large Bowel Obstructions may be caused by what? | Intussuception or Volvulus |
| A telescoping of one part of the intestine into another | Intussusception |
| When a portion of the Large Intestine twists on its own mesentery | Volvulus |
| Most common sites for a Volvulus to happen? | Cecum and Sigmoid colon |
| May be caused by a variety of conditions of the Large Intestine including Hemorrhoids, Diverticulitis, Polyps, or colon cancer | Intestinal bleeding |
| represents blood that is higher in the GI Tract | Black tarry stools |
| Is normally indicative of bleeding from Hemorrhoids | Bright red blood |
| May be caused by an infection or a blockage of blood vessels that feed the appendix | Appendicitis |
| Modality of choice for diagnosing Appendicitis | CT of the Abdomen without contrast media - RLQ pain and elevated WBC in ER |
| When preparing a single-column barium enema bag, a disposable enema bag with a premeasured amount of barium sulfate is filled by mixing the barium sulfate with what? | Lukewarm tap water - 1500cc |
| When preparing the Gastrografin Enema bag (when barium is contraindicated) how many bottles of Gastrografin are used to fill an empty disposable enema bag for a single-column Gastrografin enema? | 6-8 |
| Why do you run the contrast medium through the tubing after adding Gastrografin to the enema bag when preparing a Gastrografin Enema Bag? | to avoid introducing air into the colon - then clamp tubing with Kelly clamp and attach to an IV pole |
| An anti-spasmodic pharmaceutical that may be administered intravenously during a BE or ACBE if the patient experiences colonic spasm or discomfort during the procedure | Glucagon |
| Disposable enema tips that come in a variety of types and sizes: plastic disposable for tapwater enemas, Rectal retention tips for Barium Enemas and Air Contrast Retention tip for ACBE | Rectal Retention Enema Tips |
| What SCOUT image is required when performing an ACBE or BE prior to the insertion of the enema tip? | AP Scout image |
| Equipment prep for an AP SCOUT image including SID, kV, and Overhead x-ray tube placement? | Overhead x-ray tube centered to table at 40 in SID, kV 80-90, |
| AP SCOUT Projection - BE - prior to tip insertion: IR: Mark IR: Patient Position: CR: Expose: Collimate: | IR: 14x17 lengthwise Mark IR: lower right corner with right and SCOUT lead marker Patient position: supine recumbent, midsagittal to midline of table CR: Perpendicular to Iliac Crest, Center CR to center of IR |
| Routine BE Overheads (any combination may be requested by Radiologist): 1 2 3 4 | 1. AP and/or PA Projection 2. 35-40 Degree Bilateral Oblique Positions (RPO/LPO, RAO/LAO) 3. Axial Projection (one of following): AP or LPO - CR 30-40 Cephalad, PA or RAO - CR 30-40 Caudad 4. Coned-down Lateral Rectum 10x12 IR |
| CR placement for a PA Projection - BE Overhead? | perpendicular to the midsagittal at the level of Iliac Crest |
| RPO position - BE Overhead left hip elevation? | 35-40 degrees |
| RPO position - BE Overhead Patient position and CR location? | Center patient so Midsagittal is approx. 2-3 in. to the left of the midline of table (side up) (to the right for LPO) - CR perpendicular to Iliac Crest (or 1-2 in. above to ensure splenic flexure is included) |
| RAO position - BE Overhead patient position and CR location? | Center patient so Midsagittal is approx. 1 in to the right of the midline of table (side down) (to the left for LAO) - CR perpendicular to Iliac Crest (or 1-2 in above to ensure hepatic flexure is included) |
| AP Axial - BE Overhead CR location | 30-40 degrees cephalad to enter 2 inches above symphysis pubis |
| LPO Axial - BE Overhead - Hip elevation, CR location, patient position | elevate right hip 35-40 degrees, center patient so midsagittal is approx. 2-3 inches to the right of the midline of table (side up), CR 30-40 degrees cephalad to enter 2 in. inferior and 2 in medial to the right ASIS |
| PA Axial BE - Overhead - Patient position, CR location | Patients midsagittal centered to midline table, CR angled 30-40 degrees caudad to enter at the level of ASIS, centered to midline IR |
| RAO Axial - BE Overhead - Hip elevation, CR location, patient position | elevate patients left hip 35-40 degrees, center patients midsagittal 1-2 in to the elevated side and to the midline of table, CR 30-40 degrees caudad to enter at level of ASIS and 2 in medial to left ASIS and centered to midline of IR |
| Left Lateral Rectum - BE Overhead - Patient position, CR location, IR location | patient lies on side in true lateral with midcoronal plane to midline of table, CR perpendicular to the midcoronal at the level of ASIS (midway between ASIS and posterior sacrum), Bottom of IR at the bottom of patient's buttock |
| Lateral colon - BE Overhead - CR | to the level of Iliac Crest |
| Structures best demonstrated on an AP/PA - BE Overhead | A general survey of the Large Intestine |
| Structures best demonstrated on a T-Shot - BE Overhead | Flexures and Transverse Colon |
| Structures best demonstrated on the RPO/LAO Oblique positions - BE Overheads | Splenic Flexure |
| Structures best demonstrated on the LPO/RAO Oblique positions - BE Overheads | Hepatic Flexure |
| Structures best demonstrated on the Axial Projections - BE Overheads | Elongated Rectosigmoid Colon |
| Structures best demonstrated on the Lateral Projection - BE Overheads | Rectum |
| Structures best demonstrated on the AP Post-Evac - BE Overhead | to evaluate the Colon's ability to evacuate and mucosal lining for single-column BE |
| ACBE is particularly useful for demonstrating what? | Polyps |
| When preparing an ACBE Barium enema bag, how much thick barium is used to fill an empty enema bag? | 500cc of thick barium |
| What is the major difference between the BE and the ACBE fluoroscopy procedures? | The type of Barium used and how the contrast media is administered |
| Structures best demonstrated on a Right Lateral Decubitus - ACBE Overhead | The medial aspect of the ascending colon and lateral aspect of the descending colon |
| Structures best demonstrated on a Left Lateral Decubitus - ACBE Overhead | The lateral aspect of the ascending colon and medial aspect of the descending colon |
| Structures best demonstrated on a X-Table Lateral Rectum - ACBE Overhead | Air-Barium levels in the Rectosigmoid portion of the Large Intestine |
| Structures best demonstrated on an Upright AP/PA Projection - ACBE Overhead | Barium-air levels in the Large Intestine (barium will drop to lowest position, allowing air to rise) |
| Why is a Post-Evac image not performed for an ACBE procedure? | Because the mucosal lining has been demonstrated during the procedure |
| Performed to relieve fecal impaction using Water-soluble Iodinated Contrast Medium (Gastrografin) and fluoroscopy | Therapeutic Enema |
| A disorder characterized by a large mass of compacted feces and the degree of intestinal obstruction | Fecal Impaction |
| Performed for malignancies of the lower bowel or rectum | Colostomies |
| Once healing of the affected bowel is complete, a reconnection of the two sections of the Large Intestine is performed surgically, what is the reconnection called? | Anastomosis |
| Contrast media used for a Colonoscopy enema? | Water-soluble Iodinated Contrast Media |
| Fluoroscopic Procedure is similar to the single-column BE procedure with the following exceptions: 1 2 | 1. Insertion of the stoma or retention enema tip and the route of contrast media as a result of the bowel resection 2. As a pre-surgical resection procedure, two enema examinations may be performed (one to visualize resection, one to visualize bowel) |
Created by:
teresachristensen
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