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Rad Pro Ch.12
Upper GI
| Question | Answer |
|---|---|
| Falciform | Separates the right and left lobe of the liver. |
| Duodenum | - Shortest and widest. - C-loop. - "Romance of the abdomen". - Retroperitoneal. |
| The liver occupies almost all of the _________________ | RUQ. |
| Quadrate Lobe | Is located the inferior surface of the rifer love b/w the gallbladder and the falciform ligament. |
| Caudate Lobe | Posterior to the quadrate lobe and extends superiorly to the diaphragmatic surface. |
| Inferior Vena Cava | Contours over the surface of this caudate lobe. |
| Function of the Liver: | Production of large amounts of bile. |
| Right & Left Hepatic Ducts | Bile is formed in small lobules of the liver and travels by small ducts to this. |
| Common Bile Duct | The right and left hepatic ducts join to continue. |
| Gallbladder | Is pear-shaped sac composed of three parts: fundus, body, neck. |
| Cystic Duct | The neck is the narrow proximal end, 3-4 cm long and contains several membranous folds along its length. |
| Spiral Valve | Folds; functions to prevent distention or collapse of the cystic ducts. |
| 3 Primary functions of the gallbladder: | 1) Store Bile. 2) Concentrate Bile. 3) Contracts. |
| Common Bile Duct | Is joined by the pancreatic duct at the hepatopancreatic sphincter which empties into the duodenum via the duodenal papilla. |
| Hydrolysis | Removal of water. |
| Cholecystokinin (CCK) | Contraction of gallbladder when stimulated. |
| Pancreatic Duct (duct of Wirsung) | The terminal end of the common bile duct. |
| Choleliths | Gallstones. |
| Hepatopancreatic sphincter or sphincter of Oddi | Near the terminal opening of this passageway into the duodenum, the duct walls contain circular muscle fiber. |
| Duodenal Papilla | Presence of this ring of muscle causes protrusion into the lumen of the duodenum. |
| LAO position of the gallbladder | Demonstrates the cystic duct and 3 major divisions of the gallbladder: Cystic Duct. Neck. Body. Fundus. |
| Esophagography: Radiographer's Responsibilities | 1. Prepare fluoroscopy room. 2. Prepare contrast media. 3. Obtain clinical history. 4. Explain procedure. 5. Introduce and assist the fluoroscopist. 6. Assist the patient. |
| Mastication | "Chewing", initiate the mechanical part of digestion. |
| Digestive System includes | Alimentary canal & Accessory Organs. |
| Deglutition | The act of swallowing. |
| Alimentary Canal: | Oral Cavity (mouth.) Pharynx . Esophagus . Stomach. Duodenum & Small Intestine. Large Intestine. Anus. |
| Peristalsis | Is a wavelike series of involuntary muscular contractions that propel solid and semisolid materials through the tubular alimentary canal. |
| Parotid | "Near the ear." |
| Submandibular | "Bellow the mandible or maxilla." |
| Sublingual | "Below the tongue." |
| Accessory Organs: | Salivary glands. Pancreas. Liver. Gallbladder. |
| Functions of Digestive System: | 1. Intake or Digestion. 2. Abosrb. 3. Eliminate. |
| Esophagogram | Or barium swallow; studies the form and function of the swallowing aspect of the pharynx and esophagus. |
| Upper GI | Procedure designed to study the distal esophagus, stomach, and duodenum. |
| Oral Cavity | A continuous hollow tube. |
| Salivary Glands | Are accessory organs of digestion associated with the mouth. |
| Pharynx | Is about 12.5 cm long and is apart of the digestive tube found posterior to the nasal cavity, mouth, and larynx. |
| Nasopharynx | Is posterior to the bony nasal septum, nasal cavities and soft palate. |
| Oropharynx | Is directly posterior to the oral cavity proper; extends from the soft palate to the epiglottis. |
| Epiglottis | Is a membrane-covered cartilage that moves down to cover the opening of the larynx during swallowing. |
| Laryngopharynx | Extends from the level of the epiglottis to the level of the lower border of the larynx (level of C6). |
| Trachea | Is seen anterior to the esophagus. |
| Esophagus | Is a muscular canal about 25 cm log and 2 cm in diameter; extending from the laryngopharynx to the stomach. * Starts- (level C5-C6). * Ends- (T11). |
| Thoracic Aorta | Is b/w the distal esophagus and the lower thoracic spine. |
| Heart | Within its pericardial sac is immediately posterior to the sternum, anterior to the esophagus, and superior to the diaphragm. |
| Barrett Esophagus | is the replacement of the normal squamous epithelium with columnar-lined epithelium ulcer tissue in the mid-to-lower esophagus. May produce a stricture in the distal esophagus or peptic ulcer may develop in distal esophagus. |
| The esophagus pierces the diaphragm at the level _____________. | T 10. |
| 2 indications of the esophagus: | 1. Aortic arch. 2. Left primary bronchus. |
| Gastroesophageal reflux disease (GERD) | Is the entry of gastric contents into the esophagus, irritating the lining of the esophagus. |
| Esophageal Varices | Are characterized by dilation of the veins in the wall of the distal esophagus. |
| Greek for "Stomach" | Gaster. |
| Latin for "little belly" | Ventriculus. |
| Upper GI Patient Preparation: | - NPO 8 hours prior to study. - No gum chewing. - No smoking. - Determine pregnancy. |
| Peptic Ulcer | Describes ulceration of the mucous membrane of the esophagus, stomach, or duodenum caused by the action of acid gastric juice. |
| Hiatal Hernia | Is a condition in which a portion of the stomach herniates though the diaphragmatic opening. |
| Sliding Hiatal Hernia | 2nd type; is caused by weakening of a small muscle located b/w the terminal esophagus and the diaphragm. |
| Diverticula | Are pouch like herniations of a portion of the mucosal diverticula generally are 1 to 2 cm but may range in size from a few millimeters to 8 cm in diameter. |
| Gastritis | Is an inflammation of the lining or mucosa of the stomach. |
| Bezoar | Describes a mass of undigested material that becomes trapped in the stomach Usually made up of hair, certain vegetable fibers, or wood products. The material builds up over time and may form an obstruction in the stomach. |
| Diagnosis of Esophageal Reflux: | 1) Breathing exercises (two types). 2) The water test. 3) Compression paddle technique. 4) The toe-touch test. |
| Water Test | Positive if barium regurgitates into esophagus (LPO position, swallow water through straw). |
| Compression Paddle | - Paddle inflated under stomach with patient in prone position. - Pressure applied to stomach region to create reflux. |
| Toe-Touch Maneuver | Effective for reflux and hiatal hernia. |
| Esophagography: Radiographer's Responsibilities: | - Prepare fluoroscopy room. - Prepare contrast media. - Obtain clinical history. - Explain procedure. |
| Hypersthenic | Duodenal bulb: - To right of midline. - Level of T11-T12. |
| Sthenic | Duodenal bulb: - Slightly to right of midline. - Level of L1-L2. |
| Hyposthenic/Asthenic | Duodenal bulb: - At midline. - Level of L3-L4. |
| AP Upper GI | - No rotation. - CR to L1. |
| LPO Upper GI | - 30°-60° oblique. - CR to L1. |
| Right Lateral Upper GI | - True lateral. - CR to L1. |
| PA Upper GI | - No rotation. - CR to L1. |
| RAO Upper GI | - 40°-70° oblique. - CR to L1. |
| AP (PA) Esophagogram | - AP (PA) projection. - CR to T5-T6. |
| LAO Esophagogram | - 35°-40° oblique. - CR to T5-T6. |
| Upper Esophagus | Swimmer's lateral (for better visualization of proximal esophagus). |
| Lateral Esophagogram | - True lateral. - CR to T5-T6. |
| RAO Esophagogram | - 35°-40° oblique. - CR to T5-T6 (1 inch [2.5 cm] inferior to sternal angle). |
| High kV: Analog and digital systems | 100-125 (90-100 for double-contrast procedure). |
| Valsalva Maneuver | Patient takes in deep breath and holds in breath while bearing down as if trying to move the bowels. |
| Mueller Maneuver | Patient exhales, then tries to inhale against closed glottis. |
| Cardiac Antrum | "Abdominal segment of the esophagus" is measures 1-2 cm; curves sharply to the left after passing through the diaphragm to attach to the stomach. |
| Esophagogastric Junction | Opening b/w the esophagus and the stomach. |
| Stoamch | Located b/w the esophagus and the small intestine; is the most dilated portion of the alimentary canal, when empty tends to collapse, when full stretches to the point of rupture. |
| Cardiac Orifice | Refers to the relationship of this orifice to the portion of the diaphragm near the heart, on which the heart rests. |
| Cardiac Notch (incisura cardiaca) | Superior to the cardiac orifice. |
| Cardiac Antrum | Slightly expanded portion of the terminal esophagus. |
| Pyloric Orifice or Pylorus | Opening or orifice of the distal stomach. |
| Lesser Curvature | Found along the medial border of the stomach; forms a concave border as it extends b/w the cardiac and pyloric duodenum. |
| Greater Curvature | Is found along the lateral border of the stomach; is 4 to 5 times longer than the lesser curvature, extends from the cardiac notch & the pylorus. |
| Stomach Subdivisions | 1. Fundus. 2. Body. 3. Pylorus. |
| Angular Notch | "Notch" or constricted ring-like area that separates the body from the pyloric portion of the stomach. |
| Gastric Canal | Formed by the rug along the lesser curvature; funnels fluids directly from the body of the stomach to the pylorus. |
| Supine Position | The funds of the stomach is the most posterior portion and is where heavy barium settles. |
| RAO Recumbent Position | The funds is in the highest position causing gas to fill this portion of the stomach; barium settles in the more anterior body. |
| Duodenum | First portion of the small intestine "small bowel". |
| Head of Pancreas | "Romance of the abdomen"; nestled in the C-loop of the duodenum. |
| The Duodenal Bull or Cap | Is intraperitoneal. |
| Duodenal Papilla | 2nd descending portion; longest segment of the duodenum. |
| Horizontal portion | 3rd portion of the duodenum; curves back to the left to join the final segment. |
| Duode-nojejunal flexure | Portion is relatively fixed and it held in place by a fibrous muscular band, the ligament of Treitz. |
| Carbohydrates | Simple sugars (mouth and stomach). |
| Proteins | Amino acids (stomach and small bowel). |
| Lipids (fats) | Fatty acids and glycerol (small bowel only). |
| Colloidal Suspension | - Never dissolves in water. - Rate of separation varies by brand. - Contraindications: perforated viscus or presurgical procedure. |
| Thin Barium | 1:1 ratio of BaSO4 to water. |
| Thick Barium | 3 or 4 parts BaSO4 to 1 part water. |
| Upper GI Series | Examination of the distal esophagus, stomach, and duodenum. |
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