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| Question | Answer |
|---|---|
| What is the average length of the small intestine when uncoiled? | 23 feet (7 m) |
| What is the actual length of the small intestine during life? | 15 to 18 feet (4.5 to 5.5 m) |
| What is the diameter of the small intestine at its proximal aspect? | 1½ inches (3.8 cm) |
| What is the diameter of the small intestine at its distal end? | 1 inch (2.5 cm) |
| Where does the large intestine begin? | In the right lower quadrant (RLQ) with its connection to the small intestine. |
| What is the average length of the large intestine? | About 5 feet (1.5 m) |
| What is the common radiographic procedure to study the small intestine? | Small Bowel Series (SBS) |
| What is the procedure called that studies the large intestine? | Barium Enema (Lower GI Series) |
| What are the three parts of the small intestine in order? | Duodenum, jejunum, ileum |
| Which part of the small intestine is the shortest and widest? | Duodenum |
| Where does the jejunum primarily reside? | Left upper quadrant (LUQ) and left lower quadrant (LLQ) |
| What is the average length of the duodenum? | 8 to 10 inches (20 to 25 cm) |
| What is the primary function of the jejunum? | To aid in the absorption of nutrients. |
| What feature gives the jejunum its feathery appearance? | Numerous mucosal folds (plicae circulares) |
| What is the terminal portion of the small intestine? | Ileum |
| Where does the ileum join the large intestine? | At the ileocecal valve in the RLQ. |
| What distinguishes the appearance of the ileum from the jejunum? | The ileum has fewer mucosal folds and a smoother appearance. |
| What is the significance of the duodenojejunal flexure? | It is the point where the duodenum joins the jejunum. |
| What is the term for the condition where abdominal organs are reversed? | Situs inversus |
| What is the primary imaging technique used for the small bowel study? | Barium-filled radiographs |
| What is the appearance of the mucosal lining in the duodenum? | Tight circular folds with numerous villi. |
| What is the function of the ileocecal valve? | It regulates the flow of material from the ileum to the large intestine. |
| What is the typical appearance of the jejunum on a radiograph? | Coiled spring with a feathery appearance. |
| What is the primary function of the large intestine? | To absorb water and electrolytes and to form and store feces. |
| What is the term for a radiographic examination of the barium-filled small bowel? | Small bowel series (SBS) |
| What is the typical diameter of the jejunum? | Approximately 1 inch (2.5 cm) |
| What is the significance of the mucosal folds in the jejunum? | They increase surface area for nutrient absorption. |
| What is the appearance of the ileum on a radiograph? | Smoother with fewer indentations compared to the jejunum. |
| What are the common positions used for barium enema procedures? | RAO, LAO, LPO, RPO, and lateral positions. |
| What is the purpose of the barium enema procedure? | To visualize the large intestine and detect abnormalities. |
| What are the four major parts of the large intestine? | Cecum, colon, rectum, and anal canal. |
| What is the cecum? | A large blind pouch located inferior to the ileocecal valve, at the proximal end of the large intestine. |
| What is the vermiform appendix? | A long, narrow, worm-shaped tube that extends from the cecum. |
| What is appendicitis? | Inflammation of the appendix, which may require surgical removal (appendectomy) if it becomes inflamed. |
| What are the four sections of the colon? | Ascending colon, transverse colon, descending colon, and sigmoid colon. |
| What are the right and left colic flexures? | The right colic flexure (hepatic) and left colic flexure (splenic) are bends in the colon. |
| What is the rectum? | The final segment of the large intestine, extending from the sigmoid colon to the anus. |
| How long is the rectum? | About 4.5 inches (12 cm) long. |
| What differentiates the large intestine from the small intestine? | The large intestine has a greater internal diameter, contains taeniae coli, and has haustra. |
| What are haustra? | Pouches formed by the contraction of taeniae coli in the large intestine. |
| What is the significance of the rectal ampulla? | It is a dilated portion of the rectum located anterior to the coccyx. |
| What happens to air and barium in the large intestine during a barium enema? | Air rises to fill anterior structures, while barium sinks to fill primarily the ascending and descending colon. |
| What is the anatomical position of the large intestine relative to the small intestine? | The large intestine extends around the periphery of the abdominal cavity, while the small intestine is more centrally located. |
| What is the length of the vermiform appendix? | 2 to 8 inches (2 to 20 cm). |
| What is the common complication of appendicitis? | Rupture of the appendix, leading to peritonitis. |
| What is the role of the taeniae coli? | They are bands of longitudinal muscle fibers that help form haustra and contract to move contents through the large intestine. |
| What is the direction of the rectum along the sacrum? | Initially inferior and posterior, then changes to inferior and anterior at the rectal ampulla. |
| What is the anal canal? | The final part of the large intestine, terminating at the anus. |
| What is the difference between the colon and the large intestine? | The colon consists of four sections and two flexures, while the large intestine includes the cecum, colon, rectum, and anal canal. |
| How does the ileocecal valve prevent reflux? | It has two lips that extend into the large bowel, acting as a sphincter. |
| What is the common position of the cecum in the abdomen? | Located in the right lower quadrant (RLQ) of the abdomen. |
| What can cause appendicitis? | Obstruction of the opening into the appendix, often due to a small fecal mass. |
| What is the typical location of the rectum in relation to the sacrum? | It closely follows the sacrococcygeal curve. |
| What is the anatomical significance of the anal canal's constriction? | It forms the opening to the exterior, the anus. |
| What is the average diameter of the large intestine compared to the small intestine? | The large intestine has a greater internal diameter than the small intestine. |
| How does body habitus affect the structure of the large intestine? | The structural locations and relative sizes of the large intestine can vary depending on individual body habitus. |
| What is the location of the cecum in relation to the peritoneum? | Intraperitoneal |
| Where is the ascending colon located in relation to the peritoneum? | Retroperitoneal |
| What is the location of the transverse colon in relation to the peritoneum? | Intraperitoneal |
| Where is the descending colon located in relation to the peritoneum? | Retroperitoneal |
| What is the location of the sigmoid colon in relation to the peritoneum? | Intraperitoneal |
| How is the upper rectum classified in relation to the peritoneum? | Retroperitoneal |
| What is the classification of the lower rectum in relation to the peritoneum? | Infraperitoneal |
| What are the three parts of the small bowel visible in radiographs? | Duodenum, jejunum, ileum |
| What is the purpose of a small bowel series? | To study the form and function of the small bowel and detect abnormal conditions. |
| What are the two strict contraindications for contrast media studies of the intestinal tract? | 1. Presurgical patients or suspected perforation. 2. Possible large bowel obstruction. |
| What is enteritis? | Inflammation of the intestine, primarily the small intestine. |
| What condition is known as gastroenteritis? | When the stomach is also involved in enteritis. |
| What is regional enteritis? | A form of inflammatory bowel disease involving any part of the gastrointestinal tract, commonly the terminal ileum. |
| What is the 'cobblestone' appearance in radiographic studies indicative of? | Scarring and thickening of the bowel wall due to regional enteritis. |
| What does the 'string sign' indicate in a small bowel series? | Narrowing of segments of the intestine due to chronic spasm. |
| What are the four primary digestive functions of the intestines? | 1. Digestion (chemical and mechanical) 2. Absorption 3. Reabsorption of water, salts, and vitamins 4. Elimination (defecation) |
| What percentage of water is normally found in feces? | 65% water and 35% solid matter. |
| What types of gases are produced by bacterial action in the large intestine? | Hydrogen, carbon dioxide, and methane gas. |
| What is peristalsis? | Wavelike contractions that propel food through the intestines. |
| What is rhythmic segmentation? | Localized contractions in the intestine that segment food for more effective digestion. |
| What is haustral churning? | Movement of material within the large intestine. |
| What is mass peristalsis? | A strong wave of contraction that moves contents through the large intestine. |
| What is the significance of the ileocecal valve? | It is the junction between the small intestine and the large intestine. |
| What is the role of bacteria in the large intestine? | They synthesize vitamins like B and K and assist in the final stages of digestion. |
| What is a barium enema? | A radiographic examination of the large intestine using barium as a contrast medium. |
| What is the ligament of Treitz? | The suspensory ligament of the duodenum, marking the duodenojejunal flexure. |
| What is the appearance of the ileum in radiographs? | Smoother compared to the duodenum and jejunum. |
| What is defecation? | The process of emptying the rectum, commonly referred to as a bowel movement. |
| What are the primary functions of the small intestine? | Digestion (chemical and mechanical), absorption of nutrients, water, salts, proteins, and reabsorption of water and salts. |
| What are the main components of the small intestine? | Duodenum and jejunum. |
| What condition is characterized by inflammation of the small intestine? | Enteritis. |
| What is Crohn disease? | A type of regional enteritis affecting the small intestine, diagnosed via small bowel series or enteroclysis. |
| What is giardiasis? | A common infection of the small intestine caused by Giardia lamblia, often spread through contaminated food and water. |
| What are the symptoms of giardiasis? | Gastrointestinal discomfort, diarrhea, nausea, anorexia, and weight loss. |
| What is ileus? | An obstruction of the small intestine, which can be adynamic (paralytic) or mechanical. |
| What causes adynamic ileus? | Cessation of peristalsis due to infection, certain drugs, or postsurgical complications. |
| What is a mechanical obstruction in the intestine? | A physical blockage caused by tumors, adhesions, or hernias, leading to dilation of proximal loops. |
| What is Whipple disease? | A rare disorder of the proximal small bowel characterized by malabsorption and dilation of the intestine. |
| What is Meckel's diverticulum? | A common birth defect resulting in a saclike outpouching of the intestinal wall, usually found in the ileum. |
| What is the most common radiographic examination for enteritis? | Small bowel series or enteroclysis. |
| What does a small bowel series typically show in cases of giardiasis? | Dilation of the intestine with thickening of the circular folds. |
| What is the purpose of using barium sulfate in small bowel studies? | To visualize the small intestine during radiographic examinations. |
| What is the upper GI-small bowel combination procedure? | A radiographic examination that starts with an upper GI series followed by tracking barium through the small bowel. |
| What is the significance of the 'circular staircase' or 'herringbone' pattern in radiography? | It indicates a mechanical obstruction in the bowel. |
| What are the symptoms of mechanical ileus? | Dilation of the intestine with air and the presence of air-fluid levels on radiographs. |
| What is the role of contrast media in small bowel studies? | To enhance visibility of the small intestine during radiographic examinations. |
| What is the typical interval for obtaining radiographs during a small bowel series? | Radiographs are usually obtained at 15 to 30-minute intervals for the first 2 hours. |
| What is the expected radiographic appearance of Whipple disease? | Distorted loops of small intestine and evidence of malabsorption. |
| What is the primary method for diagnosing Meckel's diverticulum? | Nuclear medicine scan or small bowel series. |
| What adjustments are made to exposure factors during radiographic examinations? | Adjustments are made based on the presence of gas-filled segments or other conditions affecting visibility. |
| What is the purpose of enteroclysis? | To provide a detailed examination of the small intestine when standard methods are unsatisfactory. |
| What is the typical appearance of the intestine in cases of adynamic ileus? | Distended intestine with a thin bowel wall and no fluid levels on erect abdomen projections. |
| What is Meckel diverticulum? | An outpouching found in the ileum of the small bowel, usually 1/2 to 3 feet proximal to the ileocecal valve. |
| How large can Meckel diverticulum be? | It may measure 4 to 4½ inches (10 to 12 cm) in diameter. |
| In what percentage of adults is Meckel diverticulum found incidentally? | Approximately 3% of adults. |
| What symptoms can Meckel diverticulum cause? | It typically does not cause symptoms unless inflammation (diverticulitis) or bowel obstruction develops. |
| What condition can mimic the pain caused by Meckel diverticulum? | Acute appendicitis. |
| What is the recommended treatment for Meckel diverticulum? | Surgical removal to prevent possible diverticulitis, obstruction, or blood loss. |
| Why is Meckel diverticulum rarely seen on barium studies? | Due to rapid emptying during the barium study. |
| What is the best method for diagnosing Meckel diverticulum? | A radionuclide (nuclear medicine) scan. |
| What does the term 'neoplasm' mean? | New growth, which may be benign or malignant (cancerous). |
| What are common benign tumors of the small intestine? | Adenomas and leiomyomas. |
| What is the most common tumor of the small bowel? | Carcinoid tumors. |
| What radiographic sign is associated with lymphoma in the small intestine? | The 'stacked coin' sign. |
| What type of defects do adenocarcinomas produce in the small intestine? | Short and sharp 'napkin-ring' defects within the lumen. |
| What is sprue? | A group of intestinal malabsorption diseases that involve an inability to absorb certain proteins and dietary fat. |
| What is celiac disease? | A form of sprue or malabsorption disease that affects the proximal small bowel, particularly the proximal duodenum. |
| What is the routine procedure for a small bowel series? | Ingestion of 2 cups (16 oz) of barium followed by timed radiographs until barium reaches the large bowel. |
| What is enterochlysis? | A double-contrast method used to evaluate the small bowel, involving intubation and the injection of barium and air. |
| What is the purpose of using a compression cone during fluoroscopy? | To spread out loops of ileum for better visualization of the ileocecal valve. |
| What is the typical time frame for barium to reach the large intestine during a small bowel series? | Usually within 2 to 3 hours. |
| What is the significance of delayed radiographs in a small bowel study? | To follow the barium through the entire large bowel. |
| What type of contrast medium is used in the intubation method for small bowel series? | Water-soluble iodinated agent or thin mixture of barium sulfate. |
| What is the role of fluoroscopy in small bowel studies? | To provide real-time imaging and spot images during the examination. |
| What is the primary goal of the enteroclysis procedure? | To enhance visibility of the mucosa and increase accuracy of the study. |
| What are the potential disadvantages of enteroclysis? | Increased patient discomfort and the possibility of bowel perforation during catheter placement. |
| What is the first step in a small bowel series? | Obtaining a plain abdomen radiograph (scout) before introducing the contrast medium. |
| What is the significance of the 'napkin-ring' defect? | It indicates the presence of adenocarcinoma in the small intestine. |
| What is the typical interval for radiographs after barium ingestion in a small bowel series? | Every half-hour for 2 hours, followed by hourly intervals. |
| What are the disadvantages of enteroclysis? | Increased patient discomfort and the possibility of bowel perforation during catheter placement. |
| What conditions indicate the use of enteroclysis? | Clinical histories of small bowel ileus, regional enteritis (Crohn disease), or malabsorption syndrome. |
| What imaging techniques are used during enteroclysis? | Fluoroscopy spot images and various projections including AP, PA, oblique, and possibly erect projections. |
| What should patients do after an enteroclysis procedure? | Increase water intake for the day and may be recommended to take laxatives to promote evacuation of barium sulfate. |
| What precautions should be taken regarding pregnancy before performing a barium enema? | Obtain a menstrual history and avoid procedures unless absolutely necessary due to the risk of irradiating an early pregnancy. |
| What is the typical size of the image receptor used for small bowel imaging? | 14 x 17 inches (35 x 43 cm). |
| What position is most appropriate for a small bowel series? | The prone position allows abdominal compression to separate loops of bowel for better visibility. |
| What is the purpose of using a high-kVp technique during the initial radiograph of a small bowel series? | To ensure adequate imaging when most of the barium is in the stomach and proximal small bowel. |
| What is the purpose of a barium enema? | To demonstrate radiographically the form and function of the large intestine and detect abnormal conditions. |
| What are the two strict contraindications for performing a barium enema? | Possible perforated hollow viscus and possible large bowel obstruction. |
| What alternative contrast media can be used if barium is contraindicated? | Water-soluble contrast media. |
| What is gastrointestinal intubation in the context of small bowel studies? | A procedure where a nasogastric tube is passed into the jejunum for diagnostic and therapeutic purposes. |
| What is the purpose of using a double-lumen catheter like the Miller-Abbott tube? | To relieve postoperative distention or decompress a small bowel obstruction. |
| What dietary preparation is recommended before a small bowel series? | A low-residue diet 48 hours before the examination and withholding food and fluid for at least 8 hours prior. |
| What is the role of fluoroscopy in the intubation method for small bowel studies? | To guide the tube into the duodenum using compression and manual manipulation. |
| What is the typical imaging technique used for fluoroscopic spot imaging of the terminal ileum? | Fluoroscopic spot imaging is usually performed after the initial examination to complete the study. |
| What should be done if a patient has had a recent sigmoidoscopy or colonoscopy before a barium enema? | Inform the radiologist, as a biopsy may weaken the colon wall and increase the risk of perforation. |
| What is the significance of the ligament of Treitz in enteroclysis imaging? | It marks the duodenojejunal junction, indicating the end of the duodenum. |
| What is the expected outcome of a successful enteroclysis procedure? | The introduction of methylcellulose dilates the bowel lumen, allowing barium to coat the mucosa. |
| What imaging technique is often performed after fluoroscopy in a dual-modality procedure? | A CT scan of the gastrointestinal tract to detect any obstructions or adhesions. |
| What position may be used for asthenic patients during small bowel studies? | The Trendelenburg position to separate overlapping loops of ileum. |
| What is the primary goal of patient preparation for a small bowel series? | To ensure an empty stomach before the examination. |
| What is the significance of the end of the catheter being seen in the distal duodenum during enteroclysis? | It indicates that the catheter has not yet reached the duodenojejunal junction. |
| What is the typical radiographic appearance of small bowel obstruction? | Distended air-filled loops of small bowel demonstrating air-fluid levels. |
| What is the purpose of timed interval radiographs during gastrointestinal intubation? | To determine whether the catheter is advancing through the gastrointestinal tract. |
| What is a common method of small bowel study that combines examinations? | A combination of the upper GI series followed by the small bowel series. |
| What imaging modalities are preferred for diagnosing acute appendicitis? | High-resolution ultrasound with graded compression and CT. |
| What is colitis? | An inflammatory condition of the large intestine caused by factors such as bacterial infection, diet, stress, and environmental conditions. |
| What are the radiographic features of colitis? | Rigid and thick intestinal mucosa with loss of haustral markings and a 'saw-tooth' appearance. |
| What is ulcerative colitis? | A severe form of colitis characterized by chronic inflammation and the development of coinlike ulcers in the mucosal wall. |
| What appearance do ulcers from ulcerative colitis have during a barium enema? | Multiple ring-shaped filling defects creating a 'cobblestone' appearance. |
| What is intussusception? | A condition where one part of the intestine telescopes into another, most common in infants under 2 years. |
| What is the radiographic sign of intussusception? | A 'mushroom-shaped' dilation at the point of obstruction. |
| What are neoplasms in the large intestine? | Tumors that can be benign or malignant, with carcinoma being a leading cause of death. |
| What is the typical radiographic appearance of large intestine carcinoma? | Descriptive terms such as 'apple-core' or 'napkin-ring' lesions. |
| What are polyps? | Saclilke projections in the colon that can become inflamed and may require surgical removal. |
| What is volvulus? | A twisting of a portion of the intestine on its own mesentery, leading to obstruction. |
| What is the classic sign of volvulus on imaging? | A 'beak' sign indicating tapered narrowing at the site of the volvulus. |
| What is diverticulosis? | The condition of having numerous diverticula, which are outpouchings of the mucosal wall. |
| What is diverticulitis? | Infection of diverticula that may lead to bleeding or perforation. |
| What are the contraindications for using laxatives? | Gross bleeding, severe diarrhea, obstruction, and inflammatory conditions like appendicitis. |
| What are the two classes of laxatives? | Irritant laxatives (e.g., castor oil) and saline laxatives (e.g., magnesium citrate). |
| What is the importance of patient preparation for a barium enema? | The large bowel must be thoroughly cleansed for a satisfactory contrast media study. |
| What is the appearance of diverticula during a barium enema? | Small, barium-filled circular defects projecting outward from the colon wall. |
| What is the risk associated with untreated intussusception? | It can lead to bowel obstruction and necrosis. |
| What is the typical age group affected by volvulus? | Adults aged 20 to 50 years, more common in men. |
| What does the term 'stovepipe colon' refer to? | A condition in long-term ulcerative colitis where haustral markings and flexures are absent. |
| What is the role of a double-contrast barium enema? | To detect small polyps and provide detailed imaging of the intestinal mucosa. |
| What can happen if a diverticulum perforates? | It may lead to peritonitis due to fecal matter escaping into the abdominal cavity. |
| What is the significance of the 'apple-core' lesion? | It indicates annular carcinoma, a common form of colon cancer. |
| What is the typical appearance of polyps during imaging? | Barium-filled saclike projections projecting inward into the lumen of the bowel. |
| What is the main goal of bowel-cleansing procedures? | To ensure the alimentary canal is empty for accurate imaging. |
| Why is it important to have a clean large intestine for a barium enema? | A clean large intestine is crucial to avoid obscuring normal anatomy and to prevent false diagnostic information. |
| What should be prepared in the radiographic room before a patient's arrival? | The room should be clean, the fluoroscopy table should be set up, and all necessary equipment and supplies should be ready. |
| What is the maximum time for the fluoroscopy timer typically set to? | The fluoroscopy timer is usually set to a maximum of 5 minutes. |
| What protective equipment should be available for personnel during a barium enema? | Protective lead aprons and lead gloves should be available. |
| What is the purpose of waterproof protection on the fluoroscopic table? | Waterproof protection is essential to manage premature evacuation of the contrast material. |
| What are the five important safety concerns during barium enema procedures? | 1. Review patient's chart for clinical history. 2. Never force enema tip into rectum. 3. Ensure height of enema bag does not exceed 24 inches. 4. Verify water temperature of contrast medium. 5. Escort patient to restroom after the study. |
| What type of enema container is used for barium enemas? | A closed-system enema container is used to administer barium sulfate. |
| What is the benefit of using a closed-system enema bag? | It reduces the risk of cross-infection and is more convenient than older open-type systems. |
| What types of enema tips are commonly used? | The three common types are plastic disposable, rectal retention, and air-contrast retention enema tips. |
| Why is it important to identify latex allergies in patients? | Patients with latex sensitivity can experience severe allergic reactions, and precautions must be taken to avoid latex exposure. |
| What is the most common positive-contrast medium used for barium enemas? | Barium sulfate is the most common positive-contrast medium. |
| What is the typical concentration of barium sulfate for single-contrast barium enemas? | The concentration typically ranges between 15% and 25% weight to volume (w/v). |
| What concentration of barium sulfate is used for double-contrast barium enemas? | The concentration is usually between 75% and 95% or greater. |
| What are common negative-contrast agents used in double-contrast studies? | Common negative-contrast agents include room air, nitrogen, and carbon dioxide. |
| What is the purpose of using carbon dioxide as a negative-contrast agent? | Carbon dioxide is well tolerated by the large intestine and is absorbed rapidly after the procedure. |
| What should be done if a patient has a history of latex sensitivity? | Ensure that all equipment, such as enema tips and gloves, are latex-free. |
| What is the recommended kVp range for barium enema procedures? | The recommended kVp range is 85 to 95. |
| What is the role of the fluoroscopist during the insertion of the enema tip? | The fluoroscopist may insert the enema tip under fluoroscopic guidance to prevent injury. |
| What should be done after the completion of a barium enema study? | Much of the barium can be drained back into the bag by lowering the system below tabletop level. |
| What is a potential risk of fully inflating a rectal retention balloon? | Fully inflating the balloon can lead to intestinal rupture. |
| What is the purpose of using a lubricant with the enema tip? | A lubricant helps ease the insertion of the enema tip and enhances patient comfort. |
| What precautions should be taken regarding the water temperature of the contrast medium? | Water that is too hot or too cold may injure the patient or compromise the procedure. |
| What is the importance of escorting the patient to the restroom after a barium enema? | Patients may feel faint after evacuation, so escorting them ensures their safety. |
| What is the purpose of the bucky tray in the fluoroscopy setup? | The bucky tray reduces gonadal dose to the fluoroscopist when positioned correctly. |
| What should be done if a rash develops while wearing latex gloves? | Consult a physician to explore the possibility of latex sensitivity. |
| What is the recommended temperature of water for preparing barium sulfate suspension? | Tepid water (85° to 90°F) is recommended for maximal patient comfort. |
| What effect does cold water have on the colon during contrast media preparation? | Cold water may have an anesthetic effect and increase retention of contrast media. |
| What is a common side effect during a barium enema? | Colonic spasm. |
| What can be added to the contrast medium to minimize colonic spasm? | A topical anesthetic such as lidocaine. |
| What should be done if spasm occurs during the barium enema? | Glucagon can be given intravenously. |
| What position should the patient be in for enema tip insertion? | Left lateral recumbent position. |
| What should be done with the barium sulfate solution before insertion? | It should be well mixed, and a little should be run into a waste receptacle to ensure no air remains. |
| What type of gown is preferred for a patient undergoing a barium enema? | A cotton gown with the opening and ties in the back. |
| What should the technologist wear during the barium enema procedure? | Protective gloves. |
| How should the enema tip be lubricated? | With a water-soluble lubricant. |
| What should the patient be instructed to do during enema tip insertion? | Not to push the tip out, relax abdominal muscles, and breathe through the mouth. |
| What is the maximum insertion depth for the enema tip? | 3 to 4 inches (7.5 to 10 cm). |
| What is the purpose of raising the right buttock during enema tip insertion? | To open the gluteal fold and expose the anus. |
| What should be done if resistance is felt during tip insertion? | The procedure should be performed under physician supervision. |
| What is the maximum height for the intravenous pole supporting the enema bag? | No higher than 24 inches (60 cm) above the radiographic table. |
| What are the three types of lower GI examinations mentioned? | 1. Single-contrast barium enema, 2. Double-contrast barium enema, 3. Evacuative proctography (defecogram). |
| What is the main contrast material used in a single-contrast barium enema? | Barium sulfate in a thin mixture. |
| What should be done to ensure proper mixing of barium sulfate suspension? | Shake the enema bag before use. |
| What should the technologist do if the enema tip will not enter with gentle pressure? | Ask the patient to relax and assist if possible. |
| What should be done to protect the patient's modesty during the procedure? | Adjust the gown to expose only the anal region. |
| What is the initial direction for inserting the enema tip? | Toward the umbilicus. |
| What should be done with the tubing stopcock before the procedure begins? | Ensure it is in the closed position to prevent barium flow. |
| What should be communicated to the patient before the procedure? | Explain each phase of the rectal tube insertion and answer any questions. |
| What is the purpose of asking the patient to take deep breaths before enema tip insertion? | To help relax the abdominal muscles and reduce spasms. |
| What should be done if the patient experiences cramping during the procedure? | Assure the patient that the barium flow will be stopped. |
| What is the role of the fluoroscopist during the barium enema procedure? | To discuss the patient's history and reason for the examination after preparations are complete. |
| What should be done if the gown becomes soiled during the examination? | It should be changed. |
| What is the purpose of using a retention-type tip? | To help hold the enema tip in place during the procedure. |
| What type of contrast medium is required if a patient is scheduled for surgery after a single-contrast enema? | A water-soluble contrast medium |
| What is the primary advantage of a double-contrast barium enema over a single-contrast study? | It is more effective in demonstrating polyps and diverticula. |
| What two substances are introduced into the large bowel during a double-contrast barium enema? | Air and barium |
| What is essential for a double-contrast study to be effective? | An absolutely clean large bowel |
| What is the typical mixture ratio for the barium in a double-contrast procedure? | Approaches a 1:1 mix, resembling heavy cream. |
| What is the purpose of the thick barium mixture in a two-stage double-contrast procedure? | To facilitate adherence to the mucosal lining. |
| What happens during the second stage of a two-stage double-contrast procedure? | Air/gas is inflated into the bowel to move the barium forward. |
| What does a single-stage double-contrast procedure involve? | Instilling barium and air in a single procedure to reduce time and radiation exposure. |
| What is digital fluoroscopy? | A method where images are obtained digitally and stored in a computer memory. |
| What is the role of the technologist during a barium enema procedure? | To follow the radiologist's instructions, assist the patient, and control the flow of barium or air. |
| What should the technologist say when the flow of barium is started? | 'Barium on' |
| What should the technologist say when the flow of barium is stopped? | 'Barium off' |
| What is the purpose of changing patient positions during fluoroscopy? | To visualize superimposed sections of the bowel better. |
| What is the preferred position for a routine barium enema radiograph? | The PA projection with the patient in a prone position. |
| Why is the prone position preferred over the supine position for barium enema radiographs? | It results in more uniform radiographic density of the entire abdomen. |
| What is the purpose of a compensating filter during air-contrast studies? | To prevent overexposure of the air-filled region of the large intestine. |
| What should be done after the fluoroscopy procedure before the patient is allowed to empty the large bowel? | Obtain additional radiographs of the filled intestine. |
| What is the common practice regarding the enema tip during postfluoroscopy imaging? | It may be removed to promote retention of the contrast material. |
| What should be provided for a patient who cannot make a trip to the restroom after the enema tip is removed? | A bedpan |
| What is the typical experience for patients when the large bowel is filled during the examination? | Moderate discomfort |
| What is the purpose of spot radiographs during the barium enema procedure? | To obtain images of selected portions of the large intestine. |
| What is refluxed through the ileocecal valve at the end of the fluoroscopic procedure? | A little barium |
| What is the significance of the left colic flexure in barium enema imaging? | It may be clipped off the radiographs if well demonstrated on a previously obtained spot image. |
| What is the goal of the barium enema procedure? | To visualize the inner surface of the bowel and detect neoplasms or polyps. |
| What should be provided for a patient who cannot make a trip for a procedure? | A bedpan should be provided. |
| What is the purpose of lowering the plastic bag in a closed system during a procedure? | To allow most of the barium to drain back into the bag. |
| What is the first step in removing a retention tip according to department protocol? | Clamp off the retention tip. |
| What position is usually used for a postevacuation radiograph? | Prone position, but may be taken supine if needed. |
| What should be done if too much barium is retained after evacuation? | The patient is given more time for evacuation, and a second postevacuation image is obtained. |
| What postprocedure instructions should be given to patients regarding diet? | Increased fluid intake and a high-fiber diet to prevent constipation. |
| What is evacuative proctography also known as? | Defecography. |
| What is the clinical indication for performing evacuative proctography? | Conditions like rectoceles, rectal intussusception, and prolapse of the rectum. |
| What is a rectocele? | A blind pouch of the rectum caused by weakening of the anterior or posterior wall. |
| What special equipment is required for evacuative proctography? | A special commode with a waste receptacle or disposable plastic bag. |
| What is the purpose of using a very-high-density barium sulfate mixture in evacuative proctography? | To study the process of evacuation. |
| What does the mechanical applicator resemble? | A caulking gun used in the building industry. |
| What is the purpose of the nipple marker during the evacuative proctogram procedure? | To mark the anal orifice. |
| What is the preferred position for imaging during defecation? | Lateral recumbent position. |
| What must be demonstrated during the evacuative proctogram procedure? | The anorectal angle or junction. |
| What is a colostomy? | The surgical formation of an artificial connection between two portions of the large intestine. |
| What is a stoma? | An artificial opening created on the anterior surface of the abdomen for fecal discharge. |
| What is the purpose of a temporary colostomy? | To allow healing of the involved section of the large intestine. |
| What happens after healing is complete in a colostomy procedure? | An anastomosis (reconnection) of the two sections of the large intestine is performed. |
| What should be included in the procedure summary for evacuative proctogram? | Steps such as preparing the contrast medium, positioning the patient, and taking radiographs. |
| What is the purpose of a colostomy barium enema? | To assess for proper healing, obstruction, or leakage, or to perform a presurgical evaluation. |
| What is the first step in the evacuative proctogram procedure? | Place the radiographic table vertical and attach the commode with clamps. |
| What is the function of the filters found beneath the seat of the commode? | To compensate for tissue differences and help maintain acceptable levels of density and contrast. |
| What is the significance of the anorectal angle during the evacuative proctogram? | It represents the alignment between the anus and the rectum during straining and evacuating phases. |
| What is the role of the contrast medium Anatrast? | It is a premixed and packaged barium sulfate used for imaging during evacuative proctography. |
| What is the purpose of taking a scout image before the evacuative proctogram? | To include the region of the anorectal angle. |
| What should be done after instilling the contrast medium in the evacuative proctogram? | Position the patient on the commode and take radiographs during the strain and evacuation phases. |
| What is the typical outcome for patients with rectoceles after evacuation? | They may retain fecal material even after evacuation. |
| What is the purpose of using clamps during the evacuative proctogram procedure? | To secure the commode to the footboard platform for stability. |
| What additional procedure may be performed alongside a colostomy barium enema? | Another enema may be given rectally at the same time. |
| What does a colostomy barium enema evaluate? | The terminal large intestine before it is reconnected surgically. |
| What supplies are included in a colostomy barium enema kit? | Stoma tips, tubing, a premeasured barium enema bag, adhesive disks, lubricant, and gauze. |
| Why is a tapered irrigation tip used in a colostomy barium enema? | Because the stoma has no sphincter to retain the barium. |
| What must be done to the stoma before the colostomy barium enema procedure? | The patient is asked to irrigate the ostomy. |
| What is the contrast medium of choice for a colostomy barium enema? | Barium sulfate. |
| What is a key consideration when performing a colostomy barium enema? | The anatomy may be altered due to bowel resection. |
| What is the recommended procedure for pediatric patients during a barium enema? | Use a 10-French flexible silicone catheter for infants and a flexible enema tip for older children. |
| What special considerations should be taken for geriatric patients during a barium enema? | Extra care and patience are needed, and modesty should be maintained. |
| What is recommended for geriatric patients after a barium enema to prevent impaction? | Increased intake of liquids and a high-fiber diet. |
| What imaging technique is used to evaluate the lower gastrointestinal tract? | Computed Tomography (CT). |
| What is CT colonography also known as? | Virtual colonoscopy. |
| What is the purpose of CT enteroclysis? | To detect obstructions, adhesions, or narrowing of the intestinal lumen. |
| What is a common diagnostic use of CT in the abdomen? | Diagnosing acute appendicitis. |
| What should be done to ensure no fecal debris obscures anatomy during a CT scan? | The patient should be prepared to ensure the large intestine is clear. |
| What is the importance of accurate centering during a barium enema procedure? | To ensure that the imaging system reproduces the anatomy correctly. |
| What type of contrast media may be used if indicated during a barium enema? | Iodinated, water-soluble contrast media. |
| What is the role of the technologist during the fluoroscopic phase of a barium enema? | To assist and observe the anatomy for proper imaging. |
| What should be done if a patient is unable to use the restroom after a barium enema? | Have a clean appliance bag available for the post-evacuation phase. |
| What is the significance of the left colic flexure in bariatric patients? | It is frequently more superior than in sthenic patients. |
| What should be mixed according to department specifications before a barium enema? | The contrast medium. |
| What is a preliminary step before starting a colostomy barium enema? | Taking a preliminary scout image using a conventional x-ray tube. |
| What is a common concern for geriatric patients during lower GI procedures? | Stress and fear of falling off the table. |
| What should be done with the enema bag after imaging is completed? | Lower the enema bag to allow the contrast medium to flow back into it. |
| What is the purpose of using digital fluoroscopy in barium enema procedures? | To potentially eliminate the need for post-fluoroscopy projections. |
| What is a key factor in ensuring quality images during a barium enema? | Correct collimation field size. |
| What should be reviewed after each image is produced in digital imaging? | The exposure index to ensure correct exposure factors. |
| What is a common technique for imaging bariatric patients during a barium enema? | Taking multiple images to cover all of the large intestine. |
| What is the importance of using a flexible enema tip for older children? | To minimize injury to the rectum during insertion. |
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