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Upper GI (RAD 135)

Part 3

QuestionAnswer
Ionic Contrast Media Characteristics- Higher osmolality than non-ionic Higher tendency for adverse reactions Older, less expensive
Non-Ionic Contrast Media Characteristics- Lower osmolality than non-ionic Lower tendency for adverse reactions Newer, more expensive
_______ Contrast Media Separates into charged particles (ions) in a solution Ionic
________ Contrast Media Does Not separate into charged particles (ions) in a solution Non-Ionic
Gastroview and Gastrograffin are examples of Ionic Contrast Media
Omnipaque, Isovue, and Visipaque are examples of Non-Ionic Contrast Media
Why order a Modified Barium Swallow? Trouble initiating swallow or choking
Why order a Barium Swallow? Food getting stuck later
Why order a Upper GI Series (UGI)? Suspected ulcer or mass
What is being evaluated in a Swallowing Dysfunction Study (Modified Barium Swallow)? Mouth and pharynx for functional swallowing issues
What is being evaluated in a Esophagram (Barium Swallow)? Esophagus (and entrance into stomach) for motility, strictures, reflux (GERD), hiatal hernia
What is being evaluated in a Upper GI Series (UGI)? Esophagus, stomach and duodenum for motility, strictures, reflux (GERD), hiatal hernia, ulcers, masses
Both Esophagram (Barium Swallow) and Upper GI Series (UGI) procedures are run by a? Radiologist
A Swallowing Dysfunction Study (Modified Barium Swallow) procedure is run by a? Speech Pathologist + Radiologist
Esophagus X-Ray Patient Prep- NPO (nothing by mouth) for about 6–8 hours Ensures the esophagus is empty and Reduces patients risk of aspiration
AP/PA Esophagus CR Placement- Perpendicular through MSP Enters at level of T5-T6 (sternal angle)
You would see the Esophagus mostly superimposing the T-Spine (may be slightly left of midline) in a AP/PA Esophagus X-Ray
AP/PA Oblique Esophagus Patient Positioning- Can ONLY use RAO or LPO positions!! 35 – 40°oblique body position
AP/PA Oblique Esophagus CR Placement- Perpendicular, Enters 2 inches lateral to MSP at level of T5/T6 (Sternal angle)
You would see the Esophagus located between the heart and the spine As well as the Esophagus and stomach free of superimposition of T-Spine in a? AP/PA Oblique Esophagus X-Ray
Lateral Esophagus Patient Positioning- Right or left lateral position, move the patients arms out of the way
Lateral Esophagus CR Placement- Perpendicular, Enters MCP at the level of T5-T6
Patient Prep for UGI- NPO (nothing by mouth) for about 9 hours No smoking No chewing gum Stomach must be empty
AP/PA Stomach and Duodenum CR Placement- Perpendicular through MSP, Midway between the xiphoid process and the inferior costal margin At the level of L1-2 1-2 inches above the lower rib margin
You will see __________ in a AP/PA Stomach and Duodenum X-Ray Fundus almost touching spine Pylorus crossing the spine Pedicles at lateral edges of spine Centered spinous processes
Position the patient ________ for an RAO PA Oblique Stomach & Duodenum Projection 40-70°
Position the patient ________ for an LPO AP Oblique Stomach & Duodenum Projection 30-60°
You will see _______ in a PA/AP Oblique Stomach & Duodenum X-Ray? Space between fundus and spine Duodenum does not completely cross the spine
You will see _______ in a Lateral Stomach & Duodenum X-Ray? Pylorus/Duodenum does not cross the spine Esophagus (if seen) not over spine
You will see _______ in a Right Positioned Lateral Stomach & Duodenum X-Ray? Right retrogastric space Duodenal loop Duodenojejunal junction
Advantages of Iodinated Contrast Media Water-soluble, Easily absorbed and excreted by the kidneys Safe for bowel perforation Moves through the GI tract quicker than barium 
Advantages of Barium Contrast Media Adheres better to mucosal lining for best visualization, especially for double contrast studies
Barium Contrast Media administration method- Enteral only (mouth or rectum)
Iodinated Contrast Media administration method- Enteral or parenteral (Can be via IV)
What position used for the demonstration of a hiatal hernia? Trendelenburg
______ Contrast Moves slower, can cause constipation Barium
________ Contrast Moves faster, can sometimes relieve constipation Iodinated
What position is preferred? RAO
A Modified Barium Swallow is always a __________ projection Lateral
Created by: user-2016295
 

 



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