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GI Procedures

How long does it take a normal stomach to empty? 2-3 Hr
How often do peristalsis waves occur in a filled stomach? 3-4 per min
How long does is take barium to reach the IC valve? (orally) 2-3 Hrs
How long does it take barium to reach rectum? 24 Hr
What contrast is used in GI system? Barium sulfate
Why would iodinated media be used? Perforation, surgery
How does iodinated media compare to barium? Iodinate moves quickly, outline esophagus but doesn't adhere to mucosa. Barium outline lining and mucosa well
What exposure time should be used for esophagus? short
What type of contrast is used with esophagus? Single or double con (thick/thin)
What activity is the pt doing during esophagram? deglutation
Describe the action of the muscle during deglutation? adduct vocal folds, depress hyoid and thyroid cart. constrict osesophagus, and dilation of pharynx
What type of exposure time is used? ESO short exposure time, fluoro and spot films
What are the steps observed in an eso? Pt holds barium in lt hand, drinks, holds then swallow
Describe the Gunson method? Shoestring tied above thyroid cart. Pt swallows and it shows movement of larynx
ESO what is the procedure for a single con study? 30-50% wt/vol. Start upright fluoro spot, use horizontal/trend. Cup in lt hand, swallow, watch w/ fluoro
What is the procedure for double con ESO? Dizzies before barium. High density barium. Same as single
What exam would be done when looking for an opaque foreign body ESO? w/o contrast, soft tissue neck
What exam would be done when looking for a non opaque foreign body ESO? cotton-soaked w/ barium and then swallowed
What is the valsava maneuver? forced exhalation, used for esophageal varacies
Where do you center for an AP/PA projection? Evaluation criteria? ESO Cr T5-T6, see esophagus to GE junction
What oblique would you do for a PA oblique projection? ESO RAO
How many degrees do you oblique on an RAO ESO? 35-40
Where do you center on a PA oblique ESO? CR T5-T6 2" toward lat side on elevated side
Evaluation criteria on PA oblique ESO? eso between vert and heart
How would you do a lat eso? Centering? Evaluation? Center MCP, CR T5-T6, ribs superimposed, lower neck to GE junction
What is the recommended pt prep for UGI? Low residue diet 2 days prior, enema, NPO 8-9 hr, no gum, smoking- gastric juices
What is recommended single contrast wt/vol ratio? 30-50%
What are some advantages to using double contrast? What is wt/vol UGI? shows sm lesions and mucosal lining. 250%
What does biphasic mean? combo of double and single con
What is hypotonic duodenography used to detect tumors on head of pancreas
PA projection UGI 3-6" below L1-L2 (upright), 1-2" above L1-L2 (prone). shows pyloric canal and duodenal bulb
Pa oblique projection, RAO UGI 1-2" above L1-L2, 40-70 rotation, see entire stomach, duodenal loop, pyloric canal and d. bulb (best seen)
AP oblique projection, LPO UGI 1/2 between xiphiod and lower ribs. 45 degree, entire stomach to d.bulb
Rt Lat position UGI L1-L2 (recumbent) L3 (upright), retrogastric space, d loop and DJ junction
Lt lat position UGI L1-L2 (recumbent) L3 (upright).ant/post parts of stomach, pyloric canal and D. bulb. Lt retrogastric space
AP projection UGI cr l1-l2, midway between MSP and lat abd.
Name 3 ways to do sm intestine? Mouth, reflux, direct injection (enteroclysis)
what is the recommended prep for Sm intestine? NPO, enema, low residue diet x 2 days
For the oral method, how often are radiographs done? SBFT every 15-30 min
When is oral exam considered finished? SBFT 30-60 min, when it reaches IC valve
How is a complete reflux exam done? SBFT Like BE w/retension tip, needs to reach D bulb
How much contrast is used on complete reflux SBFT? 4500 ML
How is enteroclysis performed? contrast through tube into duodenum, colon prep prior
What rate is barium injected during enteroclysis? 100ml/min
How are radiographs marked on SBFT time markers, KUB
What is gastrointestinal intubation? insert tube through nose to stomach. carried by peristalsis
What are some reasons GI tube is done? therapeutic and diagnostic
What is miller-abbott tube? double channel intest tube w/ inflatable balloon, treat obstruction
Where should GI tube end up? Duodenum
What type of contrast can be used with Lg intest? barium, air,gastro
what are the recommended wt/vol single 12-25%(barium), double (air/barium) 75-95 %
What is recommended pt prep for Lg intest. dietary restrict, lax, and enema
What are the diff between using warm temp vs. cold temp? BE below body temp 85-90, too warm can irritate tissue, harder to hold. Cold is a mild anesthetic effect
Describe the sims position? LAO 35-40, flex rt knee and rest on it. Relax and deep breaths
When is single contrast study is preformed, how is it administered? MD releases contrast, rectal ampulla fills up sigmoid to descending
What radiographs are done for BE Spots?
When is a double contrast study performed, how do the single-stage procedure? View mucosal lining and lesions, barium and air inserted. rotate pt and spots overhead
What is 2 stage procedure? Barium to colic flex, evacuate then fill with air
PA projection BE 2 Ir's crosswise, center MSP, colon to rectum (both flex)
PA Axial BE Cr 30-40 caud at ASIS and MSP
PA Oblique projection, RAO position BE 35-45, cr 1-2" lat on upside at crest. See rt colic flex more "open" ascending, cecum and sigmoid
PA Oblique projec.,LAO position BE 35-45. Cr 1-2 " on lat upside at crest. See Lt colic flex :open: descending colon
Rt Lat position BE Cr at ASIS, hip and pelvis superimposed, retosigmoid
Lt Lat BE Cr at ASIS
AP oblique projection, LPO position BE 35-45. CR 1-2" lat on up side at crest. Rt Flex :open: asced, cecum and sigmoid
Ap oblique projection, RPO position BE 35-45. Cr 1-2" lat on up crest. lt colic and descending
Rt lat decub BE rt side down, cr horiz to msp @crest. see med side of ascend, lat of descend (air filled), flex to rectum
Lt Lat decub BE lt side down, cr horiz to MSP @ crest. See lat ascend.. med descend. flex to rectum
Ventral decub BE prone, cr horizontal to MCP @ crest. See post portion of colon to rectum
Upright BE same as recumbent
What are colostomy studies and how are they done? Artifical opening, study done through stoma. pt irrigated night/morning. not sterile, same as BE. Supine or prone, bring extra bag
Created by: highamc