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GI Procedures
| Question | Answer |
|---|---|
| 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
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