Mrt 263

Barium Swallow

S & D, UGI, Barium Meal

Follow Through Enteroclysis

Barium Enema

Sialogram

oral cavity, continues as the pharynx, esophagus, stomach, small intestine, large intestine and terminates as the anus

using contrast to visualize and evaluate the esophagus

lesions, esophageal varicies, foreign bodies, obstructions, strictures, size, shape, position, function

barium sulfate or Gastrografin (Do not use Gastrografin if suspected perforation in esophagus)

Patient erect or recumbent

CR: T5/T6 midsagittal plane

Patient erect or recumbent

Structures seen are the lower neck to esophagastric junction

CR: ┴ to T5/T6

using contrast to visualize and evaluate the stomach and duodenum

reflux, peptic ulcers, hiatus hernia, neoplasms, pyloric stenosis

NPO from midnight – decrease gastric juices that may dilute barium

Book patients with diabetes ASAP in am

used only for small children or very ill patients

barium sulfate and gas pills (allows mucosal lining to be better visualized)

Patient communication and instruction from technologist is essential for a successful examination

is in asthenic patient (upright to prone)

To demonstrate hiatal hernia perform in Trendelenburg position

inferior and anterior to EAM

medial to the rami of the mandible

underneath the tongue

using contrast to visualize the salivary glands and ducts

water soluble iodinated contrast – injected into the gland using a cannula

lesions, tumors, fistulae, diverticulae, strictures, and calculi

• taken to detect pathologies visible without contrast and establish optimum exposure technique
• * Lemon used as a secretory stimulant – given to patient prior to exam to open ducts and post exam to clear the duct of contrast media

AP / PA performed after patient empties their bowels

• Double contrast
• Raise patient onto sponge if necessary
• Horizontal beam

CR: ┴ to iliac crest at the midline

Demonstrates the lateral side of the ascending colon (right side)

Demonstrates the medial side of the descending colon (left side)

CR: ┴ at level of ASIS on midcoronal plane

Demonstrates rectum and distal sigmoid portion of colon

• CR ▼
• •AP 30-40° cephalad enter 2” below ASIS
• •PA 30-40° caudad exit at ASIS

Demonstrates the rectosigmoid area

Rotate patient 35-45°

•CR: ┴ level of the iliac crest, 1-2” lateral from midline on the elevated side

Demonstrates left colic flexure, desending colon

Rotate patient 35-45°

•CR: ┴ level of the iliac crest, 1-2” lateral from midline on the elevated side

•Demonstrates right colic flexure, asending colon, cecum, sigmoid

• whether at the nose and mouth or at the glottis Increases both intrathoracic and intraabdominal pressure
• Dysphagia Aspiration

• Place the patient in Sim’s position
• Communication with patient is essential
• Lubricate the tip heavily
• Instruct patient to exhale slowly
• Insert tip 3-4” past anal sphincter in an anterior then superior direction.
• Do not ever FORCIBLY PUSH the tip in against resistance.
• •Inflate balloon now if required (to hold tip in rectum)

using contrast to visualize and evaluate the large bowel

neoplasms, ulcerative colitis, diverticulosis, crohn’s, polyps, volvulus, intusseption

NPO 8-9hrs, low residue diet, laxatives, cleansing enema (when necessary)

single, barium (thinner mix) double, air and barium (thicker mix)

to clean bowel, contraindications

gross bleeding, perforated bowel, obstruction/stricture or severe diarrhea

• This radiographic procedure involves contrast media being injected directly into the duodenum under fluoroscopic control to exam the small intestine
• A Nasoenteric tube is used for this type of exam, inserted via nose or mouth

moving the food/liquid to the back of the mouth

moving the food/liquid over the back of the tongue and down to the pharynx or throat

the food/liquid enters the esophagus

complains of swallowing, choking or regurgitating, or for patients who have had past episodes of pneumonia which have yet to be diagnosed

• that occur in the mouth, at the base of the tongue, in the pharynx, or in the esophagus
• •Also provides information about tongue motion and coordination and timing of the swallow
• •Provides info on how material is managed orally just prior to the swallow and evaluates the mechanical aspects of the swallowing mechanism including airway protection and how well the material moves through the different phases of swallowing

Patient supine or prone

15 to 30 minute intervals, use time markers

•Demonstrates small intestine progressively filling with barium until it reaches the ileocecal valve

•Trendelenburg position used to unfold loops of iliem in the asthenic patient

•CR: ┴ to iliac crest (centering will change as barium moves down)

using contrast to visualize and evaluate the function of the small bowel

Crohn’s, tumors, malabsorption disorder, ulcers, obstructions, FB, strictures

NPO midnight onward – same as S&D

Barium sulfate (or gastrografin if questioning perforations)

Patient prone and rotated 40-70°

• CR:Sagittal plane – ½ way between spine and left lateral border at L1/L2
• Hypersthenic patients – more rotation
• Gastric peristalsis more active in this position

• asthenic patient (upright to prone)
• To demonstrate hiatal hernia perform in Trendelenburg position

used only for small children or very ill patients

barium sulfate and gas pills (allows mucosal lining to be better visualized)

for a successful examination

using contrast to visualize and evaluate the stomach and duodenum

reflux, peptic ulcers, hiatus hernia, neoplasms, pyloric stenosis

• NPO from midnight – decrease gastric juices that may dilute barium
• * Book patients with diabetes ASAP in am

first thing in the am

Anteriorposterior projection

Right Anterior Oblique View

Left Posterior Oblique View