Mrt 263

  1. Digestive system procedures
    Esophagus
    Barium Swallow
  2. Digestive system procedures
    Stomach and Duodenum
    S & D, UGI, Barium Meal
  3. Digestive system procedures
    Small Intestine
    Follow Through Enteroclysis
  4. Digestive system procedures
    Large Intestine
    Barium Enema
  5. Digestive system procedures
    Salivary Glands
    Sialogram
  6. Alimentary canal begins at
    oral cavity, continues as the pharynx, esophagus, stomach, small intestine, large intestine and terminates as the anus
  7. Barium Swallow
    Esophagus
    Procedure
    using contrast to visualize and evaluate the esophagus
  8. Barium Swallow
    Esophagus
    To investigate
    lesions, esophageal varicies, foreign bodies, obstructions, strictures, size, shape, position, function
  9. Barium Swallow
    Esophagus
    Contrast
    barium sulfate or Gastrografin (Do not use Gastrografin if suspected perforation in esophagus)
  10. Barium Swallow
    Esophagus
    Anterioposterior/Posteroanterior Projection
    Patient Postion
    Patient erect or recumbent
  11. Barium Swallow
    Esophagus
    Central Ray
    CR: T5/T6 midsagittal plane
  12. Barium Swallow
    Esophagus
    Lateral View
    Patient Postion
    Patient erect or recumbent
  13. Barium Swallow
    Esophagus
    Lateral View
    Structures
    Structures seen are the lower neck to esophagastric junction
  14. Barium Swallow
    Esophagus
    Lateral View
    Central Ray
    CR: ┴ to T5/T6
  15. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Procedure
    using contrast to visualize and evaluate the stomach and duodenum
  16. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    To investigate
    reflux, peptic ulcers, hiatus hernia, neoplasms, pyloric stenosis
  17. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Patient prep
    NPO from midnight – decrease gastric juices that may dilute barium
  18. When would you book a diabetic patient for a UGI,Barium Meal,S&D?
    Book patients with diabetes ASAP in am
  19. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Contrast: Single
    used only for small children or very ill patients
  20. UGI, Barium Meal,
    S & DStomach+ Duodenum
    Contrast: Double
    barium sulfate and gas pills (allows mucosal lining to be better visualized)
  21. What makes for a good exam when doing a UGI,Barium Meal,S&D Stomach
    Patient communication and instruction from technologist is essential for a successful examination
  22. UGI, Barium Meal,S & D
    Stomach+ Duodenum
    Posteroanterior Projection
    Greatest movement of stomach
    is in asthenic patient (upright to prone)
  23. UGI, Barium Meal,
    S & DStomach+ Duodenum
    Posteroanterior Projection
    Demonstrate
    To demonstrate hiatal hernia perform in Trendelenburg position
  24. Salivary Glands
    Sialography
    Location of the Gland
    Parotid Gland
    inferior and anterior to EAM
  25. Salivary Glands
    Sialography
    Location of the Glands
    Submandibular Gland
    medial to the rami of the mandible
  26. Salivary Glands
    Sialography
    Location of the Gland
    Sublingual Gland
    underneath the tongue
  27. Salivary Glands
    Sialography
    Procedure
    using contrast to visualize the salivary glands and ducts
  28. Salivary Glands
    Sialography
    Contrast
    water soluble iodinated contrast – injected into the gland using a cannula
  29. Salivary Glands
    Sialography
    Demonstrates
    lesions, tumors, fistulae, diverticulae, strictures, and calculi
  30. Salivary Glands
    Sialography
    Preliminary images
    • 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
  31. LargeIntestine
    Barium Enema
  32. LargeIntestine
    Barium Enema
    Post Evacuation
    AP / PA performed after patient empties their bowels
  33. LargeIntestine
    Barium Enema
    Left Lateral Decubitus
    – AP / PA Projection
    • Double contrast
    • Raise patient onto sponge if necessary
    • Horizontal beam
  34. LargeIntestine
    Barium Enema
    Left lateral Decubitus
    -AP/PA Projection
    Central Ray
    CR: ┴ to iliac crest at the midline
  35. LargeIntestine
    Barium Enema
    Left Lateral Decubitus
    – AP / PA Projection
    Demonstrates Right side
    Demonstrates the lateral side of the ascending colon (right side)
  36. LargeIntestine
    Barium Enema
    Left Lateral Decubitus
    – AP / PA Projection
    Demonstrates Left side
    Demonstrates the medial side of the descending colon (left side)
  37. LargeIntestine
    Barium Enema
    Rectum ▼
    Lateral View
    Central Ray
    CR: ┴ at level of ASIS on midcoronal plane
  38. LargeIntestine
    Barium Enema
  39. LargeIntestine
    Barium Enema
    Rectum
    Lateral View
    Demonstrates
    Demonstrates rectum and distal sigmoid portion of colon
  40. LargeIntestine
    Barium Enema
    Sigmoid ▼
    Anteroposterior Projection /
    Posteroanterior Projection
    Central Ray
    • CR ▼
    • •AP 30-40° cephalad enter 2” below ASIS
    • •PA 30-40° caudad exit at ASIS
  41. LargeIntestine
    Barium Enema
    Sigmoid ▼
    Anteroposterior Projection /
    Posteroanterior Projection
    Demonstrates
    Demonstrates the rectosigmoid area
  42. Large Intestine
    Barium Enema
    Right Posterior Oblique View /Left Anterior Oblique View
    Patient Position
    Rotate patient 35-45°
  43. Large Intestine
    Barium Enema
    Right Posterior Oblique View
    /Left Anterior Oblique View
    Central Ray
    •CR: ┴ level of the iliac crest, 1-2” lateral from midline on the elevated side
  44. Large Intestine
    Barium Enema
    Right Posterior Oblique View/
    Left Anterior Oblique View
    Demonstrates
    Demonstrates left colic flexure, desending colon
  45. Large Intestine
    Barium Enema
    Left Posterior Oblique View
    /Right Anterior Oblique View
    Patient Position
    Rotate patient 35-45°
  46. Large Intestine
    Barium Enema
    Left Posterior Oblique View
    /Right Anterior Oblique View
    Central Ray
    •CR: ┴ level of the iliac crest, 1-2” lateral from midline on the elevated side
  47. Large Intestine
    Barium Enema
    Left Posterior Oblique View
    /Right Anterior Oblique View
    Demonstrates
    •Demonstrates right colic flexure, asending colon, cecum, sigmoid
  48. Large Intestine
    Barium Enema
    Left Posterior Oblique View/
    Right Anterior Oblique View
    •Valsalva
    • whether at the nose and mouth or at the glottis Increases both intrathoracic and intraabdominal pressure
    • Dysphagia Aspiration
  49. Large Intestine
    Barium Enema
    Tip Insertion:
    • 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)
  50. Large Intestine
    Barium Enema
    Procedure
    using contrast to visualize and evaluate the large bowel
  51. Large Intestine
    Barium Enema
    To investigate
    neoplasms, ulcerative colitis, diverticulosis, crohn’s, polyps, volvulus, intusseption
  52. Large Intestine
    Barium Enema
    Patient Prep
    NPO 8-9hrs, low residue diet, laxatives, cleansing enema (when necessary)
  53. Large Intestine
    Barium Enema
    Contrast
    single, barium (thinner mix) double, air and barium (thicker mix)
  54. Large Intestine
    Barium Enema
    Preliminary image
    to clean bowel, contraindications
  55. Large Intestine
    Barium Enema
    Contraindications
    gross bleeding, perforated bowel, obstruction/stricture or severe diarrhea
  56. SmallIntestine
    Enteroclysis,Small Bowel Enema
    • 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
  57. SmallIntestineEnteroclysis,
    Small Bowel Enema
    3 phases of swallowing
    Oral phase
    moving the food/liquid to the back of the mouth
  58. SmallIntestineEnteroclysis
    Small Bowel Enema
    3 Phase of swallowing
    Pharyngeal phase
    moving the food/liquid over the back of the tongue and down to the pharynx or throat
  59. SmallIntestineEnteroclysis
    Small Bowel Enema
    3 Phases of swallowing
    Esophageal phase
    the food/liquid enters the esophagus
  60. SmallIntestine
    Enteroclysis
    Small Bowel Enema
    Exam is suited for patients with
    complains of swallowing, choking or regurgitating, or for patients who have had past episodes of pneumonia which have yet to be diagnosed
  61. SmallIntestine
    EnteroclysisSmall
    Bowel Enema
    Identifies problems
    • 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
  62. SmallIntestine
    Follow Through,Small Bowel Series
    Anteroposterior Projection /
    Posteroanterior Projection
    Patient Position
    Patient supine or prone
  63. SmallIntestineFollow Through,Small Bowel Series Anteroposterior Projection / Posteroanterior Projection
    Images taken after
    15 to 30 minute intervals, use time markers
  64. SmallIntestineFollow Through,Small Bowel Series Anteroposterior Projection / Posteroanterior Projection
    Demonstrates
    •Demonstrates small intestine progressively filling with barium until it reaches the ileocecal valve
  65. SmallIntestineFollow Through,Small Bowel Series Anteroposterior Projection / Posteroanterior Projection
    Trendelenburg positoin
    •Trendelenburg position used to unfold loops of iliem in the asthenic patient
  66. SmallIntestineFollow Through,Small Bowel Series Anteroposterior Projection / Posteroanterior Projection
    Central Ray
    •CR: ┴ to iliac crest (centering will change as barium moves down)
  67. SmallIntestine
    Follow Through,
    Small Bowel series
    Procedure
    using contrast to visualize and evaluate the function of the small bowel
  68. SmallIntestine
    Follow Through,
    Small Bowel series
    To investigate
    Crohn’s, tumors, malabsorption disorder, ulcers, obstructions, FB, strictures
  69. SmallIntestine
    Follow Through,
    Small Bowel series
    Patient Prep
    NPO midnight onward – same as S&D
  70. SmallIntestine
    Follow Through
    ,Small Bowel series
    Contrast
    Barium sulfate (or gastrografin if questioning perforations)
  71. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Right Anterior Oblique View
    Patient Position
    Patient prone and rotated 40-70°
  72. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Right Anterior Oblique View
    Central Ray
    • 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
  73. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Posteroanterior Projection
    Greatest movement of stomach in
    • asthenic patient (upright to prone)
    • To demonstrate hiatal hernia perform in Trendelenburg position
  74. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Contrast▼
    •Single
    used only for small children or very ill patients
  75. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Contrast▼
    Double
    barium sulfate and gas pills (allows mucosal lining to be better visualized)
  76. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Contrast▼
    Patient communication and instruction from technologist is essential
    for a successful examination
  77. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Procedure
    using contrast to visualize and evaluate the stomach and duodenum
  78. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    To investigate
    reflux, peptic ulcers, hiatus hernia, neoplasms, pyloric stenosis
  79. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    Patient prep
    • NPO from midnight – decrease gastric juices that may dilute barium
    • * Book patients with diabetes ASAP in am
  80. UGI, Barium Meal, S & D
    Stomach+ Duodenum
    When should you book patient who have diabetes
    first thing in the am
  81. Image Upload 2
    What is the protection/ view
    Anteriorposterior projection
  82. Image Upload 4
    What projection or view
    Right Anterior Oblique View
  83. Image Upload 6
    What projection or view
    Left Posterior Oblique View
Author
marlasherman
ID
137018
Card Set
Mrt 263
Description
digestive
Updated