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Radiolucent Contrast
* Carbon Dioxide & Air
* Little, if any, x-ray absorption
* Produces dark (Black) areas on image
Radiopaque Contrast
* Iodine Based & Barium Sulfate
* Absorbs Radiation
* Produces light (White) areas on image
The broadest categories of contrast media are:
Negative and radiolucent, Soluble and insoluble, Radiolucent and radiopaque, Positive and radiopaque
Radiolucent and radiopaque
(The broadest categories of contrast media are based on interactions with x-rays, which are radiolucent and radiopaque.)
Iodine-based contrast agents produce ____ image effects.
a) positive
b) negative
c) radiolucent
d) negligible
a) positive
Iodine is an element with a higher atomic number than most biologic tissues, so it produces positive (white) areas on a radiographic image.
Which of the following contrast agents are readily absorbed by the body?
(1) Air (2) Barium sulfate (3) Iodine-based
a) 1 and 2 only
b) 1 and 3 only
c) 2 and 3 only
d) 1, 2, and 3
b) 1 and 3 only
Air and iodine-based contrast agents are easily absorbed by the body with little physiologic side effects.
A contrast agent that is classified as radiolucent will produce:
a) Light areas on the radiographic image
b) Severe side effects in the body
c) Low density in the image
d) Dark areas on the radiographic image
d) Dark areas on the radiographic image
Radiolucent agents do not absorb radiation, so they produce dark (high-density) areas on the image.
When mixed with water, barium sulfate produces a(n):
a) Solution
b) Suspension
c) Gel
d) Element
b) Suspension
Barium sulfate particles do not dissolve when mixed with water, but rather they are suspended in the water medium.
A patient is scheduled for an x-ray. The __________________ tests are usually scheduled first.
Lab
A patient has a barium enema and a colonoscopy scheduled on the same day. The last exam should be the _________________ .
Barium Enema
Good ________________ help reduce scheduling errors when a patient requires more than one procedure.
Communication
Scheduling multiple imaging procedures on the same day requires the patient to undergo only one pre-procedure _____________________ and fasting.
Preparation
If an excretory urogram and an upper GI study are to be performed on a patient, the study that uses ____________________ contrast should be scheduled first.
Iodinated
Patients should be scheduled in the following order: emergency patients first, followed by ____________________ and geriatrics.
Pediatrics
Which of the following patients should have priority in the scheduling of imaging procedures? Patients with diabetes, Geriatric patients, Pediatric patients, Emergency patients
Emergency patients
(Emergency patients have priority scheduling.)
An inpatient is scheduled for a CT without contrast, an excretory urogram, and an upper GI. Which of the following is the correct sequence to perform the exams ordered on the same day?
a) Upper GI, excretory urogram, CT
b) CT, excretory urogram, upper GI
c) Excretory urogram, CT, upper GI
d) These procedures cannot be performed on the same day.
b) CT, excretory urogram, upper GI
The CT without contrast should be performed first, followed by the excretory urogram, and finally the upper GI.
When scheduling patients for procedures, which of the following would be the best, considering optimum patient care?
a) Diabetic patients should be scheduled early.
b) Outpatients should be scheduled first.
c) Adult patients should be scheduled before pediatric patients.
d) Pediatric patients should be scheduled before diabetic patients.
a) Diabetic patients should be scheduled early.
Diabetic patients should be scheduled early due to their medications, fasting, and potential complications.
Which of the following is the most common type of contrast medium used for contrast procedures of the urinary procedures?
a) Barium sulfate
b) Water-soluble, iodinated
c) Oily, iodinated
d) Air
b) Water-soluble, iodinated
Water-soluble, iodinated contrast agents are most commonly used for urinary system procedures.
After contrast studies of the urinary system, the patient should be instructed to:
a) Take a mild laxative
b) Remain NPO for 8 to 12 hours
c) Drink plenty of fluids
d) Monitor pulse and temperature
c) Drink plenty of fluids
After urinary procedures, patients are generally instructed to drink plenty of fluids to flush the contrast agent from the system.
Which of the following should be done prior to contrast administration for urinary system procedures?
(1) Obtain a complete patient history.
(2) Obtain informed consent.
(3) Administer extra fluids.
a) 1 and 2 only
b) 1 and 3 only
c) 2 and 3 only
d) 1, 2, and 3
a) 1 and 2 only
Prior to contrast administration for urinary system procedures, a complete patient history and informed consent should be obtained.
The most common contrast agent used in biliary system procedures is:
a) Air
b) Barium sulfate
c) Water-soluble, iodinated
d) Double contrast-air and barium
c) Water-soluble, Iodinated
(Water-soluble, iodinated agents are the most commonly used agent for biliary system procedures.)
The most common contrast used for a GI procedure is __________________.
Barium
On __________________ GI procedures, contrast is usually administered orally.
Upper
On __________________ GI procedures, contrast is administered via a rectal enema.
Lower
If there is a suspected perforation of the GI tract, water-soluble _________________ contrast may be used.
Iodinated
A contrast examination of the small bowel in which administration occurs via a nasogastric tube is termed a(n):
a) UGI
b) Barium enema
c) Enteroclysis
d) ERCP
c) Enteroclysis
An enteroclysis is a contrast procedure of the small bowel in which administration occurs via a nasogastric tube.
The patient preparation for a barium enema usually requires:
a) Increased fluid intake for 2 to 3 days
b) Decreased fluid intake for 2 to 3 days
c) Insertion of a nasogastric tube
d) Bowel cleansing
d) Bowel cleansing
Barium enemas are used to examine the large intestine, so the bowel must be free of fecal material to visualize the structure properly.
The most common contrast agent used for examination of the GI tract is:
a) Air
b) Barium Sulfate
c) Water-soluble, iodinated
d) Nonionic
b) Barium Sulfate
Barium is the most common contrast agent used for examinations of the GI tract.
To aid in elimination of the contrast from the digestive tract, patients are usually instructed to:
a) Use laxatives
b) Increase fluid intake
c) Use cleansing enemas
d) Decrease fluid intake
b) Increase fluid intake
Patients are usually instructed to increase their intake of fluids for a few days to aid in the elimination of the contrast from the digestive tract. Increased fluids will help in the elimination of both iodinated and barium agents. Laxative use is not recommended unless the patient's condition requires it.
When visualization of the mucosal lining of the GI tract is desired, what contrast agents are used?
a) Air and barium
b) Iodinated and barium
c) Nonionic and ionic
d) Air and carbon dioxide
a) Air and barium
Double-contrast studies are used to visualize the mucosal lining of the GI tract. The most common contrast agents used for double-contrast studies are air and barium.
A hysterosalpingogram is usually performed for reasons of:
a) Infertility
b) Infidelity
c) Incontinence
d) Incompetence
a) Infertility
Infertility is one of the primary reasons a hysterosalpingogram might be performed.
Which types of joints may be examined via arthrography?
Fibrous, Cartilaginous, Synovial, Syndemoses
Synovial
(Synovial joints have a joint cavity that will hold the contrast medium, thus enabling visualization of the joint structures.)
Which imaging modalities have reduced the number of radiographic contrast procedures?
(1) Sonography
(2) PET scans
(3) MRI
a) 1 and 2 only
b) 1 and 3 only
c) 2 and 3 only
d) 1, 2, and 3
b) 1 and 3 only
Cross-sectional modalities, such as sonography, MRI, and CT, have decreased the number of radiographic contrast procedures.
Valsalva Maneuver
Forcible exhalation against a closed glottis, resulting in increased intrathoracic pressure
(The patient is asked to take a deep breath and, while holding the breath in, to bear down as though trying to move the bowels.)
A contrast agent that is classified as radiolucent will produce:
Dark (Black) areas on the radiographic image
What is not used as part of the patient preparation before a BE exam?
Corticosteroids
All are used as part of the patient preparation before a UGI exam except:
a) NPO for 8 hours before exam
b) Cleansing enemas
c) No smoking before the exam
d) No gum before the exam
b) Cleansing enemas
All of the following are common post-procedure patient care for a BE except:
a) Evacuate as much barium as possible in the toilet after the enema tip is removed
b) Increase fluid intake
c) A post-evacuation image
d) Cleansing enemas
d) Cleansing enemas
If a perforation of the GI tract is suspected, what type of contrast agent is usually used?
Water-soluble, Iodinated
Iodine-based contrast agents produce ____ image effects.
Positive (White/Light)
Iodine-based contrast agents produce _________ areas on radiographic images.
Brighter (decreased density)
The broadest categories of contrast media are:
- Negative and radiolucent
- Soluble and insoluble
- Radiolucent and radiopaque
- Positive and radiopaque
Radiolucent and Radiopaque
The coordinated, rhythmic, serial contraction of smooth muscle that forces food through the digestive tract defines:
Peristalsis
The most common imaging procedure for examination of the small intestine is:
Small Bowel Series, oral method
To aid in elimination of the contrast from the digestive tract, patients are usually instructed to:
Increase fluid intake
(Patients are usually instructed to increase their intake of fluids for a few days to aid in the elimination of the contrast from the digestive tract. Increased fluids will help in the elimination of both iodinated and barium agents. Laxative use is not recommended unless the patient's condition requires it.)
What is a cathartic?
A drug that stimulates emptying of the bowels
(It is often used as part of the preparation for a BE.)
What is a hiatal hernia?
Protrusion of a portion of the stomach upward through the diaphragm
What is the purpose of administering glucagon for examinations of the GI tract?
To decrease cramping and peristalsis
What risk is associated with an elderly patient who has a history of diverticulitis having a BE exam?
Perforation
When mixed with water, barium sulfate produces a(n):
Suspension
A mixture of barium sulfate and water forms a colloidal suspension, not a solution.
When visualization of the mucosal lining of the GI tract is desired, what contrast agents are used?
Air/gas and Barium Sulfate
High-density barium is used to coat the stomach mucosa. The radiolucent contrast medium is either room air or CO2 gas.
Which are included in the patient care instructions following a UGI exam?
(1) Increase fluid intake
(2) Warning of the danger of constipation after barium ingestion
(3) Increase high-bulk food
1, 2, and 3
Which are usually included in the patient preparation for a lower GI exam?
(1) Cathartics
(2) Cleansing enema
(3) Low-residue diet
1, 2, and 3
Which lower GI tract exam is best for demonstration of the intestinal mucosa?
Double-contrast BE
Which of the following contrast agents are readily absorbed by the body?
(1) Air
(2) Barium sulfate
(3) Iodine-based
1 and 3 only
water-soluble material escapes into the peritoneal cavity, the body can readily absorb it. Barium sulfate is not absorbed.
Which of the following contrast agents produce light (white) areas in the radiographic image?
(1) Carbon dioxide
(2) Barium sulfate
(3) Iodine-based
2 and 3 only
Which of the following is usually part of a patient's preparation for an upper GI exam?
NPO for 8 to 12 hours before the exam
Which of the following should be included during the patient education for contrast procedures of the upper GI tract?
(1) Details of administration route
(2) Thorough patient history
(3) Cleansing enemas
1 and 2 only
Every imaging procedure requires a thorough patient history. For contrast studies, the patient should be informed of the administration route. Cleansing enemas are part of the patient preparation for a barium enema.
Which of the following substances is classified as a radiolucent contrast medium?
Air
Which patient population is provided a lower volume barium administration?
Patients with ostomies
Which patient population might be accommodated by having the BE bag lowered to decrease the flow rate and pressure during contrast administration?
Patients at risk of perforation
Which term denotes an inflammation of the membrane lining the abdominal cavity?
Peritonitis
Which term is defined as the introduction of a solution into the colon via the rectum for cleansing or therapeutic purposes?
Enema
Which upper GI exam best demonstrates the gastric mucosa?
Double-contrast UGI
The longitudinal gastric folds of the stomach are termed:
Rugae
When the stomach is empty, the internal lining is thrown into numerous longitudinal mucosal folds termed rugae
The esophagus terminates at the level of:
T11
In which position is the patient placed for the rectal tip insertion prior to the barium enema procedure?
Sim's
In which body type are the large intestines located higher and more toward the lateral aspects of the body?
Hypersthenic
Closes off the nasopharynx during swallowing?
Soft Palate
Covers laryngeal opening during swallowing?
Epiglottis
level the esophagus pierces the diaphragm
T10
Opening between the esophagus and stomach?
Cardiac Orifice
Wavelike series of involuntary muscular contractions?
Peristalsis
Longitudinal muscular folds?
Rugae
A sphincter?
Pyloric valve
Funnels fluids directly from the body of the stomach to the pylorus?
Gastric Canal
Most common type of positive contrast medium?
Barium Sulfate
Only positive contrast media is used?
Single contrast
More effective in demonstrating polyps and diverticula?
Double contrast
Surgical formation of an artificial opening of the large intestine?
Colostomy
Surgical reconnection of two sections of the large intestine
anastomosis
Iliac Crest spine landmark
L4/L5
(T/F) The esophagus is posterior to the trachea.
True
Which structure is air-filled when the patient is in a prone position during a double-contrast barium enema?
Descending colon
Transverse colon
Sigmoid colon
Right colic flexure
Descending colon
Which portion of the small bowel is characterized by a feathery appearance?
Jejunum
Which one of the following upper GI positions will demonstrate the fundus filled with barium and an air-contrast view of the duodenal bulb?
LPO
PA
AP erect
PA erect
LPO
Which one is not a method used to detect esophageal reflux?
Compression paddle technique
Valsalva maneuver
Mueller maneuver
Sim's position
Sim's position
Which of the principles of radiation protection is most effective in reducing exposure to the technologist?
Distance
Which protective devices will best reduce exposure to the gonadal region of the fluoroscopist?
Bucky slot cover
Which aspect of the stomach is most posterior?
Fundus
What is the recommended height of the enema bag at the start of the barium enema procedure?
24 inches
What contraindication(s) exist in the use of barium sulfate?
Suspected Perforation
Types of digestive movement characteristic of the large intestine include:
1. Peristalsis
2. Haustral
3. Churning
1, 2, and 3
The widest portion of the large intestine is the?
Cecum
The typical recipe for a thin barium mixture is:
One part barium sulfate to one part water
The typical recipe for a thick barium mixture is:
3 parts barium to 1 part water
The three bands of longitudinal muscle that cause pouch-like appearance of the large intestine are termed:
Taenia coli
The shortest segment of the small intestine is the:
Duodenum
The recommended water temperature for a barium sulfate mixture used for most barium enema procedures is:
85 to 90 °F
The purpose of the upper GI procedure is to examine:
1. distal esophagus
2. stomach
3. duodenum
1, 2, and 3
The maneuver whereby the patient takes a deep breath and while holding bears down as if to have a bowel movement is known as?
Valsalva Maneuver
Note 
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