Proced II Chapter 13

The ileocecal valve is located where, in relation the large bowel?

The ileocecal valve is located at the terminal end of the ileum (TI) where it meets the 1stportion of the large bowel, which is the cecum. This is in the RLQ.

What is the routine for a SBS?

There is not a specific routine. However, a prelim/scout is taken, followed by timed abdomenimages until the contrast reaches the ileocecal valve. At this point, fluoroscopy images maybe taken to better visualize the ileocecal valve.

What is known as the shortest, widest, and most fixed portion of the small intestine?

Duodenum

What are the four (4) parts of the duodenum?

Superior portion, descending portion, horizontal portion, and ascending portion

How would/do you know that a SBS exam is complete? What would be your next step?

When the contrast has reached the terminal ileum/ileocecal valve. At this point, you wouldnotify the radiologist and get the patient ready on the fluoro table to take spot images.

List all of the markers that need to be present on a 30-minute SBS exam radiograph:

Left/Right marker, 30-minute marker

The longest portion of the small bowel is termed the:

Ileum

The portion of the small bowel that is considered the shortest, widest, and most fixed portion, is the:

Duodenum

Depending on departmental protocol for a SBS exam the first radiograph is taken either 15 or 30minutes after completion of barium ingestion. Name a positioning difference between the firstradiograph taken and the films taken for the rest of the series and why there is this positioningdifference between the films.

One difference is the CR. The first picture should be centered 2 inches above the crest in orderto see more of the stomach. The rest of the pictures should be centered at the crest. Anotherdifference is PA vs. AP. Some facilities will only complete the first image PA and then the restwill be AP.

List in order the portions of the small intestine from smallest internal diameter to the largest

Ileum, jejunum, duodenum

Digestive movements throughout the length of the small bowel to propel intestinal contentsalong the digestive tract are called what?

Mechanical digestion (peristalsis and rhythmic segmentation)

As a technologist performing a SBS examination, the study is considered to be complete whenthe barium reaches the ___________________. At this time, what type of filming is usuallyperformed to indicate completion of the examination?

Terminal Ileum (TI); Fluoro/spot images with the radiologist

Describe the differences in the procedures between a combination UGI with Air and SBS exam and a SBS Only exam.

UGI with Air and SBS - the UGI will be 1st with the radiologist, overheads will be taken, and then the patient will drink more contrast for the SBS exam.

SBS Only - the patient will drink 8-16oz of barium and then timed images are taken until the contrast has reached the TI. Then more fluoro/spot images will be taken with the radiologist

When does the timing for a small bowel ONLY series begin?

When the patient starts to drink the 1st cup of contrast.

Ideally, the patient should be examined in the ______________________ position for each small bowel radiograph. Why is this?

PA (prone); it adds natural compression to the abdomen

Name the portion of the alimentary canal immediately proximal to the ileocecal valve:

Ileum

Barium sulfate entering the stomach reaches the ileocecal valve (on average) in about_____________ hour(s) after ingestion.

1-2 hours; It depends on the patient/contrast given, and it could be more or less time.

When performing a SBS Only exam, a plain abdominal radiograph should be obtainedbefore introduction of the contrast medium. What other marker, besides the "Right or Left"marker, should be on the film?

Prelim/Scout Image

What instructions should be provided to a patient that has completed a SBS exam?

Post barium instruction: drink fluids, maybe take a light laxative if feeling constipated, increase fiber intake, and stools will be gray/white

What portion of the small bowel has a "feathery" appearance, when filled with barium? Whatgives it a feathery appearance?

Jejunum; Mucosal folds/villi

What is the purpose of a Small Bowel Series exam?

To study the form and function of the small intestine and any abnormalities that areoccurring.

What three functions mainly occur in the small bowel?

Digestion, absorption, and reabsorption