Fluoro Part 1: UGI/Esophagus

Accessory Glands

Salivary glands, liver, gallbladder and pancreas; secrete digestive enzymes into alimentary canal

Alimentary Canal

Mouth, pharynx, esophagus, stomach, small intestine, large intestine (colon) and anus

Uvula

Center of soft palate

Mastication

Chewing

1?

Sublingual gland

2?

Submandibular gland

3?

Parotid gland

Pharynx

Passageway for air and food; extends from portions of sphenoid/occipital bones to C6-C7

Nasopharynx

Above hard/soft palates

Oropharynx

Extends from soft palate to hyoid bone

Laryngeal Pharynx

Posterior to larynx; extends inferior to esophagus

Green?

Nasopharynx

Blue?

Oropharynx

Purple?

Laryngeal pharynx

Larynx

Organ of voice; air passage between pharynx and trachea

Epiglottis

Serves as trap to prevent leakage into larynx between acts of swallowing

Piriformis Recess

Each side of larynx; visualized on AP projections of esophagus study when puffing cheeks with air

Esophagus

Runs C6-T11 (cardiac opening of stomach); 4 layers, anterior to spine, posterior to trachea and lies in midsagittal plane

Esophageal Hiatus

Passes through diaphragm around T10

Esophagogastric Junction

Joins the stomach around T11; opening is called the cardiac orifice

Cardiac Antrum

Wide, distal end of esophagus; lies in abdomen

Upper Esophageal Sphincter (UES)

Junction with pharynx; prevents air from entering esophagus during respiration

Lower Esophageal Spincter (LES)

Relaxes to allow food to pass into the stomach; closes to prevent stomach acid and digestive juices from flowing back into the esophagus

Stomach

Storage area for food until digested; acids, enzymes and chemicals are secreted to break down food chemically, mechanically broken down by churning (peristalsis)

Chyme

Mechanically and chemically broken down food in stomach to duodenum

1?

Cardia

2?

Pylorus

3?

Body

4?

Fundus

1?

Duodenal bulb

2?

Pyloric sphincter

3?

Cardiac sphincter

4?

Rugae

Hypersthenic

Sthenic

Hyposthenic

Asthenic

Around what level does the pylorus and duodenal bulb lie on a hypersthenic patient?

T11-12

Around what level does the pylorus and duodenal bulb lie on a sthenic patient?

L2

Around what level does the pylorus and duodenal bulb lie on a hyposthenic/asthenic patient?

L3-4

White is barium: what position is the patient in?

Supine

White is barium: what position is the patient in?

Prone

White is barium: what position is the patient in?

Erect

Federal regulations tabletop exposure rates should not exceed ________ mGy per minute

88

SSD Fixed Fluoro

15 in (38 cm)

SSD Mobile Fluoro

12 in (30 cm)

Purpose of Contrast

Better anatomic definition and to assess function

Positive Contrast Agents

Barium sulfate and iodinated contrast (omnipaque or gastrografin)

Negative Contrast Agents

Air; EZ Gas, CO₂, O₂

What age do you use thick barium?

12+

Single Contrast Study

One type of contrast used; typically barium, shows overall function/motility of body part

Double Contrast Study

Two types of contrast used; typically barium (+) and air (-), shows both function/motility and more detail of the organ

What study requires no patient prep?

Esophagus

How long must a patient be NPO before studies?

Typically 8 hours

When is a scout image done?

When a patient had to prep their body prior to the exam

RAO Esophagus Obliquity

35-40 degrees

RAO Esophagus Collimation

12×17

RAO Esophagus: If esophagus is over the spine what positioning error occured?

Under obliqued

RAO Esophagus: If esophagus is over the heart what positioning error occured?

Over obliqued

What does a PA UGI best visualize?

Body of stomach, medial and lateral margains

PA UGI collimation

14×17

What does a right lateral UGI best visualize?

Retrogastric area and duodenal loop in profile, anterior and posterior margains

Right lateral UGI collimation

11×14

PA oblique UGI obliquity

RAO 40-70 degrees

What does a PA oblique stomach UGI best visualize?

Duodenal bulb filled with barium