Radiographic Contrast Examination Review

Comprehensive set of 100 flashcards based on the lecture transcript regarding radiographic contrast examinations, procedures, anatomy, and patient reactions.

What is the definition of contrast media in radiography?

A substance or material that has a higher atomic number than the surrounding tissue.

What is the primary purpose of using contrast media?

To achieve opacification, visualization, and a contrast study of internal structures.

What are the characteristics of positive contrast media, such as $BaSO_4$?

It is radiopaque, has a high atomic number, decreases density, and increases absorption.

What are the characteristics of negative contrast media, such as Air or Nitrogen?

It is radiolucent, has a low atomic number, increases density, and decreases absorption.

Regarding reactions to contrast media, when does a hemodynamic reaction occur?

It occurs upon injection.

Which reaction is associated with patient anxiety, fatigue, or state of dehydration?

Psychosomatic Reaction.

What is the definition of a pyrogenic reaction in radiographic contrast studies?

A reaction that tends to cause a rise in body temperature.

What are the potential effects of hemodynamic systemic shock?

A sudden drop in blood pressure ($BP$).

What are common symptoms of a mild, non-allergenic reaction to contrast media?

Lightheadedness, anxiety, nausea, and vomiting.

What are the clinical indicators for a severe vasovagal reaction during contrast introduction?

Systolic $BP < 80$ min, bradycardia ($< 50$ beats/min), and cardiac arrhythmias.

What are the three major reactions categorized in contrast media studies?

Cardiac arrest, severe bronchial spasm, and severe hypertension.

In the context of selecting contrast media, what is defined as the quality of a sticky fluid?

Viscosity.

What is the 'intrathecal' method of introducing contrast media?

Introducing contrast media into a sheath.

What is the most common form of parenteral administration of contrast media?

Intravenously ($IV$) or intra-arterial injection into the bloodstream.

Which specialized form of lung or brain imaging uses inhaled Xenon gas?

Inhalation method.

Why is Barium Sulfate ($BaSO_4$) considered non-toxic for GIT studies?

It is insoluble in water and stable, meaning it cannot be absorbed by the Gastrointestinal Tract ($GIT$).

What is the definition of osmolality in the context of contrast agents?

A measure of the total number of particles in a solution.

What is a colloidal substance in radiology?

A mixture of barium and water where barium never dissolves, forming a suspension rather than a solution.

What is the ratio of barium to water in 'Thin Barium' used for the entire GI tract?

$1$ part Barium to $1$ part Water.

What is the ratio of barium to water in 'Thick Barium' used for the esophagus?

$3$ to $4$ parts Barium to $1$ part Water.

What is Sialography?

The radiographic examination of salivary gland ducts and calculi using water-soluble iodinated contrast media.

What height should the drip stand be placed for Sialography contrast introduction?

$38\text{"}$ or $70\text{\,cm}$ above the level of the mouth.

What substance is used in Sialography to identify the orifice of ducts and promote salivation?

Lemon juice.

What is the largest salivary duct, also known as Stensen's duct?

The Parotid duct ($5\text{\,cm}$ or $2\text{"}$ long).

What is the name of the Submandibular/Submaxilla salivary duct?

Wharton's Duct.

What is the name of the Sublingual salivary duct?

Bartholin's Duct.

Which projection in sialography best demonstrates all three pairs of salivary glands?

Lateral projection.

In Sialography, where is the central ray ($RP$) for the lateral projection?

$1\text{"}$ ($2.5\text{\,cm}$) superior to the mandibular angle.

What method is used specifically for the demonstration of salivary calculi by depressing the floor of the mouth?

Iglauer Method.

How is the superior surface of the soft palate coated for Palatography?

By injecting $0.5\text{\,ml}$ of creamy barium into the nasal cavity.

What is the purpose of the Morgan method (1970) in Palatography?

Evaluating abnormalities of the chewing mechanism and swallowing in children.

What medication is given $30$ minutes before Nasopharyngography to suppress secretions?

Atropine.

What contrast media and volume are typically used for Nasopharyngography?

Dionosil aqueous, $8-10\text{\,ml}$.

What is the purpose of Pharyngography?

To identify abnormalities during the active progress of deglutition (swallowing).

Which Pharyngography method involves tying a dark shoestring around the throat above the thyroid cartilage?

Gunson Method.

What is the purpose of the Valsalva maneuver in laryngo-pharyngography?

To distend the subglottic larynx and trachea with air by forcible exhalation against a closed airway.

What is the purpose of normal expiratory phonation introduced by Holtz and Ogura?

To test the adduction of the vocal cords.

Which maneuver demonstrates the laryngeal ventricle by inhaling to make a harsh sound?

Inspiratory phonation or aspirant maneuver.

The Benassi Method for the liver uses which two axial exposures?

$25^{\circ}$ caudad and $10^{\circ}$ cephalad.

What are the dimensions of the esophagus (gullet)?

$10\text{"}$ ($25\text{\,cm}$) long and $3/4\text{"}$ ($2\text{\,cm}$) in diameter.

What are the three segments of the esophagus?

Cervical, Thoracic, and Intraabdominal.

What volume of barium is used for a standard barium swallow?

$50-100\text{\,mL}$.

In a recumbent AP or PA esophagus projection, at what level is the central ray ($RP$)?

$T5/T6$.

What is the required body rotation for the RAO projection of the esophagus?

$35-40^{\circ}$ rotation.

Which projection best demonstrates the esophagus between the hilar region of the lungs and thoracic spine?

LAO (Left Anterior Oblique).

What condition is defined as the abnormal constriction of the Gastroesophageal junction?

Achalasia.

In the Water Test for esophageal reflux, what does the patient do?

The patient swallows a mouthful of water through a straw while in a specific position.

What is the percentage prevalence and description of the Hypersthenic body habitus?

$5\%$ and describes a massive build.

What is a 'Bezoar' in the stomach?

A mass of undigested material, such as hair (trichobezoar) or vegetable fiber (phytobezoar).

What clinical term refers to the act of vomiting?

Emesis.

What is the radiographic sign of a sliding hiatal hernia characterized by a ringlike constriction?

Schatzki's ring.

Which projection is used for an infantile stomach to account for its transverse position?

Gugliantini Projection ($20$ to $25^{\circ}$ cephalad).

What is a 'Cascade Stomach'?

A variation where the fundus is lower than the gastro-esophageal junction.

What is the typical emptying time of a normal stomach in a barium meal study?

$2-3\text{\,hrs}$.

How long does it usually take for barium to reach the rectum?

Within $24\text{\,hrs}$.

Which stomach projection demonstrates the left retrogastric space?

Left Lateral Erect.

What are the common crystals used for gas production in a double-contrast stomach study?

Calcium and magnesium citrate.

In a RAO projection of the stomach, what is the rotation for a sthenic patient?

$45-55^{\circ}$.

In an RAO projection of the stomach, what rotation is required for a hypersthenic patient?

$70^{\circ}$.

The Hamptons method uses which position to demonstrate the leaf-like pattern of the pylorus?

LPO (Left Posterior Oblique).

What is the Wolf Method ($Guglielmo$) used for?

Demonstrating small lesions or sliding gastro-esophageal herniations by applying intra-abdominal pressure.

The Small Intestine Study ($SIS/SBS$) extends between which two landmarks?

Duodenojejunal junction (ligament of Treitz) and the ileocecal valve.

What is the average length of the small intestine?

$22\text{\,ft}$ ($6.5\text{\,m}$).

What is the shortest and widest part of the small intestine?

The Duodenum ($$8-10 ext{\

What is the function of the Jejunum and its diameter?

Located in the LUQ and LLQ with a diameter of $3-3.5\text{\,cm}$.

What is 'Enteroclysis'?

A procedure where contrast ($1200\text{\,ml}$) is introduced directly into the duodenum via a specialized tube.

Which specialized tube is used for the intubation method to relieve post-operative distention?

Miller-Abbot tube.

What is 'Hypotonic Duodenography' used for?

Evaluation of post-bulbar duodenal lesions and detection of pancreatic disease.

What is the standard length of the large intestine?

$5$ to $5.5\text{\,ft}$.

What is the purpose of using Sim's Position ($35-40^{\circ}$) during a Barium Enema?

To relax abdominal muscles and the anal sphincter, decreasing intra-abdominal pressure.

What is the maximum height the Barium Enema container should be above the table top?

$90\text{\,cm}$ ($$36 ext{\

What is the radiographic appearance of Colitis?

Saw-tooth or 'jagged' appearance.

What is the radiographic appearance of Ulcerative Colitis?

Cobblestone appearance.

Which condition is described as the 'apple-core' or 'napkin ring' appearance?

Neoplasm (benign or malignant tumor).

What is 'Volvulus'?

The twisting of a portion of the intestine, common in males aged $20-50$.

What is 'Intussusception' and its typical appearance?

The telescoping of one part of the intestine into another; appears 'mushroom shaped'.

In a Barium Enema PA Prone projection, what structures are filled with air?

Rectum, Ascending colon, and Descending colon.

What projection is used to demonstrate the splenic flexure and descending portion of the colon?

LAO ($35-45^{\circ}$ rotation).

Which projection demonstrates the rectum in profile?

Left Lateral ($LL$).

What is the Chassard Lapine (Jack Knife Axial) method used for?

Demonstrating the rectosigmoid junction and sigmoid.

What is 'Defecography'?

A functional study of the anus and rectum during evacuation and rest phases to evaluate defecation dysfunction.

What are the three parts of the Gallbladder?

Fundus, Body, and Neck.

What is the capacity of the Gallbladder?

$30-40\text{\,cc}$ of bile.

What contrast media and dosage are used for Oral Cholecystography?

Telepaque (Telepaque) tablets: $6$ for normal patients and up to $12$ for larger patients.

What is 'Cholelithiasis'?

A condition having abnormal calcifications or stones in the gallbladder.

In gallbladder studies, what happens during full exhalation?

The gallbladder moves laterally and superiorly $1-3\text{\,inches}$.

What projection is best for demonstrating floating gallstones?

Erect LAO ($20^{\circ}$ body rotation).

When is an Operative Cholangiography performed?

During surgery to investigate the patency of the ducts.

What is Post-operative (T-Tube) Cholangiography?

A study performed typically $10$ days after surgery to check for residual stones in the CBD.

What needle is used for Percutaneous Transhepatic Cholangiography ($PTC$)?

Chiba 'Skinny' needle.

What does ERCP stand for and what is it used to diagnose?

Endoscopic Retrograde Cholangio-Pancreatography; used for biliary and pancreatic pathologies.

What are the normal BUN and Creatinine levels for urinary studies?

BUN: $8-25\text{\,mg/ml}$; Creatinine: $0.6-1.5\text{\,mg/100ml}$.

What is 'Nephroptosis'?

An abnormal positional change of the kidneys where they drop more than $2\text{\,inches}$ when upright.

When does contrast begin to appear in the pelvicalyceal system during an IVP?

Within $2-3\text{\,minutes}$ after injection.

What is the purpose of a Nephrogram taken $1$ minute after injection?

To see the 'blush' of the entire kidney substance (renal parenchyma).

In which cases should ureteric compression NOT be applied?

Renal failure, obstruction, children, or recent abdominal surgery.

What is Hysterosalpingography ($HSG$) used for?

To demonstrate the uterus and uterine tubes, primarily for infertility assessment.

Who first described Bronchography in $1922$?

Siccard and Forestier.

What is 'Myelography'?

Radiographic study of the spinal cord and nerve roots after introducing contrast into the subarachnoid space at the $L2-L3$ interspace.

What is the Seldinger Technique?

A method of catheterization used to visualize blood vessels in angiography.