RTE 1021 - Unit 3

What are the three cardinal rules of radiation protection. Which is the most effective in reducing occupational dose?

Time, Distance, Sheilding

Briefly describe each radiation safety method:

• Bucky Slot Cover

• Lead Gloves

• Lead Apron

• Fluoro Timer

• Bucky slot cover - Reduces scatter from the fluoro table

• Lead Gloves - Protect hands from radiation (compton scatter)

• Lead Apron - Protect body and organs from radiation (compton scatter)

• Fluoro Timer - 5 minute timer. Only counts when fluoro is active.

Where is the best place for the technologist to stand during fluroroscopy?

Side of the table behind the RPA or doctor.

• Never stand at the foot or head of the table

What tools may be used to help visualize GERD?

Esophagram is the exam that visualizes this.

• Tools are breathing exercises, water tests, compression paddle, and toe-touch

What is the Valsalva maneuver?

Deep breath in, hold it, and bear down as though trying to move bowels

What type of breathing instructions should be given to the patient during an esophagogram using a thin barium mixture?

Valsalva Maneuver and Mueller Maneuver

When must the technologist inform the radiologist during the samll bowel timed imaging?

When the contrast passes through the ileocecal valve.

To make the patient as comfortable as possible during a single-contrast barium enema, the radiographer should:

Communicate with the patient as much as possible throughout the exam. Warm the contrast to 85-90 degrees.

The barium enema bad should be placed:

No higher than 24” above the table

If the patient has a SBS, UGI, and BE scheduled in one day, what order should they be competed in?

BE, UGI, SBS

Ingestion of barium sulfate is contraindicated in which of the following situation(s)?

Esophageal or bowl perforation, bowel obstruction, recent or soon GI tract surgery, allergy to barium

What is a potential risk associated with the use of water-soluble contrast agents, especially for geriatric patients?

Dehydration

List side effects that may occur with injected iodinated contrast:

Sensation of warmth, metallic taste, nausea, headache, dizziness

Largest solid organ in the body, is located in the _____________ quadrant.

Right upper

Where is the gallbladder located in relation to the liver?

Posterior and inferior

There are ___ major lobes and ___ minor lobes.

• 2

• 2

What separates the right and left lobe?

Falciform ligament

Bile is manufactured in the __________ and stored in the ___________.

• Liver

• Gallbladder

What are the major functions of bile?

Aid in the digestion of fats by emulsifying fat globules and in the absoportion of fat following its digestion.

The ________ is the main organ involved in metabolism.

Liver

Label

1. Right lobe

2. Left lobe

3. Gallbladder

4. Falciform ligament

Label

1. Caudate lobe

2. Inferior Vena Cava

3. Right lobe

4. Left lobe

5. Falciform ligament

6. Quadrate lobe

7. Gallbladder

Bile is carried to the gallbladder via the _____________ or into the duodenum via the ________________.

• Cystic duct

• Common bile duct

What are the 3 parts of the gallbladder?

Fundus, Body, and Neck

List the 3 primary functions of the gallbladder:

1. Store bile

2. Concentrate bile

3. Contract when stimulated

The hormone secreted when fatty acids are in the duodenum:

Cholecystokinin

The terminal end of the common bile duct is closely associated with the terminal end of the _____________ duct or duct of _______________.

• Pancreatic

• Wirsung

Label

1. Common Hepatic Duct

2. Common Bile Duct

3. Liver

4. Cystic Duct

5. Gallbladder

6. Duodenum

Label

1. Gallbladder

2. Cystic Duct

3. Right Hepatic Duct

4. Left Hepatic Duct

5. Common Hepatic Duct

6. Common Bile Duct

7. Pancreatic Duct (Duct of Wirsung)

8. Hepatopancreatic Ampulla (Ampulla of Vater)

9. Descending Duodenum

List the 3 primary function of the digestive system:

1. Intake and Digestion

2. Absorption

3. Elimination

Mastication

Act of chewing

Deglutition

Act of swallowing

Peristalsis

Wave-like involuntary muscle contractions that propel solid materials

List and describe the 3 salivary glands:

1. Parotid

2. Submandibular

3. Sublingual

This covers the opening of the larynx during swallowing:

Epiglottis

List the 3 parts of the pharynx (superiorly to inferiorly):

• Nasopharynx

• Oropharynx

• Laryngopharynx

The esophagus is about ___ inches in length and ___ in diameter.

• 10 inches

• ½ inch

Where is the esophagus located in relation to the trachea? To the C-Spine?

• Posterior to the trachea

• Anterior to the C-Spine

The opening between the esophagus and the stomach is the:

• Also referred to as the:

• Esophagogastric junction

• Cardiac orifice

Vertebral level of Upper margin of larynx

C3

Vertebral level of Cricoid cartilage of larynx

C5-C6

Vertebral level of Larynx-Trachea junction

C6

Vertebral level of Carina

T4-T5

Vertebral level of Esophagogastric junction

T11

Vertebral level of Iliac Crest

L4-L5

Vertebral level of Thryoid cartilage

C4-C5

Vertebral level T6 can be found by palpating ___ inches _________ inferior to the jugular notch.

• 2”

• Inferior

The stomach has 3 main subdivisions:

Fundus, Body, Pylorus

The gastric air bubble is typcially found in this subdivision:

Fundus

Rugae

Stomach is empty and internal lining is thrown into muscosal folds.

Where is rugae most evident?

Lower body of the stomach alond the greater curvature.

The head of the pancreas is located where?

C-loop of the duodenum

The only portion of the duodenum considered intraperitoneal is:

Duodenal bulb (first portion)

The longest portion of the duodenum where the opening for the common bile and pancreatic ducts is located:

Second portion (duodenal papilla)

The duodenum and jejunum join at the:

Duodenojejunal flexure

The small intestine has three main sections (list in order):

Duodenum, Jejunum, Ileum

Haustral churining primarily takes place in the:

Large intestine

Label

1. Esophagogastric junction

2. Cardiac notch

3. Fundus

4. Body

5. Greater curvature

6. Pyloric portion

7. Pyloric antrum

8. Pyloric canal

9. Pyloric orifice

10. Angular notch

11. Lesser curvature

12. Cardiac antrum

What position is the patient in?

Prone

Describe the orientation of the stomach on an average patient:

J shaped and extends from T11 down to L2

Where would the barium be located (use fundus, body, and pylorus)?

• Supine

• RAO

• Prone

• Erect

• Supine - Fundus

• RAO - Body and Pylorus

• Prone - Body and Pylorus

• Erect - Body and Pylorus

Hypersthenic Body Type

• Transverse colon

• Large Intestine

• Gallbladder

• Stomach

• Duodenal Bulb

• Transverse colon - High

• Large Intestine - Extends to the periphery of the abdominal cavity

• Gallbladder - High and almost transverse

• Stomach - High and assumes a transverse position

• Duodenal Bulb - T11 or T12, right of midline

Hyposthenic/Asthenic Body Type

• Transverse colon

• Large Intestine

• Gallbladder

• Stomach

• Duodenal Bulb

• Large Intestine - Down into the low abdominal and pelvic cavities

• Stomach - J shaped and low in the abdominal cavity

• Gallbladder - Near midline a lvl of iliac crests

• Duodenal Bulb - Near midline at lvl L3-L4

Sthenic Body Type 

• Stomach - J shaped and lower than the hypersthenic

• Gallbaldder - Less transverse and lies midway b/w lateral abdominal wall and midline

• Large Intestine - High, under the left diaphragm

• Duodenal Bulb - lvl of L1-L2, right of midline

List additional factors that may affect the position of the stomach:

Stomach contents, respiration, body position, previous abdominal surgeries, and age.

All abdominal organs tend to drop ____ inches in an ______ erect position.

• 1-2”

• Erect

List the quadrant(s) each of the three parts of the small intestine is located in:

• Duodenum

• Jejunum

• Ileum

• Duodenum - RUQ and LUQ

• Jejunum - LUQ and LLQ

• Ileum - RUQ, RLQ, and LLQ

The jejunum contains numerus plicae circulars, which are:

Mucosal folds which increase the surface area to aid in the absorption of nutrients

The terminal ileum joins the large intestine at the __________ valve.

Ileocecal

What causes teh feather-like appearance of the duodenum when it is filled with barium?

Tight circular folds formed by the mucosa that contain villi.

Most digestion and absorption take place within the:

Small intestine

List and describe the two digestive movements of the small intestine:

• Peristalsis - wave like contraction that proplels food through the digestive tract

• Rhythmic segmentation - localized contractions in area that contain food

The primary function of the large intestine is to:

Eliminate feces

List and describe the four digestive movements of the small intestine:

• Peristalsis - wave like contraction that propels food through digestive tract

• Haustral churning - produces movement of material within the large intestine

• Mass peristalsis - moves the entire large bowel contents into the sigmoid colon and rectum

• Defecation - emptying of the bowel

The large intestine beings in the ______ quandrant.

Right lower

List the 4 major parts of the large intestine:

Cecum, colon, rectum, and anal canal

List the 4 sections of the colon:

Ascending, transverse, descending, and sigmoid

The right colic flexure is also called:

Hepatic

The left colic flexure is also called:

Splenic

The appendix is attached to this part of the large intestine:

Cecum

Label

1. Right Colic Flexure

2. Cecum

3. Vermiform appendix

4. Sigmoid colon

5. Rectum

6. Left Colic Flexure

7. Transverse Colon

8. Haustra of Colon

9. Descending Colon

Describe which contain air and barium.

• Supine

  • Barium (ascending/descending/rectum)

  • Air (transverse/sigmoid)

• Prone

  • Barium (transverse/sigmoid)

  • Air (ascending/descending/rectum)

Define bolus injection:

Entire volume of contrast medium is injected at one time.

Define drip infusion:

Specified amount of contrast is given over a specified period

Which veins are most suitable for IV urograms?

Veins found within the antecubital fossa

The needle bevel must be:

Facing up

The injection angle for an IV is:

25 degrees or less (15-25)

What type of contrast must be used for urinary imaging?

Omnipaque, non-ionic (Water-soluble, iodinated)

What is one major downfall of ionic contrast agents?

More likely to experience a reaction

What is one major downfall of non-ionic contrast agents?

High cost

List common side effects of injected iodinated contrast media:

Temporary hot flash and metallic taste in mouth

Normal level of Creatinine

0.6-1.2 mg/dL

Normal level of BUN

7-20 mg/dL

Normal level of GFR

Over 90 ml/min/1.73 m²

What is the common drug given during a severe allergic reaction?

Epinephrine

What might patients be premedicated with to reduce the chances of an allergic reaction?

Benadryl/Antihistamine and may include prednisone (decreases inflammation)

Which kidney is slightly lower?

Right

The average kidney is ____ inches long.

4-5

A normal kidney is rotated about ____ to the midline and forms a vertical angle of about ____ to the MSP.

• 30 degress

• 20 degrees

Kidneys lie about halfway between the _____________ and the ____________.

• Xiphoid process

• Iliac crest