What is administered if the patient is constipated before the procedure?
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A non-gas-forming laxative.
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What is administered if the patient is constipated before the procedure?
A non-gas-forming laxative.
What is the barium sulfate suspension concentration used in a single-contrast examination?
30% to 50% weight/volume.
What is Peptic Ulcer Disease?
Erosion of the stomach or duodenal mucosa due to various physiological or environmental conditions.
What is the patient preparation for Gastro-Jejunostomy?
The same as for patients who have not undergone surgery; NPO prior to examination is sufficient.
How much barium should be prepared for a patient undergoing Gastro-Jejunostomy?
About 50 cc.
What is the focus during imaging after barium ingestion in Gastro-Jejunostomy?
Concentrating at the anastomosis portion of the point of suture.
What does the 45° RAO position reveal in the cardiac series?
The huge right atrium casting a triangular density behind the esophagus.
How do you determine the reference point using two planes?
Mark the intersection of the transpyloric plane and scapular spine, then measure 4 inches to the left.
What is Malabsorption Syndrome?
A condition where the body cannot absorb nutrients properly.
What is the central ray (CR) direction for the left lateral projection of the barium-filled esophagus?
Horizontal or perpendicular.
What is the purpose of the spot film during stomach and duodenum imaging?
To capture a radiograph during the examination under fluoroscopic control.
What is the primary projection for demonstrating esophageal carcinoma?
AP, PA, LAO, RAO, or lateral during the filling phase.
What is the procedure for demonstrating a mediastinal mass?
Filling phase with continuous barium swallow, using fluoroscopic guidance.
What position is the patient placed in during the single-contrast examination?
Upright position.
What condition is indicated for a cardiac series?
Cardiomegaly - Enlargement of the heart.
What is the reference point for the Sommer-Feegelle Method?
Xyphoid process.
What is the procedure for Hiatal Hernia?
Allow the patient to ingest the barium mixture before positioning.
What positions are used for Hiatal Hernia?
Trendelenburg Position and Touch Toe Position.
What are the three sections of the small intestine?
Duodenum, Jejunum, Ileum.
What is the focus of the upper gastrointestinal series (UGIS)?
Radiographic examination of the distal esophagus, stomach, and duodenum.
What is the purpose of the modifications described for the Trendelenburg position?
To apply greater intra-abdominal pressure for consistent results in radiographic demonstration of small sliding gastroesophageal hernias.
How is the Valsalva Maneuver performed?
The patient takes a deep breath while holding it in, forcing air against the closed glottis.
What is the recommended angle for the patient in the Wolf Method?
40-50 degrees RAO position.
What is one method to produce air in the stomach during imaging?
Instruct the patient to sip the barium mixture using two straws.
What is the central ray angle for Gordon's modification?
Projected 35-45 degrees cranially (cephalad).
What should be done after taking all projections in the study?
Advise the patient to wait for the radiologist to confirm the radiographs.
What is a Bezoar?
A mass of undigested material trapped in the stomach, often made of hair or vegetable fibers.
What is the preparation for an esophagogram for infants?
Starve the patient for 2 to 3 hours before the examination.
What is the purpose of the hypotonic duodenography method?
To show duodenal anatomy without interference from peristaltic activity.
Which method is frequently employed for administering the barium mixture?
Single Meal Method.
What is the central ray direction for Gugliani's modification?
Directed at an angle of 20-25 degrees cranially (cephalad).
What projection is used to demonstrate dysphagia during the filling phase?
Upright PA or oblique.
What is the projection for the one-hour delayed film in overhead technique?
AP Recumbent.
What are the two phases of studying the esophagus?
What projections are used for achalasia during the filling phase?
RPO and LAO upright.
How is barium typically prepared for infants?
A milk barium mixture of 4 parts milk to 1 part barium.
What is the purpose of giving the patient a gas-forming substance?
To help expand the stomach and improve visualization.
What should the patient do to ensure even coating of the stomach walls?
Turn from side to side or roll over a few times.
What is the length of the duodenum?
Approximately 1 foot (12 inches).
What is Enteritis?
Inflammation of the small intestine.
What type of diet should the patient have before the examination?
Soft, low-residue diet for 2 days.
What does the Mueller Maneuver involve?
The patient exhales and then tries to inhale against the closed glottis.
What is the purpose of delayed radiographs in UGIS?
To ensure filling of the GI tract.
What are the two types of Peptic Ulcers?
Duodenal Ulcer and Gastric Ulcer.
What should be done after studying the rugae during the examination?
Instruct the patient to drink the rest of the barium mixture.
What can be determined using a single-contrast examination?
Size, shape, and position of the stomach.
What is a psychological maneuver used during esophagography?
Giving the patient a mouthful of barium paste and having them swallow on the count of three, or instructing them to sip the barium mixture using a straw.
What is the importance of double contrast in imaging?
It enhances the visibility of structures in the stomach.
What is Meckel’s Diverticulum?
A congenital defect in the small intestine that appears as a bulge or outpouching in the inner wall.
What patient positions are used for infants during an esophagogram?
AP, Oblique, and Lateral using fast exposure.
What is esophagography or barium swallow?
A common radiographic procedure for examining the pharynx and esophagus using a radiopaque contrast medium.
What is the initial step for esophagus imaging using fluoroscopy?
Ask the patient to swallow a barium mixture while in RPO upright position.
What should the patient do during the exposure for the one-hour delayed film?
Suspend respiration.
What is the NPO requirement for infants younger than 1 year before UGIS?
NPO for 4 hours.
What is Gastro-Jejunostomy?
A procedure where the jejunum is connected to the stomach after removing the duodenum and a portion of the distal stomach.
What position is used for Chalasia?
Trendelenburg Position, where the head is lower than the feet.
What is the source-to-image receptor distance (SID) for the PA projection in the cardiac series?
72 inches.
What is a Hiatal Hernia?
A condition where a portion of the stomach herniates through the diaphragmatic opening.
What is Gastritis?
Inflammation of the lining or mucosa of the stomach.
What should the patient avoid doing during the examination?
Belching or burping.
What is the purpose of the preliminary (scout) radiograph in UGIS?
To delineate the organs of the abdomen and detect any calcifications or tumor masses.
What should be done to prepare for a Small Bowel Series (SBS)?
Light evening meal, laxatives before bedtime, and NPO on the day of the examination.
What is Adynamic/Paralytic Ileus?
Intestinal blockage in the absence of a physical obstruction, often due to foreign bodies.
What should be used instead of Barium Sulfate in certain patients?
Water-soluble iodinated contrast media, with caution for allergic reactions.
What is the significance of the left lateral position in esophagography?
It minimizes the magnification of the heart.
What is Partial Gastrectomy?
A surgical procedure where the pathologic portion of the stomach is removed.
What is the Modified Valsalva Maneuver?
The patient pinches off the nose, closes the mouth, and tries to blow the nose, expanding the cheeks outward.
What is the NPO requirement for children older than 1 year before UGIS?
NPO for 6 hours.
What is achalasia?
A condition involving abnormal constriction of the lower portion of the esophagus.
How does fluoroscopy affect the length of the examination?
It considerably reduces the length of time of the examination.
What is the first step in determining the reference point for the stomach using scout film?
Trace the shadow of the stomach from the fundus down to the pylorus.
What is one way to produce air in the stomach using medication?
By giving the patient gas-producing tablets like 'GASTROLUFT'.
What should be communicated to the patient regarding UGIS?
Inform the patient about how long the procedure is going to take.
What are the two types of Ileus?
Adynamic/Paralytic Ileus and Mechanical Ileus.
What is the best projection to demonstrate the greater and lesser curvature of the stomach for hypersthenic patients?
The projection that shows the antral portion of the stomach, pyloric canal, and duodenal bulb.
What structures are demonstrated using Poppel's method?
The right angle view of the stomach and the retrogastric space, as well as pancreatic pathologies.
What is the patient position for the Wolf Method?
The patient is placed in a prone position on the radiographic table.
What is the purpose of the RPO projection?
To demonstrate the entire length of the esophagus free from superimposition with adjacent structures.
How is the RAO projection performed if the patient cannot stand?
The patient is placed in a supine position and elevated approximately 45 degrees.
What is observed in the left lateral position during the cardiac series?
The barium-filled esophagus pushed by the poststenotic dilation of the descending aorta.
Why should the barium mixture be prepared in advance?
To minimize the unpalatable taste for the patient.
What methods can be used to introduce contrast for infants?
By feeding bottle or by pressure or gravity method via catheter inserted through the nose.
What are the contraindications for using Barium Sulfate?
Presurgical patients, patients with perforated hollow viscus, and possible large bowel obstruction.
How long does it take for barium to reach the ileocecal valve after ingestion?
2-3 hours.
What is the purpose of Hampton's modification?
To demonstrate a leaf-like pattern of the pylorus and the duodenal bulb.
How long should food and water be withheld before the procedure?
8-9 hours.
What is Sub-total Gastrectomy?
A procedure where only half of the stomach is removed.
What is the Sommer-Feegelle Method?
It uses a specially constructed 34-degree angle board to place the patient in a Trendelenburg position.
What is the AP projection positioning for esophagography?
Patient is placed in PA position, centered to the midline of the table with RP at T6.
What is the main advantage of a double-contrast examination?
Small lesions are less easily obscured and the mucosal lining can be more clearly visualized.
What is the length of the small intestine?
Approximately 21 feet (252 inches).
How are foreign bodies examined in the esophagus?
Use cotton balls soaked with barium mixture and allow the patient to swallow it.
What is the recommended barium mixture for preparation?
A 2:1 (60 to 66%) or 3:1 (70 to 80%) barium mixture.
What is the function of the ileocecal valve?
It prevents retrograde flow from the ileum to the cecum of the colon.
What is the disadvantage of the Double Meal Method?
Superimposition between the filling of the small intestine and the stomach.
What is the barium preparation volume for adults?
600-1,200 ml of barium sulfate.
What is the positioning for Poppel's method?
The patient is positioned supine after ingesting contrast media, with two exposures taken: one horizontal and one vertical.
What is the reference point for the second exposure in Poppel's method?
4 inches to the left of the pylorus, centered to the midline of the table.
What are some clinical indications for esophagography?
Ulcer, Hiatal Hernia, Acute or Chronic Gastritis, Tumor, carcinoma, Diverticulae, Bezoars.
Where are Duodenal Ulcers frequently located?
In the second or third aspect of the duodenum.
What does the PA projection show in the cardiac series?
A barium-filled esophagus and the level of aortic coarctation.
What is the significance of taking exposure at the count of three after swallowing?
It ensures that the barium mixture is properly positioned for imaging.
What is the best position to demonstrate soft tissue inflammation for foreign bodies?
Lateral position.
What is the biphasic examination?
Both single-contrast and double-contrast examinations performed on the same day.
What is the purpose of the Supine position during SBS?
To avoid abdominal pressure and prevent overlapping of intestinal loops.
How long does it take for barium to reach the rectum after ingestion?
24 hours.
What must the stomach be during the procedure?
Empty.
What is the Wolf Method used for in radiographic demonstration?
It involves a semi-cylindrical compression device to increase intra-abdominal pressure and ensure adequate contrast filling of the esophagus.
What are the characteristics of the esophagus?
It is a collapsible fibromuscular tube, posterior to the trachea and heart, beginning at C6 and connecting to the stomach around T10, approximately 9.7 inches (25 cm) long.
What is Total Gastrectomy?
A surgical procedure where the whole stomach is removed.
What is a disadvantage of using fluoroscopy in UGIS?
It is more hazardous.
What position should the patient be in before administering the gas-forming substance?
Upright position.
What is Addison's Plane in relation to UGIS?
A plane drawn transversely midway between the manubrial notch and the upper border of the symphysis pubis.
What is the barium preparation for infants?
Milk barium mixture, 4 parts water milk and 1 part barium.
What additional study may be performed during UGIS?
A small intestine study consisting of radiographs obtained at frequent intervals.
What is the most frequently employed method of study in UGIS?
Overhead or Conventional Method.
What is the purpose of various breathing exercises?
To increase both intra thoracic and intra abdominal pressure.
How is thyroid gland enlargement demonstrated radiographically?
Using AP or PA for lateral displacement and lateral for anterior or posterior displacement.
What is a common clinical indication for UGIS in infants?
Obstruction, possibly due to foreign bodies or pathology.
What is the primary purpose of the cardiac series radiographic examination?
To study heart size and configuration.
What is dysphagia?
A clinical indication for esophagography characterized by difficulty in swallowing.
What types of contrast media are used in the study?
Both positive and negative contrast media.
What is Gordon's modification in UGIS?
The patient is placed in a prone position with specific adjustments to the body and central ray.
What is a hiatal hernia?
An abnormal protrusion of an organ through an aperture, where part of the fundus enters the esophagus or forces the diaphragm above.
How should a patient be psychologically prepared for esophagography?
By explaining the taste of the barium mixture, its importance, and how to drink it, using a well-modulated voice and clear instructions.
What is the recommended projection for barium in the fundus during AP projection?
Supine position.
Where is the jejunum primarily located?
In the Left Upper Quadrant (LUQ) of the abdomen.
What type of studies are included in the UGIS examination?
Fluoroscopic and serial radiographic studies using ingested contrast material.
What is peristalsis?
Contraction waves that propel contents through the digestive tube towards the anus.
What is the recommended patient position for the left lateral projection of the esophagus?
The patient is placed in the left lateral position, either recumbent or erect.
What is the most common breathing exercise?
The Valsalva Maneuver.
What is the purpose of cleansing enemas before the procedure?
To ensure a clean colon.
What is the procedure for Chalasia?
Exposure is taken after contrast media has passed through the gastroesophageal junction, and the patient should ingest the barium mixture first.
When should the exposure be made during the Sommer-Feegelle Method?
During the Muller/Valsalva Maneuver.
What structures are demonstrated in the radiographic study of hiatal hernias?
The relationship of the stomach to the diaphragm.
How far should you measure to the left of the pylorus to find the reference point?
4 inches.
What medications may be given to the patient before the procedure?
Glucagon or other anti-cholinergic medications.
What imaginary line is used to find another reference point for the stomach?
An imaginary line passing at the level of the elbow joint and the right mammary line.
What is the purpose of a Small Bowel Series (SBS)?
To study the form, function, anatomy, and physiology of the small bowel and detect any abnormal conditions.
What is Mechanical Ileus?
Obstruction caused by another pathological condition, such as tumors or masses.
What position is best for demonstrating the body, pylorus, and duodenal bulb in hypersthenic patients?
Left lateral recumbent position.
What is the purpose of the Prone position during SBS?
To compress abdominal contents for better radiographic quality and visibility of bowel loops.
What is the J-shaped portion of the digestive tract?
The stomach.
What is the purpose of studying the stomach radiographically?
To study the form and function of the distal esophagus, stomach, and duodenum, as well as to detect abnormal and functional conditions.
What is the function of the pyloric orifice?
It communicates with the duodenum.
What are the parts of the stomach?
Cardia, Fundus, Body, Pylorus.
How does the position of the body affect the movement of the stomach?
Upright position causes the stomach to go down, supine position causes the stomach to go up, prone position causes slight downward movement, right lateral recumbent position causes the stomach to swing forward, and left lateral upright position causes the body of the stomach to swing backward.
Where is the cardiac orifice located?
At the level of the seventh left costal cartilage, about 1 inch from the side of the sternum.
Where is the stomach located in the abdomen?
In the left upper quadrant (LUQ) below the diaphragm.