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Medicine
Date
Nov 24, 2024
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How long is the average small bowel if removed and stretched out during an autopsy? -
ans
23 ft
In a person with good muscle tone, the length of the entire small intestine is - ans
15
to 18 ft
The average length of the large intestine is - ans
5 ft
Three divisions of the small intestine in descending order, starting with the widest
division. - ans
Duodenum, Jejunum, Ileum
Which division of the small intestine is the shortest? - ans
Duodenum
Which two abdominal quadrants would be the majority of the jejunum be found? - ans
LUQ and LLQ
Which division of the small intestine has a feathery or coiled-spring appearance during a
small bowel series? - ans
Jejunum
Which division of the small intestine is the longest? - ans
Ileum
Which two aspects of the large intestine are not considered part of the colon? - ans
Cecum and Rectum
The colon is divided into ___ sections and has ___ flexures. - ans
Four, Two
Two functions of the ileocecal valve - ans
Prevents contents of the ileum from passing
too quickly into cecum and prevents reflux back into the ileum
What is another term for the appendix? - ans
Veriform appendix
Makes up 40% of the small intestine - ans
Jejunum
Shortest aspect of the small intestine - ans
Duodenum
Aspect of the small intestine that is the smallest in diameter but longest in length - ans
Ileum
Widest portion of the large intestine - ans
Cecum
A blind pouch inferior to the ileocecal valve - ans
Appendix
Found between the cecum and transverse colon - ans
Ascending colon
Distal part of the large intestine; also called the iliac colon - ans
Descending colon
Longest aspect of the large intestine - ans
Transverse colon
Lies in pelvis but possesses a wide freedom of motion - ans
Sigmoid colon
What is term for the three bands of muscle that pull the large intestine into pouches? -
ans
Taenia Coli
These pouches, or sacculations, seen along the large intestine wall are called - ans
Haustra
Which portion of the small intestine is located primarily to the left of the midline? - ans
Jejunum
Which portion of the small intestine is located primarily in the RLQ? - ans
Ileum
Which portion of the small intestine has the smoothest internal lining and does not
present a feathery appeared when barium-filled? - ans
Ileum
Which aspect of the small intestine is most fixed in position? - ans
Duodenojejunal
Junction
In which quadrant does the terminal ileum connect with the large intestine? - ans
RLQ
Which muscular band marks the junction between the duodenum and jejunum? - ans
Ligament of Treitz
The widest portion of the large intestine is - ans
Cecum
Which flexure of the large intestine usually extends more superiorly? - ans
Left
Splenic Flexture
Inflammation of the vermiform appendix is called - ans
Appendicitis
What structures fill with air during a double-contrast barium enema with the patient
supine? - ans
Transverse and Sigmoid colon
Which aspect of the GI tract is primarily responsible for digestion, absorption, and
reabsorption? - ans
Small Intestine
Which aspect of the GI tract is responsible for the synthesis and absorption of vitamins
B and K and amino acids? - ans
Large Intestine
Intraperitoneal, Retroperitoneal or Infraperitoneal: Cecum - ans
Intraperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Ascending Colon - ans
Retroperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Transverse Colon - ans
Intraperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Descending Colon - ans
Retroperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Sigmoid Colon - ans
Intraperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Upper Rectum - ans
Retroperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Lower Rectum - ans
Infraperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: C loop Duodenum - ans
Retroperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Jejunum - ans
Intraperitoneal
Intraperitoneal, Retroperitoneal or Infraperitoneal: Ileum - ans
Intraperitoneal
Two conditions that may prevent the use of barium sulfate during a small bowel series -
ans
Possbile perforated viscus or large bowel obstruction
What type of patients should be given extra care when using a water-soluble contrast
medium? - ans
Young and Dehydrated
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Clinical Indications for SBS: Common birth defect found in the ileum - ans
Meckel's
Diverticulum
Clinical Indications for SBS: Common parasitic infection of the small intestine - ans
Giardiasis
Clinical Indications for SBS: Obstruction of the small intestine - ans
Ileus
Clinical Indications for SBS: Patient with lactose or sucrose sensitivities - ans
Malabsorption Syndrome
Clinical Indications for SBS: New growth - ans
Neoplasm
Clinical Indications for SBS: A form of sprue - ans
Celiac Disease
Clinical Indications for SBS: Inflammation of the intestine - ans
Enteritis
Clinical Indications for SBS: Form of inflammatory disease of the GI tract - ans
Regional enteritis
Pathologic Conditions: Circular staircase or herringbone sign - ans
Ileus
Pathologic Conditions: Cobblestone appearance - ans
Regional enteritis
Pathologic Conditions: Apple core sign - ans
Adenocarcinoma
Pathologic Conditions: Dilation of the intestine with thickening of circular folds - ans
Giardiasis
Pathologic Conditions: large diverticulum of the ileum - ans
Meckel's Diverticulum
Pathologic Conditions: "Beak sign" - ans
Volvulus
Giardiasis is a condition acquired through - ans
Contaminated food and water and
person to person contact
Meckel's diverticulum is best diagnosed with which modality? - ans
Nuclear Medicine
Whipple's disease is a rare disorder of the - ans
Proximal small intestine
How much barium sulfate is generally given to an adult patient for a small bowel series
only? - ans
2 cups (16 oz)
When is a small bowel series deemed completed? - ans
When contrast media passes
through ileocecal valve
How long does it usually take to complete an adult small bowel series? - ans
2 hrs
When is the first radiograph generally taken during a small bowel series? - ans
15-30
min after injection of contrast media
TF: Fluoroscopy is sometimes used during a small bowel series to visualize the
ileocecal valve. - ans
True
The term enteroclysis describes what type of small bowel study? - ans
Double
contrast media
What two types of contrast media are used for enteroclysis? - ans
High density barium
and air
Which two pathololgc conditions are best evaluated though an eteroclysis procedure? -
ans
Crohn's Disease and Malabsorption Syndromes
TF: It takes approximately 12 hours for barium sulfate in a healthy adult, given orally, to
reach the rectum. - ans
False, 24 hrs
The tip of the catheter is advances to the ___ during an enteroclysis. - ans
Duodenojejunal flexure
What is the purpose of introducing methyl cellulose during an enteroclysis? - ans
Dilates the intestinal lumen to produce a more diagnostic study
A procedure to alleviate postoperative distention of a small intestine obstructions is
called - ans
therapeutic intubation
What is the recommended patient preparation before a small bowel series? - ans
NPO 8 hrs, no smoking or chewing gum
Which position is recommended for small bowel radiographs, why? - ans
Prone; to
separate the loops of intestine
A twisting of a portion of the intestine on its own mesentery - ans
Volvulus
Outpouching of the mucosal wall - ans
Diverticulum
Inflammatory condition of the large intestine - ans
Colitis
Severe form of colitis - ans
Ulcerative colitis
Telescoping of one part of the intestine into another - ans
Intussusception
Inward growth extending from the lumen of the intestinal wall - ans
Polyp
Which type of patient usually experiences intussusception? - ans
Infant
A condition of numerous herniations of the mucosal wall of the large intestine is called -
ans
Diverticulosis
Which pathologic condition may produce a "tapered or corkscrew" radiographic sign
during a barium enema? - ans
Volvulus
Which condition may produce the "cobblestone" radiographic sign during a barium
enema? - ans
Ulcerative Colitis
What is the most common form of carcinoma found in the large intestine? - ans
Anular
Carcinoma
TF: Intestinal polyps and diverticula are very similar in structure. - ans
False
TF: Volvulus occurs more frequently in males than females - ans
True
TF: The barium enema is a commonly recommended procedure for diagnosing possible
acute appendicitis. - ans
False
TF: Any stool retained in the large intestine may require postponement of a barium
enema study. - ans
True
What four conditions would prevent the use of a laxative cathartic before a barium
enema procedure? - ans
Gross bleeding, Severe diarrhea, Obstructions, Inflammatory
lesions
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TF: An example of an irritant cathartic is magnesium citrate. - ans
False, castor oil
Three types of enema tips commonly used - ans
Plastic disposable, Rectal retention,
Air-contrast retention
What water temperature is recommended for barium enema mixture? - ans
Room
temperature
To minimize spasm during a barium enema, ___ can be added to the contrast media
mixture. - ans
Lidocaine
What is the name of the patient position recommended for insertion of the rectal enema
tip? - ans
Sims Position
The initial insertion of the rectal enema tip should be pointed toward the - ans
Umbilicus
Which procedure is most effective to demonstrate small polyps in the colon? - ans
double-contrast barium enema
Which aspect of the large intestine must be demonstrated during evacuative
proctography? - ans
Anorectal Angle
Which clinical conditions is best demonstrated with evacuative proctography? - ans
Rectal Prolapse
Which procedure uses the thickest mixture of barium sulfate? - ans
Evacuative
Proctogram
Into what position is the patient placed for imaging during the evacuative proctogram? -
ans
Lateral
TF: A special tapered enema tip is inserted into the stoma before a colostomy barium
enema. - ans
True
TF: The enema bag should not be more than 36 inches above the table tip before the
beginning of the procedure. - ans
False, 24 inches
TF: The technologist should review the patients chart before a barium enema to
determine whether a sigmoidoscopy or colonoscopy was performed recently. - ans
True
TF: Both computed tomography and sonography may be performed to aid in diagnosing
appendicitis. - ans
True
TF: Because of the density and the amount of barium within the large intestine,
computer radiography should not be used during a barium enema. - ans
False
Another term for CT colonography (CTC) is - ans
Virtual colonoscopy
TF: A cleansing bowel prep is not required before a CTC. - ans
False
Why is oral contrast media sometimes given during a CTC? - ans
To mark or "tag"
fecal matter
What is the chief disadvantage of a CT colonography? - ans
Cannot remove polyps
discovered during CTC
TF: Single-contrast barium enemas are performed commonly on patients with a clinical
history of diverticulosis. - ans
False
Which of the following projections is recommended to be taken during a small bowel
series? - ans
Prone PA
TF: Shielding is not recommended during studies of the lower GI tract. - ans
False
Due to faster transit time of barium from the stomach to the ileocecal valve in pediatric
patients, how frequently should images be taken during a small bowel series to avoid
missing critical anatomy and possible pathology. - ans
Every 20 to 30 minutes
TF: If a retention- type enema tip is used, it should be removed after fluoroscopy is
completed and before overhead projections are taken to better visualize the rectal
region. - ans
False
The___ position is a recommended alternative for the lateral rectum projection during a
double-contrast BE procedure. - ans
Ventral Decubitus
What kV is recommended for a small bowel series (single contrast study)? - ans
100-125 kV
Where is the CR centered for the 15-minute radiograph during a small bowel series? -
ans
2 inches above iliac crest
What are the breathing instructions for a projection taken during a small bowel series? -
ans
Exposure on expiration
Generally, a small bowel series is complete once the contrast media reaches the ... -
ans
ileocecal valve- large intestine
Which type of patient habitus may require two 14x17 crosswise cassette for an AP
barium enema projection? - ans
Hypersthenic
Which projections taken during a barium enema best demonstrates the right colic
flexure? - ans
RAO or LPO
How much body rotation is required for oblique barium enema projection? - ans
35-45
egrees
Which position should be performed if the patient cannot lie prone on the table to
visualize the left colic flexure? - ans
RPO
Which projection, taken during a double-contrast barium enema, produces an air-filled
image of the right colic flexure, ascending colon and cecum? - ans
Left Lateral
Decubitus
Where is the CR centered for a lateral projection of the rectum? - ans
Level of ASIS at
midcoronal plane
Which projection during a double-contrast barium enema series best demonstrates the
descending colon for possible polyps? - ans
Right Lateral Decubitus
Which aspect of the large intestine is best demonstrated with an AP axial projection? -
ans
Rectosigmoid Region
What is the advantage of performing an AP axial oblique projection rather than an AP
axial? - ans
Creates less superimposition of rectosigmoid segments
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What is another term describing the AP and PA axial projection? - ans
Butterfly
projection
What CR angle is required for the AP axial? - ans
30-40 cephalad
What CR angle is required for the PA Axial? - ans
30-40 caudad
Which position is recommended for the post evacuation taken following a barium
enema? - ans
PA Prone
What kV range is recommended from a post evacuation projection following a barium
enema? - ans
90-100 kV
What is the recommended kV range for oblique projections taken during a
single-contrast barium enema study? - ans
100-125 kV
What is the recommended kV range for oblique projections taken during a
double-contrast study? - ans
90-100 kV
What medication can be given during a barium enema to minimize colonic spasm during
a barium enema? - ans
Glucagon
Situation: A radiograph for a double contrast BE reveals an obscured anatomic side
marker. The tech is unsure whether it is an AP or PA recumbent projection. The
transverse colon is primarily filled with barium, with ascending & descending with a
lesser amount. Which position is this? - ans
PA Prone, since transverse colon is an
intraperitoneal aspect of large intestine, it is located more anteriorly, it will fill with barium
Situation: A radiograph of lateral decubitus taken during an air contrast BE reveals that
the upside aspect of the colon is overpenetrated. The following factors were used: 120
kV, 30 mAs, 40 SID, high speed screens, & compensating filter for teh air filled aspect of
the large intestine, which factors needs to be modified on the repeat image? - ans
Wedge compensating filter, reduction of kV required, kV range is 90 to 100 kV
Situation: A radiograph of an AP axial BE projection of the rectosigmoid region reveals
that there is considerable superimposition of the sigmoid colon & rectum. The following
factors were used: 120 kV, 20 mAs, 40 SID, 35 caudad CR angle, & collimation. Which
factor needs to be changed? - ans
CR angled 35 cephalad for AP axial
Situation: A BE study performed on a hypersthenic patient reveals that the majority of
the radiographs demonstrate that the left colic flexure was cut off. What can be done to
correct this on the repeat? - ans
Use two 14 x 17 inch cassettes for AP/PA & obliques,
1 film centered higher & 1 film centered lower, both crosswise, ensures all anatomy is
demonstrated
Situation: A tech has inserted an air contrast retention tipe for a double contrast BE
study. He is not sure how much to inflate the retention balloon. Should he inflate it as
much as the patient can tolerate, or is there a better alternative? - ans
Retention
catheters should be fully inflated only by the radiologist under fluoroscopic guidance
Situation: A student tech is told to place the patient on the x-ray table in the Sims'
position in preparation for the tip insertion for a BE. Describe how the patient should be
positioned. - ans
Lay on left side & flex head & upper body forward drawing the right
leg up above the partially flexed left leg
Situation: A patient with a clinical history or regional enteritis comes to the radiology
department. What type of procedure would be most diagnostic for this condition? - ans
Enteroclysis, a double contrast small bowel series
Situation: A patient is referred to the radiology department for a presurgical small bowel
series. What modification to the standard study needs to be made for this particular
patient? - ans
Using a water soluble iodinated contrast media
Situation: A patient comes to the radiology department for a small bowel series.
However, because of the stroke, the patient is unable to swallow the contrast media.
What type of study should be performed for this patient? - ans
A diagnostic intubation
small bowel series
Situation: An infant with a possible intussusception is brought to the ER. Which
radiographic procedure may serve a therapeutic role in correcting this condition? - ans
BE or air enema, re-expansion of telescoped aspect fo the large intestine
Situation: Before a BE, the tech experienced difficulty in inserting the enema rectal tip
(No pain experienced). What should the tech do to complete this task? - ans
Inform
the radiologist & have him or her insert it under fluoroscopic guidance
Situation: During the fluoroscopy aspect of a BE, the radiologist detects an unusual
defect within the right colic flexure. She asks that the tech provide the best images
possible of this region. Which two projections will best demonstrate the right colic
flexure. - ans
RAO and LPO
Situation: A patient with a clinical history of possible enteritis comes the radiology
department. Which type of radiographic GI study would most likely be indicated for this
condition? - ans
Small bowel series
Situation: A patient's clinical history includes possible giardiasis. What radiographic
procedures would likely be indicated for this condition? - ans
Small bowel series
Situation: A patient is scheduled for a computed tomography colonoscopy (CTC). what
is recommended patient prepartion for this procedure? - ans
Patient undergoes a
cleansing bowel preparation. Food limited to clear liquids prior to exam, wear loose
fitting clothes without any metal snaps or clips the day of exam
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