BIliary System and Upper GI Radiology

BIliary System and Upper GI Radiology What is the largest solid organ? Correct Answer: Liver The gallbladder is located inferior/superior to the liver? Correct Answer: inferior The liver has ____ lobes. Correct Answer: 4 The liver weighs ________ lbs and is _____ inches across. Correct Answer: 3-4 lbs, 8-9 inches The liver produces ______ mL of bile. Correct Answer: 800-1000mL What are the four lobes of the liver? Correct Answer: RIght lobe, left lobe, caudate lobe, quadrate lobe What ligament divides the lobes of the liver? Correct Answer: Falciform ligament What is the bile route? Correct Answer: Right and left hepatic ducts, common hepatic duct, common bile duct, pancreatic duct (duct of Wirsung), duodenum Bile acts as a ______ process of digestion. Correct Answer: mechanical What are the parts of the gallbladder? Correct Answer: cystic duct, spiral valve, neck, body, fundus What are the functions of the gallbladder? Correct Answer: stores bile, concentrates bile What stimulates contraction of the gallbladder? Correct Answer: cholecystokinin (CCK) What is a cholelith? Correct Answer: gallstone Where is the gallbladder located on a hypersthenic patient'? Correct Answer: pushed up in the higher RUQ; superior and lateral Where is the gallbladder located on a sthenic patient? Correct Answer: middle of RUQ Where is the gallbladder located on an asthenic patient? Correct Answer: towards the midline and lower of RUQ Define cholangiogram Correct Answer: radiographic exam of ducts Define cholecystocholangiogram Correct Answer: study of both gallbladder and biliary ducts Define cholelithiasis Correct Answer: condition of having gallstones Define cholecystectomy Correct Answer: surgical removal of gallbladder What is the alimentary canal? Correct Answer: The digestive pathway from the mouth to the anus What parts make up the alimentary canal? Correct Answer: upper GI tract, lower GI tract, accessory organs What makes up the upper GI tract? Correct Answer: oral cavity, pharynx, esophagus, stomach, duodenum, small intestine What makes up the lower GI tract? Correct Answer: large intestine and anus What are the accessory organs? Correct Answer: salivary glands, pancreas, liver, and gallbladder What are the functions of the alimentary canal? Correct Answer: intake and digestion, absorption, and elimination What is the purpose of an esophogram? Correct Answer: to study the form and function of the pharynx and the esophagus What is the purpose of an upper GI procedure? Correct Answer: to study the form and function of the distal esophagus, stomach, and duodenum Define mastication Correct Answer: chewing Define deglutition Correct Answer: swallowing Define paristalsis Correct Answer: rhythmic movement of the intestine and bowls to move waste forward What are the three salivary glands? Correct Answer: parotid, submandibular, sublingual What are the three parts of the pharynx? Correct Answer: nasopharynx, oropharynx, laryngopharynx What are the two indentations of the esophagus? Correct Answer: aortic arch and left primary bronchus Name the parts of the stomach Correct Answer: fundus, body, pyloric portion, cardiac notch, esophagastric junction, cardiac antrum, lesser curvature, greater curvature, angular notch, pyloric orifice The fundus is _____ part of the stomach? Correct Answer: most posterior The body is ______ part of the stomach? Correct Answer: anterior/inferior to fundus The pylorus is _______ part of the stomach? Correct Answer: posterior/ distal to body If the patient is in a supine position during a barium and air contrast study, where will the barium settle? Correct Answer: In the fundus If the patient is in a prone position during a ACBE study, where is the barium? Correct Answer: Filling most of the stomach, air is at the top If a patient is erect during a ACBE, where is the barium? Correct Answer: Barium fills most of the stomach creating a very crisp line in the stomach Duodenum is the ______ and ______ of three sections of small intestine. Correct Answer: shortest and widest What is the romance of the abdomen? Correct Answer: the c-loop around the head of the pancreas Intestines start off ______ and ______ as you get toward the large bowl. Correct Answer: wider, stricture What are the four parts of the duodenum? Correct Answer: Superior Descending Horizontal Ascending The duodenojejunal flexure is at the _______. Correct Answer: ligament of Trietz How long is does it take for food to digest in the stomach? Correct Answer: 2-6 hours, How long does food stay in the small intestine? Correct Answer: 3-5 hours Most digestion takes place in the ______ Correct Answer: small bowl/small intestine What are the three primary functions of the digestive system? Correct Answer: ingesting or digestion, absorption, elimination What is the purpose of an operative cholangiogram? Correct Answer: to detect choleliths, patency of biliary ducts, functionally status of hepatopancreatic ampulla, small lesions in biliary ducts What are the advantages of today's operative cholangiogram? Correct Answer: less invasive procedure, outpatient procedure What is the post-op procedure for a cholangiogram? Correct Answer: T-tube What is a t-tube procedure? Correct Answer: t-tube placed in common bile duct during surgery extending outside body clamped off, contrast media is injected into t-tube for image What is a percutaneous transhepatic cholangiogram? Correct Answer: Direct puncture of the biliary ducts with a needle passed through the liver Why would a PTC be done? Correct Answer: Patient has a history of obstructive jaundice What are the risks of a PTC? Correct Answer: liver hemorrhage, pneumothorax, bile escaping into peritoneal cavity What does ERCP stand for? Correct Answer: endoscopic retrograde cholangiogram What happens during an ERCP? Correct Answer: Endoscopic inspection, cannulation, and injection of biliary ducts using a duodenoscope What are ERCP pathologic indications? Correct Answer: patency of biliary ducts, indetected choleliths, small lesions Why is contrast media required for upper GI procedures? Correct Answer: increases or decreases tissue density What type of contrast media is barium sulfate? Correct Answer: positive and radiopaque colloidal suspension What is the ratio for thick barium? Thin? Correct Answer: 3:1, 1:1 What is a colloidal suspension? Correct Answer: never dissolves in water When would you NOT use barium sulfate? Correct Answer: perforated viscus or presurgical procedure What is the most common position for an esophagram? Correct Answer: RAO What are the two breathing exercises that can be utilized during an esophogram? Correct Answer: Valsalva maneuver and Mueller maneuver What are some upper GI pathologic conditions Correct Answer: ulcer, hiatal hernia, diverticula, diverticula, gastritis, tumor, bezoar What is the patient prep for an Upper GI procedure? Correct Answer: NPO 8 hrs, no smoking, no gum, pregnant? What is the usual technique for an Upper GI series? Correct Answer: high kv/ short exposure time (100-125) What are the postfluoro esophogram routines? Correct Answer: RAO (35-40 degrees), lateral, and AP What are some special projections for a postfluoro esophogram? Correct Answer: LAO, soft tissue lateral Describe an RAO esophagram Correct Answer: 35-40 degree obliquity, CR @ T