Transcript Chapter 15
Chapter 13 Lower GI Large Intestine Anatomy • From Iliocecal valve (___________) • _________ – Appendix • Ascending colon Large Intestine Anatomy • Hepatic flexure (___________) • Transverse Colon • Splenic Flexure (__________) • Descending Colon Large Intestine Anatomy • Sigmoid Colon • ___________ • Anal canal –__________ Large Intestine Anatomy • ___________ – Pouches of the large intestine • ____________ Colon Orientation • __________ aspects – Transverse and sigmoid • __________ aspects – Rectum, ascending, and descending colon Barium and Air Distribution _________ • Air within the _____ aspects – __________ and Sigmoid • Barium within the _______ aspects – Rectum, Ascending, and __________ Barium and Air Distribution ________ • Air within __________aspects – Rectum, Ascending, and Descending • Barium within ____________ – Transverse and Sigmoid Intestine Purpose • ___________ – Primarily done in Small • __________ – Primarily done in Small • ___________ – Primarily done in Small Some done in Large Moving it • Elimination (____________) – Large Intestine • Movement – ___________Small and Large – ____________churning in Large Barium Enema • Patient prep – NPO __________ – Bowel prep • __________________ • Cleansing enema • ________________________ Contraindications to Laxatives • Gross ____________ • Severe _____________ • Obstruction • Inflammatory Condition – _______________ Room prep • ___________ • Gloves • Have everything ready ___________ BE Equipment • Determine if it’s ____________ Contrast • Enema tip – Single or Double – Check ___________ – _____________ Barium Prep • Barium bag – Mixed with __________ – _________– Scald mucosal linings – Bag should not be more than ___ above the table Tip Insertion • _____________________________ • Have Barium ___________up to tip • Place pt in ____________ position • Lubricate tip • Have _____________and blow it out Here It Comes!! • On _____________ insert tip into rectum – Toward __________ then anterior/superior • Insert only 3 – 4 cm _____________ • DO NOT ____________ • Some rads will want to insert and some want you to inflate. During Fluoro • • • • • Assist the _____________ Control the ______________ Help the patient roll _______________ Prepare for the worst and hope for the best After The Radiologist Leaves • Work _____________ • ____________ the patient Once your overheads are done • Ensure you did not ______________ • Place the enema bag on __________ • Drain as much as possible into ________ • Assist the patient to the _____________ Barium Contraindications • Any possibility of a ____________ • Bowel _________ • If there is a contraindication – __________________contrast is used. Other than the routine • ___________ • Colostomy • ___________ • Un-prepped BE Imaging Routine • • • • • • • Scout AP RPO (RAO) LPO (LAO) Lt Lateral AP and/or PA Axial Post Evac kV – 75-80 kV - 100 kV - 100 kV - 100 kV - 100 kV - 100 kV – 75-80 AP / PA BE • Position as a _____________ • Center at crest • Have pt ____________ RPO • _____________ • Center at crest or ______ • Center to mid body mass • Shows ______________ • Same as __________ LPO • ____________ • Center at ___________ • Shows ______________ • Same as __________ Lateral Rectum • Place pt on side (____________) • Center at _______________ • Shows rectum AP Axial (Butterfly) • Supine • _______________ • Center ________________ • Mid sagittal PA Axial • Prone • ____________ • Center at ___________ • Mid sagittal Post Evac • PA or AP • Position as a routine ________ Air Contrast Additional Positions • Right and Left Decubitus • X-table Rectum Right Lateral Decubitus • Place patient in true ____________ • Using a __________holder place center of the cassette at the _____________ • Center CR to cassette • Ensure arms are up • Shows ____________ levels Left Lateral Decubitus • Position patient in true ___________ • Center as RLD X-table rectum • Lie the ____________ • CR to go ___________ the table • Center at __________ and mid coronal