Transcript RAD 322_review

RAD 435
PRACTICAL REVIEW
Manal alOsaimi
Contents
1.
2.
3.
4.
5.
6.
7.
8.
Ba Swallow (Esophagogram).
Ba Meal.
Ba Follow through.
Ba Enema.
Gall Bladder & Biliary Ducts.
Sialography.
Hysterosalpingography.
Urography procedure.
Marks
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Total Practical Fluoro = 20 Marks
Ba Swallow
The Normal indentations
Barium Swallow
AP view
Barium Swallow
LAO view
Barium Swallow
Write the name of the procedure
RAO
The esophagus is seen
between the heart and
the spine
The patient is rotate 3540 degrees with the RT
side against the table
Barium Swallow
Write the name of the procedure
LATERAL
1 Barium Swallow
Esophagogastric Junction
( Cardiac Orifice)
Barium Meal
Stomach openings and curvatures
Stomach subdivisions:
1- fundus: upper portion of the stomach.
2- body.
3- pylorus
When the stomach is empty
The internal lining is thrown into numerous longitudinal
folds called RUGAE
1- cardiac orifice (esophagogastric junction):
opening between the esophagus and the
stomach.
2-cardiac notch: superior to the cardiac orifice.
3-distal esophagus.
4-pyloric valve or sphincter: distal opening of the
stomach.
5- lesser curvature: medial border of the
stomach, extends between the cardiac and
pyloric openings.
6-greater curvature: lateral border of the
stomach, four or five times longer than the lesser
curvature.
Barium Meal
A. Distal esophagus
B. Esophagogastric junction
(cardia orifice)
C. Lesser curvature
D. Angular notch
E. Pylorus of stomach
F. Pyloric valve
G. Duodenal bulb of the
duodenum
H. Descending portion of the
duodenum
I. Body of stomach
J. Greater curvature of stomach
K. Gastric folds
L. Fundus of stomach
Air-Barium Distribution in the Stomach
Label: 1, 2
(AP recumbent)
Fundus
When the pt is
Supine position
(PA recumbent)
Prone position
Erect (upright) position
Most posterior part
Highest part
Highest part
Filled with air
Filled with air
Filled with Ba
2
Pylorus filled with Ba
The air-fluid level is a
straight line
Barium Meal
Ba in fundus
2
LPO recumbent
SUPINE
(AP recumbent)
Air in Fundus
Prone
(PA recumbent)
RAO
Erect
recumbent
Air-fluid level straight
2 Barium Meal
Air in fundus
Prone
RAO
2 Barium Meal
Air in fundus
Erect
Small Bowel Procedures
Small Bowel Procedures
Barium meal follow through.
Barium follow through (Small Bowel only Series).
Enteroclysis
Intubation ( Small bowel enema).
ANATOMY
Parts of S.I:
Duodenum: 1st,shortest,widest and most fixed.
Jejunum: 2/5 and feathery appearance.
Ileum: 3/5, longest, smooth no feathery appearance,
and joins large intestine at ileocecal valve
ANATOMY
A: duodenum
C: jejunum
D:ileum
E: area of ileocecal valve
PA 30 mins
Small Bowel Series
Small Bowel Series
1.Ba Meal Follow through
30 minutes
1 Hour
2 Hour
Small Bowel Series
2.Barium follow through
Small Bowel Series
2.Ba Follow through
Enteroclysis
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Injection of c/m into the S.B.
It is a Double contrast method used to evaluate the S.B.
the pt is intubated under flouroscopic control with a special
catheter. Stomach → duodenum → duodenojujinal junction.
CM
1. Thin BaSO4. ( Coats the mucosa).
2. Air or Methylcellulose, why ? which is Better ?
To distend the bowel and provide double contrast
Methylcellulose, shows the mucosal details as it
adheres to the walls and distends the bowel.
It propel the barium from intestine
It evacuate barium from the large intestine.
Small Bowel Series
3.Enteroclysis
Intubation ( S.B enema)
It is a single contrast method where a nasogastric tube
is passed through:
pt’s nose→esophagus→stomach→duodenum and into
the jejunum. (RAO position is preferred ? )
To help pass the tube from stomach →duodenum by
gastric peristalsis.
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diagnostic
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Therapeutic
C.M: thin BaSO4 or water soluble iodinated c.m.
Small Bowel Series
4.Intubation
BARIUM ENEMA
Technique
Preliminary Film to:
1.
2.
Bowel preparation.
Complete
obstruction,
Perforation
4 Barium Enema
Splenic flexure
Hepatic flexure
Transverse colon
Aescending colon
Descending colon
Sigmoid colon
single contrast
4 Barium Enema
Single Contrast
4 Air Barium Distribution
Supine
Transverse c. filled with
air
Prone
Transverse c. filled with
ba
4 Barium Enema
LT LAT Decubitus
4 Barium Enema
RT LAT Decubitus
Barium Enema
RPO
Splenic flexure
descending colon appear
open
Barium Enema
LPO
Hepatic flexure ascending
colon and rectosigmoid
region appear open
4 Barium Enema
Hepatic Flexure
Splenic Flexure
4 Barium Enema
RectoSegmoid Region
4 Barium Enema
Rectum
Gall Bladder and Biliary System
Procedures
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Definition
Performed during surgery, usually During a Cholecystectomy
(wherein the surgeon removes the GB).
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Indication
If the surgeon suspects that residual stones are located in the
biliary ducts
Anatomy
Operative (Immediate) Cholangiogram
Lt hepatic duct
Rt hepatic duct
Common hepatic duct
Common bile duct
catheter
Gall Bladder and Biliary System Procedures
5 Gall Bladder & Biliary Ducts
Catheter
T-shape
Endoscope
Sialography
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Definition
radiographic examination of the salivary ducts.
Sialography
6 Sialography
Lateral
Anatomy
8 Hystrosalpingography
A = RT fallopian tube.
B = Uterine cavity .
C = LT fallopian tube.
D = Catheter.
Hystrosalpingography
Hystrosalpingography
Urography Procedures
Urography Procedures
1
• Retrograde Cystography
(Cystogram)
2
• MCUG Micturating
Cystourethrography
Retrograde Cystography (Cystogram)
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Definition
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Is a Non Functional radiographic examination of the
urinary bladder after injection of CM via urethral
catheter
A retrograde cystogram is a radiographic study of the
bladder, made after a direct injection of a radiopaque
contrast material by means of a urethral catheter
CM
Urographine
7 Urography Procedures
Cystography
MCUG Micturating Cystourethrography
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Definition
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Is a Functional radiographic examination of the urinary
bladder and urethra to evaluate the patient’s ability to
urinate.
micturating cystourethrogram (MCUG), is a technique for
watching a person's urethra and urinary bladder while
the person urinates (voids).
CM
Urographine
7 Urography Procedures
MCUG
Wish you Best of Luck