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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
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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 kV – 75-80 • AP kV - 100 • RPO (RAO) kV - 100 • LPO (LAO) kV - 100 • Lt Lateral kV - 100 • AP and/or PA Axial kV - 100 • Post EvackV – 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