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Chapter 13

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  1. Chapter 13 Lower GI

  2. Large Intestine Anatomy • From Iliocecal valve (___________) • _________ • Appendix • Ascending colon

  3. Large Intestine Anatomy • Hepatic flexure (___________) • Transverse Colon • Splenic Flexure (__________) • Descending Colon

  4. Large Intestine Anatomy • Sigmoid Colon • ___________ • Anal canal • __________

  5. Large Intestine Anatomy • ___________ – Pouches of the large intestine • ____________

  6. Colon Orientation • __________ aspects – Transverse and sigmoid • __________ aspects – Rectum, ascending, and descending colon

  7. Barium and Air Distribution_________ • Air within the _____ aspects • __________ and Sigmoid • Barium within the _______ aspects • Rectum, Ascending, and __________

  8. Barium and Air Distribution________ • Air within __________aspects • Rectum, Ascending, and Descending • Barium within ____________ • Transverse and Sigmoid

  9. Intestine Purpose • ___________ – Primarily done in Small • __________ – Primarily done in Small • ___________ – Primarily done in Small Some done in Large

  10. Moving it • Elimination (____________) – Large Intestine • Movement – ___________Small and Large • ____________churning in Large

  11. Barium Enema • Patient prep • NPO __________ • Bowel prep • __________________ • Cleansing enema • ________________________

  12. Contraindications to Laxatives • Gross ____________ • Severe _____________ • Obstruction • Inflammatory Condition • _______________

  13. Room prep • ___________ • Gloves • Have everything ready ___________

  14. BE Equipment • Determine if it’s ____________ Contrast • Enema tip • Single or Double • Check ___________ • _____________

  15. Barium Prep • Barium bag • Mixed with __________ • _________– Scald mucosal linings • Bag should not be more than ___ above the table

  16. Tip Insertion • _____________________________ • Have Barium ___________up to tip • Place pt in ____________ position • Lubricate tip • Have _____________and blow it out

  17. 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.

  18. During Fluoro • Assist the _____________ • Control the ______________ • Help the patient roll • _______________ • Prepare for the worst and hope for the best

  19. After The Radiologist Leaves • Work _____________ • ____________ the patient

  20. 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 _____________

  21. Barium Contraindications • Any possibility of a ____________ • Bowel _________ • If there is a contraindication • __________________contrast is used.

  22. Other than the routine • ___________ • Colostomy • ___________ • Un-prepped

  23. 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

  24. AP / PA BE • Position as a _____________ • Center at crest • Have pt____________

  25. RPO • _____________ • Center at crest or ______ • Center to mid body mass • Shows ______________ • Same as __________

  26. LPO • ____________ • Center at ___________ • Shows ______________ • Same as __________

  27. Lateral Rectum • Place pt on side (____________) • Center at _______________ • Shows rectum

  28. AP Axial(Butterfly) • Supine • _______________ • Center ________________ • Mid sagittal

  29. PA Axial • Prone • ____________ • Center at ___________ • Mid sagittal

  30. Post Evac • PA or AP • Position as a routine ________

  31. Air Contrast Additional Positions • Right and Left Decubitus • X-table Rectum

  32. 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

  33. Left Lateral Decubitus • Position patient in true ___________ • Center as RLD

  34. X-table rectum • Lie the ____________ • CR to go ___________ the table • Center at __________ and mid coronal