Why is the PA projection rather than the AP projection recommended for a small bowel series?

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Why is the PA projection rather than the AP projection recommended for a small bowel series?

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Digestive System-- LGI

QuestionAnswer
Primary function of the small intestine? Digestion and absorption of food
Primary function of the large intestine? Reabsorption of fluids and elimination of waste.
Length of the small intestine? Length of the large intestine? 22 feet; 5 feet
What are the four parts to the large intestine? 1)Cecum 2)Colon 3)Rectum 4)Anal Canal
Where and what is the vermiform appendix attached to? Posteromedial Side of the Cecum
The opening between the large intestine and small intestine is what? Ileocecal Valve
What is the contraction wave that moves contents towards the rectum? Peristalsis
What 2 abdominal regions are occupied almost entirely by the liver? Epigastric and Right Hypochondrium regions
What methods are used to administer barium for radiographic examinations of the Small Intestine? 1)By Mouth 2)Complete reflux filling with a large volume barium enema 3)Direct injection through an intestinal tube inserted into the nose or mouth (method called enteroclysis)
Which examinations are time stamps used for? Small Bowel Series
"High-density" barium sulfate is used primarily for: double-contrast intestine examinations ONLY
The general term used to describe the surgical procedure of forming an artificial opening to the intestine for the passage of fecal material is: a. colostomy b. enterectomy c. enterotomy d. enterostomy Enterostomy
What projection is used for radiographic examinations for defecography? Lateral
In which body habitus will the large intestine appear bunched together and positioned low in the abdomen? Asthenic Habitus
During an ERCP, an endoscope is passed into the duodenum under fluoroscopic control. "Spot" radiographs are usually taken of the: 1.) pancreatic duct 2.)common bile duct
During an operative cholangiogram, the surgeon injects the contrast medium directly into the biliary system. Which of the following projections are typically done during this procedure in surgery? 1.) AP 2.) AP oblique, RPO
What is the patient preparation for a small intestine examination? 1)food and fluid withheld after the evening meal and no breakfast 2)preferably a soft or low residue diet for 2 days prior
The first small intestine radiograph is taken how many minutes after the patient drinks barium? 15 Minutes
Which of the following are essential projections for examination of the small intestine? AP and PA
Where is the IR centered for radiographs of the small intestine that are taken within 30 minutes of drinking the barium? L2 or 2 inches above the Iliac Crest
Where is the IR centered for delayed radiographs of the small intestine? Level of the iliac crest
What is the respiration phase for projections of the large intestine? Expiration
What methods are used for radiographic examinations of the colon? Single or Double Contrast
What are the preparation methods for examinations of the colon? 1)Laxatives 2)Dietary Restrictions 3)Cleansing enemas
What is the proper inflation of the retention balloon for barium enema? One complete squeeze of the 90mL inflator under fluoroscopy
What is the patient position for a barium enema tip insertion? Sims
How far above the anus is the bag placed? 18 inches to no more than 24 inches
Which radiographs are taken during a single contrast BE? Spot radiographs and Post evac (AP or PA, PA Obliques, Axial for Sigmoid, and lateral)
What are the methods of performing a double contrast barium enema? Single stage, & two stage by Welin
For AP or PA projections of a sthenic patient during a barium enema, where is the IR centered? Level of the Iliac Crest
Which projections will show the rectosigmoid area? AP/PA Axial and Lateral
What is the CR angle for the PA Axial projection of the large intestine? 30-40 Caudad
What is the amount of body rotation for the PA Obliques of the large intestine (RAO or LAO) 35 to 45 degrees
The CR enters what body plane for a PA Oblique projection of the large intestine? Sagittal plane 1 to 2 inches lateral of the midline toward the elevated side at the level of the iliac crest
Which projection(s) best demonstrates the Right Colic Flexure? AP LPO or PA RAO
Which projection best demonstrates the Ascending Colon? PA RAO/ AP LPO
The PA Oblique projection LAO best demonstrates what part of the colon? Left colic flexure and the descending portion
Which projection(s) best demonstrates the Left Colic Flexure? PA LAO / AP RPO
At what level is the center of the IR positioned for a lateral projection of the rectosigmoid area? ASIS
What plane is centered to the grid for a lateral projection? Midcoronal plane
What is the central ray angle for an AP Axial projection of the large intestine? 30 to 40 degrees Cephalad
What is the degree of body rotation for the AP Oblique projection of the large intestine? 35 to 45 degees
Which projections clearly demonstrate the descending colon? PA Oblique LAO and AP Oblique RPO
Where is the IR centered for a decubitus projection of the large intestine? Level of the Iliac Crest
What method demonstrates the rectum and rectosigmoid area in true axial? Chassard-Lapine Method (patient bent over grabbing ankles)
The large intestine is made up of a series of pouches called? Haustra
What is the pouchlike portion of the large intestine below the junction of the ileum and colon? Cecum
Where does the ascending colon join the transverse colon? Right colic flexure
How far is the enema tip inserted into the rectum for a colon exam? No more than 4 inches
The entire colon is best demonstrated in which projection(s)? AP or PA
In the left lateral decubitus position, air will be demonstrated where in the large intestine? Lateral side of Ascending and Medial side of Descending
What Projection and position will best demonstrate the posterior portion of the colon? Lateral projection in Left or Right Ventral Decubitus position
What part of the small intestine makes up three-fifths of its entirety? Ileum
Which part of the large intestine is located highest, or most superior, in the abdomen? Left colic flexure
What part of the colon is not considered a main part of the colon? Cecum
Which part of the large intestine has the widest diameter? Cecum
Which part of the colon has the greatest amount of potential movement? Transverse Colon
What is the name for the three bands of muscle that pull the large intestine into pouches? Taeniae Coli
Which part(s) of the colon will most likely be filled with air with the patient in the prone position? Ascending, Descending, & Rectum
The circular staircase, or herringbone pattern, is a common radiographic sign for what? Ileus
What condition may produce the "cobblestone" or "string" sign? Regional Enteritis (Crohn's Disease)
Which procedure is considered a functional study with the intestine? Small Bowel Series
When is a small series deemed to be complete? Once contrast media passes the ileocecal valve
What is a term describing a "double-Contrast" small bowel procedure? Enteroclysis
What condition would an enteroclysis study be indicated for? Regional Enteritis (Crohn's Disease)
What is the amount of barium ingested for the average adult in a small bowel series? 16 ounces
The tip of the catheter is advanced to the ____________ during an enteroclysis. Duodenojejunal Flexure (suspensory ligament)
The "stovepipe" radiographic sign is often seen with what pathology? Chronic Ulcerative Colitis
A telescoping, or invagination, of one part of the intestine into another is termed ____________. Intussusception
The tapered or 'corkscrew' radiographic sign is often seen with ______________. Volvulus
Which radiographic sign is frequently seen with carcinoma of the colon? Napkin ring or apple core sign
Which of the following is classified as an irritant laxative? Castor Oil
What conditions would contraindicate the use of a cathartic prior to a barium enema? Ileus
During the initial enema tip insertion, the tip is aimed toward the ___________. Umbilicus
What pathologic condition is best demonstrated with evacuative proctography? Rectal prolapse
The idea kV range for a double-contrast barium enema is? 80 to 90 kV
Central ray and image receptor centering for a 1-hour small bowel radiograph should be? Level of the iliac crest
Which projection/position is most commonly performed during an evacuative proctogram? Lateral
Why is the PA rather than the AP recommended for a small bowel series? Better separation of the loops of the small intestine.
A radiograph of an AP barium enema projection reveals poor visualization of the sigmoid due to excessive superimposition of the sigmoid colon and rectum. How can this area be better visualized on the repeat? Angle the CR 30 - 40 degrees cephalad with the AP projection
A patient comes in with possible diverticulosis. Which study is most diagnostic for detecting this condition? Double Contrast Barium Enema
If a patient is having a double contrast BE but cannot lie on their side, what projection could replace the lateral rectum projection? Ventral Decubitus
What BE projection/position provides the greatest amount of gonadal dosage to both male and female patients? Lateral Rectum
What is another name for the AP Axial projection? Butterfly position
If insertion of the enema tip experiences resistance, what should the next step be by the technologist? Have the radiologist insert under fluoro
UGI, IVP, BE: What is the correct scheduling sequence? IVU, BE, UGI
Desirable qualities for a barium sulfate suspension for the lower GI tract are: Uniform coating and No foam-forming elements
The lateral and Chassard-Lapine projections are most commonly used for visualization of what during a lower GI tract exam? Rectosigmoid Region
When would saline be used for mixing barium sulfate suspension instead of normal tap water? Patients with hypoglycemia (older patients) during a BE
What position may be used to separate the overlaying loops of the large intestine? Trendelenburg
What procedure would best be able to assist in a suspected diagnosis of Crohn's Disease? Barium Enema or small bowel series
What projections are taken during a barium enema to demonstrate the rectosigmoid area? lateral, PA axial, AP Axial
During radiographic evaluation of the large intestine using a barium contrast agent, the AP Oblique projections are most commonly employed to improve visualization of what? Right & Left Colic Flexures
During evaluation of the large intestine, the use of high density barium contrast agent in combination with air has proven to be beneficial in the evaluation of what? Intestinal Polyps


You will continue to drink the contrast material throughout the exam to ensure that the radiologist can sufficiently examine the full length of the small intestine. You may be asked to lie on your right side between x-rays in order to encourage fluid to pass from the stomach into the small intestine.

Which of the following positions is routine for a small bowel radiograph?

Unit test 1, 2, 3, & Midterm.

What is the purpose of a small bowel series?

What is a Small Bowel Series? A small bowel series is an x-ray examination of the small intestine that uses a special form of x-ray called fluoroscopy and an orally ingested contrast material called barium. An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

Which one of the following imaging modalities and/or procedures is very effective in detecting the Meckel diverticulum?

Computed tomography colonography (CTC) is considered as an effective alternative to endoscopic colonoscopy. Meckel diverticulum is best diagnosed with a radionuclide (nuclear medicine) scan.