Chapter 15 Lower GI

Large Intestine Anatomy From Iliocecal valve (Terminal Ileum) ____________ –Appendix ____________ colon

Large Intestine Anatomy __________ flexure (Right Colic) __________ Colon ___________Flexure (Left Colic) ___________Colon

Large Intestine Anatomy __________ Colon Rectum _____________ –Anus

Large Intestine Anatomy ___________ – Pouches of the large intestine __________ Coli

Colon Orientation Anterior aspects – _______________ Posterior aspects – __________________________colon

Barium and Air Distribution Supine Air within the anterior aspects – ________________________ Barium within the posterior aspects –___________________________

Barium and Air Distribution Prone Air within ____________ aspects –Rectum, Ascending, and Descending Barium within ___________ –Transverse and Sigmoid

Intestine Purpose __________ – Primarily done in Small Absorption – Primarily done in Small _______________ – Primarily done in Small Some done in Large

Moving it Elimination _______________ – Large Intestine Movement – Peristalsis Small and Large –____________in Large

Barium Enema Patient prep –______________ –Bowel prep _________________ Cleansing __________ ________________________________

Contraindications to Laxatives Gross ______________ Severe _____________ Obstruction Inflammatory Condition –________________

Room prep ______________ _____________ Gloves Have everything ready _____ the test

BE Equipment Determine if it’s ___________ Contrast Enema tip –Single or Double –Check ___________ –_________

Barium Prep Barium bag –Mixed with _____________(Cold is debatable) –_________– Scald mucosal linings –Bag should not be more than ______ the table

Tip Insertion TALK EACH STEP WITH THE PATIENT Have Barium ____________to tip Place pt in ____________ position Lubricate tip Have pt take in a ____________it out

Here It Comes!! On expiration insert tip into rectum –Toward ____________________ Insert only _____________ __________________________ Some rads will want to insert and some want you to inflate.

During Fluoro Assist the radiologist Control the _______________ Switch out spot films if applicable Help the patient roll _________________ Prepare for the _________________for the best

After The Radiologist Leaves Work _____________ Encourage the patient

Once your overheads are done Ensure you did not miss ____________ Place the enema bag ____________ _______ as much as possible into the bag Assist the patient to the ________

Barium Contraindications Any possibility of a _____________ Bowel ______________ If there is a contraindication –_______________iodinated contrast.

Other than the routine Babies ___________ Un-prepped

BE Imaging Routine Scout kVp – AP kVp RPO (RAO) LPO (LAO) Lt Lateral AP and/or PA Axial Post Evac kVp – 75-80

AP / PA BE Position as a KUB Center at crest Have pt hold breath

RPO 45° Oblique Center at crest or _______________ Center to mid body mass Shows __________________ Same as _______

LPO 45° Oblique Center at crest Shows ________________ Same as ___________-

Lt Lateral Rectum Place pt on lt side Center at ______________ Shows rectum

AP Axial (Butterfly) Supine ________________ Center _____________ASIS Mid sagittal

PA Axial Prone _______________ Center at ____________ Mid sagittal

Post Evac PA or AP Position as a routine KUB

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

Right Lateral Decubitus Place patient in true ___________ Using a x-table grid holder place center of the cassette at the __________ Center CR to cassette Ensure arms are up Shows ______________

Left Lateral Decubitus Position patient in true left lateral Center as RLD

X-table rectum Lie the patient prone CR to go _______________ Center at ____________ and mid coronal