Chapter 12 Biliary Tract and Upper Gastrointestinal System

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1

1. What is the average weight of the adult human liver?

3 to 4 pounds or 1/36 of total body weight

2

2. Which abdominal quadrant contains the gallbladder?

Right upper quadrant

3

3. What is the name of the soft tissue structure that separates the right from the left lobe of the liver?

Falciform ligament

4

4. Which lobe of the liver is larger, the right or the left?

Right

5

5. List the other two lobes of the liver (in addition to right or the left)?

Quadrate, Caudate

6

6. True or False: the liver performs more than 100 functions?

True

7

7. True or False: The average healthy adult liver produces 1 gallon, or 3000 to 4000 mL, of bile per day.

False

8

8. List the three primary functions of the gallbladder?

Store bile, concentrate bile, contracts to release bile into duodenum

9

9. True or False: Concentrated levels of cholesterol in bile may lead to gallstones?

True

10

10. What is a common site for impaction, or lodging, of gallstones?

Duodenal papilla

11

11. True or False: In about 40% of individuals, the end of the common bile duct and the end of the pancreatic duct are totally separated into two ducts rather than combining into one single passageway into the duodenum?

True

12

12. True or False: An older term for the main pancreatic duct is the duct of Vater.

False

13

13. The gallbladder is located more (posteriorly or anteriorly) within the abdomen?

anteriorly

14

14. Which imaging modality produces cholescintigraphy?

Nuclear medicine

15

15. True or False: Acute cholecystitis may produce a thickened gallbladder wall?

True

16

16. Cholelithiasis

condition of having gallstones

17

17. Cholecystitis

Inflammation of the gallbladder

18

18. Biliary stenosis

Narrowing of the biliary ducts

19

19. Cholecystectomy

Surgical removal of the gallbladder

20

20. Neoplasm

benign or malignant tumors

21

21. Choledocholithiasis

enlargement or narrowing of the biliary ducts because of the presence of stones.

22

22. List the seven main components of the alimentary canal

mouth, pharynx, esophagus, stomach, small & large intestine, anus, salivary glands, pancreas, liver, gallbladder

23

23. List the four accessory organs of digestion

salivary glands, pancreas, liver, gallbladder

24

24. The three primary functions of the digestive system

intake and digestion of food, absorption of digested food particles, elimination of solid waste.

25

25. What two terms refer to a radiographic examination of the pharynx and esophagus?

esophagram or barium swallow

26

26. Which terms describes the radiographic study of the distal esophagus, stomach, and duodenum?

Upper gastrointestinal series or upper GI

27

27. Which three pairs of salivary glands are accessory organs of digestion associated with the mouth?

parotid, sublingual, submadibular

28

28. The act of swallowing is called?

deglutition

29

29. List the three divisions of the pharynx

nasopharynx, oropharynx, laryngopharynx

30

30. What structures create the two indentations seen along the lateral border of the esophagus?

aortic arch, left primary bronchus

31

31. List the three structures that pass through the diaphragm

esophagus, inferior vena cava, aorta

32

32. What part of the upper GI tract is a common site for the ulcer disease?

duodenal bulb or cap

33

33. What term describes the junction between the duodenum and jejunum?

duodenojejunal flexure (suspensory muscle of the duodenum or ligament of Treitz)

34

34. The C-loop of the duodenum and pancreas are (intraperitoneal or retroperitoneal) structures.

retroperitoneal

35

35. The three main subdivisions of the stomach are?

Fundus, body, pylorus

36

36. Another term for mucosal folds of the stomach is?

rugae

37

37. True or False: Mechanical digestion includes movement of the entire gastrointestinal tract?

True

38

38. Peristaltic activity is not found in which of the following structures ( Pharynx, Esophagus, Stomach, Small Intestine)?

pharynx

39

39. Stomach contents are churned into a semifluid mass called?

chyme

40

40. A churning or mixing activity present in the small bowl is called?

rhythmic segmentation

41

41. List the three classes of substances that ingested and must be chemically digested.

carbohydrates, proteins, lipids

42

42. Biologic catalysts that speed up the process of digestion are called?

enzymes

43

43. List the end products of digestion for the following classes of food carbohydrates (carbohydrates, lipids, proteins)

simple sugars, fatty acids and glycerol, amino acids

44

44. What is the name of the liquid substance that aids in digestion and is manufactured in the liver and stored in the gallbladder?

bile

45

45. How does bile assist in emulsification in fat?

large fat droplets are broken down to small fat droplets, which have greater access for the breakdown of lipids

46

46. Absorption of nutrients primarily takes place in the ____________, although some substances are absorbed through the lining of the ___________.

small intestine, of the stomach

47

47. Any residues of digestion or unabsorbed digestive products are eliminated from the ________ as a component of feces.

large intestine

48

48. Peristalsis is an example of which type of digestion.

mechanical

49

49. Which term describes food once it is mixed with gastric secretions in the stomach?

chyme

50

50. A high and transverse stomach would be found in a (hypersthenic, sthenic, hyposthenic, asthenic)

hypersthenic

51

51. A J-shaped stomach that is more vertical and lower in the abdomen with the duodenal bulb at the level of L3-L4 would be found in a(n) (hyperstenic, sthenic, hyposthenic/asthenic or none of the above)

hyposthenic/asthenic

52

52. On the average, how much will abdominal organs drop in the erect position?

1 to 2 inches

53

53. Name the two abdominal organs most dramatically affected, in relation to location, by body habitus?

Stomach and gallbladder

54

54. Would the fundus of the stomach be more superior or more inferior when one takes in a deep breath? Why?

Inferior, because of its proximity to the diaphragm

55

55. Type of mechanical digestion and/or movement that occur in oral cavity

mastication and deglutition

56

56. Type of mechanical digestion and/or movement that occur in pharynx

deglutition

57

57. Type of mechanical digestion and/or movement that occur in Esophagus

deglutition, peristalsis

58

58. Type of mechanical digestion and/or movement that occur in stomach

peristalsis and mixing

59

59. Type of mechanical digestion and/or movement that occur in the small intestine

peristalsis and rhythmic segmentation

60

60. True or False: With the use of digital fluoroscopy, the number of postfluoroscopy radiographs ordered has greatly diminished.

True

61

61. Another term for a negative contrast medium is ____

Radiolucent contrast medium

62

62. What substance is most commonly ingested to produce carbon dioxide gas as a negative contrast medium for gastrointestinal system?

calcium or magnesium citrate

63

63. Is a mixture of barium sulfate a suspension or a solution?

suspension

64

64. True or False: Barium sulfate never dissolves is water.

True

65

65. True or False: Certian salts of barium are poisonous to humans, so barium contrast studies require a pure sulfate salt of barium for human consumption during GI studies.

True

66

66. What is the ratio of water to barium for a thin mixture of barium sulfate

1:1

67

67. What is the chemical symbol for barium sulfate?

BaSO4

68

68. When is the use of barium sulfate contraindicated?

when the mixture may escape the peritoneal cavity

69

71. What patient condition prevents the use of a water-soluble contrast medium for an upper GI?

sensitivity to iodine

70

72. What is the major advantage for using a double-contrast medium technique for esophagrams and upper GI?

better coating and visibility of the mucosa. Polyps, diverticula, and ulcers are better demonstrated.

71

73. The speed with which barium sulfate passes through the GI tract is called gastric

motility

72

74. What is the purpose of the gas with a double-contrast media technique

It forces the barium sulfate against the mucosa for better coating

73

75. Which of the following devices on a digital fluoroscopy system converts the analog into a digital signal (PACS, Light converter, CCD, OTS)

CCD

74

76. What device (found beneath the radiographic table when correctly positioned) greatly reduces exposure to the technologist from the fluoroscopic x-ray tube?

bucky slot shield

75

77. How is the bucky slot shield activated or placed in its correct position for fluoroscopy?

by moving the bucky tray all the way to the end of the table

76

78. What is the minimum level of protective apron worn during fluoroscopy?

0.5 mm Pb/Eq apron

77

79. What is the major benefit of using a compression paddle during an upper GI study?

reduces exposure to arms and hands of radiologist

78

80. List the three cardinal principles of radiation protection.

time, distance, shielding

79

81. Which one of the three cardinal principles is most effective in reducing exposure to the technologist during a fluoroscopic procedure?

distance

80

82. Which capability on most digital fluoroscopy systems demonstrates dynamic flow of contrast media through the GI Tract.

cine loop capability

81

83. What is the correct pathological condition for the esophagram: Difficulty in swallowing

dysphagia

82

84. What is the correct pathological condition for the esophagram: Replacement of normal squamous epithelium with columnar epithelium

barrett's esophagus

83

85. What is the correct pathological condition for the esophagram: May lead to esophagitis

GERD

84

86. What is the correct pathological condition for the esophagram: Large outpouching of the esophagus?

Zenker's diverticulum

85

87. What is the correct pathological condition for the esophagram: also called cardiospasm

achalasia

86

88. What is the correct pathological condition for the esophagram: most common form is adenocarcinoma

carcinoma of the esophagus

87

89. What pathology for upper GI series is: Blood in vomit

hematemesis

88

90. What pathology for upper GI series is: inflammation of lining of stomach

gastritis

89

91. What pathology for upper GI series is: blind outpouching of the mucosal wall

diverticula

90

92. What pathology for upper GI series is: undigested material trapped in stomach

bezoar

91

93. What pathology for upper GI series is: synonymous with gastric or duodenal ulcer

peptic ulcer

92

94. What pathology for upper GI series is: portion of stomach protruding through the diaphragmatic opening

hiatal hernia

93

95. What pathology for upper GI series is: only 5% of ulcers lead to this condition

perforating ulcer

94

96. What pathology for upper GI series is: Double - contrast upper GI is recommended for this type of tumor

gastric carcinoma

95

97. Radiographic appearance of the following conditions: Its presence indicates a possible sliding hiatal hernia

schatzki's diverticulum

96

98. Radiographic appearance of the following conditions: Speckled appearance of gastric mucus

gastritis

97

99. Radiographic appearance of the following conditions: "wormlike" appearance of esophagus

esophageal varices

98

100. Radiographic appearance of the following conditions: Stricture of esophagus

achalasia

99

101. Radiographic appearance of the following conditions: Gastric bubble above diaphragm

hiatal hernia

100

102. Radiographic appearance of the following conditions: Irregular filling defect within stomach

gastric carcinoma

101

103. Radiographic appearance of the following conditions: Enlarged recess in proximal esophagus

zenker's diverticulum

102

104. Radiographic appearance of the following conditions: "Lucent-halo" sign during upper GI

ulcers

103

105. Which procedure is often performed to detect early signs of GERD

endoscopy

104

106. Which specific structure of the gastrointestinal system is affected by HPS

antral muscle at the orifice of the plyorus

105

107.Which imaging modality is most effective in diagnosing HPS while reducing dose to the patient?

ultrasound

106

108. What does the acronym NPO stand for and what does it mean

non per os, nothing by mouth

107

109. True or False: The patient must be NPO 4-6 hours before an esophagram

False 8 hours

108

110. True or False: The esophagogram usually begins with fluoroscopy with the patient in the erect position

True

109

111. What materials may be used for swallowing to aid in the diagnosis of radiolucent foreign bodies in the esophagus?

barium soaked cotton balls, barium pills, or marshmallows followed by thin barium

110

112. A breathing technique in which the patient takes in a deep breath and bears down is called the _____?

valsalva maneuver

111

113. What position is the patient usually placed in during the water test?

LPO

112

114. Which region of the GI tract is better visualized when the radiologist uses a compression paddle during an esopagram

esophagogastric junction

113

115. What type of contrast medium should be used if the patient has a history of bowl perforation?

oral, water soluble iodinated contrast media

114

116. What is the minimum amount of time that the patient should be NPO before an upper GI

8 hours

115

117. True or False: The body of the stomach curves inferiorly and posteriorly from the fundus

False

116

118. What is the most common form of positive contrast medium used for studies of the gastrointestinal system

barium sulfate