Chapter 13 Lower Gastrointestinal System
1. How long is the average small bowel if removed and stretched out during autopsy?
23 feet or 7 m =
2. In a person with good muscle tone, the length of the entire small intestine is
15 to 18 ft or 4.5 to 5.5
3. The average length of the large intestine is
5 feet or 1.5 m
4. List the three divisions of the small intestine in descending order, starting with the widest division.
Duodenum, Jejunum, Ileum
5. The colon is divided into ___ sections and has ___ flexures
4 sections, 2 flexures
6. In which two abdominal quadrants would the majority of the jejunum be found?
LUQ and LLQ
7. Which division of the small intestine has a feathery or coiled spring appearance during a small bowel series?
8. Which division of the small intestine is the longest?
9. Which two aspects of the large intestine are not considered part of the colon?
cecum and the rectum
10. List the two functions of the ileocecal valve?
Prevents contents of the ileum from passing too quickly into the cecum and it prevents reflux back into the ileum.
11. What is another term for the appendix?
12. Longest aspect of the large intestine
13. Widest portion of the large intestine
14. A blind pouch inferior to the ileocecal valve
15. Aspect of the small intestine that is the smallest in diameter but longest in length?
16. Distal part; also called iliac colon
17. Shortest aspect of small intestine
18. Lies in pelvis but possesses a wide freedom of motion
19. Makes up 40% of the small intestine
20. Found between the cecum and transverse colon
21. What is the term for the three bands of muscle that pull the large intestine into pouches
22. Pouches, or sacculations, seen along the large intestine wall are called?
23. What is an older term for the mucosal folds found within the jejunum?
25. What portion of the small intestine is located primarily to the left of the midline?
26. Which portion of the small intestine is located primarily in the RLQ
27. Which portion of the small intestine has smoothest internal lining and does not present a feathery appearance when barium filled
28. Which aspect of the small intestine is most fixed in position?
29. In which quadrant does the terminal ileum connect with the large intestine?
30. Which muscular band marks the junction between the duodenum and jejunum
ligaments of treitz
31. The widest portion of the large intestine is the
32. Which flexure of the large intestine usually extends more superiorly
33. Inflammation of the vermiform appendix is called?
34. Which structures will fill up with air during a double contrast barium enema with the patient supine?
Transverse colon, sigmoid colon
35. Which aspect of the GI tract is primarily responsible for digestion, absorption, and reabsorption?
36. Which aspect of the GI tract is responsible for the synthesis and absorption of vitamins B and K and amino acids?
37. The cecum is located in the intraperitoneal, retroperitoneal, or infraperitoneal
38. The ascending colon is located in the is in the intraperitoneal, retroperitoneal, or infaperitoneal?
39. The transverse colon is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
40. The Descending colon is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
41. The sigmoid colon is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
42. The upper rectum is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
43. The lower rectum is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
44. The C-loop of the duodenum is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
45. The jejunum is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
46. The ileum is located in the intraperitoneal, retroperitoneal, or infraperitoneal?
47. Which of the following conditions pertains to a radiographic study of the small intestine?
A. May perform as a double-contrast media study?
B. An enteroclysis procedure
C. Timing of the procedure is necesssary
D. All of the above are correct
All of the above
48. Two conditions that may prevent the use of sulfate during a small bowel series
Possible perforated hollow viscus or large bowel obstruction
49. What type of patients should be given extra care when given water-soluble contrast medium?
Young and dehydrated
50. Common birth defect found in the ileum?
51. Common parasitic infection of the small intestine?
52. Obstruction of the small intestine?
53. Patient with lactose or sucrose sensitivities/.
54. New growth?
55. A form of sprue
56. Inflammation of the intestine
57. Form of inflammatory disease of the GI tract
apple core sign
59. Meckel's diverticulum
large diverticulum of the ileum
circular staircase or herringbone sign
dilation of the intestine with thickening of circular folds
62. Regional enteritis
64. Giardiasis is a condition acquired through
contaminated food, contaminated water, person-to-person contact
65. Meckels diverticulum is best diagnosed with which imaging modality
66. Whipple's disease is a rare disorder of the?
proximal small intestine
67. How much barium sulfate is generally given to an adult patient for small bowel only series
2 cups or 16 ounces
68. When is a small bowel series deemed completed?
when the contrast medium passes through the ileocecal valve
69. How long does it usually take to complete an adult small bowl series?
70. When is the first radiograph generally taken during a small bowel series?
15 to 30 mins after ingesting the contrast medium
71. True or False: Fluoroscopy is sometimes used during a small bowel series to visualize ileocecal valve?
72. The term enteroclysis describes what type of small bowel study?
double contrast study
73, What two types of contrast media are used for an enteroclysis?
High-density barium sulfate
74. Which two pathological conditions are best evaluated through an enteroclysis procedure?
regional enteritis (chrons disease) malabsorption syndromes
75. True or False: It takes approximately 12 hours for barium sulfate in a healthy adult, given orally, to reach the rectum.
76. The tip of the catheter is a advanced to the _______ during an enteroclysis
duodenojejunal flexure (suspensory ligament)
77. What is the purpose of introducing methylcellulose during an entrocclysis
it dilates the intestinal lumen to produce a more diagnostic study
78. A procedure to alleviate postoperative distention of a small intestine obstruction is called?
79. What is the recommended patient preparation before a small bowel series?
NPO for at least 8 hrs before procedure; no smoking or gum chewing
80. Which position is recommended for small bowel radiographs? why?
prone. to separate the loops of intestine
81. A twisting of a portion of the intestine on its own mesentery
82. Outpouching of the mucosal wall
83. Inflammatory condition of the large intestine
84. Severe form of colitis
85. Telescoping of the one part if the intestine into another
86. Inward growth extending from the lumen of the intestinal wall
87. Which type of patient usually experiences intussusception?
88. A condition of numerous herniation of the mucosal wall of the large intestine is called?
89. Which pathologic conditions may produce a "tapered or corkscrew: radiographic sign during a barium enema.
90. Which of the following conditions may produce the "cobblestone: radiographic sign during a barium enema?
91. What is the most common form of a carcinoma found in the large intestine
92. True or False: Intestinal polyps and diverticula are very similar in structure
93. True or False: Volvulus occurs more frequently in males than females
94. True or False: The barium enema is commonly recommended procedure for diagnosing possible acute appendicitis
95. True or False: Any stool retained in the large intestine may require postponement of barium enema study
96. What 4 conditions would prevent the use of a laxative cathartic before barium enema procedure
gross bleeding, severe diarrhea, obstruction, inflammatory lesions
97. True or False: An example of an irritant cathartic is magnesium citrate.
98. Three types of enema tips commonly used
plastic disposable, rectal retention, air-contrast retention
99. True or False: Synthetic latex enema tips or gloves do not cause problems for latex-sensitive patients.
100. What water temperature is recommended for barium enema mixtures?
room temp 85-90
101. To minimize spasm during a barium enema _________ can be added to the contrast media mixture?
102. What is the name od the patient position recommended for insertion of the rectal enema tip?
103. The initial insertion of the rectal enema tip should be pointed toward the?
104. Which procedure is most effective to demonstrate small polyps in the colon?
double - contrast barium enema
105. Which aspect of the large intestine must be demonstrated during evacuative proctography?
106. Which procedure uses the thickest mixture of barium sulfate?
107. Into which position is the patient placed for imaging during the evacuative proctogram?
108. True or False: A special tapered enema tip is inserted into the stoma before a colostomy barium enema
109. True or False: The enema bag should not be more than 36 inches above the table top before the beginning of the procedure/
110. True or False: The technologist should review the patient's chart before a barium enema to determine whether a sigmoidoscopy or colonoscopy was performed recently.
111. True or False: Both computed tomography and sonography may be performed to aid in diagnosing appendicitis
112. True or False: Because of the density and the amount of barium within the large intestine, computed radiography should not be used during a barium enema.
113. Which one of the following statements is true regard to CT enteroclysis.
a. a duodenojejunal tube does not have to be inserted for this procedure
b. 0.1% barium sulfate suspension is often instilled before the procedure
c. Does not detect obstruction of the small intestine
d. Is rarely performed today
0.1% barium sulfate suspension is instilled before the produre
114. Another term for CT colonography (CTC) is
115. True or False: a cleansing bowel prep is not required before a CTC.
116. Why is oral contrast medium sometimes given during a CTC.
to mark or "tag" fecal matter
117. What is the chief disadvantage of a CT colonography (CTC)
can not remove polyps discovered during ct
118. True or False: Single-contrast barium enemas are performed commonly on patients with a clinical history of diverticulosis.
119. Which projections is recommended to be taken during a small bowel series?
120. True or False: Shielding is not recommended during studies of the lower GI tract.
121. Due to faster transit time of barium from the stomach to the ileocecal valve in pediatric patients, how frequently should images be taken during a small bowel series to avoid missing critical anatomy and possible pathology?
every 20 - 30 min
122. True or False: If a retention-type enema tip is used, it should be removed after fluoroscopy is completed and before overhead projections are taken to better visualize the rectal region.
123. The ____ position is a recommended alternative for the lateral rectum projection during a double - contrast BE procedure.
124. What kv is recommended for a small bowel series (single contrast study)
100 to 125 kV
125. Where is the CR centered for the 15-minute radiograph during a small bowel series?
2 inches above iliac crest
126. What are the breathing instructions for a projection taken during a small bowel series?
make exposure on expiration
127. Generally, a small bowel series is complete once the contrast media reaches the ________
128. What type of patient habitus may require two 14X17 cross wire cassettes or an AP barium enema projection?
129. Which projection taken during a barium enema best demonstrate the right colic flexure?
RAO or LPO
130. How much body rotation is required for oblique barium enema projections?
35 - 45 degrees
131. Which position should be performed if the patient cannot lie prone on the table to visualize the left colic flexure
132. Which projection, taken during a double-contrast barium enema, produces an air-filled image of the right colic flexure, ascending colon, and cecum.
left lateral decubitus
133. Where is the CR centered for a lateral projection of the rectum
level of ASIS at the midcoronal
134. Which projection during a double - contrast barium enema series best demonstrates the descending colon for possible polyps?
right lateral decubitus
135. Which aspect of the large intestine is best demonstrated with an AP axial projection?
136. What is the advantage of performing an AP axial oblique projection rather than an AP axial
creates less superimposition o the rectosigmoid segments
137. What is another term describing the AP and PA axial projections
138. What CR angle is required for the AP axial?
cr 3o to 40 cephalad
139. What CR angle is required for the PA axial?
CR 30 to 40 caudad
140. What position is recommended for the postevacuation projection taken following a barium enema?
141. What kV range is recommended kV range for oblique projections taken during a single - contrast barium enema study
142. What is the recommended kV range for oblique projections taken during a double contrast study?
143. What medication can be given during a barium enema to minimize colonic spasms during a barium enema>
144. A radiograph of a double - contrast barium enema projections reveals an obscured anatomic side marker. The tech is unsure whether it is an AP or PA recumbent projection. The transverse colon is primarily filled with barium, with the ascending and descending colon containing a lesser amount. Which position does the radiograph represent?
145. A radiograph of a lateral decubitus projection taken during an air-contrast barium enema reveals that the upside aspect of the colon is overpenetrated. The following factors were used during this analog exposure: 120 kV, 30 mAs, 40 inch SID, and compensating filter for air-filled aspect of the large intestine. Which one of these factors must be modified during the repeat exposure.
146. A radiograph of an AP axial barium enema projection of the rectosigmoid region reveals that there is considerable superimposition of the sigmoid colon and rectum. The following factors were used during this analog exposure: 120 kV, 20 mAs, 40 SID 35 degree caudad CR angle, and collimation. Which of the factors must be modified or corrected for the repeat exposure?
147. A barium enema study performed on a hypersthenic patient reveals that the majority of the radiographs demonstrate that the left colic flexure was cut off. What can be done during the repeat exposures to avoid this problem?
148. A technologist has inserted an air-contrast retention tip for a double- contrast BE study. He is not sure how much to inflate the retention balloon. Should he inflate it as much as the patient can tolerate, or is there a better alternative?
149. A student tech is told to place the patient on the x-ray table in a sim's position in prep for the barium enema. How should the patient be positioned.
150. A patient with a clinical history of regional enteritis comes to the radiology department. What type of procedure would be most diagnostic for this condition?
151. A patient is referred to the radiology department for a presurgical small bowel series. What modification to the standard study needs to be made for this particular patient?
152. A patient comes to the radiology department for a small bowel series. However, because of a stroke, the patient is unable to swallow the contrast medium. What type of the study should be performed for this patient?
153. An infant with a possible intussusception is brought the ER. Which radiographic procedure may serve a therapeutic role in correcting this condition?
154. Before a barium enema, the tech experienced difficulty in inserting the enema rectal tip. What should the tech do to complete this task?
155. During the fluoroscopy aspect of a barium enema, the radiologist detects an unusual defect within the right colic flexure. She asks that the tech provides the best images possible of this region. Which two projections will best demonstrate the right colic flexure?
156. A patient with a clinical history of possible enteritis comes to the radiology department. Which type of radiographic GI study would most likely be indicated for this condition?
157. A patient's clinical history includes possible giardiasis. What radiographic procedure would likely be indicated for this condition?
158. A patient is scheduled for a CTC. What is the recommended patient prep for this procedure?
159. Which division of the small intestine is the shortest?