Rad 435 practical Review Manal alOsaimi

Contents Ba Swallow (Esophagogram). Ba Meal. Ba Follow through. Ba Enema. Gall Bladder & Biliary Ducts. Sialography. Hysterosalpingography. Urography procedure.

Marks Total Practical Fluoro = 20 Marks

Ba Swallow

The Normal indentations

Barium Swallow AP view

Barium Swallow LAO view

Write the name of the procedure Barium Swallow Write the name of the procedure RAO The esophagus is seen between the heart and the spine The patient is rotate 35- 40 degrees with the RT side against the table

Write the name of the procedure Barium Swallow Write the name of the procedure LATERAL

Esophagogastric Junction 1 Barium Swallow Esophagogastric Junction ( Cardiac Orifice)

Barium Meal

Stomach openings and curvatures Stomach subdivisions: 1- fundus: upper portion of the stomach. 2- body. 3- pylorus When the stomach is empty The internal lining is thrown into numerous longitudinal folds called RUGAE

1- cardiac orifice (esophagogastric junction): opening between the esophagus and the stomach. 2-cardiac notch: superior to the cardiac orifice. 3-distal esophagus. 4-pyloric valve or sphincter: distal opening of the stomach. 5- lesser curvature: medial border of the stomach, extends between the cardiac and pyloric openings. 6-greater curvature: lateral border of the stomach, four or five times longer than the lesser curvature.

Barium Meal Distal esophagus Esophagogastric junction (cardia orifice) Lesser curvature Angular notch Pylorus of stomach Pyloric valve Duodenal bulb of the duodenum Descending portion of the duodenum Body of stomach Greater curvature of stomach Gastric folds Fundus of stomach

Erect (upright) position Air-Barium Distribution in the Stomach Fundus When the pt is (AP recumbent) Supine position Most posterior part Filled with Ba (PA recumbent) Prone position Highest part Filled with air Erect (upright) position Pylorus filled with Ba The air-fluid level is a straight line Label: 1, 2 2

Barium Meal Ba in fundus 2 LPO recumbent SUPINE (AP recumbent)

Air-fluid level straight Air in Fundus Prone (PA recumbent) RAO recumbent Erect Air-fluid level straight

2 Barium Meal Air in fundus Prone RAO

2 Barium Meal Air in fundus Erect

Small Bowel Procedures

Small Bowel Procedures Barium meal follow through. Barium follow through (Small Bowel only Series). Enteroclysis Intubation ( Small bowel enema). 1 2 3 4

ANATOMY Parts of S.I: Duodenum: 1st,shortest,widest and most fixed. Jejunum: 2/5 and feathery appearance. Ileum: 3/5, longest, smooth no feathery appearance, and joins large intestine at ileocecal valve

ANATOMY A: duodenum C: jejunum D:ileum E: area of ileocecal valve PA 30 mins

Small Bowel Series

Small Bowel Series 1.Ba Meal Follow through 30 minutes 1 Hour 2 Hour

Small Bowel Series 2.Barium follow through

Small Bowel Series 2.Ba Follow through

Enteroclysis Injection of c/m into the S.B. It is a Double contrast method used to evaluate the S.B. the pt is intubated under flouroscopic control with a special catheter. Stomach → duodenum → duodenojujinal junction. CM Thin BaSO4. ( Coats the mucosa). Air or Methylcellulose, why ? which is Better ? To distend the bowel and provide double contrast Methylcellulose, shows the mucosal details as it adheres to the walls and distends the bowel. It propel the barium from intestine It evacuate barium from the large intestine.

Small Bowel Series 3.Enteroclysis

Intubation ( S.B enema) It is a single contrast method where a nasogastric tube is passed through: pt’s nose→esophagus→stomach→duodenum and into the jejunum. (RAO position is preferred ? ) To help pass the tube from stomach →duodenum by gastric peristalsis. C.M: thin BaSO4 or water soluble iodinated c.m. diagnostic Therapeutic

Small Bowel Series 4.Intubation

BARIUM ENEMA

Technique Preliminary Film to: Bowel preparation. Complete obstruction, Perforation

4 Barium Enema

single contrast Splenic flexure Hepatic flexure Transverse colon Aescending colon Descending colon Sigmoid colon single contrast

4 Barium Enema Single Contrast

Air Barium Distribution 4 Air Barium Distribution Supine Transverse c. filled with air Prone Transverse c. filled with ba

4 Barium Enema LT LAT Decubitus

4 Barium Enema RT LAT Decubitus

Splenic flexure descending colon appear open Barium Enema RPO Splenic flexure descending colon appear open

Hepatic flexure ascending colon and rectosigmoid region appear open Barium Enema LPO Hepatic flexure ascending colon and rectosigmoid region appear open

4 Barium Enema Hepatic Flexure Splenic Flexure

4 Barium Enema RectoSegmoid Region

4 Barium Enema Rectum

Gall Bladder and Biliary System Procedures Definition Performed during surgery, usually During a Cholecystectomy (wherein the surgeon removes the GB). Indication If the surgeon suspects that residual stones are located in the biliary ducts

Anatomy

Operative (Immediate) Cholangiogram Lt hepatic duct Rt hepatic duct Common hepatic duct Common bile duct catheter

Gall Bladder and Biliary System Procedures

Gall Bladder & Biliary Ducts 5 Gall Bladder & Biliary Ducts Catheter T-shape Endoscope

Sialography Definition radiographic examination of the salivary ducts.

Sialography

6 Sialography Lateral

Hysterosalpingography

Anatomy

Hystrosalpingography 8 Hystrosalpingography A = RT fallopian tube. B = Uterine cavity . C = LT fallopian tube. D = Catheter.

Hystrosalpingography

Hystrosalpingography

Urography Procedures

1 2 Urography Procedures MCUG Micturating Cystourethrography Retrograde Cystography (Cystogram) 2 MCUG Micturating Cystourethrography

Retrograde Cystography (Cystogram) Definition Is a Non Functional radiographic examination of the urinary bladder after injection of CM via urethral catheter A retrograde cystogram is a radiographic study of the bladder, made after a direct injection of a radiopaque contrast material by means of a urethral catheter CM Urographine

7 Urography Procedures Cystography

MCUG Micturating Cystourethrography Definition Is a Functional radiographic examination of the urinary bladder and urethra to evaluate the patient’s ability to urinate. micturating cystourethrogram (MCUG), is a technique for watching a person's urethra and urinary bladder while the person urinates (voids). CM Urographine

7 Urography Procedures MCUG

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