Chapter 13 Lower GI

Large Intestine Anatomy From Iliocecal valve (___________) _________ Appendix Ascending colon

Large Intestine Anatomy Hepatic flexure (___________) Transverse Colon Splenic Flexure (__________) Descending Colon

Large Intestine Anatomy Sigmoid Colon ___________ Anal canal __________

Large Intestine Anatomy ___________ – Pouches of the large intestine ____________

Colon Orientation __________ aspects – Transverse and sigmoid – Rectum, ascending, and descending colon

Barium and Air Distribution _________ Air within the _____ aspects __________ and Sigmoid Barium within the _______ aspects Rectum, Ascending, and __________

Barium and Air Distribution ________ Air within __________aspects Rectum, Ascending, and Descending Barium within ____________ Transverse and Sigmoid

Intestine Purpose ___________ __________ – Primarily done in Small – Primarily done in Small Some done in Large

Moving it Elimination (____________) Movement – Large Intestine Movement – ___________Small and Large ____________churning in Large

Barium Enema Patient prep NPO __________ Bowel prep __________________ Cleansing enema ________________________

Contraindications to Laxatives Gross ____________ Severe _____________ Obstruction Inflammatory Condition _______________

Room prep ___________ Gloves Have everything ready ___________

BE Equipment Determine if it’s ____________ Contrast Enema tip Single or Double Check ___________ _____________

Barium Prep Barium bag Mixed with __________ _________– Scald mucosal linings Bag should not be more than ___ above the table

Tip Insertion _____________________________ Have Barium ___________up to tip Place pt in ____________ position Lubricate tip Have _____________and blow it out

Here It Comes!! On _____________ insert tip into rectum Toward __________ then anterior/superior Insert only 3 – 4 cm _____________ DO NOT ____________ Some rads will want to insert and some want you to inflate.

During Fluoro Assist the _____________ Control the ______________ Help the patient roll _______________ Prepare for the worst and hope for the best

After The Radiologist Leaves Work _____________ ____________ the patient

Once your overheads are done Ensure you did not ______________ Place the enema bag on __________ Drain as much as possible into ________ Assist the patient to the _____________

Barium Contraindications Any possibility of a ____________ Bowel _________ If there is a contraindication __________________contrast is used.

Other than the routine ___________ Colostomy Un-prepped

BE Imaging Routine Scout kV – 75-80 AP kV - 100 RPO (RAO) kV - 100 LPO (LAO) kV - 100 Lt Lateral kV - 100 AP and/or PA Axial kV - 100 Post Evac kV – 75-80

AP / PA BE Position as a _____________ Center at crest Have pt ____________

RPO _____________ Center at crest or ______ Center to mid body mass Shows ______________ Same as __________

LPO ____________ Center at ___________ Shows ______________ Same as __________

Lateral Rectum Place pt on side (____________) Center at _______________ Shows rectum

AP Axial (Butterfly) Supine _______________ Center ________________ Mid sagittal

PA Axial Prone ____________ Center at ___________ Mid sagittal

Post Evac PA or AP Position as a routine ________

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

Right Lateral Decubitus Place patient in true ____________ Using a __________holder place center of the cassette at the _____________ Center CR to cassette Ensure arms are up Shows ____________ levels

Left Lateral Decubitus Position patient in true ___________ Center as RLD

X-table rectum Lie the ____________ CR to go ___________ the table Center at __________ and mid coronal