1. Rad 435 practical Review
Manal alOsaimi

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

3. Marks
Total Practical Fluoro = 20 Marks

4. Ba Swallow

5. The Normal indentations

6. Barium Swallow
AP view

7. Barium Swallow
LAO view

8. 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 degrees with the RT side against the table

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

10. Esophagogastric Junction1
Barium Swallow
Esophagogastric Junction
( Cardiac Orifice)

11. Barium Meal

12. 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

13. 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.

14. 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

15. 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

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

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

18. 2
Barium Meal
Air in fundus
Prone
RAO

19. 2
Barium Meal
Air in fundus
Erect

20. Small Bowel Procedures

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

22. 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

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

25. Small Bowel Series

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

27. Small Bowel Series
2.Barium follow through

28. Small Bowel Series
2.Ba Follow through

29. 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.

30. Small Bowel Series
3.Enteroclysis

31. 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

32. Small Bowel Series
4.Intubation

33. BARIUM ENEMA

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

35. 4
Barium Enema

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

37. 4
Barium Enema
Single Contrast

38. Air Barium Distribution4
Air Barium Distribution
Supine
Transverse c. filled with air
Prone
Transverse c. filled with ba

39. 4
Barium Enema
LT LAT Decubitus

40. 4
Barium Enema
RT LAT Decubitus

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

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

43. 4
Barium Enema
Hepatic Flexure
Splenic Flexure

44. 4
Barium Enema
RectoSegmoid Region

45. 4
Barium Enema
Rectum

46. 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

47. Anatomy

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

49. Gall Bladder and Biliary System Procedures

50. Gall Bladder & Biliary Ducts5
Gall Bladder & Biliary Ducts
Catheter
T-shape
Endoscope

51. Sialography
Definition
radiographic examination of the salivary ducts.

52. Sialography

53. 6
Sialography
Lateral

54. Hysterosalpingography

55. Anatomy

56. Hystrosalpingography8
Hystrosalpingography
A = RT fallopian tube.
B = Uterine cavity .
C = LT fallopian tube.
D = Catheter.

57. Hystrosalpingography

58. Hystrosalpingography

59. Urography Procedures

60. 1 2 Urography Procedures MCUG Micturating Cystourethrography
Retrograde Cystography (Cystogram) 2
MCUG Micturating Cystourethrography

61. 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

62. 7
Urography Procedures
Cystography

63. 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

64. 7
Urography Procedures
MCUG

65. Wish you Best of Luck