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Chapter 15

Chapter 15. Lower GI. Large Intestine Anatomy. From Iliocecal valve (Terminal Ileum) ____________ Appendix ____________ colon. Large Intestine Anatomy. __________ flexure (Right Colic) __________ Colon ___________Flexure (Left Colic) ___________Colon. Large Intestine Anatomy.

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Chapter 15

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  1. Chapter 15 Lower GI

  2. Large Intestine Anatomy • From Iliocecal valve (Terminal Ileum) • ____________ • Appendix • ____________ colon

  3. Large Intestine Anatomy • __________ flexure (Right Colic) • __________ Colon • ___________Flexure (Left Colic) • ___________Colon

  4. Large Intestine Anatomy • __________ Colon • Rectum • _____________ • Anus

  5. Large Intestine Anatomy • ___________ – Pouches of the large intestine • __________ Coli

  6. Colon Orientation • Anterior aspects – _______________ • Posterior aspects – __________________________colon

  7. Barium and Air DistributionSupine • Air within the anterior aspects • ________________________ • Barium within the posterior aspects • ___________________________

  8. Barium and Air DistributionProne • Air within ____________ aspects • Rectum, Ascending, and Descending • Barium within ___________ • Transverse and Sigmoid

  9. Intestine Purpose • __________ – Primarily done in Small • Absorption – Primarily done in Small • _______________ – Primarily done in Small Some done in Large

  10. Moving it • Elimination _______________ – Large Intestine • Movement – Peristalsis Small and Large • ____________in Large

  11. Barium Enema • Patient prep • ______________ • Bowel prep • _________________ • Cleansing __________ • ________________________________

  12. Contraindications to Laxatives • Gross ______________ • Severe _____________ • Obstruction • Inflammatory Condition • ________________

  13. Room prep • ______________ • _____________ • Gloves • Have everything ready _____ the test

  14. BE Equipment • Determine if it’s ___________ Contrast • Enema tip • Single or Double • Check ___________ • _________

  15. Barium Prep • Barium bag • Mixed with _____________(Cold is debatable) • _________– Scald mucosal linings • Bag should not be more than ______ the table

  16. Tip Insertion • TALK EACH STEP WITH THE PATIENT • Have Barium ____________to tip • Place pt in ____________ position • Lubricate tip • Have pt take in a ____________it out

  17. Here It Comes!! • On expiration insert tip into rectum • Toward ____________________ • Insert only _____________ • __________________________ • Some rads will want to insert and some want you to inflate.

  18. During Fluoro • Assist the radiologist • Control the _______________ • Switch out spot films if applicable • Help the patient roll • _________________ • Prepare for the _________________for the best

  19. After The Radiologist Leaves • Work _____________ • Encourage the patient

  20. Once your overheads are done • Ensure you did not miss ____________ • Place the enema bag ____________ • _______ as much as possible into the bag • Assist the patient to the ________

  21. Barium Contraindications • Any possibility of a _____________ • Bowel ______________ • If there is a contraindication • _______________iodinated contrast.

  22. Other than the routine • Babies • ___________ • ___________ • Un-prepped

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

  24. AP / PA BE • Position as a KUB • Center at crest • Have pt hold breath

  25. RPO • 45° Oblique • Center at crest or _______________ • Center to mid body mass • Shows __________________ • Same as _______

  26. LPO • 45° Oblique • Center at crest • Shows ________________ • Same as ___________-

  27. Lt Lateral Rectum • Place pt on lt side • Center at ______________ • Shows rectum

  28. AP Axial(Butterfly) • Supine • ________________ • Center _____________ASIS • Mid sagittal

  29. PA Axial • Prone • _______________ • Center at ____________ • Mid sagittal

  30. Post Evac • PA or AP • Position as a routine KUB

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

  32. Right Lateral Decubitus • Place patient in true ___________ • Using a x-table grid holder place center of the cassette at the __________ • Center CR to cassette • Ensure arms are up • Shows ______________

  33. Left Lateral Decubitus • Position patient in true left lateral • Center as RLD

  34. X-table rectum • Lie the patient prone • CR to go _______________ • Center at ____________ and mid coronal

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