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Rad 435 practical Review

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.

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Rad 435 practical Review

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  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. 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

  9. Barium Swallow Write the name of the procedure LATERAL

  10. Barium Swallow 1 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. Air-Barium Distribution in the Stomach Label: 1, 2 2

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

  17. Air in Fundus

  18. Barium Meal 2 Air in fundus Prone RAO

  19. Barium Meal 2 • Air in fundus Erect

  20. Small Bowel Procedures

  21. Small Bowel Procedures 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

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

  24. Small Bowel Series

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

  26. Small Bowel Series • 2.Barium follow through

  27. Small Bowel Series 2.Ba Follow through

  28. 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.

  29. Small Bowel Series 3.Enteroclysis

  30. 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.

  31. Small Bowel Series 4.Intubation

  32. BARIUM ENEMA

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

  34. Barium Enema 4

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

  36. Barium Enema 4 Single Contrast

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

  38. Barium Enema 4 LT LAT Decubitus

  39. Barium Enema 4 RT LAT Decubitus

  40. Barium Enema RPO Splenic flexure descending colon appear open

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

  42. Barium Enema 4 Hepatic Flexure • Splenic Flexure

  43. Barium Enema 4 RectoSegmoid Region

  44. Barium Enema 4 Rectum

  45. 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

  46. Anatomy

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

  48. Gall Bladder and Biliary System Procedures

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

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