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

• __________ aspects

– 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

• ___________– Primarily done in Small

Some done in Large

Moving it

• Elimination (____________) – 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