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

• __________ Colon

• Rectum

• _____________

–Anus

Large Intestine Anatomy

• ___________– Pouches of the large intestine

• __________ Coli

Colon Orientation

• Anterior aspects

– _______________

• Posterior aspects

– __________________________colon

Barium and Air DistributionSupine

• Air within the anterior aspects– ________________________

• Barium within the posterior aspects– ___________________________

Barium and Air DistributionProne

• Air within ____________ aspects– Rectum, Ascending, and Descending

• Barium within ___________– Transverse and Sigmoid

Intestine Purpose

• __________

– Primarily done in Small

• Absorption – Primarily done in Small

• _______________– Primarily done in Small

Some done in Large

Moving it

• Elimination _______________– Large Intestine

• Movement – Peristalsis Small and Large

– ____________in Large

Barium Enema

• Patient prep– ______________

– Bowel prep

• _________________

• Cleansing __________

• ________________________________

Contraindications to Laxatives

• Gross ______________

• Severe _____________

• Obstruction

• Inflammatory Condition– ________________

Room prep

• ______________

• _____________

• Gloves

• Have everything ready _____ the test

BE Equipment

• Determine if it’s ___________ Contrast

• Enema tip– Single or Double

– Check ___________

– _________

Barium Prep

• Barium bag– Mixed with _____________(Cold is

debatable)

– _________– Scald mucosal linings

– Bag should not be more than ______ the table

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

Here It Comes!!

• On expiration insert tip into rectum– Toward ____________________

• Insert only _____________

• __________________________

• Some rads will want to insert and some want you to inflate.

During Fluoro

• Assist the radiologist

• Control the _______________

• Switch out spot films if applicable

• Help the patient roll

• _________________

• Prepare for the _________________for the best

After The Radiologist Leaves

• Work _____________

• Encourage the patient

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 ________

Barium Contraindications

• Any possibility of a _____________

• Bowel ______________

• If there is a contraindication– _______________iodinated contrast.

Other than the routine

• Babies

• ___________

• ___________

• Un-prepped

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

AP / PA BE

• Position as a KUB

• Center at crest

• Have pt hold breath

RPO

• 45° Oblique

• Center at crest or _______________

• Center to mid body mass

• Shows __________________

• Same as _______

LPO

• 45° Oblique

• Center at crest

• Shows ________________

• Same as ___________-

Lt Lateral Rectum

• Place pt on lt side

• Center at ______________

• Shows rectum

AP Axial(Butterfly)

• Supine

• ________________

• Center _____________ASIS

• Mid sagittal

PA Axial

• Prone

• _______________

• Center at ____________

• Mid sagittal

Post Evac

• PA or AP

• Position as a routine KUB

Air Contrast Additional Positions

• Right and Left Decubitus

• X-table Rectum

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 ______________

Left Lateral Decubitus

• Position patient in true left lateral

• Center as RLD

X-table rectum

• Lie the patient prone

• CR to go _______________

• Center at ____________ and mid coronal