Lower GI

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 its ___________ 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