Rad 435 practical Review
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Transcript of Rad 435 practical Review
RAD 435 PRACTICAL REVIEW Manal alOsaimi
Contents 1. Ba Swallow (Esophagogram).2. Ba Meal.3. Ba Follow through.4. Ba Enema.5. Gall Bladder & Biliary Ducts.6. Sialography.7. Hysterosalpingography.8. Urography procedure.
Marks Total Practical Fluoro = 20
Marks
Ba Swallow
The Normal indentations
Barium Swallow
AP view
Barium Swallow
LAO view
Write the name of the procedure
Barium Swallow
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
Write the name of the procedure
Barium Swallow
LATERAL
Barium Swallow
Esophagogastric Junction( Cardiac Orifice)
1
Barium Meal
Stomach subdivisions:1- fundus: upper portion of the stomach.2- body.3- pylorusWhen the stomach is emptyThe internal lining is thrown into numerous
longitudinal folds called RUGAE
Stomach openings and curvatures
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.
Barium Meal
A. Distal esophagusB. Esophagogastric junction
(cardia orifice)C. Lesser curvatureD. Angular notchE. Pylorus of stomachF. Pyloric valveG. Duodenal bulb of the
duodenumH. Descending portion of
the duodenumI. Body of stomachJ. Greater curvature of
stomachK. Gastric foldsL. Fundus of stomach
Label: 1, 2
Air-Barium Distribution in the Stomach
2
FundusWhen the pt is
(AP recumbent )Supine position
Most posterior partFilled with Ba
(PA recumbent)Prone position
Highest partFilled with air
Erect (upright) position
Highest partFilled with air Pylorus filled with Ba
The air-fluid level is a straight line
Ba in fundus
Barium Meal
2
LPO recumbent
SUPINE (AP
recumbent)
Air in Fundus
Prone (PA recumbent)
ErectAir-fluid level
straight
Barium Meal 2Air in fundus
Prone RAO
Barium Meal 2 Air in fundus
Erect
Small Bowel Procedures
Small Bowel Procedures
Barium meal follow through.
Barium follow through (Small Bowel only Series).
Enteroclysis
Intubation ( Small bowel enema).
1
2
3
4
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
ANATOMY
A: duodenumC: jejunumD:ileumE: area of ileocecal
valve
PA 30 mins
ANATOMY
Small Bowel Series
Small Bowel Series
30 minutes 1 Hour 2 Hour
1.Ba Meal Follow through
Small Bowel Series
2.Barium follow through
Small Bowel Series
2.Ba Follow through
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
1. Thin BaSO4. ( Coats the mucosa).2. 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 intestineIt evacuate barium from the large intestine.
Small Bowel Series
3.Enteroclysis
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.
diagnostic
Therapeutic
Small Bowel Series
4.Intubation
BARIUM ENEMA
Preliminary Film to:1. Bowel
preparation.2. Complete
obstruction, Perforation
Technique
Barium Enema4
Hepatic flexure
Splenic flexure
Transverse colon
Aescending colon Descending colon
Sigmoid colon
single contrast
Barium Enema4
Single Contrast
Air Barium Distribution 4
SupineTransverse c. filled with air
ProneTransverse c. filled with ba
Barium Enema4
LT LAT Decubitus
Barium Enema4
RT LAT Decubitus
Barium Enema
RPO
Splenic flexure descending colon appear
open
Barium Enema
LPO
Hepatic flexure ascending colon and rectosigmoid region
appear open
Barium Enema4
Hepatic Flexure Splenic Flexure
Barium Enema4
RectoSegmoid Region
Barium Enema4
Rectum
• DefinitionPerformed during surgery, usually During a
Cholecystectomy (wherein the surgeon removes the GB).
• IndicationIf the surgeon suspects that residual stones are
located in the biliary ducts
Gall Bladder and Biliary System Procedures
Operative (Immediate) Cholangiogram
Rt hepatic ductLt hepatic duct
Common hepatic duct
Common bile ductcatheter
Gall Bladder and Biliary System Procedures
Gall Bladder & Biliary Ducts5
Catheter
T-shape
Endoscope
• Definitionradiographic examination of the salivary
ducts.
Sialography
Sialography
Sialography6
Lateral
Hysterosalpingography
Hystrosalpingography
A = RT fallopian tube.
B = Uterine cavity .
C = LT fallopian tube.
D = Catheter.
8
Hystrosalpingography
Hystrosalpingography
Urography Procedures
Urography Procedures
1• Retrograde
Cystography (Cystogram)
2• MCUG Micturating
Cystourethrography
• Definition• Is a Non Functional radiographic examination of the
urinary bladder after injection of CM via urethral catheter
• A retrograde cystogram is a radiographic study of the bladder, made after a direct injection of a radiopaque contrast material by means of a urethral catheter
• CMUrographine
Retrograde Cystography (Cystogram)
Urography Procedures 7
Cystography
• Definition• Is a Functional radiographic examination of the
urinary bladder and urethra to evaluate the patient’s ability to urinate.
• micturating cystourethrogram (MCUG), is a technique for watching a person's urethra and urinary bladder while the person urinates (voids).
• CMUrographine
MCUG Micturating Cystourethrography
Urography Procedures 7
MCUG
Wish you Best of Luck