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58 Cards in this Set

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  • Back
Normal levels of the esophagus that are narrowed
C6, T3, T4-5, T10
Extrinsic causes of Abnormal Stenosis
aortic aneurism
tumour
achalasia
double ring aortic arch
Intrinsic causes of Abnormal Stenosis
ingestion of corrosives
varices
neoplasia
esophagitis
polyps
cutting
stomach acids
True of False: The most common symptom associated with esophageal disorders is pain
True
True of False: The major cause of reflux esophagitis is dyspepsia
False (dyspepsia isn't a cause. GERD, vomit, hernia, irritant foods, intubation, and corrosives are causes)
What is the most common area for ulcers in the GI
duodenum/duodenal bulb
What is a complication of a rolling hiatus hernia?
volvulus formation
What is a complication of ulcers?
fibrosis and stricture formation
perforation
gastric outlet obstruction
hemorrhage
What is the radiographic sign for a sliding hiatus hernia?
many thick folds without parallel orientation in the posterior mediastinum
What disorder can be visualized by serpiginous and wormlike filling defects in the esophagus?
esophageal varices (aka rosary beads)
What is the most common abnormality detected on and upper GI examination?
hiatus hernia
True or False: Achalasia is a mechanical obstruction
False, it's a functional obstruction
Does achalasia have a difficulty relaxing or contracting the LES?
difficulty relaxing
What do air-fluid levels detected on a lateral chest x-ray indicate?
hiatus hernia (can be an abscess if well circumscribed)
What are the major symptoms of esophageal diseases?
dysphagia
heart burn
What is the age group and predominant sex related to cancer of the esophagus?
50-70 years
male
What is the age group and predominant sex related to cancer of the stomach?
70-80 in low risk countries
40's in high risk countries (Japan, Chile, East Europe)
5:1 male predominance
How does stomach cancer appear on a radiograph?
thickened walls
large, irregular mass
What causes pyloric stenosis?
congenital: hypertophy of the circular layer of smooth muscle in the pyloric region
Acquired: ulcers, cancer
What part of the stomach most often gets cancer?
distal stomach
How can ulcers be treated?
less caffeine and alcohol
antibiotics to treat H. pylori
antacids to neutralize acids
What type of ulcer is considered pre-malignant?
gastric ulcer
What must be visualized to have an unequivocal diagnosis of a duodenal ulcer?
the ulcer crater
What are the major complications of peptic ulcer disease?
hemorrhaging
What is the most common cause of gastric outlet obstruction?
PUD
What is the modality of choice for pyloric stenosis?
ultrasound
What does pyloric stenosis appear as when imaged with the modality of choice?
thickened pyloric muscle, elongated pyloric canal, and a doughnut shape when on transverse scan
What condition has symptoms of aspiration and dysphagia?
Zenkers Diverticulum
What is the best way to view PUD?
endoscopy
What is the most common tracheo-esophageal fistula?
Blind pouch (atresia of the esophagus with distal portion of esophagus attached to the trachea)
How do you radiograph a TE fistula?
plain x-ray (no contrast)
water soluble contrast study (fluoro and a catheter)
What conditions would be radiographed if the patient was in a trandelenburg position?
esophageal varices
TE fistula (to prevent aspiration)
What type of breathing technique should a radiographer utilize to demonstrate varices?
valsalva in the supine or trandelenburg position
What is the most common location of esophageal cancer?
lower 2/3 of the esophagus
What are the major causes of esophageal cancer?
increased alcohol intake
smoking
If a patient complains of progressive dysphagia and sudden hemoptysis, what condition would they most likely have?
esophageal cancer
What's another word for cardiospasm?
achalasia
What is an anatomical condition that can cause esophagitis
incompetent lower esophageal sphincter
What are some non-anatomical causes of esophagitis?
vomitting
irritant foods
corrosive agents
prolonged nasogastric intubation
What type of ulceration could reach the submucosa layer of the GI tract?
deep ulceration
What is the prognosis of esophageal cancer?
less than 10% 5 year survival rate
What are some of the treatments for achalasia?
drugs to relax the sphincter
botox injections to paralyze
laproscopic myotomy
balloon in the sphincter to dilate
What is the difference between a benign and malignant ulcer radiographically?
benign: radiation of mucosal folds of the edge of the crater
malignant: irregular folds that merge into a mound of tissue
What are the indications for performing a Barium Swallow Study?
Dysphagia
Pain
What are the contraindications of performing a Barium Swallow Study?
sensitivity to the contrast
What is the routine procedure for a Barium Swallow Study?
Esophogram: RAO, L lat, AP/PA, LAO
What are the complications when performing a Barium Swallow Study?
leak due to perforation
aspiration
Upper GI series contraindication
complete bowel obstruction
Patient prep for Upper GI series
NPO after midnight
no smoking
no gum
What concentration of barium is needed for a single contrast study
30-50% w/v
What concentration of barium is needed for a double contrast study
up to 250% w/v
When studying motility, what type of study should be performed?
single contrast study
When studying mucosa, what type of study should be performed?
double contrast study
RAO upper GI
loop in profile
Ba in pyloris
R lat upper GI
duodenal loop in profile
Ba in pyloris
PA upper GI
entire stomach
Ba in pyloris and body
LPO upper GI
bulb without superimposition
Ba in fundus
AP upper GI
entire stomach visualized
Ba in fundus