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