Barium Enema Sample Questions

The dorsal decubitus and lateral decubitus projections of the abdomen may be used to demonstrate air or fluid levels. The dorsal decubitus position involves the patient lying on their back, while the lateral decubitus position involves the patient lying on their side. Both of these positions can help to visualize air or fluid levels within the abdomen. The AP trendelenburg projection, on the other hand, is not typically used to demonstrate air or fluid levels in the abdomen.

The AP abdomen best demonstrates the size and shape of the liver and kidneys. The AP (anterior-posterior) view allows for a frontal view of the organs, providing a comprehensive assessment of their size and shape. This view helps to identify any abnormalities or changes in the liver and kidneys, such as enlargement or tumors. The other options, lateral abdomen, dorsal decubitus abdomen, and ventral decubitus abdomen, may provide limited or different perspectives of the organs, making the AP abdomen the most suitable choice for evaluating their size and shape.

The flexure that lies between the transverse colon and the ascending colon is called the hepatic flexure. This flexure is located in the right upper quadrant of the abdomen, near the liver. It is formed by the bend of the colon as it transitions from the transverse colon to the ascending colon.

The completion of the small bowel series is signaled by barium entering the cecum of the large bowel via the ileocecal valve. This indicates that the barium has successfully passed through the entire small intestine and has reached the beginning of the large intestine. Barium in the appendix, ileum, or rectum does not necessarily indicate the completion of the small bowel series, as it could be present in these areas for various reasons unrelated to the series.

An ambulatory patient refers to someone who is able to walk. This means that the person is not bedridden or unable to move independently. The term "ambulatory" is derived from the Latin word "ambulare" which means "to walk". Therefore, an ambulatory patient is someone who is mobile and capable of walking on their own.

To demonstrate small amounts of fluid in the pleural cavity, the patient should be positioned in a lateral decubitus position with the affected side down. This position allows the fluid to settle at the dependent portion of the pleural cavity, making it easier to visualize on imaging studies such as X-rays or CT scans. In this position, the fluid will accumulate at the lowermost part of the pleural cavity, making it more visible and aiding in diagnosis.

Most malignant tumors arise in the recto-sigmoid part of the colon. This area is the junction between the rectum and sigmoid colon, which is the last part of the large intestine before the rectum. The recto-sigmoid has a higher risk of developing tumors compared to other parts of the colon due to factors such as increased exposure to fecal material and longer transit time of stool, which can lead to the accumulation of genetic mutations and the development of malignant cells.

Careful explanation of the procedure is the best way to control voluntary motion because it helps the patient understand what is expected of them and reduces anxiety or fear that may cause involuntary movements. By providing clear instructions and information about the procedure, the patient is more likely to cooperate and remain still, resulting in better image quality and accurate diagnosis. Immobilization of the part, short exposure time, and physical restraint may also help in controlling motion, but they are not as effective or patient-friendly as a careful explanation of the procedure.

Fluoroscopic imaging of the ileocecal valve is generally part of a small bowel series. This is because the ileocecal valve is located between the small intestine and the large intestine, and a small bowel series is a radiographic examination that focuses on the small intestine. The small bowel series involves the ingestion of barium contrast material, which helps to visualize the structure and function of the small intestine, including the ileocecal valve. Therefore, it is the most appropriate option among the given choices.

The RAO (Right Anterior Oblique) position would best demonstrate hepatic flexure. This position involves the patient lying on their back at a 45-degree angle with the right side elevated. This allows for optimal visualization of the hepatic flexure, which is the bend in the colon located near the liver. The RAO position helps to separate the hepatic flexure from other structures and provides a clear image for diagnosis and evaluation.

Placing the patient in Trendelenburg position involves tilting the patient's body with the head lower than the feet. This position is commonly used in medical procedures to increase blood flow to the head and upper body. However, it does not directly help reduce colonic spasms during a radiographic examination of the barium-filled large bowel. The other methods mentioned in the question, such as lowering the enema bag, administering glucagon, and slowing or stopping the flow of barium, are all techniques that can help reduce colonic spasms and improve the quality of the examination.

The radiographer should see air in the lateral descending colon and medial ascending colon in order to identify the right lateral decubitus image. This is because the decubitus position allows air to rise and fluid (such as barium) to settle. In this position, the lateral descending colon should contain air, while the medial ascending colon should also contain air due to the change in patient position. This combination of air in the lateral descending colon and medial ascending colon is characteristic of the right lateral decubitus image.

Single-contrast studies do not help to demonstrate polyps. In single-contrast studies, only one type of contrast agent is used, either barium sulfate or air, which allows for visualization of the overall shape and size of the large bowel. However, it does not provide detailed visualization of small lesions such as polyps. Double-contrast studies, on the other hand, involve the use of both barium sulfate and air, which allows for better visualization of smaller lesions like polyps.

To correct the issue of the entire abdomen not being included on the 14x17 inches IR, two cassettes can be used and placed crosswise. This will provide a larger imaging area and ensure that the entire abdomen is captured in the radiograph.

The lateral radiographic projection of the large intestine is the best for demonstrating the rectum. In the lateral position, the patient is lying on their side, which allows for optimal visualization of the rectum. This projection provides a side view of the large intestine, allowing for better assessment of any abnormalities or pathologies in the rectal area. The lateral projection also helps to differentiate between the rectum and other nearby structures, providing a clearer image for diagnosis and evaluation.

Prior to inserting the enema tip into the rectum, it is important to ensure that there is no air present in the tubing. This is because the instillation of air into the colon can cause discomfort and distension. It can also lead to the formation of air pockets, which may interfere with the proper administration of the enema. Therefore, by ensuring that there is no air in the tubing, the risk of instilling air into the colon is avoided.

Demonstrating small amounts of air within the peritoneal cavity is best achieved by performing a lateral decubitus X-ray with the affected side up. This position allows the air to rise and collect in the dependent part of the peritoneal cavity, making it easier to visualize on the X-ray. The other positions listed, such as lateral decubitus affected side down, AP Trendelenburg, and AP supine, may not effectively demonstrate the presence of small amounts of air in the peritoneal cavity.

The correct answer is "Supine, with the tube angled 45 degrees caudally". In this position, the sigmoid colon is visualized separately from the overlying loops. The supine position allows for better visualization of the large bowel, and angling the tube 45 degrees caudally helps to separate the sigmoid colon from other loops. This view is commonly used in radiographic imaging to demonstrate the large bowel and identify any abnormalities or pathology.

If air is seen in the colon on a radiograph of the abdomen, it may indicate obstruction or infection. The presence of air in the colon suggests that there is an abnormal accumulation of gas in this part of the digestive system. This could be caused by a blockage or narrowing of the colon, which prevents the normal passage of gas and stool. Alternatively, it could be a sign of infection, such as diverticulitis or colitis, which can cause inflammation and gas buildup in the colon.

The correct sequence of events when performing double-contrast studies in Upper GI Series is to first give the patient a gas-producing substance, then give them a small amount of high-density barium, and finally place them in a recumbent position. This sequence allows for the gas-producing substance to create air bubbles in the stomach, which helps to distend the stomach and improve visualization. The high-density barium is then administered to coat the lining of the stomach and create contrast with the surrounding tissues. Placing the patient in a recumbent position ensures that the barium is evenly distributed and allows for better imaging of the upper gastrointestinal tract.

The correct examination scheduling sequence is IVP, Barium enema & Upper GI. This sequence is the correct order in which these examinations should be scheduled. The IVP (intravenous pyelogram) is typically performed first, followed by the Barium enema and then the Upper GI series. This sequence ensures that the examinations are performed in a logical and efficient manner, allowing for proper visualization and evaluation of the gastrointestinal and urinary systems.

The purpose of a one-hour delayed film in an Upper GI Series examination is to determine how much barium was left in the stomach. This allows the radiologist to assess the rate at which the stomach empties and to evaluate any abnormalities or conditions that may affect gastric motility. Demonstrating the presence of Ascaris and determining stomach habitus are not specific purposes of the one-hour delayed film.

The positions of lateral rectum, AP axial rectosigmoid, and RAO & LAO abdomen are commonly used for both single contrast and double contrast examinations of the large bowel. However, the right & left lateral decubitus abdomen position is not typically employed for these examinations.

The AP or PA Erect position would afford the best double-contrast visualization of both colic flexures. This position allows for optimal separation and contrast between the colic flexures, providing clear visualization of any abnormalities or pathologies. The LAO and RPO positions may also provide some double-contrast visualization, but they may not be as effective as the AP or PA Erect position. The lateral position and left lateral decubitus position would not provide the desired double-contrast visualization of both colic flexures.

The hypersthenic body type is characterized by a short, wide, transverse heart, a diaphragm positioned low, and a large bowel that is high and peripheral. However, it does not have a short thoracic cavity. The thoracic cavity refers to the space within the chest that contains the heart, lungs, and other organs. In a hypersthenic body type, the thoracic cavity is not short, but rather it is deep and wide.