Chapter 12 Biliary Tract and Upper Gastrointestinal System
1. What is the average weight of the adult human liver?
3 to 4 pounds or 1/36 of total body weight
2. Which abdominal quadrant contains the gallbladder?
Right upper quadrant
3. What is the name of the soft tissue structure that separates the right from the left lobe of the liver?
Falciform ligament
4. Which lobe of the liver is larger, the right or the left?
Right
5. List the other two lobes of the liver (in addition to right or the left)?
Quadrate, Caudate
6. True or False: the liver performs more than 100 functions?
True
7. True or False: The average healthy adult liver produces 1 gallon, or 3000 to 4000 mL, of bile per day.
False
8. List the three primary functions of the gallbladder?
Store bile, concentrate bile, contracts to release bile into duodenum
9. True or False: Concentrated levels of cholesterol in bile may lead to gallstones?
True
10. What is a common site for impaction, or lodging, of gallstones?
Duodenal papilla
11. True or False: In about 40% of individuals, the end of the common bile duct and the end of the pancreatic duct are totally separated into two ducts rather than combining into one single passageway into the duodenum?
True
12. True or False: An older term for the main pancreatic duct is the duct of Vater.
False
13. The gallbladder is located more (posteriorly or anteriorly) within the abdomen?
anteriorly
14. Which imaging modality produces cholescintigraphy?
Nuclear medicine
15. True or False: Acute cholecystitis may produce a thickened gallbladder wall?
True
16. Cholelithiasis
condition of having gallstones
17. Cholecystitis
Inflammation of the gallbladder
18. Biliary stenosis
Narrowing of the biliary ducts
19. Cholecystectomy
Surgical removal of the gallbladder
20. Neoplasm
benign or malignant tumors
21. Choledocholithiasis
enlargement or narrowing of the biliary ducts because of the presence of stones.
22. List the seven main components of the alimentary canal
mouth, pharynx, esophagus, stomach, small & large intestine, anus, salivary glands, pancreas, liver, gallbladder
23. List the four accessory organs of digestion
salivary glands, pancreas, liver, gallbladder
24. The three primary functions of the digestive system
intake and digestion of food, absorption of digested food particles, elimination of solid waste.
25. What two terms refer to a radiographic examination of the pharynx and esophagus?
esophagram or barium swallow
26. Which terms describes the radiographic study of the distal esophagus, stomach, and duodenum?
Upper gastrointestinal series or upper GI
27. Which three pairs of salivary glands are accessory organs of digestion associated with the mouth?
parotid, sublingual, submadibular
28. The act of swallowing is called?
deglutition
29. List the three divisions of the pharynx
nasopharynx, oropharynx, laryngopharynx
30. What structures create the two indentations seen along the lateral border of the esophagus?
aortic arch, left primary bronchus
31. List the three structures that pass through the diaphragm
esophagus, inferior vena cava, aorta
32. What part of the upper GI tract is a common site for the ulcer disease?
duodenal bulb or cap
33. What term describes the junction between the duodenum and jejunum?
duodenojejunal flexure (suspensory muscle of the duodenum or ligament of Treitz)
34. The C-loop of the duodenum and pancreas are (intraperitoneal or retroperitoneal) structures.
retroperitoneal
35. The three main subdivisions of the stomach are?
Fundus, body, pylorus
36. Another term for mucosal folds of the stomach is?
rugae
37. True or False: Mechanical digestion includes movement of the entire gastrointestinal tract?
True
38. Peristaltic activity is not found in which of the following structures ( Pharynx, Esophagus, Stomach, Small Intestine)?
pharynx
39. Stomach contents are churned into a semifluid mass called?
chyme
40. A churning or mixing activity present in the small bowl is called?
rhythmic segmentation
41. List the three classes of substances that ingested and must be chemically digested.
carbohydrates, proteins, lipids
42. Biologic catalysts that speed up the process of digestion are called?
enzymes
43. List the end products of digestion for the following classes of food carbohydrates (carbohydrates, lipids, proteins)
simple sugars, fatty acids and glycerol, amino acids
44. What is the name of the liquid substance that aids in digestion and is manufactured in the liver and stored in the gallbladder?
bile
45. How does bile assist in emulsification in fat?
large fat droplets are broken down to small fat droplets, which have greater access for the breakdown of lipids
46. Absorption of nutrients primarily takes place in the ____________, although some substances are absorbed through the lining of the ___________.
small intestine, of the stomach
47. Any residues of digestion or unabsorbed digestive products are eliminated from the ________ as a component of feces.
large intestine
48. Peristalsis is an example of which type of digestion.
mechanical
49. Which term describes food once it is mixed with gastric secretions in the stomach?
chyme
50. A high and transverse stomach would be found in a (hypersthenic, sthenic, hyposthenic, asthenic)
hypersthenic
51. A J-shaped stomach that is more vertical and lower in the abdomen with the duodenal bulb at the level of L3-L4 would be found in a(n) (hyperstenic, sthenic, hyposthenic/asthenic or none of the above)
hyposthenic/asthenic
52. On the average, how much will abdominal organs drop in the erect position?
1 to 2 inches
53. Name the two abdominal organs most dramatically affected, in relation to location, by body habitus?
Stomach and gallbladder
54. Would the fundus of the stomach be more superior or more inferior when one takes in a deep breath? Why?
Inferior, because of its proximity to the diaphragm
55. Type of mechanical digestion and/or movement that occur in oral cavity
mastication and deglutition
56. Type of mechanical digestion and/or movement that occur in pharynx
deglutition
57. Type of mechanical digestion and/or movement that occur in Esophagus
deglutition, peristalsis
58. Type of mechanical digestion and/or movement that occur in stomach
peristalsis and mixing
59. Type of mechanical digestion and/or movement that occur in the small intestine
peristalsis and rhythmic segmentation
60. True or False: With the use of digital fluoroscopy, the number of postfluoroscopy radiographs ordered has greatly diminished.
True
61. Another term for a negative contrast medium is ____
Radiolucent contrast medium
62. What substance is most commonly ingested to produce carbon dioxide gas as a negative contrast medium for gastrointestinal system?
calcium or magnesium citrate
63. Is a mixture of barium sulfate a suspension or a solution?
suspension
64. True or False: Barium sulfate never dissolves is water.
True
65. True or False: Certian salts of barium are poisonous to humans, so barium contrast studies require a pure sulfate salt of barium for human consumption during GI studies.
True
66. What is the ratio of water to barium for a thin mixture of barium sulfate
1:1
67. What is the chemical symbol for barium sulfate?
BaSO4
68. When is the use of barium sulfate contraindicated?
when the mixture may escape the peritoneal cavity
71. What patient condition prevents the use of a water-soluble contrast medium for an upper GI?
sensitivity to iodine
72. What is the major advantage for using a double-contrast medium technique for esophagrams and upper GI?
better coating and visibility of the mucosa. Polyps, diverticula, and ulcers are better demonstrated.
73. The speed with which barium sulfate passes through the GI tract is called gastric
motility
74. What is the purpose of the gas with a double-contrast media technique
It forces the barium sulfate against the mucosa for better coating
75. Which of the following devices on a digital fluoroscopy system converts the analog into a digital signal (PACS, Light converter, CCD, OTS)
CCD
76. What device (found beneath the radiographic table when correctly positioned) greatly reduces exposure to the technologist from the fluoroscopic x-ray tube?
bucky slot shield
77. How is the bucky slot shield activated or placed in its correct position for fluoroscopy?
by moving the bucky tray all the way to the end of the table
78. What is the minimum level of protective apron worn during fluoroscopy?
0.5 mm Pb/Eq apron
79. What is the major benefit of using a compression paddle during an upper GI study?
reduces exposure to arms and hands of radiologist
80. List the three cardinal principles of radiation protection.
time, distance, shielding
81. Which one of the three cardinal principles is most effective in reducing exposure to the technologist during a fluoroscopic procedure?
distance
82. Which capability on most digital fluoroscopy systems demonstrates dynamic flow of contrast media through the GI Tract.
cine loop capability
83. What is the correct pathological condition for the esophagram: Difficulty in swallowing
dysphagia
84. What is the correct pathological condition for the esophagram: Replacement of normal squamous epithelium with columnar epithelium
barrett's esophagus
85. What is the correct pathological condition for the esophagram: May lead to esophagitis
GERD
86. What is the correct pathological condition for the esophagram: Large outpouching of the esophagus?
Zenker's diverticulum
87. What is the correct pathological condition for the esophagram: also called cardiospasm
achalasia
88. What is the correct pathological condition for the esophagram: most common form is adenocarcinoma
carcinoma of the esophagus
89. What pathology for upper GI series is: Blood in vomit
hematemesis
90. What pathology for upper GI series is: inflammation of lining of stomach
gastritis
91. What pathology for upper GI series is: blind outpouching of the mucosal wall
diverticula
92. What pathology for upper GI series is: undigested material trapped in stomach
bezoar
93. What pathology for upper GI series is: synonymous with gastric or duodenal ulcer
peptic ulcer
94. What pathology for upper GI series is: portion of stomach protruding through the diaphragmatic opening
hiatal hernia
95. What pathology for upper GI series is: only 5% of ulcers lead to this condition
perforating ulcer
96. What pathology for upper GI series is: Double - contrast upper GI is recommended for this type of tumor
gastric carcinoma
97. Radiographic appearance of the following conditions: Its presence indicates a possible sliding hiatal hernia
schatzki's diverticulum
98. Radiographic appearance of the following conditions: Speckled appearance of gastric mucus
gastritis
99. Radiographic appearance of the following conditions: "wormlike" appearance of esophagus
esophageal varices
100. Radiographic appearance of the following conditions: Stricture of esophagus
achalasia
101. Radiographic appearance of the following conditions: Gastric bubble above diaphragm
hiatal hernia
102. Radiographic appearance of the following conditions: Irregular filling defect within stomach
gastric carcinoma
103. Radiographic appearance of the following conditions: Enlarged recess in proximal esophagus
zenker's diverticulum
104. Radiographic appearance of the following conditions: "Lucent-halo" sign during upper GI
ulcers
105. Which procedure is often performed to detect early signs of GERD
endoscopy
106. Which specific structure of the gastrointestinal system is affected by HPS
antral muscle at the orifice of the plyorus
107.Which imaging modality is most effective in diagnosing HPS while reducing dose to the patient?
ultrasound
108. What does the acronym NPO stand for and what does it mean
non per os, nothing by mouth
109. True or False: The patient must be NPO 4-6 hours before an esophagram
False 8 hours
110. True or False: The esophagogram usually begins with fluoroscopy with the patient in the erect position
True
111. What materials may be used for swallowing to aid in the diagnosis of radiolucent foreign bodies in the esophagus?
barium soaked cotton balls, barium pills, or marshmallows followed by thin barium
112. A breathing technique in which the patient takes in a deep breath and bears down is called the _____?
valsalva maneuver
113. What position is the patient usually placed in during the water test?
LPO
114. Which region of the GI tract is better visualized when the radiologist uses a compression paddle during an esopagram
esophagogastric junction
115. What type of contrast medium should be used if the patient has a history of bowl perforation?
oral, water soluble iodinated contrast media
116. What is the minimum amount of time that the patient should be NPO before an upper GI
8 hours
117. True or False: The body of the stomach curves inferiorly and posteriorly from the fundus
False
118. What is the most common form of positive contrast medium used for studies of the gastrointestinal system
barium sulfate