Deck 13: Lower Gastrointestinal System

Question 1

Meckel diverticulum is best diagnosed with a radionuclide (nuclear medicine)scan.

Answer 1

True

Question 2

Which part of the small intestine makes up three fifths of its entirety?

A) Duodenum
B) Jejunum
C) Ileum
D) Ilium

Answer 2

Ileum

Question 3

Which structure is labeled 1?

A) Ascending colon
B) Left colic flexure
C) Right colic flexure
D) Sigmoid colon

Answer 3

Left colic flexure

Question 4

What is the term for the three bands of muscle that pull the large intestine into pouches?

A) Haustra
B) Valvulae conniventes
C) Suspensory ligaments
D) Taenia coli

Question 5

Which of the following structures is not considered part of the colon?

A) Transverse colon
B) Right and left colic flexures
C) Rectum
D) All of the above are part of the colon.

Question 6

Which part of the large intestine has the widest diameter?

A) Descending colon
B) Transverse colon
C) Cecum
D) Ascending colon

Question 7

Which of the following conditions may produce the "cobblestone" or "string" sign?

A) Whipple disease
B) Regional enteritis (Crohn's disease)
C) Giardiasis
D) Ileus

Question 8

Which part of the gastrointestinal (GI)tract synthesizes and absorbs vitamins B and K?

A) Ileum
B) Duodenum
C) Jejunum
D) Large intestine

Question 9

Which structure is labeled 6?

A) Cecum
B) Sigmoid colon
C) Vermiform appendix
D) Iliac colon

Question 10

Which aspect of the large intestine is located highest,or most superior,in the abdomen?

A) Right colic flexure
B) Left colic flexure
C) Transverse colon
D) Ascending colon

Question 11

Which sections of the large intestine will most likely be filled with air with the patient in the prone position during a double-contrast barium enema (BE)?

A) Ascending colon, descending colon, and rectum
B) Transverse and sigmoid colon
C) Rectum only
D) Right and left colic flexure and sigmoid colon

Question 12

Which of the following conditions may lead to an adynamic ileus?

A) Small bowel tumor
B) Scar tissue within the jejunum
C) Peritonitis
D) Stricture of ileum due to an inguinal hernia

Question 13

Which structure is labeled 7?

A) Descending colon
B) Sigmoid colon
C) Cecum
D) Rectum

Question 14

Which part of the small intestine has the largest diameter?

A) Duodenum
B) Ileum
C) Jejunum
D) Cecum

Question 15

The circular staircase,or herringbone pattern,is a common radiographic sign for a mechanical ileus.

Question 16

Which part of the small intestine has a feathery appearance when filled with barium?

A) Ileum
B) Jejunum
C) Cecum
D) Duodenum

Question 17

Which part of the colon has the greatest amount of potential movement?

A) Descending colon
B) Transverse colon
C) Sigmoid colon
D) Ascending colon

Question 18

The ascending colon and upper rectum are intraperitoneal structures.

Question 19

Which part of the small intestine is the shortest?

A) Duodenum
B) Ileum
C) Jejunum
D) Pylorus

Question 20

Which part of the large intestine is located between the rectum and the descending colon?

A) Left colic flexure
B) Right colic flexure
C) Sigmoid colon
D) Cecum

Question 21

For an average adult,the amount of barium ingested is one 16-oz cup for a small-bowel-only series.

Question 22

Which of the following conditions would contraindicate the use of a cathartic before a barium enema?

A) Colitis
B) Diverticulosis
C) Obstruction
D) Diverticulitis

Question 23

In what position is the patient placed for the enema tip insertion?

A) Sims'
B) Lithotomy
C) Modified lithotomy
D) Prone

Question 24

The enteroclysis procedure is indicated for patients with regional enteritis.

Question 25

The term describing a double-contrast small bowel procedure is:

A) two-stage small bowel procedure.
B) diagnostic intubation.
C) enteroclysis.
D) none of the above.

Question 26

The "stovepipe" radiographic sign is often seen with:

A) volvulus.
B) intussusception.
C) neoplasm.
D) chronic ulcerative colitis.

Question 27

Ultrasound,with graded compression,can be used in diagnosing acute appendicitis.

Question 28

Which radiographic sign is frequently seen with adenocarcinoma of the large intestine?

A) "Sail" sign
B) Diverticula
C) "Napkin ring" or "apple core" sign
D) Thickened mucosa

Question 29

When are small bowel series deemed to be complete?

A) Two hours after the ingestion of barium
B) Once the contrast media passes the ileocecal valve
C) Once the contrast media reaches the rectum
D) Once the contrast media passes the duodenojejunal flexure

Question 30

Which of the following procedures is considered as a functional study?

A) Barium enema
B) Enteroclysis
C) Air-contrast BE
D) Small bowel series

Question 31

Which of the following is classified as an irritant laxative?

A) Magnesium citrate
B) Magnesium sulfate
C) Castor oil
D) None of the above

Question 32

Synthetic latex enema tips are safe to use for latex-sensitive patients.

Question 33

The tip of the catheter is advanced to the ____ during an enteroclysis.

A) duodenojejunal junction (ligament of Treitz)
B) C-loop of the duodenum
C) pyloric sphincter
D) ileocecal sphincter

Question 34

CT may be performed to diagnose acute appendicitis.

Question 35

Rectal retention enema tips should be fully inflated by the technologist before beginning a barium enema.

Question 36

A twisting of the intestine on its own mesentery is termed:

A) intussusception.
B) volvulus.
C) diverticulosis.
D) enteritis.

Question 37

A telescoping,or invagination,of one part of the intestine into another is termed:

A) diverticulosis.
B) volvulus.
C) intussusception.
D) colitis.

Question 38

The patient must be NPO a minimum of ____ hours before the small bowel series.

A) 4
B) 6
C) 8
D) 24

Question 39

At what stage of respiration should the enema tip be inserted into the rectum?

A) During deep breaths
B) During shallow breaths
C) Suspended inspiration
D) Suspended expiration

Question 40

The "tapered," or "corkscrew," radiographic sign is often seen with:

A) diverticulosis.
B) neoplasm.
C) volvulus.
D) intussusception.

Question 41

Which of the following statements is NOT true in regard to a pediatric small bowel series?

A) The transit time for barium through the small intestine is longer than that of an adult.
B) Barium sulfate is the contrast medium of choice.
C) The small bowel series should be scheduled early in the morning.
D) A gonadal shield often cannot be used during the later stages of the study.

Question 42

A patient comes to radiology with possible diverticulosis.Which of the following studies is most diagnostic for detecting this condition?

A) Single-contrast barium enema
B) Double-contrast barium enema
C) Evacuative proctogram
D) Small bowel series

Question 43

Which of the following positions best demonstrates the left colic flexure?

A) LPO
B) Left lateral decubitus
C) Left lateral
D) Left anterior oblique (LAO)

Question 44

During a double-contrast barium enema (BE)procedure,the radiologist suspects a polyp in the descending colon.Which position would best demonstrate this?

A) Supine for AP projection
B) 45° erect PA projection
C) Right lateral decubitus
D) Left lateral decubitus

Question 45

The height of the enema bag should not exceed 36 inches (92 cm)above the radiographic table at the beginning of the study.

Question 46

The opening leading into the intestine for the patient with a colostomy is termed the stoma.

Question 47

Which of the following pathologic conditions is best demonstrated with evacuative proctography?

A) Intussusception
B) Volvulus
C) Rectal prolapse
D) Diverticulosis

Question 48

Central ray and image receptor centering for a 1-hour small bowel radiograph should be:

A) 2 inches (5 cm) above level of the iliac crest.
B) at the level of the iliac crest.
C) 1 inch (2.5 cm) below the level of the iliac crest.
D) at the level of the ASIS.

Question 49

Which imaging modality can demonstrate abscesses in the retroperitoneum?

A) MRI
B) Nuclear medicine
C) Sonography
D) Conventional radiography

Question 50

During the initial enema tip insertion,the tip is aimed:

A) toward the coccyx.
B) toward the umbilicus.
C) directly posterior.
D) directly superior.

Question 51

Which one of the following imaging modalities and/or procedures is very effective in detecting the Meckel diverticulum?

A) CT
B) Double-contrast barium enema
C) Sonography
D) Nuclear medicine

Question 52

The ideal kV range for a double-contrast barium enema is:

A) 70 to 80.
B) 90 to 100.
C) 100 to 125.
D) 130 to 140.

Question 53

A patient comes to radiology for a barium enema (BE).He has a possible fistula extending from the rectum to the urinary bladder.Which one of the following projections and/or positions would best demonstrate the fistula?

A) Lateral rectum position
B) AP erect projection
C) LPO axial projection
D) LPO and RPO positions

Question 54

Which specific aspect of the large intestine must be demonstrated during evacuative proctography?

A) Sigmoid colon
B) Haustra
C) Anorectal angle
D) Rectal ligament

Question 55

Evacuative proctography is most commonly performed on geriatric patients.

Question 56

A radiograph of an AP barium enema (BE)projection reveals poor visualization of the sigmoid due to excessive superimposition of the sigmoid colon and rectum.How can this area be better visualized on the repeat exposure?

A) Angle the central ray (CR) 30° to 40° cephalad with AP projection.
B) Increase kV.
C) Take a PA projection with the patient in the left lateral decubitus position.
D) Take a PA projection with a 30° to 40° cephalad CR angle.

Question 57

Why is the posteroanterior (PA)rather than the AP projection recommended for a small bowel series?

A) Less gonadal dose for female patients
B) More comfortable for patient
C) Places small intestine closer to image receptor (IR)
D) Better separation of loops of small intestine

Question 58

What type of enema tip is recommended for a barium enema on an infant?

A) Rectal retention
B) Plastic disposable
C) 10 Fr, flexible silicone catheter
D) Foley catheter

Question 59

Which projection and/or position is most commonly performed during an evacuative proctogram?

A) Anteroposterior (AP) erect
B) Lateral
C) Right posterior oblique (RPO) and left posterior oblique (LPO)
D) AP axial

Question 60

During a colostomy barium enema,a double-contrast retention enema tip is used.

Question 61

MATCHING
Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series.(Use each option only once.)
Obstruction of the small intestine

A)Ileus
B)Neoplasm
C)Meckel diverticulum
D)Malabsorption syndrome (sprue)
E)Enteritis
F)Regional enteritis (Crohn's disease)
G)Giardiasis
H)Adynamic or paralytic ileus

Question 62

MATCHING
Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series.(Use each option only once.)
Chronic inflammatory disease of the GI tract

A)Ileus
B)Neoplasm
C)Meckel diverticulum
D)Malabsorption syndrome (sprue)
E)Enteritis
F)Regional enteritis (Crohn's disease)
G)Giardiasis
H)Adynamic or paralytic ileus

Question 63

A patient comes to radiology for a double-contrast barium enema.The patient cannot lie on her side during the study.Which of the following projections could replace the lateral rectum projection?

A) AP axial
B) LPO axial projection
C) Ventral decubitus
D) Dorsal decubitus

Question 64

How much CR angulation is required for the AP axial projection?

A) 10° to 15°
B) 20° to 25°
C) 30° to 40°
D) 45°

Question 65

MATCHING
Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series.(Use each option only once.)
Inflammation of the intestine

A)Ileus
B)Neoplasm
C)Meckel diverticulum
D)Malabsorption syndrome (sprue)
E)Enteritis
F)Regional enteritis (Crohn's disease)
G)Giardiasis
H)Adynamic or paralytic ileus

Question 66

MATCHING
Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series.(Use each option only once.)
New growth observed in intestine as filling defects

A)Ileus
B)Neoplasm
C)Meckel diverticulum
D)Malabsorption syndrome (sprue)
E)Enteritis
F)Regional enteritis (Crohn's disease)
G)Giardiasis
H)Adynamic or paralytic ileus

Question 67

A patient comes to radiology with a history of rectocele.Which of the following procedures best demonstrates this condition?

A) Single-contrast barium enema
B) Evacuative proctogram
C) Double-contrast barium enema
D) Enteroclysis

Question 68

Why is it important for the technologist to review the patient's chart and inform the radiologist before beginning the barium enema examination if a biopsy was performed as part of a prior sigmoidoscopy or colonoscopy procedure?

A) A sigmoidoscopy or colonoscopy would make the BE examination unnecessary.
B) The biopsy of the colon may weaken that portion of the colon, which could lead to a perforation during the BE examination.
C) The radiologist would want to confer with the referring physician to see whether the biopsy revealed a malignancy.
D) None of the above; the radiologist does not need to know this information before the BE examination.

Question 69

The average time to scan the large intestine during a computed tomography colonography is:

A) 1 hour.
B) 20 minutes.
C) 30 minutes.
D) 10 minutes.

Question 70

MATCHING
Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series.(Use each option only once.)
Patient with lactose or sucrose sensitivities

A)Ileus
B)Neoplasm
C)Meckel diverticulum
D)Malabsorption syndrome (sprue)
E)Enteritis
F)Regional enteritis (Crohn's disease)
G)Giardiasis
H)Adynamic or paralytic ileus

Question 71

While attempting to insert an enema tip into the rectum,the technologist experiences resistance.What should be the next step taken by the technologist?

A) Retry the insertion using more lubrication.
B) Ask the patient to try to insert it himself.
C) Have the radiologist insert it using fluoroscopic guidance.
D) Cancel the procedure.

Question 72

A single-stage,double-contrast barium enema involves instilling both the negative and positive contrast media at the same time.

Question 73

What is another term for the AP axial projection taken during a barium enema procedure?

A) Sims' position
B) Butterfly position
C) Chassard-Lapine position
D) Smith position

Question 74

During barium enema fluoroscopy,the radiologist detects a possible defect in the right colic flexure.He asks the technologist to produce a radiograph that will best demonstrate this region of the large intestine.Which one of the following positions will accomplish this goal?

A) LAO
B) AP axial projection
C) AP recumbent
D) LPO

Question 75

Computed tomography colonography (CTC)is considered as an effective alternative to endoscopic colonoscopy.

Question 76

Which of the following barium enema projections and/or positions provides the greatest amount of gonadal dosage to both male and female patients?

A) AP/PA
B) Lateral rectum
C) Left lateral decubitus
D) Left posterior oblique

Question 77

Why is oral contrast media sometimes given during computed tomography colonography?

A) To determine if a fistula is present
B) To mark or "tag" possible fecal matter
C) To demonstrate possible diverticula
D) To prevent spasm of the large intestine

Question 78

Overhead,radiographic projections are often not taken when using digital fluoroscopy.

Question 79

During a single-contrast barium enema,the radiologist detects a possible defect within the right colic flexure.Which of the following projections and/or positions best demonstrates this region of the colon?

A) RPO
B) LAO
C) AP axial
D) LPO

Question 80

An infant is brought to the ED with a possible intussusception.Which of the following procedures may actually correct this condition?

A) Small bowel enema
B) Small bowel series
C) Defecography
D) Barium or air enema