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Chapter 13: Lower Gastrointestinal System

Total questions: 75

Worksheet time: 1hrs 15mins

Name
Class
Date
1.

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

a)

Ileum

b)

Jejunum

c)

Cecum

d)

Duodenum

2.

Which part of the small intestine has the largest diameter?

a)

Duodenum

b)

Ileum

c)

Jejunum

d)

Cecum

3.

Which part of the small intestine is the shortest?

a)

Duodenum

b)

Ileum

c)

Jejunum

d)

Pylorus

4.

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

a)

Duodenum

b)

Jejunum

c)

Ileum

d)

Ilium

5.

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

6.

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.

7.

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

8.

Which part of the large intestine has the widest diameter?

a)

Descending colon

b)

Transverse colon

c)

Cecum

d)

Ascending colon

9.

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

a)

Descending colon

b)

Transverse colon

c)

Sigmoid colon

d)

Ascending colon

10.

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

11.

Which structure is labeled 6?

a)

6 is the appendix.

b)

6 is the ileum.

c)

6 is the cecum.

d)

6 is the sigmoid colon.

12.

Which structure is labeled 1?

a)

Ascending colon

b)

Left colic flexure

c)

Right colic flexure

d)

Sigmoid colon

13.

Which structure is labeled as number 7?

a)

Descending colon

b)

Sigmoid colon

c)

Cecum

d)

Rectum

14.

The ascending colon and upper rectum are intraperitoneal structures.

a)

True

b)

False

15.

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

16.

The part of the gastrointestinal (GI) tract that synthesizes and absorbs vitamins B and K is:

a)

Ileum

b)

Duodenum

c)

Jejunum

d)

Large intestine

17.

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

a)

True

b)

False

18.

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

a)

True

b)

False

19.

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

20.

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

21.

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

a)

Barium enema

b)

Enteroclysis

c)

Air-contrast BE

d)

Small bowel series

22.

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

23.

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.

24.

The enteroclysis procedure is indicated for patients with regional enteritis.

a)

True

b)

False

25.

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

a)

True

b)

False

26.

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

a)

4

b)

6

c)

8

d)

24

27.

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

28.

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

a)

intussusception.

b)

volvulus.

c)

diverticulosis.

d)

enteritis.

29.

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

a)

diverticulosis.

b)

volvulus.

c)

intussusception.

d)

colitis.

30.

The “stovepipe” radiographic sign is often seen with:

a)

volvulus.

b)

intussusception.

c)

neoplasm.

d)

chronic ulcerative colitis.

31.

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

a)

diverticulosis.

b)

neoplasm.

c)

volvulus.

d)

intussusception.

32.

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

33.

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

a)

True

b)

False

34.

CT may be performed to diagnose acute appendicitis.

a)

True

b)

False

35.

Which of the following is classified as an irritant laxative?

a)

Magnesium citrate

b)

Magnesium sulfate

c)

Castor oil

d)

None of the above

36.

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

a)

Colitis

b)

Diverticulosis

c)

Obstruction

d)

Diverticulitis

37.

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

a)

True

b)

False

38.

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

a)

True

b)

False

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

40.

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

a)

Sims’

b)

Lithotomy

c)

Modified lithotomy

d)

Prone

41.

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

a)

toward the coccyx.

b)

toward the umbilicus.

c)

directly posterior.

d)

directly superior.

42.

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

a)

Intussusception

b)

Volvulus

c)

Rectal prolapse

d)

Diverticulosis

43.

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

a)

Sigmoid colon

b)

Haustra

c)

Anorectal angle

d)

Rectal ligament

44.

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.

45.

Evacuative proctography is most commonly performed on geriatric patients.

a)

True

b)

False

46.

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

a)

True

b)

False

47.

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

a)

True

b)

False

48.

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

a)

True

b)

False

49.

Which imaging modality can demonstrate abscesses in the retroperitoneum?

a)

MRI

b)

Nuclear medicine

c)

Sonography

d)

Conventional radiography

50.

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

51.

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.

52.

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

53.

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.

54.

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

55.

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

56.

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)

57.

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

58.

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.

59.

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

60.

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

61.

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

62.

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

63.

A patient comes to radiology with a history of rectocele. The procedure that best demonstrates this condition is:

a)

Barium enema

b)

IV pyelogram

c)

Hysterosalpingography

d)

Mammography

64.

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

65.

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

66.

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

67.

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

68.

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.

69.

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.

70.

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

a)

True

b)

False

71.

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

a)

True

b)

False

72.

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

73.

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

a)

True

b)

False

74.

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

75.

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