Lower atomic number = less dense

Hand held fluoroscope – nilalagay sa mata

Teichman’s mixture – combination of lead, barium and bismuth

Pinaka unang contrast – air during retrograde urography

1st pic – fluoroscopic image

2nd pic – retrograde urography

Positive CM – radiopaque or white appearance

Negative CM – radiolucent or black appearance

Mas maganda ang barium sulfate sa small bowel series

Water soluble
Colloidal – para hindi mg settle diown agad ang barium

Suspended – uses additives para ang barium particles ay mas matagal nan aka suspend

Weight / weight – also means grams/ grams

Denominator is always fix value which is 100. Ex: 95% w/w = 95 grams / 100 grams
Weight / volume = grams/ Ml

Ex: 250 grams / 100 ml

Para sumarap ang barium due to its unpalatable taste

No additives
Advantage is maganda ang mucosal coating, cheaper If ma gwa sulphate or sulfate, choose SULFATE.
Nka F based on IUPAC.

Fistula – may daanan ang 2 organs

Onstruction- bara

No barium on px for operation or surgery . pre and post if ever done, px has to go for aspiration

Perforation – a whole sa GI tract like ulcers

Allergy – very rare

Venous embolism – barium is not injected to the vein might result to this
Has 2 kinds:

- Water soluble iodinated contrast

- Oil based iodinated contrast
High osmolar contrast media – HOCM
 range of osmolality of blood therefore you can induce
1800- 2400 of ionated contras media

Higher osmolality = higher chance of adverse reaction

Higher osmolality is nasisisra ang homeostasis sa px?

Cation – positively charge component of ionic contrast

Anion – negative charge

Under cation – pwede mg combine

Underanion – 1 lng pwede

Basta bulong nga may ate sa punta anion na

Under ionic contrast higher osmolality happens because dissociating agent or substance is injected. The
particles is hiwahiwalay and sumasabog resulting to higher osmolality
Baba osmolality = baba contrast media reaction

Intact or solid no dissociating things that happens here when injected in the patient.

Best ex: Glucose and amide

Memorize ni . memorize the ratio number kay amo nag a gwa. Eample: which of the ff has a number of
3:2. Answer: ionic monomer

In a monomer benzene ring there are 3 iodine

Sa dimer 6 ka iodine

Ionic – 2 particle

Non ionic – 1 particle

Ng 3: 2 siya kay 3 ka iodine, and 2 ka particle same to all

Higher ratio value – lower reaction of contrast media
Gum of acacia – use to make sticky …

Prevents foaming – simethicone and polysorbate

Systeic reaction – invoolves an organ

Contrast media ng awas kay pumutok ang ugat
Other term: prelimainary film

Pinaka una nga radiogram right after ng inject ng contrast – immediate film
GI
Aka: [Link] swallow
Abnormal stricture at the distanct part of an organ

Chalasia – abnormal opening

Rat tail sign and bird’s beak sign for achalsia

Some effects are due to megaesophags

Because food can no longer pass thru

No opening
Usually affected is distal part of esophagus could be because of GERD
Happens due to px that attempted suicide after drinking strong acid or poison

Odynophagia – painful swallow

Dysphagia- difficulty in swallowing

For old patients who cannot swallow is Presbyesophagus

Outpouching

Zenker’s diverticulum – esophagus is affected

Cork’s screw appearance – uncoordinated muscle contraction of esophgus

Uses double contrast tecnique

Ex: ulceration

There’s a filling defect

Use double contrast basta inflammation erosion, use double contrast

Pro kung enhancement lng or motility – single contrast

Worm like or cobblestone appearance

Mostly bronchus, trachea
Mostly baby
No prep for esophagogram

Under esophagogram, mas recommended ang recumbent

Kay if erect there’s gravity

Not much recommended due to superimposition to the hilar region of lungs

Best position for esophagogram – RAO – beause not superimposed to spine and heart and mas kita sya
from mouth down compared to the lateral position
3 manuever for breathing exercises

- Valsalva – done everyday, like dumudumi or umiire. Instruct px to inhale, exhale with ire
- Modified valsalva – nose pinching, blow mouth
- Mueller – inhale hangin, and close glottis

Water test
- Px is in LPO recumbent position

Compression paddle technique

- Pingpong rocket to produce abdominal pressure

Toe touch maneuver

- Px is in lateral abutin the paa niya

- Not done on geriatric px
Best image ng pyloric canal and duodenum
Reference point: duodenal bulb
In RAO peristaltic movement is very active. this the position kung diin ga kwa serial study

When to use RAO position para ma pa gwa ang purlirc canal – if px is sthenic

Fundus – filled with air sa amo ni nga projection

UGIS – demonstrates only the barium filled stomach
Right lateral view ni

If ang gna hanap is pyloric canal and duiodenal bulb na ang body habitus is hyper stehnic – right lat
recumbent

If asthenic – prone PA position

Stenic – rao
If wala nakabutang nga body habitus just answer – RAO
Stomach contents goes to the fundus
Junction of duo and jejunum – superimposed if upright position
Gamot na gna inject to stop the peristaltic movement of duodenum or duodenal atony - Antocolinergic
drug - pro banthine
Bulb and pylorus
Right lat ang position

Clinical indication:
Ileus means presenece of large amount of air in the intestine small
Meckles diverticulum – diverticulum sa small intestine
Unknown cause
Basat amall bowerl npo lng wala bowel prep
The first contrast nga mg touch sa ileocecal valve amo na ina ang indication na done na ang procedure

Recommended posi sa SIS – prone

Methylceluose – used sa double contrast sa entteroclysis
Used for patient na may ileus or obstruction
Flow of contrast is retrograde

To relieve from discomfort give patient glucagon and diazepam

Fundus makadto c barium kay may reflux

Let px drink iced cold water coffee or tea foe patient to make bilis the transit .
Outpouching

Usually arises on the retrosigmoid area

Claaw sign and coild spring pwede mn mushroom shape appearance
Twisted ang bituka
Congenital megacolon anganglinic nerve

Transition zone where ma kita si kirschsprungs disease

Board exam question na ang number of air
Capacity is 3000 ml
LPO lng e use d
Rectosigmoid

Hepatic flexure

Kalaba un ni ascending colon

All if these kitaon sa LpO posi

Posterior art of bituka is air filled
Once appendix is een bal an mo nga ara ka na sa cecum

If it is absent, there is reflux of contrast sa ileocecal area

Iglauer manuerver - calcification superimposed sa mandibular area

Px should depressed thumb using the index finger

Projection na gna gamit SMV.

VSM – from vertico to submento. Not use apical film kay ma una tamaan ng rad ung film
Soft palate rad exam - posterior part
Boar exam question ni, gn ask if ano nga projection ang may deglutition
Other term – reverse phonation

Key word: Glottis

Ng gwa mn ni
phantom of canaliculus – injection site ni dacrycyctograohy
Basta sa boar exam 7 to 20 minutes

Rotate head 10 to 15 degrees

Most common si hystero

Clinical indication
Contrast should leak pakadto peritoneum – meaning good indication ni nga wala bara sa fallopian tube

Air is induced to visualize ecternal conitur of the organ

Fistula is between the sigmoid and ileum – posit of px should be oblique

Fistula bet. B=vagina and rectum – lateral

Fetograpy – para Makita ang bata sa chan

Pelvimtery – size ka cephalic head para mg gwa si baby in relation s aka dakuon sng pelvis ni mother
PA or AP – routine ni

Oblique – used only if may case na congenital defect

Prone is used for less magnification
Level of ruler at the level of ischial tuberosity or 10 cm below pubic symphysiss
puncture site scaphoid, lunate and radius
Injection site ng lumbar tap, l3-l4
Alternative projection

Notes:

Breast radiography

cleopatra position – used in mamo to demonstrate tail end of breats

ciserna chili