Colonoscopy Techniques and Procedures

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Questions and Answers

What is the purpose of the larger outer control knob on a colonoscope?

To move the tip laterally

To maneuver the tip vertically (correct)

To adjust the instrument channel

To control air suction

Which of the following is NOT a potential difficult segment during a colonoscopy?

Sigmoidodescending

Transverse colon (correct)

Rectosigmoid junction

Hepatic flexure

In which position should the patient be placed prior to a colonoscopy?

Supine with arms extended

Sitting upright with legs uncrossed

Right lateral decubitus position

Left lateral decubitus position with knees bent (correct)

What is the primary benefit of performing a digital rectal examination before a colonoscopy?

To prelubricate the anal canal and relax the sphincters Signup and view all the answers

What does air insufflation during a colonoscopy refer to?

Inflation of the colon using air Signup and view all the answers

What is the approximate length of the anal canal?

2-3 cm Signup and view all the answers

What action should be taken to remove a loop formed during colonoscope advancement at the RSJ?

Pull back the shaft Signup and view all the answers

How should Houston's valves be navigated while advancing the colonoscope?

Employ right and left turns with pushing force Signup and view all the answers

What is the main characteristic of the rectum that facilitates scope advancement?

Attachment to the retroperitoneal wall Signup and view all the answers

What is the primary reason for insufficient visualizing of the lumen in the SC region?

Obstruction from redundant folds Signup and view all the answers

Which technique is advisable when progressing through the SC and SDJ?

Continuous right torque and jiggling Signup and view all the answers

At what approximate length should the endoscopist aim to advance the colonoscope if minimal loop formation occurs?

40 cm Signup and view all the answers

What is the most common site of iatrogenic perforation during colonoscopy?

SC and SDJ Signup and view all the answers

What is one of the potential severe risks associated with ERCP?

Infection Signup and view all the answers

Which condition would be classified as a contraindication for performing an ERCP?

Existing bowel perforation Signup and view all the answers

What is the primary purpose of using an endoscope in endoscopy?

To evaluate the interior surface of an organ Signup and view all the answers

Which of the following advancements in endoscopy was developed first?

Endoscopic sphincterotomy Signup and view all the answers

What is a possible consequence of tissue damage during an endoscopy procedure?

Radiation exposure Signup and view all the answers

What is the primary function of optical fibers in an endoscope?

To illuminate the interior of the organ Signup and view all the answers

Why might a coagulopathic patient be advised against ERCP with sphincterotomy?

Increased risk of excessive bleeding Signup and view all the answers

What advancement in endoscopy was introduced in 1996?

Self-expanding metal stents Signup and view all the answers

Which of the following conditions can endoscopy help explain?

Reflux oesophagitis Signup and view all the answers

In what instance would an enteroscope be used?

Chronic abdominal pain Signup and view all the answers

What therapeutic application is NOT typically performed with an endoscope?

Coronary artery bypass Signup and view all the answers

What differentiates double balloon enteroscopy (DBE) from other enteroscopy techniques?

Balloon attachment at the tip Signup and view all the answers

For what purpose is a percutaneous endoscopic gastrostomy (PEG) primarily used?

Long-term feeding support Signup and view all the answers

What is the primary function of push enteroscopy?

Assessment of small bowel pathologies Signup and view all the answers

Which statement about the enteroscope's mechanism is correct?

Small bowel peristalsis helps propel it Signup and view all the answers

What advantage does the Discovery SB overtube provide during enteroscopy?

Enhanced stability during withdrawal Signup and view all the answers

What is the primary purpose of inserting a nasobiliary tube during an ERCP procedure?

To assist in the drainage of bile Signup and view all the answers

Which of the following is a common complication associated with ERCP?

Infection Signup and view all the answers

What is duodenoscope-assisted cholangiopancreatoscopy (DACP) used for?

To visualize bile ducts and pancreatic ducts Signup and view all the answers

What is the success rate range for performing an ERCP based on physician experience?

70% to 95% Signup and view all the answers

What happens to patients after the ERCP procedure in terms of monitoring?

They are monitored for 1-2 hours Signup and view all the answers

In which situation would the pancreatic duct likely be cannulated during ERCP?

In cases of pancreatitis Signup and view all the answers

What is cholangiocarcinoma?

A cancer originating from bile duct cells Signup and view all the answers

What is the maximum estimated risk percentage for complications occurring during ERCP?

5% Signup and view all the answers

What is a possible reason for performing an ERCP?

To check for blockages in bile or pancreatic ducts Signup and view all the answers

Which procedure is NOT considered a therapeutic use of ERCP?

Blood transfusion Signup and view all the answers

What preparation is required from patients before undergoing an ERCP?

Avoiding food and drink for 8 hours prior Signup and view all the answers

During the ERCP procedure, which is the primary method used to visualize blockages in the ducts?

Radiocontrast injection with fluoroscopy Signup and view all the answers

Why is deep sedation desirable during an ERCP?

To ensure a stable endoscopic position in the duodenum Signup and view all the answers

Which of the following could cause a blockage in the bile or pancreatic ducts?

Scarring of the ducts Signup and view all the answers

What is the purpose of a sphincterotomy during an ERCP?

To enlarge the opening of the ampulla for access Signup and view all the answers

What type of anesthesia is commonly used during an ERCP?

Local anesthetic and IV sedatives Signup and view all the answers

Study Notes

Bronchoscopy

Bronchoscopy is a procedure using a flexible tube (bronchoscope) inserted through the nose or mouth to view the tracheobronchial tree.
It's used for collecting bronchial/lung secretions and performing tissue biopsies.
The bronchoscope is a slender, flexible tube (less than 0.5 inches/2.5 cm wide and about 2 feet/60cm long).
It uses fiberoptic technology, meaning very fine filaments that can bend and carry light.
Two types of bronchoscopes exist: rigid tube and fiberoptic tube.
Purposes include visually examining the lower airways (larynx, trachea, bronchi, bronchioles), identifying abnormalities related to lung diseases, and performing therapeutic interventions.
The procedure typically takes 45-60 minutes.
Before the procedure, patients fast for 6-12 hours and avoid smoking for 24 hours.
Liquid intake is also restricted the day of the procedure.
Patients should also avoid taking aspirin or ibuprofen-type medications.
After the procedure, patients are monitored for vital signs (heart rate, blood pressure, and breathing).
Food and drink are avoided for about 2 hours after the procedure.
Bronchoscopic treatments include stent therapy, laser therapy, and argon beam coagulation.

Colonoscopy

Colonoscopy is a procedure to examine the large intestine.
A flexible tube with a camera (colonoscope) is inserted through the anus to view the colon.
It's used to diagnose diseases of the colon and rectum (e.g., cancer, polyps, diverticulitis).
It can also treat some conditions like removing polyps, performing biopsies, and treating some bleeding sources.
The procedure typically takes about 30-60 minutes.
Preparation includes a clear liquid diet and laxative solutions the day before the procedure to clean the colon.
The patient fasts for at least 6 to 12 hours prior to the procedure.
Indications include gastrointestinal bleeding, abdominal pain, chronic constipation, unintended weight loss and to monitor existing conditions in patients who have previously had surgical interventions.
Complications like perforation, bleeding, and infection are possible for colonoscopy.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

ERCP combines endoscopy and fluoroscopy (X-ray) to diagnose and treat problems of the bile and pancreatic ducts.
It involves inserting a flexible tube (endoscope) through the mouth, esophagus and into the duodenum.
A small catheter/cannula is advanced into the pancreatic and/or bile ducts for dye injection and/ or stone removal, dilation or placement of stents.
ERCP used for diagnostic purposes when a blocked or narrowed bile or pancreatic duct is suspected.
This method can also be therapeutic, enabling gallstone removal and opening of narrowed or obstructed ducts (sphincterotomy).
Preparation includes an empty stomach (no food or drink for 8 hours).
The procedure typically takes 1 - 2 hours.
Monitoring is warranted after the procedure, and the patient's throat can become numb after receiving sedatives.

Proctoscopy

A procedure used to examine the anal cavity, rectum, and sigmoid colon
A short, straight, rigid, hollow metal tube (proctoscope/rectoscope) with a light bulb is inserted.
To detect diseases of the rectum or anus.
To evaluate abnormal results of barium enema.
To locate causes of rectal bleeding.
To monitor polyps and detect return of rectal cancer in individuals having undergone surgery.
Procedure involves inserting the lubricated instrument into the rectum.
Air is pumped gently to enhance visualization.
The entire process typically takes around 5-10 minutes.
It's often replaced by the more comfortable fiber optic version.
Preparation typically involves a warm tap water enema or Fleet's enema.
Patients are monitored for complications, like heavy bleeding, difficulty urinating and/or pain.
Post-procedure, patients can usually resume normal activities and diet.

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Description

Test your knowledge on colonoscopy techniques, including patient positioning, digital rectal examinations, and navigating the colonoscope through various segments. This quiz covers essential concepts and practices important for safe and effective endoscopic procedures.