Abdomen

Question 1

Flat Plate Abdomen/ KUB projections/ views

Answer 1

1. AP Supine
2. AP Upright
3. AP/ PA Upright Substitute (Left Lt decub if pt too ill to stand)

Question 2

Demo size and shape of liver, spleen, kidneys, and intra abdominal calcification and masses

Answer 2

Flat Plate Abdomen/ KUB AP Supine

Question 3

Flat Plate Abdomen/ KUB is only done in — unless required by certain indications

Answer 3

supine

Question 4

Flat Plate Abdomen/ KUB AP Supine cxt and crd

Answer 4

14x17- longit- BD- Perp- MSP- iliac crest

Question 5

Respiration suspended at end of expiration so that abdominal organs are not compressed

Answer 5

Flat Plate Abdomen/ KUB AP Supine and Uprght

Question 6

Demo visceroptosis and air-fluid levels

Answer 6

Flat Plate Abdomen/ KUB AP Upright

Question 7

Flat Plate Abdomen/ KUB AP Upright CXT and CRD

Answer 7

14x17- longit- BD
(H)- MSP at 2” (5cm) above iliac crest

Question 8

Use marker arrow in H RP

Answer 8

Flat Plate Abdomen/ KUB AP Upright

Question 9

H RP requires ensured inclusion of the diaphragm but if bladder is to be included, center IR at iliac crest

Answer 9

Flat Plate Abdomen/ KUB AP Upright

Question 10

If pt is too tall to include entire pelvic area, a 2nd radiography to in include bladder on a 10x12 CW IR is needed

Answer 10

Flat Plate Abdomen/ KUB AP Upright

Question 11

10x12- CW- MLL- 2-3” (5-7cm) above upper border of SP

Answer 11

Flat Plate Abdomen/ KUB AP Upright if pt is too tall

Question 12

When kidneys are nor of primary interest, consider (1) Proj as it greatly reduced pt (2) dose

Answer 12

1. Upright PA
2. gonadal

Question 13

Why should upright PA Proj be considered when kidneys are not of primary interest during flat plate abdomen/ KUB?

Answer 13

Kidneys are posteriorly positioned and there is higher radiation dose upon entry. Thus, when xray enters from posterior, there is lower gonadal dose because of the attenuation effect

Question 14

Used when pt is too ill to dtand to demo air-fluid levels

Answer 14

Flat Plate Abdomen/ KUB AP/ PA Upright Substitute (L Lat Decub)

Question 15

Have pt lie on side for several minutes before exposure to allow air to rsie to its highest level within the abdomen

Answer 15

Flat Plate Abdomen/ KUB AP/ PA Upright Substitute (L Lat Decub)

Question 16

14x17 vertically transverse on the surf of the RT (to follow LA of abdomen)

Answer 16

Flat Plate Abdomen/ KUB AP/ PA Upright Substitute (L Lat Decub)

Question 17

Adjust height of CXT w grid so that the MLL or IR is centered to MSP and MTL at iliac crest/ 2” above iliac crest

Answer 17

Flat Plate Abdomen/ KUB AP/ PA Upright Substitute (L Lat Decub)

Question 18

R Lat decub can be made if pt cannot lie on L side

Answer 18

Flat Plate Abdomen/ KUB AP/ PA Upright Substitute (L Lat Decub)

Question 19

Why is left lat decub recommended during Flat Plate Abdomen/ KUB AP/ PA Upright?

Answer 19

To ensure that free air rises and stands out clearly against the liver (solid mass), detecting air-fluid levels.

If pt lie on their right, rising air might overlap with the air-filled intestines (splenic flexure of LI)

Question 20

Done if pt is due for emergency operation

Answer 20

Acute Abdomen Series/ Three-way series

Question 21

Acute Abdomen Series/ Three-way series Indication

Answer 21

To rule out free air and infections

Question 22

Acute Abdomen Series/ Three-way series Proj/Views

Answer 22

1. AP w supine
2. AP w upright or L lat decub
3. PA chest

Question 23

Used to detect free air that may accumulate under the diaphragm

Answer 23

Acute Abdomen Series/ Three-way series PA Chest

Question 24

Also used for cardiopulmonary clearance

Answer 24

Acute Abdomen Series/ Three-way series PA Chest

Question 25

Acute Abdomen Series vs Abdominal Sequencing

Answer 25

Acute Abdomen (three way) Series: RT is stationary and pt is moving (positioned AP supine, upright, and PA chest)

Abdominal sequencing: RTable moves along w the pt

Question 26

Demo small amount of intra peritoneal gas in acute abdominal cases

Answer 26

Abdominal sequencing

Question 27

Abdominal sequencing

(1) recommended that pt be kept in L lat posn on a stretcher for (2) mins before abdominal radiography are obtained. This posn allow (3) into the area under the R hemidiaphragm, where the image will not be superimposed by the gastric gas bubbe

Answer 27

1. Miller
2. 10-20
3. gas to rise

Question 28

Abdominal suqeuncing

If larger amounts of free air are present, many Radiology dept may suggest that the pt lie on the side for a minimum of (1) before teh radiography is produced

Answer 28

1. 5 mins

Question 29

Abdominal suqeuncing

Smaller amount of air= (1) time the pt is in L lat in order to (2)

Answer 29

1. longer
2. give chance to all the air to rise from the side not dep on RT

Question 30

Abdominal suqeuncing

3 Pt/ Structure positioning

Answer 30

1. AP/ PA of chest and upper abdomen (L lat decub) (Chest expo etchnique)
2. AP/ PA of chest and abdomen (L lat decub, pt being moved onto a H’lly placed table- tilt table and pt to upright posn)
3. RT back to H posn for Supine AP/PA of abdomen