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Radiographic Positioning > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What system is the spleen a part of?

A

Lymphatic system

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2
Q

Where is the spleen located?

A

Posterior and to the left of the stomach in LUQ.

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3
Q

Can the spleen be visualized on a radiograph?

A

Faintly, particularly if enlarged (splenomegaly).

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4
Q

What can be lacerated during trauma to left lower rib cage?

A

The spleen.

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5
Q

What are the accessory organs of digestion?

A

Pancreas, liver, gallbladder.

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6
Q

Where is the pancreas located?

A

Posterior to the stomach, between the stomach & the spleen.

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7
Q

Is the pancreas an endocrine or exocrine gland?

A

Both. It secretes hormones that it produces, into the blood stream, making it endocrine. It also secretes digestive juices into the digestive tract (considered “outside” of the body) making it exocrine.

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8
Q

Where does the body and tail of the pancreas extend towards?

A

The upper left abdomen.

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9
Q

Where is the liver located?

A

The liver occupies most of the right upper quadrant and is inferior to the right hemidiaphragm.

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10
Q

What is the function of the liver?

A

It produces bile.

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11
Q

How does the liver show up on a radiograph?

A

As decreased optical density (whiter).

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12
Q

Where is the pear shaped gall bladder located?

A

In the inferior aspect of the liver.

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13
Q

What does the gall bladder do?

A

Stores and concentrates bile.

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14
Q

Can a normal gall bladder be seen on plain films?

A

No.

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15
Q

What percentage of gall stones can be seen on plain film radiographs?

A

10-15% (due to calcium.).

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16
Q

What is the urinary system composed of?

A

Kidneys, ureters, bladder, urethra.

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17
Q

Are the kidneys retroperitoneal, intraperitoneal, or infraperitoneal?

A

Retroperitoneal.

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18
Q

What is the function of the kidneys?

A

To remove liquid waste products from the blood.

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19
Q

Which kidney is lower than the other and why?

A

The right kidney is lower due to the liver taking up so much room on the right side.

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20
Q

What level of the spine are the kidneys located?

A

T12 to the level of transverse processes of L3.

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21
Q

What do the ureters do?

A

They connect the kidneys to the bladder.

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22
Q

How large are the ureters?

A

About 10-12 inches long.

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23
Q

Are the ureters retroperitoneal, intraperitoneal or infraperitoneal?

A

Retroperitoneal.

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24
Q

What is the name of the tube that leads from the floor of the urinary bladder to the outside?

A

Urethra.

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25
Q

What system are the adrenal glands a part of?

A

The endocrine system.

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26
Q

Where are the adrenal glands located?

A

Superior and medial to each kidney.

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27
Q

Are the adrenal glands visible on a radiograph?

A

Not usually.

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28
Q

Why are the kidneys visible on a radiograph?

A

Because of a fatty capsule that surrounds the kidneys.

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29
Q

How are the organs of the urinary system made visible on a radiograph?

A

With contrast media injected intravenously. (Excratory Urography or Intravenous Urography.)

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30
Q

What are the two main cavities of the body?

A

The dorsal cavity and the ventral cavity.

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31
Q

The organs of any cavity are referred to as:

A

the viscera.

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32
Q

What is the dorsal cavity made up of?

A

The cranial cavity and the spinal cavity.

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33
Q

What is the ventral cavity made up of?

A

The thoracic cavity and the abdominopelvic cavity.

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34
Q

What does “Parietal peritoneum” refer to?

A

the covering of walls of the cavity.

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35
Q

What does “Visceral peritoneum” refer to?

A

The covering on an organ.

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36
Q

Four terms describing the anatomy of the abdominal cavity.

A

Peritoneum, mesentery, mesocolon, omentum.

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37
Q

What is the peritoneum?

A

A double-walled seromembranous sac that encloses the abdominopelvic cavity.

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38
Q

What is the parietal peritoneum?

A

The outer portion of the peritoneum that adheres to the cavity wall.

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39
Q

What is the visceral peritoneum?

A

The inner portion of the peritoneum.

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40
Q

What is the peritoneal cavity?

A

The space or cavity between the parietal peritoneum and visceral peritoneum which contains serous fluid.

41
Q

What is the purpose of the serous fluid in the peritoneal cavity?

A

Allows organs to move against each other without friction.

42
Q

What is ascites?

A

Abnormal accumulation of fluid in the peritoneal cavity.

43
Q

What is the definition of retroperitoneal?

A

“Behind” the peritoneum. Organs that lie on the posterior abdominal wall and are covered by peritoneum on their anterior surfaces only are retroperitoneal.

44
Q

Describe the purpose of the folds of the peritoneum.

A

The folds bind the organs to each other and to the walls of the abdominal cavity and contain blood and lymphatic vessels and nerves that supply the abdominal organs.

45
Q

What is the name of the folds in the peritoneum that hold the small intestine in place and attaches the small intestine to the abdominal wall?

A

The mesentary.

46
Q

What does the mesentary hold?

A

The small intestine and various nerves and arteries of the abdomen.

47
Q

Which fold of the peritoneum attaches the large intestine to the posterior abdominal wall?

A

The mesocolon.

48
Q

What does the mesocolon do?

A

Carries blood and lymphatic vessels to the intestines.

49
Q

What is something the mesentery and mesocolon have in common?

A

They both hold intestines loosely in place to allow for peristalsis.

50
Q

Which double fold of the peritoneum extends from the lesser curvature of the stomach to portions of the liver?

A

The lesser omentum.

51
Q

Which double fold of the peritoneum is the largest peritoneal fold and is the “fatty apron” that hangs over the transverse cold on and small intestine?

A

The greater omentum.

52
Q

What is a pneumoperitoneum?

A

Free air or gas in the peritomeal cavity.

53
Q

What can a pneumoperitoneum be caused by?

A

A perforation of a gas containing viscus. Ex: perforating ulcer or some penetrating trauma.

54
Q

How is a pneumoperitoneum best demonstrated?

A

With a horizontal beam, erect abdomen, or chest xray.

55
Q

What does the X-ray of a pneumoperitoneum look like?

A

Small amounts of free air seen as it rises to the highest position under the diaphragm.

56
Q

What is peritonitis?

A

And acute inflammation of the peritoneum.

57
Q

What is peritonitis caused by?

A

The common cause is contamination of the peritoneum by infectious microbe. Bacteria can gain access to the peritoneal activity through rupture of appendix.

58
Q

What does retroperitoneal organs mean?

A

Refers to organs that lie behind the peritoneum.

59
Q

What does infraperitoneal organs mean?

A

refers to organs located under or beneath the peritoneum.

60
Q

What does intraperitoneal organs mean?

A

Refers to organs located within the abdominal cavity that are either partially or completely covered by some type of visceral peritoneum but are not retro- or infraperitoneal.

61
Q

Describe the peritoneal enclosure in men.

A

In men, the lower aspect of the peritoneum is a closed sac. The peritoneum lies above the urinary bladder totally separating reproductive organs from those within the peritoneum.

62
Q

Describe the peritoneal enclosure in women.

A

In women, the lower aspect of the peritoneum is not a closed sac. The uterus, uterine tubes and ovaries pass directly into the peritoneum.

63
Q

Name the retroperitoneal organs.

A

Kidneys, ureters, adrenal glands, pancreas c-loop of the duodenum, ascending and descending colon, upper rectum, and major abdominal blood vessels (aorta and inferior vena cava.).

64
Q

Name the intraperitoneal organs.

A

Liver, gallbladder, spleen, stomach, jejunum, ileum, cecum, transverse colon, sigmoid colon.

65
Q

Name the infraperitoneal organs.

A

Lower rectum, urinary bladder, reproductie organs (men having a closed peritoneal sac and women having an open sac with their reproductive organs extending into the peritoneal cavity.

66
Q

The two methods to describe the location of organs or other structures within the abdominopelvic cavity are:

A

Four abdominal quadrants and nine abdominal regions.

67
Q

The name of the four abdominal quadrants are:

A 
RUQ = right upper quadrant
LUQ = left upper quadrant
RLQ = Right lower quadrant
LLQ = Left lower quadrant.
68
Q

A transverse plane and a midsaggital plane pass through the umbilicus forming the:

A

Four abdominal quadrants.

69
Q

The nine abdominal regions are formed by:

A

two horizontal (transverse) planes (L1 and L5) and two vertical (lateral) planes (located parallel to and midway between the MSP and each ASIS on both sides.

70
Q

The names of the nine abdominal regions are:

A 
Right hypochondriac
epigastric
left hypochondriac,
right lateral (lumbar)
umbilical
left lateral (lumbar) 
right inguinal (iliac)
Pubic (hypogastric)
left inuinal (iliac)
71
Q

Topographic landmarks

A

Palpable bony landmarks that are used to aid in radiographic positioning. Inform patient before palpating gently.

72
Q

The seven bony landmarks of the abdomen are:

A 
Xiphoid process (T9 - T10)
inferior costal margin (L2 - L3)
Iliac crest (L4 - L5)
Anterior superior iliac spine (ASIS)
Greater trochanter
Pubic symphysis
Ischial tuberosity
73
Q

Which bony landmark is the superior margin of the abdomen and not a primary landmark due to variations in body habitus?

A

Xiphoid process

74
Q

Which bony landmark is used to locate upper abdominal organs such as the gallbladder and stomach and what level of the spine is it associated with?

A

Inferior costal margin (L2 - L3).

75
Q

What is the most commonly used abdominal landmark and what level of the spine is it associated with?

A

Iliac crest (L4 - L5).

76
Q

What is the bump that is inferior and anterior to the iliac crest and used for positioning for the pelvis and lumbar spine?

A

Anterior Superior Iliac Spine (ASIS).

77
Q

Where is the uppermost margin of the greater trochanter?

A

About the same level of the pubic symphysis.

78
Q

What is the anterior junction of the 2 pelvic bones and corresponds to the inferior margin of the abdomen?

A

Pubic symphysis.

79
Q

What can be palpated (or used) instead of the pubic symphysis?

A

The greater trochanter or inguinal fold.

80
Q

What is the lower margin of the abdomen when the patient is prone?

A

The ischial tuberosity.

81
Q

What bony landmark bears most of one’s weight of the trunk when one is sitting?

A

Ischial tuberosity.

82
Q

Where are the lower margins of the ischial tuberosity?

A

1 to 1 and a half inches distal to the pubic symphysis.

83
Q

What are the basic steps for patient preparation?

A 
All clothing removed
Opaque objects removed.
hospital gown worn
pillow for head, clean linen on table.
cover patient for warmth and modesty.
84
Q

What is the single greatest deterrent to image sharpness as related to positioning?

A

Motion. Voluntary and involuntary.

85
Q

What are ways to prevent motion in abdominal radiography?

A

Shortest exposure time possible

Careful breathing instructions.

86
Q

When are abdominal radiographs exposed? Upon inspiration or expiration and why?

A

Expiration, in order to have the diaphragm in a superior position to better visualize abdominal structures.

87
Q

What are two ways to reduce voluntary motion?

A

Through explanation of procedure and precise breathing instructions as well as use of sponges and sandbags as immobilization devices.

88
Q

What does voluntary motion look like on a radiograph compared to involuntary motion?

A

Voluntary motion involves a blurring of the entire area, while involuntary motion involves localized blurring.

89
Q

Correctly placed markers need to be ______ and cannot _______.

A

Visible, obscure essential anatomy.

90
Q

True or false: If one forgets to place their image marker on the IR before exposure, they can add it digitally in post processing.

A

False.

91
Q

Why is radiation protection especially essential in abdomen radiography?

A

Because of the proximity of the gonads.

92
Q

How is gonadal shielding placed on males?

A

With the upper edge of the shield placed at the pubic symphysis.

93
Q

When can gonadal shielding be used on females during abdominal radiography?

A

Only when shields do not obscure essential anatomy.

94
Q

Where should gonadal shielding be placed on females?

A

Top of ovarian shield should be placed slightly above or at the level of ASIS and the lower border at the pubic symphysis.

95
Q

True or false: All women of childbearing age should be screened for possibility of pregnancy.

A

True. If patient indicates a chance that she is pregnant, the radiologist must be consulted.

96
Q

What kVp range should be used in an abdominal radiograph?

A

70-80 kVp. (Moderate contrast required with medium kV to allow for visualization of various abdominal structures, including possible semiopaque stones in gallbladder or kidneys.)

97
Q

Should a short or long exposure time be used in abdominal radiography and why?

A

Short…to minimize the effect of involuntary motion of peristalsis of the bowels.

98
Q

A correctly exposed abdominal radiograph will show what?

A 
Psoas muscles
Lower liver margin
Kidney outlines
Lumbar vertebrae
Transverse processes.
99
Q

Pediatric applications for abdominal radiographs

A

Supine and horizontal beam
pigg-o-stat
control motion and use short exposure time
reduction in mAs and kV (under 12 or 13 y.o.)
minimize repeats

Radiographic Positioning (23 decks)

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