abdomen Flashcards
What is the optimal kV for an abdomen?
70-80kV
Is abdomen long scale or short scale?
Long scale because you can see lots of colors
Is abdomen Low contrast or high contrast?
Low
How can you control involuntary motion?
quick exposure time
How can you control voluntary motion?
Control breathing
What are the 3 criteria’s for decubs?
Recumbent patient, Vertical IR, Horizontal CR
What does AAA stand for?
Abdominal Aortic Aneurysm
For lateral how long should the patient lay before taking the exposure?
Minimum-5 minutes Recommended 15-20 minutes
Why would you do a Dorsal Decub Lateral Abdomen?
To R/O Aneurysm
What position would you do to R/O an aneurysm?
Dorsal Decub
What are the 3 natural openings of the diaphragm?
Esophagus, aorta, superior vena cava
3 history questions for abdomen?
1 Are you having any pain or discomfort in your abdomen? If so can you show me where? How long has the pain been there, and has it worsened recently? Do you have any blood in your stool or urine? Is it bright red or dark red?
What does hematuria mean?
Blood in the Urine
What does Micro-hematuria mean?
The lab found the blood
What does Gross-hematuria mean?
Blood is visible to the patient
appendix removal
appendectomy
If patient is unable to do upright abdomen what would be your alternative and why?
Left Lateral Decubitus- because air in the stomach will only rise to the midline of the abdomen
Gall Bladder removal
Cholecystectomy
Female Reproductive Removal
hysterectomy or parietal hysterectomy if only one ovary is taken.
Types of Hernias
R or L inguinal, umbilical, hiatal
Term for blood in the stool
hematochezia
Why do we do exhalation for abdomens?
So that the diaphragm goes up so you can see full view of the abdomen
minimum of what degree is considered to be upright?
70
The abdominal cavity extends from what superiorly to what inferiorly?
diaphragm-upper bony pelvis
How long is the small intestine?
23ft
How long is the large intestine?
5ft
Whats in the LUQ
stomach, spleen
whats in the RUQ
Liver, Gallbladder
What does the pelvic cavity contain?
Bladder, Rectum, sigmoid, reproductive organs
The abdominopelvic cavity is enclosed by the double walled seromembranous sac called?
The peritoneal sac
The peritoneal sac has an outer covering called the?
Parietal peritoneum
What means ‘lining of the caity’
parietal peritoneum
What is the loose lining also called the omenta or mesentery?
visceral peritoneum
What is positioned over the internal organs and covers around the organs and is a support mechanism?
mesentery and omenta
Parietal=
Cavity
Visceral=
Organs
If the abdomen is full of gas what do you do to your technique?
Lower kV
What is the air pocket called in the stomach?
Meganblase
When is the small and large intestine visualized on an x-ray?
when it is full or barium or air and gas
Which intestine is responsible for defecation? Small or Large?
Large
Which side of the Large intestine is lower and why?
Right side because the liver pushes it down
What is the largest solid organ in the body?
Liver
What organ is in the RUQ and just beneath the diaphragm?
Liver
What does flexure mean?
Bend
What 2 organs does the liver push down and what muscle does the liver push up?
Right side of intestine and right kidney go down right hemi-diaphragm go up
What color does the liver show up as on a radiograph and why?
White, because it is very dense and hard to penetrate
The gallbladder is located in what quadrant?
RUQ
When is the gallbladder visualized on a radiograph?
When enhanced with barium
When can the gallbladder be visualized without barium?
When stones are present
What is an example of an opaque contrast?
Barium
What is an example of a radiolucent contrast?
Air or Gas
What quadrant is the Spleen located?
LUQ
Can you see a spleen on a radiograph
no
What procedures do you do to visualize the spleen?
CT or MRI
What is the head of the pancreas and loop of duodenum called?
love affair of the abdomen
What quadrant is the pancreas located in?
LUQ
What 2 things are the pancreas responsible for?
Glucose and Insulin
Can you see your pancreas or a radiograph?
No
Where are the kidneys located?
Retroperitoneum
What vertebral levels are the kidneys located?
T12 (LK) - L3 (RK)
Why does the right kidney usually lower than the left?
Due to the liver pushing it down
What test is done to the kidneys?
IVP test
give an example of a radiopaque contrast
Iodine
Which contrast barium or Iodine can be absorbed by the body?
Iodine
What does non-gravid mean?
Not pregnant
ASIS
Anterior Superior Iliac Spine
What must be seen on a KUB
Kidneys, Ureters, and Bladder
What is the respiration for abdomen?
Exhalation
Why do they do a 2 series film for an ER patient? and what 2 films do they do?
Looking for air and fluid levels or Tear in the digestive tract. Flat and upright
When do you do a post void?
After IVP exam
When do you do a Post Evac?
After BE exam
For a SBS follow up how often do you take an X-ray?
15-20 minutes
What does a patient drink for a SBS?
Barium
Where do you center for a SBS follow up, Post Evac, and Post Void
L4
What do you need to mark for a SBS follow up?
Mark film with appropriate time
For a SBS follow up and a Post Evac what is the patients position?
Prone
What is the position of post void?
AP upright
Why do we do a post evac and post void?
To see how much contrast the patient is able to get rid of
Whats another name for surveys and follow up films?
SCOUTS
What is the love affair of the abdomen?
head of pancreas and loop of duodenum
What are 3 ways you can cleanse the abdomen tract?
Controlled diet, laxative, enema
To include the bladder on a film what structure must you have?
Pubic Symphysis
What vertebral level is the iliac crest?
L4
What vertebral level are the kidneys?
T12-L3
Is abdomen long scale or short scale?
Long Scale
Is abdomen high contrast or low contrast?
Low contrast
What is the optimum kV for abdomen?
70-80
What muscle will we see is we have penetrated the abdomen?
Psoas
How can we see voluntary motion on a radiograph?
Blur
What does involuntary motion look like on a radiograph and what is it caused by in an abdomen film?
Haziness, caused by peristalsis
All ___ radiographs are abdominal radiographs
KUBS
Not all abdominals are ____
KUBS
What is in the RLQ?
Appendix
What structure is usually at the level of the appendix?
Acetabulum
Why do many institutions perform Spine AP protection and an upright AP projection?
To R/O free air and fluid levels.
In an upright AP projection from what to what should be included
Diaphragm to acetabulum
What is the Acetabulum
Hip Joint (socket)
If free air is in the abdomen it won’t rise any further than what on an upright?
Diaphragm
If free air is in the abdomen it won’t rise any further that what on a lateral?
Midline
3 criteria’s for gonadal protection
1- if gonads lie within 2 inches of X-ray field. 2- if the exam will not be compromised 3- if patin has reasonable reproductive potential
Abdomen AP Projection the CR should be ___ to the IR?
Perpendicular
Abdomen AP projection you should center at?
L4 (iliac crest)
proper SID for an abdomen
40’’
film size for AP abdomen?
14x17
What is a diaphragm shot?
If you clip diaphragm on an upright film use 14x17 CW, Top of film at armpit
What film do you use for a bladder shot?
10x12
Where do you center for a bladder shot?
2’’ below ASIS or 2-3’’ ABOVE pubic symphysis
Where do you center for Supine position?
Level of L4 (iliac crest)
Where of you center for upright position?
2’’ above iliac crest
What is the term for air in the abdomen
pneumoperitoneum
For a kidney shot where will the IR be directed?
midway between typhoid process (T10) and Umbilicus (L4)
Why is PA projection preferred over AP when the kidneys are not of primary interest?
It greatly reduces gonad dose
Why don’t we do a PA projection of the kidneys?
Because it will magnify the kidneys
Decub
Recumbent patient, vertical IR, horizontal CR
Meganblase doesn’t rise higher than what?
The midline
What system is your liver, and pancreas part of?
Billiary System
Which lobe of the liver is bigger?
Right Lobe
Why do they call your small intestine small?
Diameter size
can you live without your spleen
yes
What side of your abdomen has the ascending colon?
Right
What is the fissure in your liver called?
Falciform ligament
What is in the retroperitoneum?
Kidneys and pancreas
what connects your kidneys to your bladder?
ureturs
What does AAA stand for?
Abdominal Aorta Aneurysm
How long should you lay on your side for a lateral?
min 5 minutes, recommended 15-20
Proper respiration for abdominal radiography should be?
Exhalation
The optimal KV used for abdominal radiography is?
70-80
What kv should you use when doing a barium study?
90kV+
why do you increase kv when doing a barium study?
barium is hard to penetrate
We chose 70-80kv for abdomen because?
Then we are able to view lots of densities
For upright radiography of the abdomen when free air is to be ruled out, the CR should be directed to ______
2’’ above level of umbilicus/iliac crest/ L4
The proper decubitus to be performed for an abdomen series on a patient who is unable to stand is?
Left Lateral Decub
Why do we do a left lateral decub and not a right lateral decub
so that we don’t mistake meganblase for free air
The proper decubitus that may be utilized to demonstrate the presence of a AAA is?
Dorsal Decub
What type of motion can be eliminated by the use of proper instructions and high com for level of the patient when performing abdominal radiography?
Voluntary
This anatomical structure must be included on upright radiography?
Diaphragm
What muscle can be demonstrated on either side of the vertebral column in a triangular shape on abdominal radiography?
Psoas
List the two structures and vertebral level to bisect when centering for a kidney shot?
Xyphoid process T10 Umbilicus L4
Which kidney is lower and why
The right kidney is lower because for the liver pushing it down
The proper centering for a KUB
L4- vertebral level, Iliac crest- structure
When a patient can’t sit up to 70 degrees what position do you do?
Left Lateral Decub
What is the proper centering for a bladder shot?
2-3’’ above the border of the pubic symphisis and/or 2’’ below ASIS
Why is it important to use the proper respiration when performing abdominal radiography?
So that the diaphragm goes up (on exhalation) so you can get full view of the abdomen
What are upright or decubitus radiographs performed?
To look for free and and fluid levels
If performing an upright abdomen on a patient who cannot stand completely upright how should the CR be directed to accurately demonstrate air and fluid levels?
CR must be horizontal
What is the projection of the decubitus abdomen radiograph that has their anterior surface facing the tube
AP projection
List an advantage for doing the abdomen using a PA projection
greatly reduces patients gonad dose
What must be included on an upright abdomen radiograph? From what to what?
Diaphragm- acetabulum
If performing 2 CW radiographs of the abdomen on a large patient what needs to be demonstrated on the finished radiograph to ensure that all anatomy is included?
Overlapping
The movement of foodstuff through the digestive tract will cause what type of motion on a radiograph?
Involuntary
What is the term for food moving through the digestive tract
peristalsis
What structure is included on a radiograph to ensure that the bladder is included?
Pubic Symphysis
If you can’t locate the umbilicus or crest of a patient what should you feel for?
Greater trochanter
Which hemi-diaphragm is lower? Why?
Left because the right side is being pushed up by the liver
