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MRT Year 2 > Abdomen Comp > Flashcards

Abdomen Comp Flashcards

1
Q

Muscles of the abdomen?

A
  • Diaphragm

- Psoas Muscles

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2
Q

What does the diaphragm do?

A
  • separates abdominal cavity from thoracic cavity

- primary muscle of inspiration

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3
Q

Where are the psoas muscles located (vertebral level?)

A

-L1 to lesser trochanters

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4
Q

Parts of the digestive system?

A
  • oral cavity
  • pharynx
  • esophagus
  • stomach
  • small intestine
  • large intestine
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5
Q

What is the first organ of the digestive system located in the abdominal cavity?

A

Stomach

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6
Q

3 parts of the small intestine?

A
  1. Duodenum
  2. Jejunum
  3. Ileum
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7
Q

What ligament is at the duodenojejunal junction?

A

Ligament of trietz

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8
Q

What increases surface area in the jejunum?

A

Plicae circularis

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9
Q

Where is the appendix attached to the colon?

A

Posteromedial colon

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10
Q

What is the sphincter at the terminal opening of the large intestine called?

A

Anus

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11
Q

How does the spleen sit in relation to the stomach?

A

Posterior and left

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12
Q

Can the spleen be seen on plain radiographs?

A

Faintly, especially if enlarged

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13
Q

Accessory digestive organs?

A
  • pancreas
  • liver
  • gallbladder
  • salivary glands
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14
Q

Can the pancreas be seen on plain radiographs?

A

No

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15
Q

Where is the spleen located?

A
  • posterior to the stomach
  • between the duodenum and spleen
  • head in C-loop of duodenum “romance of abdomen”
  • body and tail extend to upper left abdomen
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16
Q

What is the largest solid organ in the body?

A

Liver

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17
Q

What percent of gallstones have enough calcium to be visualized?

A

10-15%

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18
Q

Parts of the urinary system?

A
  • 2 kidneys
  • 2 ureters
  • bladder
  • urethra
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19
Q

Vertebral level of kidneys?

A

T11-L3

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20
Q

3 constriction points of ureters?

A
  1. ureteropelvic junction
  2. pelvis brim
  3. ureterovesical junction
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21
Q

Where do the ureters enter the bladder?

A

Posterolateral aspect

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22
Q

Can kidneys been seen on plain radiographs? Why/why not?

A

Yes, because they have a fatty capsule that surrounds them

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23
Q

How do the kidneys sit in the body?

A

20 degrees medial (superior more medial)

30 degrees anterior (inferior more anterior)

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24
Q

What is the peritoneum? Parts?

A
  • serous, double walled membrane
  • parietal: adheres to cavity
  • visceral: portion that covers organs
  • contains serous fluid
  • mesentery, omentum (greater/lesser), mesocolon
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25
Q

The visceral peritoneum only partially covers what organs?

A
  • ascending and descending colon
  • aorta
  • IVS
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26
Q

What are contained within the fold of the peritoneum?

A
  • blood vessels
  • lymph vessels
  • nerves
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27
Q

What is the mesentery? What does it do?

A
  • double fold of peritoneum that extends anteriorly from the posterior abdominal wall to envelope completely a loop of small bowel
  • loosely connects small bowel to abdominal cavity
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28
Q

What is the omentum? What does it do?

A
  • double fold of peritoneum that extends from the stomach to another organ
  • Lesser omentum: extends superiorly from the lesser curvature to portions of the liver
  • Greater omentum: extends inferiorly from the greater curvature to the transverse colon, drapes down over small bowel and back up to form an apron “fatty apron” provides insultation
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29
Q

What is the mesocolon? What does it do?

A

-part of the peritoneum that attaches the colon to the abdominal wall
4 forms:
-ascending, transverse, descending, and sigmoid/pelvic portions (named according to which part of the colon they attach to the abdominal wall)

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30
Q

What are the greater and lesser sac?

A

-divisions of the peritoneal cavity

31
Q

Another name for the lesser sac?

A
  • small upper posterior portion of the peritoneal cavity

- “omentum bursa”

32
Q

Retroperitoneal organs?

A

Behind peritoneum

  • kidneys
  • ureters
  • adrenal glands
  • pancreas
  • C-loop of duodenum
  • ascending and descending colon
  • upper rectum
  • abdominal aorta
  • IVC
33
Q

Are retroperitoneal or intraperitoneal organs less mobile (move around less?)

A

Retroperitoneal because intraperitoneal organs are loosely attached by the mesentery

34
Q

Infraperitoneal organs?

A

Under/beneath the peritoneum in the true pelvis

  • lower rectum
  • urinary bladder
  • reproductive organs
35
Q

Intraperitoneal organs?

A

Organs that are partially/completely covered by some type of visceral peritoneum, but are not retro or infra peritoneal

  • liver
  • gallbladder
  • spleen
  • stomach
  • jejunum
  • ileum
  • cecum
  • transverse colon
  • sigmoid colon
36
Q

4 abdominal quadrants?

A
  • RUQ
  • LUQ
  • RLQ
  • LLQ
37
Q

Organs contained in the RUQ?

A
  • liver
  • gallbladder
  • right hepatic flexure
  • duodenum
  • head of pancreas
  • right kidney
  • right suprarenal gland
38
Q

Organs contained in the LUQ?

A
  • spleen
  • stomach
  • left colic flexure
  • tail of pancreas
  • left kidney
  • left suprarenal gland
39
Q

Organs contained in t-he RLQ?

A
  • ascending colon
  • vermiform appendix
  • cecum
  • 2/3 of ileum
  • ileocecal valce
40
Q

Organs contained in the LLQ?

A
  • descending colon
  • sigmoid colon
  • 2/3 jejunum
41
Q

9 abdominal regions

A
  • R/L hypochondriac
  • R/L lumbar (lateral)
  • R/L inguinal (iliac)
  • epigastric
  • umbilical
  • hypogastric (pubic)
42
Q

2 transverse planes separating the 9 abdominal regions?

A
  • Transpyloric plane (lower L1)

- Transtubercular plane (L5)

43
Q

7 landmarks of the abdomen?

A
  1. Xiphoid process (T9/T10): superior margin of abdomen
  2. Lower Costal Margin (L2/L3): used to locate upper abdo organs
  3. Iliac Crests (L4/L5): corresponds to mid abdomen
  4. ASIS: secondary landmark for general abdo positioning
  5. Greater Trochanter: superior border of symp
  6. Symphysis Pubis: inferior margin of abdomen
  7. Ischial tuberosity: lower margin on PA abdomen, 1-4cm below symph
44
Q

What is the most commonly used landmark?

A

Iliac crests

45
Q

Exposure factors for abdomen?

A

70-80kVp at 10mAs

46
Q

Ascites?

A

Fluid in the peritoneal cavity

  • caused by cirrhosis of the liver or metastatic disease to the peritoneal cavity
  • general abdominal haziness (increase technique)
47
Q

Pneomoperitoneum?

A

Free air in the peritoneal cavity

  • caused by perforation (ulcer) or trauma
  • small amounts of air can be visualized 2-3weeks post abdominal surgery-best demonstrated with horizontal beam upright abdomen or chest
  • decrease technique because of air
48
Q

Dynamic or mechanical bowel obstruction? Causes?

A

Complete/nearly complete blockage of flow to the intestinal contents caused by:

  • Fibrous adhesion
  • Crohn’s disease
  • Intussusception
  • Volvulus
49
Q

What is a fibrous adhesion?

A

Most common mechanical obstruction

-fibrous band of tissue interrelates with the intestine causing a blockage

50
Q

What is Crohn’s disease?

A

“Regional enteritis”: chronic inflammation of (all layers) of the intestinal wall

  • common in young adults
  • fistulas form
  • common in terminal ileum and proximal colon
51
Q

What is intussusception?

A

Telescoping of one section of bowel into another

  • common in terminal ileum
  • common in children
52
Q

What is a volvulus?

A

Twisting of a loop of intestine

53
Q

Ileus (non mechanical) bowel obstruction?

A
  • adynamic (without power/force)
  • caused by peritonitis or paralysis ileus (lack of intestinal mobility)
  • abdominal surgery can cause
  • large air fluid levels and no obvious obstruction
  • decrease technique because of air
54
Q

What is ulcerative colitis?

A
  • chronic inflammation of the colon in young adults primarily
  • common in the rectosigmoid region
  • can cause toxic megacolon with potential perforation
  • decrease technique because of air
55
Q

What is done to demonstrate free air below the diaphragm better?

A

PA chest: exposure technique for chest better demonstrates air

56
Q

When the kidneys are of primary interest, is a PA or AP less desirable?

A

PA because increased OID

57
Q

What can a dorsal decubitus abdomen demonstrate?

A
  • calcification of the aorta or other vessels
  • umbilical hernia
  • aneurysms
58
Q

What does a true lateral demonstrate?

A

Foreign bodies

59
Q

Indications for a 3 view abdomen?

A
  • ileus
  • ascites
  • performed bowel viscus
  • intra-abdominal mass
  • post-operative
60
Q

What can happen if you don’t decrease your technique when theres air in the abdomen?

A

Picture may be overexposed

61
Q

How much do you decrease your technique for air in the abdomen?

A
  • decrease mAs 30-50%

- decrease kVp 5-8%

62
Q

What is a spinal stimulator implant?

A
  • placed under the skin in the abdomen, leads go to spinal canal
  • to treat chronic pain
63
Q

Widest part of the abdomen on different body habitus?

A
  • Hypersthenic: short and wide abdo, upper abdomen widest

- Asthenic: long and narrow abdo, lower abdomen widest

64
Q

How much does the diaphragm move from inspiration to expiration? Vertebral levels?

A

4”

  • inspiration: as low as T12
  • expirationL T8/T9
65
Q

What happens if 3 AEC cells are selected on inspiration?

A

-underexposed because side cells are over lung

66
Q

Rotation on an abdomen decreases visualization of what?

A

Fat lines

67
Q

What does enlargement of the fat strips indicate?

A

Ascites

68
Q

Including what vertebral level will include both diaphragms?

A

T8

69
Q

If the MSP is not parallel to the IR, what happens?

A
  • decreases visualization of fat lines

- when rotated fat shifts anterior or posterior to muscle and eliminates subject contrast

70
Q

Why do we do a LLD?

A

So the air rises away from the stomach bubble

71
Q

How long should a patient lie on their side or be upright before we take the respective upright or decubitus picture?

A

5 mins
-10-20 preferred
To allow air to rise and fluid to settle

72
Q

What do we do for patients with wide hips on a LLD?

A

-include right hemidiaphragm to iliac wing

73
Q

What kind of filter do we use for a LLD? Why?

A

Wedge compensating filter because the belly drops to the lower side and makes it thicker

MRT Year 2 (18 decks)

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