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Image Eval R216 > Abdomen (x-ray and fluoro) > Flashcards

Abdomen (x-ray and fluoro) Flashcards

1
Q 
AP Abdomen (Supine and Upright)
Positioning
A
  • 14 x 17 IR crosswise for bigger patients, lengthwise for smaller patients
  • collimate to 1” outside of abdominal shadow (if poss)
  • CR centered to Iliac Crest (supine) or 2” above Crest (upright)
  • if high and low are needed, to get bladder center at 2-3” above superior pubic symphysis
  • expose on expiration to decompress abdominal organs
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2
Q 
AP Abdomen (Supine and Upright)
Image Eval
A
  • all of abdomen from pubic symphysis to bottom of the diaphragm (2 images needed for large pt)
  • kidneys, ureters, and bladder most important
  • no rotation
  • spinous processes midline
  • Alae or wings symmetrical
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3
Q

Why do PA Abdomen (Upright)?

Where to center?

A
  • only done if kidneys are not of interest
  • done PA to reduce gonadal dose
  • center 2” above crest
  • same image criteria
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4
Q

Left Lateral Decubitus Abdomen

Positioning

A
  • done in place of upright abdomen
  • place radiolucent pad under pt
  • lie in L Lat Decub for several minutes (air/fluid)
  • bring arms above level of diaphragm
  • center 2” above iliac crest, perp. to IR
  • expose on expiration
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5
Q

Left Lateral Decubitus Abdomen

Image Eval

A
  • if poss, all interperitoneal organs visible
  • no rotation
  • spinous processes centered
  • Alae or wings of the illa symmetrical
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6
Q

Lateral Dorsal Decubitus Abdomen

Positioning & Image Eval

A

Positioning
-lie on back, arms out of FOV (on chest or above head)
-IR perp. to IR 2” above iliac crest
-elevate pt if neccessary
Image Eval
-all of abdomen (if poss) but definitely the inferior diaphragm
-good for visualization of prevertebral space

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7
Q

Why do Lateral Dorsal Decubitus Abdomen?

A
  • done if patient cannot lie on side or stand

- good for showing air-fluid levels

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8
Q

Esophagus (Fluoro Study)

AP/PA, Oblique, and Lateral

A
  • done recumbent (unless specified)
  • positioning for AP/PA and Lateral similar to Chest
  • **except center IR at T5-T6
  • use RAO or LPO for oblique projections
  • 35-40 degrees obliquity (from IR)
  • shows esophagus between heart and vertebrae
  • include esophagogastric junction
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9
Q

Swallowing Dysfunction Study

A
  • Modified Barium Swallow
  • center at C4 (?)
  • start AP
  • end on Lateral
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10
Q 
PA Stomach (Contrast Study)
Positioning and Image Eval
A
  • center halfway between vertebral column and lateral border of abdomen
  • Prone:
  • center IR (and CR) at the MSP at L1-L2, 1-2” above lower rib margin
  • Upright:
  • center 3-6” lower than L1-L2
  • b/c stomach drops lower (esp. in asthenic pt)
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11
Q 
Oblique Stomach (LPO vs. RAO)
Positioning
A
  • Pt recumbent
  • LPO oblique 40-70 degrees, more for hypersthenic
  • RAO oblique 30-60 degrees, 45 for sthenic
  • center IR at 1-2” above lower rib margin
  • halfway between midline and lateral border of abdomen
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12
Q 
Oblique Stomach (LPO vs. RAO)
Image Eval
A
  • PA Obl. RAO shows pyloric canal and duodenal bulb filled with barium
  • and air in fundus
  • AP Obl. LPO shows fundus filled with barium
  • air and little barium in pyrolus
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13
Q

AP Stomach

Positioning

A
  • pt supine
  • if very thin, tilt table in Trendelenburg position (head titled back) to fill the fundus
  • center IR at halfway between lower rib margin and xiphoid tip, and halfway between lateral margin of abdomen and MSP
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14
Q

AP Stomach

Image Eval

A
  • fundus filled with barium
  • double-contrast delineation of stomach body, pylorus, and duodenum
  • lower section of lung field
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15
Q

Why do AP Scout for Barium Stomach studies?

A

used to check for calcifications or tumor masses of the spleen, liver, kidneys, psoas muscles, and bony structures. standard AP supine abdomen (?)

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16
Q

R Lateral Stomach

Positioning

A
  • true lateral pos. (MCP perp. with IR)
  • IR centered midway between MCP and anterior surface of abdomen
  • IR centered at 1-2” above lower rib margin (L1-L2) or
  • L3 for upright
17
Q

R Lateral Stomach

Image Eval

A
  • R Lat good for visualization of:
  • right retrogastric space
  • duodenal loop and duodenojejunal junction
  • most importantly, the pyloric canal
  • no rotation of pt shown by vertebral column
18
Q

PA Scout Small Bowel

A
  • on belly to compress abdominal contents
  • IR centered at L2 (1-2” above lower rib margin)
  • IR centered at MSP
19
Q

PA Small Bowel Follow Through

A
  • take PA images every 15-30 minutes until barium reaches iliocecal valve
  • IR center at level of iliac crests, MSP
20
Q

Centering Point for all Large Intestine Exams (NOT including Rectum or Axial projections)

A

-Iliac Crest, MSP for Sthenic pt, higher for Hyper- and lower for Asthenic

21
Q

What anatomy should be included on all Large Intestine images? (not including Rectum or Axial)

A
  • all of the colon including flexures

- may need two images for Hypersthenic pt

22
Q

Where are air and barium located in a PA Large Intestine image?

A
  • air is in ascending and descending colon

- barium is in transverse colon

23
Q

For Large Bowel:

PA Obl RAO and AP Obl LPO both show what anatomy?

A
  • ascending colon
  • cecum
  • sigmoid colon
  • center 1-2” from midline towards the elevated side
24
Q

For Large Bowel:

PA Obl LAO and AP Obl RPO both show what anatomy?

A
  • descending colon
  • left colic flexure
  • center 1-2” from midline towards the elevated side
25
Q

Lateral Large Intestine

Positioning

A
  • true lateral (MCP perp. to IR) with knees flexed
  • shoulders and hips perp. to IR
  • IR center at ASIS
26
Q

Lateral Large Intestine

Image Eval

A
  • rectum and distal sigmoid demonstrated

- superimposed proximal femora

27
Q

Right Lateral Decubitus LB shows barium and air where?

A
  • left side is “up”
  • ascending colon (medial side) is air filled
  • ascending colon (lateral side) is barium filled
28
Q

Left Lateral Decubitus LB shows barium and air where?

A
  • right side is “up”
  • descending colon (medial side) is air filled
  • ascending colon (lateral side) is barium filled
29
Q

AP Axial LB

Positioning

A
  • pt supine
  • IR centered at 2” above iliac crests
  • CR angled 30-40 degrees cephalad, entering 2” below ASIS
30
Q

PA Axial LB

Positioning

A
  • IR centered at iliac crests
  • CR 30-40 degrees caudad
  • CR exits at the ASIS
31
Q

AP Axial and PA Axial LB

Image Eval

A
  • best demonstrates rectosigmoid area
  • transverse colon and flexures NOT included
  • less superimposition than normal AP or PA
32
Q

When does a Small Bowel Follow Through stop?

A

when the barium reaches the iliocecal valve

Image Eval R216 (8 decks)

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