CH. 16 Abdomen Flashcards
Which of the following might be used to demonstrate a pneumoperitoneum?
A. upright, AP projection
B. Left lateral decubitus
C. Dorsal decubitus
D. All of the above
D. All of the Above!
What are the membranes that line the wall of the Abdomen?
Peritoneum and Retroperitoneum
What two layers consist of the Peritoneum?
Visceral and Parietal
What cavity is postrior to the Peritoneum?
Retroperitoneum
What two organs lie in the space of the Retroperitoneum?
Kidneys and pancreas
What do you want to see in an Abdominal Image, High contrast or Moderate contrast?
Moderate Contrast
What are some Radiation Protection procedures regarding Abdominal Images?
- Shielding pediatric patients & patients of reproductive age
- Close collimation
- Optimum technique factors
Essential Projections for Abdomen
- AP supine and upright positions
- PA upright position
- Lateral
- Lateral, R or L dorsal decubitus position
- AP/Lateral Decubitus
What positions does the 3-way abdomen or acute abdominal series consist of?
- Ap supine
- AP upright
- PA Chest
What is another common request for Abdomen procedures?
Two-view abdomen series consisting of AP supine and AP upright
If a patient can not stand for an upright position, what do you do?
Position patient in Left lateral Decubitus
AP Supine is often referred to as what?
KUB
What does KUB stand for?
Kidneys, Ureters, and Bladdar
Positioning for AP Abdomen supine
Supine, without rotation and support knees to reduce strain of back
Where is the IR centered for AP supine?
Centered at the level of iliac crests (check that pubic symphysis is included)
How is the CR in relation to the IR in an AP supine position?
- CR is perpendicular to the IR
- Enters patient on MSP at level of iliac crests
- MSP is perpendicular and MCP is parallel
How can you tell if pubic symphysis is included in an AP supine?
Feel for Greater Trochanter; this is in alignment w. the pubic symphysis
Mesentery and Omentum (folds)
The folds of the peritoneum that function to support the viscera of the abdomen in position
To which level of the patient should the CR be centered for the KUB?
iliac crests
For the AP upright abdomen image of an adult of average size, why should the centering be slightly higher than the centering level used for the supine KUB image?
To include the diaphragm
Why is it desirable to include the diaphragm in the upright Abdomen image?
To demonstrate free air in the abdomen
Which projection does not demonstrate free air levels within the abdomen?
a. AP supine
b. AP upright
c. Lateral, dorsal decubitus
d. AP, left lateral decubitus
a. AP supine
What is the major advantage of the PA projection of the abdomen over the AP projection of the abdomen?
PA projection reduces the exposure to the gonads
What is pneumoperitoneum?
Presence of air in the peritoneal cavity
Where do you center the IR for Decubitus position?
2 in. above iliac crest
where do you center the IR for Upright positiono?
2 in. above iliac crest
What does a three-way abdomen (acute abdominal) series demonstrate in the abdomen?
Abdominal contents, presence of free air, and air fluid levels
Why would a 3 Abdominal series be ordered?
To evaluate bowel gas or to rule out free air, bowl obstruction, and infection in abdomen
How can you evaluate rotation on a KUB?
AP ABDOMEN SUPINE
- Alae or wings of the ilia should be symmetric.
- If seen, ischial spines of the pelvis should be symmetric
- Spinous processes should be in the center of the lumbar vertebrae.
How can you evaluate rotation on a KUB?
AP ABDOMEN SUPINE
- Alae or wings of the ilia should be symmetric.
- If seen, ischial spines of the pelvis should be symmetric
- Spinous processes should be in the center of the lumbar vertebrae.
Patient position for AP upright
- Standing upright, w. back in contact w. vertical grid
- MSP centered to grid
- weight distributed equally on both feet
If you need to include the bladdar in an AP upright position, where do you center the IR?
Center IR to the iliac crest
When is PA done instead of AP?
When thinking about dose; when trying to minimize dose thyroid, breasts, etc.
Left Lateral Decubitus Position
- Performed in place of upright position for patients who are too ill to stand
- Patient in recumbent left lateral
- Arms up and out of the way
- Knees bent
- Center iliac crests to IR or 2 in above
CR alignment for Left Lateral Decubitus
Directed Horizontal and perpendicular to center of IR
-MSP is perpendicular to IR and MCP is parallel
Lateral Abdomen Patient Position
- Recumbent right or left lateral
- knees bent to increase stability and comfort
- bent elbows and place hands under head
Where is IR centered in the Lateral Abdomen?
At level of iliac crests or 2 in above if diaphragm is included
CR for Lateral Abdomen
- Perpendicular to IR
- Enters on MCP at level of crest or 2 in above crests
- -MSP parallel to IR and MCP is perpendicular
What position is used if patient cannot stand or lie on their side?
Lateral Abdomen, Dorsal Decubitus
Describe Lateral Dorsal Decubitus
- Patient lies on
- horizontal x-ray beam
- Arms crossed on upper chest or behind head
- Support knees for comfort
- Center 2 in above iliac crests to IR
CR for Lateral Abdomen, Dorsal decubitus
- Horizontal and perpendicular to center of IR
- MSP is parallel to IR and MCP is perpendiculara
- Enters MCP at 2 in above iliac crests
Image evaluation of AP Supine
- Evidence of proper collimation
- Area from pubic symphysis to the upper abdomen
How to identify proper alignment for AP supine?
- Centered vertebral column
- Ribs, pelvis, and hips equidistant to the edge of image
What is pneumoperitoneum?
abnormal presence of air or other gas in the peritoneal cavity
The abdominopelvic cavity is enclosed in a double-walled seromembranous sac called ….
the peritoneum
What are the tissue structures that are used to determine effective technique?
Lower liver border, psoas muscles, kidneys, ribs, and transverse processes of lumbar vertebrae
What positions have the CR directed horizontal and perpendicular to the center of the IR?
- Lateral, dorsal decubitus
- Left lateral decubitus
What position has the CR horizontal and 2 in. above the iliac crest?
- AP upright
- PA upright
- Dorsal Decubitus
- Left Lateral Decubitus
How is the CR displayed in relation to the IR in an AP supine position?
CR is perpendicular to the IR at level of iliac crests
-MSP is perpendicular and MCP is parallel
How is the CR displayed in relation to the IR in a PA upright?
CR is directed horizontal and perpendicular to the center of the IR
-MSP is perpendicular and MCP is parallel
How is the CR displayed in relation to the IR in a Lateral Projection?
Perpendicular to the IR and entering the MCP plane at iliac crest level or 2 in. above iliac crest level
-MSP is parallel to IR and MCP is perpendicular
How is the CR displayed in relation to the IR in a Dorsal Decubitus position?
CR is directted horizontally and perpendicular to the center of the CR.
-MSP is parallel to IR and MCP is perpendicular
In an acute abdomen series (three-way seriess), what image should be substituted for the upright abdomen radiograph when the patient is unable to stand?
Left lateral decubitus
