Chapter 3 Flashcards
These acute or emergency conditions require what is commonly referred to as an “__” wherein several abdominal images are performed in different positions to demonstrate air-fluid levels, free air, or both within the abdominal cavity.
acute abdominal series,
Typically, a __ are performed to complete the acute abdominal series
supine KUB, an upright AP or decubitus abdomen, and a PA or AP chest
The___ must be perfectly motionless during imaging of the abdomen or the chest.
diaphragm
The most important in abdominal radiography are the
right and left hemidiaphragms and the right and left psoas (so-es) major
The six organs of the digestive system are as follows:
- Oral cavity
- Pharynx
- Esophagus
- Stomach
- Small intestine
- Large intestine
The three digestive organs within the abdominal cavity are the
stomach and small and large intestines
The __ is the first organ of the digestive system located entirely within the abdominal cavity.
stomach
The __ continues from the stomach as a long, tubelike convoluted structure about 15 to 18 feet (4.5
to 5.5 m in length.
small intestine
The small intestine’s three parts are labeled in descending order in are as follows:
duodenum (doo-o-de-num) (A); jejunum (ie-joo-num) (B); and ileum (il-eum) (C).
The first portion of the small intestine, the __, is the shortest and widest, in diameter of the three seg-ments. It is about 10 inches (25 cm) in length.
duo-denum
Ducts from the __ drain into the duodenum to aid digestive functions.
liver, gallblad-der, and pancreas
The first two-fifths, following the duodenum, are the __, and the distal three-fifths are the __.
jejunum ileum
The orifice (valve) between the distal ileum and the cecum portion of the large intestine is the
ileocecal valve
The sixth and last organ of digestion is the __, which begins in the right lower quadrant at the junction of the small intestine and the ileocecal valve.
large intestine
The portion of the large intestine below the ileocecal valve is a saclike portion named the __.
cecum
The __ is attached to the posteromedial aspect of the cecum
appendix (vermiform appendix)
The vertical portion of the large bowel, above the cecum, the __, joins the transverse colon at the right colic (kol-ik, referring to the colon) flexure.
ascending colon
The transverse colon joins the __ at the left colic flexure.
descending colon
Alternative secondary names for the two colic flexures are __, based on their proximity to the liver and spleen,
hepatic (right) and splenic (left) flexures
The descending colon continues as the __.
S-shaped sigmoid colon in the lower left abdomen
The __ is the final 6 inches (15 cm) of the large intestine.
rectum
The rectum ends at the __, the sphincter muscle at the terminal opening of the large
anus
shape and location of the large intestine varies greatly, with the transverse colon located _ in the abdomen of broad hypersthenic body types and __ in the abdomen of slender hyposthenic and asthenic body types
high , low
The spleen is the part of the __ that, along with the heart and blood vessels, is part of the circulatory system.
lymphatic system
It is an essential abdominal organ that occupies a space posterior and to the left of the stomach in the left upper quadrant,
Spleen
Three accessory organs of digestion, also located in the abdominal cavity, are the
(1) pancreas, (2) liver, and (3) gallbladder.
of digestion are outside the digestive tract but aid in digestion via the materials they secrete into the digestive tract.
Accessory organs
, which is not visualized in an abdominal image, is an elongated gland located posterior to the stomach and near the posterior abdominal wall, between the duodenum and the spleen.
The pancreas
The relationship between the duodenum and the head of the pancreas is sometimes referred to as
the romance of the abdomen.”
is part of the endocrine (internal) secretion system and the exocrine (external) secretion system.
pancreas
The endocrine portion of the pancreas produces essential hormones, such as __, which aids in controlling the blood sugar level of the body.
insulin
large intestine varies greatly, with the transverse colon located __ in the abdomen of broad hypersthenic body types and __ in the abdomen of slender hyposthenic and asthenic body types
high, low
The spleen is the part of the __ system
lymphatic
is an essential abdominal organ that occupies a space posterior and to the left of the stomach in the left upper quadrant,
Spleen
Three accessory organs of digestion, also located in the abdominal cavity, are
the (1) pancreas, (2) liver, and (3) gallbladder.
of digestion are outside the digestive tract but aid in digestion via the materials they secrete into the digestive tract.
Accessory organs
is an elongated gland located posterior to the stomach and near the posterior abdominal wall, between the duodenum and the spleen.
The pancreas
is the largest solid organ in the body, occupying most of the right upper quadrant of the abdomen.
liver
The __ is the largest solid organ in the body, occupying most of the right upper quadrant of the abdomen.
liver
The liver has numerous functions, one of which is the production of bile that assists in the
emulsification (breakdown) of fats.
is a pear-shaped sac located posterior and inferior to the liver.
gallbladder
The gallbladder contracts and releases the stored bile when stimulated by an
appropriate hormone (cho-lecystokinin).
In most cases, the gallbladder cannot be visualized without the use of contrast media because the gallbladder and the biliary ducts are
similar in tissue density and subject contrast to the surrounding abdominal soft tissues.
is the presence of one or more calculi (gallstones) in the gallbladder.
Cholelithiasis
Gallstones are composed of either __ made of bile salts, phosphate, and carbon-ate.
cholesterol or pigments
Cholesterol-based gallstones are more commonly found in populations within the United States (80%), whereas pigment-based stones are more commonly found in populations within Asia.
Only about 20% of all gallstones contain enough __ to allow visualization on an abdominal image.
calcium
The majority of gallstones are
radiolucent (not visible radiographically).~
The majority of gallstones are radiolucent (not visible radiographically).~ Alternative imaging modal-ities, such as diagnostic medical __ are better able to detect the presence and location of radiolucent gallstones.
sonography
The urinary system comprises the following (Fig. 3.10):
• Two kidneys
• Two ureters (u-re’-ters or yoo-ret’-ers) 3
• One urinary bladder
• One urethra (u-re’-thrah or yoo-re’-thra)
Each kidney drains via its
ureter to the single urinary bladder.
The bladder, situated superior and posterior to the symphysis pubis, stores urine. Under voluntary control, the stored urine passes to the exterior environment via the
urethra
The right kidney is typically situated a little more inferior than the left kidney because of the presence of the
liver on the right.
Waste materials, including excess water, are eliminated from the blood by the __ and are transported through the __ to the __
kidneys, ureters, urinary bladder.
The kidneys are usually faintly demonstrated on an abdominal image because of a
fatty capsule surrounding each kidney.
The contrast medium examination is an __, which examines the urinary system performed with an intravenous contrast medium. During this exami-nation, the hollow organs of this system are visualized by the contrast medium that has been filtered from the blood flow by the kidneys.
excretory or intravenous urogram (IVU)
Four terms that describe the abdominal cavity anatomy appear on the figures to the right and are described subsequently. These four terms are:
- Peritoneum (per”-i-to-ne-um)
- Mesentery (mes’-en-ter-e)
- Omentum (o-men-tum)
- Mesocolon (mez’-o-ko-lon)
Most of the abdominal structures and organs and the wall of the abdominal cavity in which they are contained are covered to varying degrees by a large serous, double-walled, saclike membrane called the
peritoneum.
Two types of peritonea exist:
parietal and vis-ceral.
The two-layered peritoneum that adheres to the abdominal cavity wall is the __, whereas the portion that covers an organ is the ___.
parietal peritoneum, visceral peritoneum
__ is the space or cavity between the parietal and visceral portions of the peritoneum.
The peritoneal cavity
peritoneal cavity also contains some serous lubricating-type fluid, allowing organs to move against each other without friction. An abnormal accumulation of this serous fluid is a condition called
ascites
__ peritoneum only partially covers specific organs that are more closely attached to the posterior abdominal wall.
visceral____At this level, the ascending and descending colon, the aorta, and the inferior vena cava are only partially cov-ered; therefore, this lining would not be considered mesentery, and these structures and organs are called retroperitoneal, as described
The __ forms large folds that bind the abdominal organs to each other and the walls of the abdomen.
peritoneum
Blood and lymph vessels, and the nerves that supply these abdominal organs, are contained within these folds of the.
peritoneum
is the specific term for a double fold of peritoneum that loosely connects the small intestine to the posterior abdominal wall
mesentery
The mesentery is the __ that extends anteriorly from the posterior abdominal wall to completely envelop a loop of the small bowel.
double fold of the peritoneum
The mesentery is the __ that extends anteriorly from the posterior abdominal wall to completely envelop a loop of the small bowel.
double fold of the peritoneum
The peritoneum forms large folds that bind the abdominal organs to each other and the walls of the abdomen. Blood and lymph vessels, and the nerves that supply these abdominal organs, are contained within these folds of the peritoneum. One of these double folds that hold the small intestine in place is known as __.
mesentery
___ forms large folds that bind the abdominal organs to each other and the walls of the abdomen. Blood and lymph vessels, and the nerves that supply these abdominal organs, are contained within these folds of the ___.
peritoneum, peritoneum
The term __ refers to a double-fold peritoneum that extends from the stomach to another organ
omentum
The lesser omentum extends
superiorly from the lesser curvature of the stomach to portions of the liver.
The greater omentum connects the
transverse colon to the greater curvature of the stomach infe-riorly.
The greater omentum drapes over the
small bowel then folds back on itself to form an apron along the anterior abdominal wall
Varying amounts of fat are deposited in the greater omentum, which is a layer of insulation between the abdominal cavity and the exterior. This is sometimes called the
“fatty apron” because of its location and the amount of fat contained therein
is the peritoneum that connects the colon to the posterior abdominal wall.
mesocolon
The prefix meso- refers to
mesentery-type folds from which other abdominal organs are suspended.
Four forms of mesocolon exist, each named according to the portion of the colon to which it is attached:
ascending, transverse, descending, and sigmoid or pelvic.
, is the visceral peritoneum that loosely connects the transverse colon to the posterior abdominal wall.
transverse mesocolon
The major portion of the peritoneal cavity is the
greater sac and is commonly referred to as the peritoneal cavity.
The lesser sac is a smaller portion of the upper posterior peritoneal cavity located posterior to the stomach known as the
omentum bursa.
retroperito-neal means
(retro, meaning “backward” or “behind”)
infraperitoneal means __ in relation to the peritoneal cavity
infra, meaning “under” or “beneath”)
Structures closely attached to the retroperitoneal posterior abdominal wall are the
kidneys and ureters, adrenal glands, pancreas, C-loop of the duodenum (aspect adjacent to the head of the pancreas), ascending and descending colon, upper rectum, abdominal aorta, and inferior vena cava.
These retroperitoneal structures
are less __, within the
abdomen than other intraperitoneal organs.
mobile
Located under or beneath the peritoneum, in the true pelvis, are the
lower rectum, urinary bladder, and reproductive organs.
Organs within the abdominal cavity that are partially or wholly covered by some type of visceral peritoneum, but are not retroperi-toneal or infraperitoneal, may be called __
intraperitoneal
intraperitoneal (intra, meaning “within”. These organs, which have been removed from the drawing in Fig. 3.17, include the
liver, gallbladder, spleen, stomach, jejunum, ileum, cecum, and transverse and sigmoid colon.
The lower aspect of the peritoneum is a closed sac in (gender)
male but not in the female.
In males, the lower peritoneal sac lies above the
urinary bladder, completely separating the reproductive organs from those within the peritoneal cavity (see Fig. 3.16).
lIn females, the uterus, uterine (fallopian) tubes, and ovaries pass directly into the.
peritoneal cavity
If two imaginary perpendicular planes (at right angles) were passed through the abdomen at the umbilicus (or navel), they would divide the abdomen into four quadrants. One plane would be transverse through the abdomen at the level of the umbilicus, which in most people is at the intervertebral disk level
between L4 and L5 (fourth and fifth lumbar vertebrae), which is at about the level of the iliac crests on a female.
If two imaginary perpendicular planes (at right angles) were passed through the abdomen at the umbilicus (or navel), they would divide the abdomen into four quadrants
The vertical plane would coincide with the midsagittal plane, or midline, of the abdomen and would pass through both the __
umbilicus and the symphysis pubis.
If two imaginary perpendicular planes (at right angles) were passed through the abdomen at the umbilicus (or navel), they would divide the abdomen into four quadrants
These two planes would divide the abdominopelvic cavity into four quadrants:
right upper quadrant (RUQ), left upper quadrant (LUQ), right lower quadrant (RLQ), and left lower quadrant (LLQ).
The abdominopelvic cavity can also be divided into nine regions by using
two horizontal or transverse planes and two vertical planes.
The abdominopelvic cavity can also be divided into nine regions by using two horizontal or transverse planes and two vertical planes.
The two transverse/horizontal planes are the __. The two vertical planes are the __
transpyloric plane and the transtubercular plane.
right and left lateral planes
The transpyloric plane is at the lower border of __, and the transtubercular plane is at the level of __ The right and left lateral planes are parallel to the midsagittal plane and are located midway between it and each anterior superior iliac spine
LI (first lumbar vertebra), L5.
The nine regions of abdomen
- Right hypochondriac
- Epigastric
- Left hypochondriac
- Right lateral (lumbar)
- Umbilical
- Left lateral (lumbar)
- Right inguinal (iliac)
- Pubic (hypogastric)
- Left inguinal (iliac)
The following seven palpable landmarks are essential in positioning the abdomen or locating organs within the abdomen
- Xiphoid process (level of T9 to 10):
- Inferior costal (rib) margin (level of L2 to L3):
- Iliac crest (level of L4 to L5 vertebral interspace):
- Anterior superior iliac spine (ASIS):
- Greater trochanter:
- Symphysis pubis:
Xiphoid process is at the level of
T9 to 10):
- Inferior costal (rib) margin is at the level of
L2 to L3)
This landmark is used to locate upper abdominal organs, such as the gallbladder and stomach.
- Inferior costal (rib) margin (level of L2 to L3):
- Iliac crest is at the level of
L4 to L5 vertebral interspace):
The iliac crest can be palpated easily by The uppermost, or most superior, portion of the crest is the most commonly used abdominal landmark.
pressing inward and downward along the mid-lateral margin of the abdomen.
The iliac crest corresponds approximately to the level of the
mid-abdominopelvic region, which is also at or just slightly below the level of the umbilicus on most people.
ASIS can be found by locating
the iliac crest, then palpating anteriorly and inferiorly until a prominent projection or “bump” is felt (more pronounced in females).
This landmark is commonly used to position pelvic and vertebral structures but can also serve as a secondary landmark for general abdominal positioning
Asis
the greater trochanter is at about the same level as the
superior border of the sym-physis.
The most superior anterior
portion of the pubis can be palpated
when the patient is in a supine position.
The most superior anterior
portion of the pubis corresponds to the
inferior margin of the abdomen.
