Chapter 4 Flashcards
What does the abdominal cavity contain?
- stomach
- small intestines
- large intestines
- liver
- gallbladder
- spleen
- pancreas
- kidneys
What does the pelvic cavity contain?
- rectum
- sigmoid
- urinary bladder
- reproductive organs
What is the peritoneum?
double-walled membranous sac that encloses the cavity
What is the inner layer of the peritoneum called?
visceral peritoneum
What is the outer layer of the peritoneum called?
parietal peritoneum
What is the retroperitoneum? What structures are located there?
- the space behind the peritoneum
- kidneys and pancreas
What are the general procedural guidelines?
- exposure technique
- IR and collimation field size
- SID
- ID markers
- radiation protection
- patient and breathing instructions
When would you decrease the kVp for an abdomen x-ray? Why?
you decrease the kVp to 70 instead of 80 because 80 kVp will burn kidney stones
What is the collimation size for an abdomen x-ray?
- 35cm x 43cm (14in x 17in)
- 1in (2.5cm) of shadow of the abdomen flanks
What is the SID for an abdomen projection?
40in (102cm)
What are the breathing instructions for an abdomen x-ray? Why?
- take a deep breath in, blow it all out and hold
- the diaphragm goes up and we’re able to see all the organs
What is a KUB? What does it include? How many images is it?
- kidneys, ureters, bladder
- also known as a supine projection
- includes the pubic symphysis
- 1 image
What does an upright abdominal x-ray include? What is another name for it?
- diaphragm
- FUA - flat, upright abdomen, 2 images
What is a complete abdomen x-ray?
- 3 images:
- PA chest
- supine
- upright
What are the essential projections for the abdomen?
- AP supine
- AP upright
- PA upright
- left lateral decubitus
- R or L lateral
- R or L dorsal decubitus
What is a scout? Why is it done?
- x-ray to show that the patient is clean of poop
Why is an abdominal projection used?
- demonstrates abdominal contents
- presence of free air (pneumoperitoneum)
- air fluid levels
What are some important things to remember when doing an AP abdomen supine x-ray?
- patient is supine with knees supported
- pubic symphysis must be included
- IR is centered at the iliac crest
- CR is perpendicular to IR and enters on midsagittal plane at level of the iliac crests
- collimation is 35cm x 43 cm with shadow 1in
- exposure is made when patient breathes out and holds it out
How would you find the iliac crest on a large patient?
feel for the hip bone and move their foot in and out
What may be required if a patient is hypersthenic?
hypersthenic patients may require 2 projections that overlap
What may be required if a patient is too tall?
tall patients may require a separate bladder image
What are some important things to remember when doing an upright AP abdomen x-ray?
- patient’s back is in contact with IR
- arms are out of view
- IR is centered 2in (5cm) above the iliac crest
- diaphragm must be included
- if bladder has to be shown, obtain a second image
- CR is horizontal and enters patient at the midsagittal plane 2in above the iliac crests
- collimation is 35cm x 43cm and 1in of shadow
- exposure is made at the end of breathing out and holding
Why is a PA abdomen used?
to show the organs that are more anterior
What are some important things to remember when doing a PA upright abdomen x-ray?
- patient is upright
- reduces gonadal dose when kidneys are not of primary interest
- anterior surface is in contact with IR
- IR is centered to 2in (5cm) above the iliac crest
- CR enters at the midsagittal at 2in (5cm) above iliac crest
How do you shield male and female patients during an abdomen x-ray?
- female: only able to shield the breasts when doing an upright abdomen x-ray
- males: can be shielded for both upright and supine
When is a lateral decubitus abdomen x-ray done?
performed for patients who are too sick to stand
What are some important things to remember when doing an AP lateral decubitus abdomen x-ray?
- patient is lying on their right or left side
- arms are up and out of the way
- center iliac crests to IR
- if diaphragm needs to be shown, center IR 2in above iliac crests
How do you annotate an AP left lateral decubitus x-ray?
- R marker is on top and left lateral decub its annotated
Why would you use a left lateral decubitus AP abdomen x-ray?
it shows the free air and fluid levels; air floats while fluid sinks
What are some important things to remember when doing a dorsal decubitus abdomen x-ray?
- this is used when a patient cannot stand or lie on their side
- done while the patient is supine on bed or stretcher
- right or left side is touching IR
*grid is centered to the midcoronal plane 2in above the iliac crest to IR - CR is horizontal and perpendicular to IR
- collimate 35cm x 43cm
What is the evaluation criteria for an AP abdomen x-ray in the supine position?
- proper collimation
- pubic symphysis is present
- centered vertebral column
- ribs, pelvis, and hips are equidistant
- no rotations
What is the evaluation criteria for an AP and PA abdomen x-ray in the upright position?
- proper collimation
- diaphragm is shown
- marker indicating the upright position
- ribs, pelvis, and hips are equidistant
- no rotations
- centered vertebral column
What is the evaluation criteria for an AP left lateral decubitus x-ray?
- proper collimation
- diaphragm without motion
- both sides of the abdomen are present
- if free air is suspected, the side should be up
- no rotation
What is the evaluation criteria for a lateral dorsal decubitus abdomen x-ray?
- proper collimation
- diaphragm present
- entire abdomen is present
- proper identification
What are the structures shown in a R or L lateral abdomen x-ray?
- prevertebral space occupied by the abdominal aorta
- any intra-abdominal calcifications or tumor masses
- show proper placement of abdominal aorta aneurysm (AAA) grafts and other vascular interventional devices
What are the structures shown in a AP supine and upright abdomen x-ray?
- size and shape of the liver
- spleen
- kidneys
- intra-abdominal calcifications
- evidence of tumor masses
What are the structures shown in a PA upright and AP left lateral decubitus abdomen x-ray?
- size and shape of liver
- spleen
- kidneys
- showing free air and fluid levels when standing upright is not possible
What are the structures shown in a lateral dorsal decubitus abdomen x-ray?
- prevertebral space
- useful in determining air-fluid levels in the abdomen
