Rad Positioning - Abdomen Full Deck Flashcards
AP Abdomen (KUB)
Demonstrates borders of psoas major muscles
KUB
Kidneys
Ureter
Bladder
Radiography significant abdominal muscles
Diaphragm
Psoas
Diaphragm
Umbrella-shaped
Separates thoracic & abdominal cavities
Psoas
Lateral to vertebral column
Visible on abdominal radiograph
3 accessory organs of digestion
Liver
Gallbladder
Pancreas
Note: Pwrpt slide incorrectly states Spleen as 4th accessory organ
3 segments of Small Intestine
Duodenum
Jejunum
Ileum
Duodenum
1st segment of small intestine
Shortest & widest diameter
“C” loop appearance
Duodenal bulb or cap
Proximal portion of duodenum
Ducts that drain into duodenum
Ducts from:
Liver
Pancreas
Gallbladder
Acronym: Ladies Professional Golf
Jejunum
Middle segment of small intestine
2/5 of remaining small bowel
Central & lower in abdominal cavity
Ileum
3rd segment of small intestine
3/5 of remaining small bowel
Cecum
Large bowel
Ileocecal valve
Connection between ileum and cecum
Large intestine
Appendix
Colon - Ascending, Transverse, Descending
Cecum
Ileocecal valve
Left colic (splenic) flexure
Right colic (hepatic) flexure
Sigmoid colon
Rectum
Anus
Pancreas
Lies transverse & posterior to stomach
Not seen on plain abdominal X-ray
Head of pancreas lies in “C” loop
Endocrine function - produces insulin
Liver
RUQ location
Produces bile for digestion
Exocrine function - produces digestive juices to move food thru duodenum
Gallbladder
Stores bile
Can be seen with contrast enhancement
Usually seen with ultrasound
Urinary System
2 kidneys
2 ureters
1 urethra
1 bladder
2 suprarenal adrenal glands
Excretory or Intravenous Urogram (IVU)
Faint visualization of kidneys on KUB
Injection - contrast media
IVP term used in past - not fully accurate
Intravenous Pyelogram (IVP)
Old term for current IVU term
Not fully accurate - pyelo refers to renal pelvis of kidney only
True/False: Stomach’s shape, size, position varies between individuals
True
Connection between large & small bowel is called _____
Ileocecal valve
Which is not an abdominal organ?
- Spleen
- Pancreas
- Thymus
- Adrenal gland
Thymus
Peritoneum
Double walled membran enclosing most abdominal organs
Contains some lubricating fluid
Parietal Peritoneum
Outer layer adheres to abdominal wall
Visceral Peritoneum
Inner layer adheres to organs
Peritoneal Cavity
Space between parietal & visceral peritoneum
Potential cavity - filled w/ bowel & other organs
Omentum
a.k.a. Fatty Apron
Double fold peritoneum extending from stomach to another organ
Lesser Omentum
Extends superiorly from lesser curvature of stomach to portions of liver
Greater Omentum
Connects transverse colon to greater curvature of stomach inferiorly
Drapes down over small bowel - provides insulation between interior & exterior
9 Intraperitoneal Organs
Liver
Gallbladder
Spleen
Stomach
Jejunum
Ileum
Cecum
Transverse colon
Sigmoid colon
8 Retroperitoneal Organs
Kidneys
Ureters
Adrenal glands
Pancreas
Duodenum
Ascending & descending colon
Upper rectum
Major abdominal blood vessels (aorta & IVC)
5 Infraperitoneal Organs
Lower rectum
Urinary bladder
Reproductive organs
Male - closed sac
Female - open sac (the female uterus, tubes & ovaries, extending into peritoneal cavity)
Outer lining of peritoneum covering walls of peritoneal cavity
Parietal peritoneum
What is called the “fatty apron”?
Omentum
Which is infraperitoneal?
- Kidneys
- Pancreas
- Aorta
- Urinary bladder
Urinary bladder
7 things in RUQ
Liver
Gallbladder
Right colic flexure
Duodenum
Head of pancreas
Right kidney
Right suprarenal
6 things in LUQ
Spleen
Stomach
Left colic flexure
Tail of pancreas
Left kidney
Left suprarenal
5 things in RLQ
Ascending colon
Appendix
Cecum
2/3 Ileum
Ileocecal valve
3 things in LLQ
Descending colon
Sigmoid colon
2/3 Jejunum
9 Abdominal regions
Right hypochrondriac
Epigastric
Left hypochondriac
Right lateral (lumbar)
Umbilical
Left lateral (lumbar)
Right inguinal (iliac)
Pubic (hypogastric)
Left inguinal (iliac)
Xiphoid process location
T9 - T10
Inferior costal margin location
L2 - L3
Iliac crest
L4 - L5
3 Mid/upper abdomen landmarks
Xiphoid process - T9 - T10
Inferior costal margin - L2 - L3
Iliac crest - L4 - L5
4 Lower abdomen/pelvic landmarks
ASIS
Greater trochanter
Symphysis pubis
Ischial tuberosity
What 2 large abdominal muscles extend parallel to lumbar spine & are indicators of well-exposed KUB?
Psoas major
Which of following is not an accessory organ for digestion?
- Spleen
- Pancreas
- Liver
- Gallbladder
Spleen
Pancreas is classified as _____ structure
Retroperitoneal
Appendix is usually in which quadrant?
RLQ
If patient indicates pain in left lower anterior rib area - which quadrant?
LUQ
If patient indicates pain near xiphoid tip - which abdominal area?
Epigastric
Topographic landmark for middle of abdomen
Iliac crest
3 positions for Abdomen
KUB
Acute abdomen series
Decubitus positions
3 Acute Abdomen Series
AP supine abdomen
AP erect abdomen
PA erect chest
2 Decubitus abdomen positions
Lateral decubitus
Dorsal decubitus
What is kVP for AP Erect abdomen
70-80 kVp
Routine abdomen
AP supine (KUB)
CR location for AP Supine abdomen
Center to iliac crest
Evaluation criteria for AP Supine abdomen
Symphysis pubis included
Kidneys & lower liver margin included
No rotation
No motion
Exposure factors optimal
CR location for PA Prone abdomen
Center to iliac crest
Evaluation criteria for PA Prone abdomen
Symphysis pubis included
Kidneys & lower liver margin included
No rotation
No motion
Exposure factors optimal
CR location for Left Lateral Decubitus
2 inches above iliac crest
Evaluation criteria for Left Lateral Decubitus
Diaphragm Included
Both sides of body included
No rotation
No motion
Exposure factors optimal
CR location for Erect AP Abdomen
2 inches above iliac crest
Evaluation criteria for Erect AP Abdomen
Diaphragm included
No rotation
No motion
Exposure factors optimal
CR location for Dorsal Decubitus Right Lateral
2 inches above iliac crest to midcoronal plane
Evaluation criteria for Dorsal Decubitus Right Lateral
Diaphragm included
No rotation
No motion
Exposure factors optimal
CR location for Right Lateral Abdomen
???
Evaluation criteria for Right Lateral Abdomen
Diaphragm included
No rotation
No motion
Exposure factors optimal
Ileus
Nonmechanical bowel obstruction
Inability of intestine (bowel) to contract normally & move waste out
Paralysis of movement to the bowel
Ascites
Accumulation of fluid
Pneumoperitoneum
Free air or gas in peritoneal cavity
Perforated hollow viscus
Loss of GI wall integrity w/ leakage of contents
Intra-abdominal mass
Abnormal growth occurring in abdomen
6 Clinical indications for Acute Abdomen Series
Ileus
Intra-abdominal mass
Ascites
Pneumoperitoneum
Post-op abdominal surgery
Perforated hollow viscus
Acronym: Ileus [Elias] Is A Professional Post-op Performer
Acute Abdomen Series - 3-Way
AP erect
AP supine
PA chest
Acute Abdomen Series - 2-Way
AP supine
AP erect or Left lateral decubitus - must include diaphragm
AP Supine abdomen - 2 or 3 Way?
Both 2-Way & 3-Way
Pathological condition - twisting of loop of intestine creating an obstruction
Volvulus
What is the preferred length of time a patient should lie on side prior to lateral decubitus projection?
10 - 20 min
Mayo: 10-20 sec or positioning time
CR location for AP erect abdomen projection as part of acute abdomen series?
1 to 2 inches above iliac crest
What is kVp for abdomen?
70-80 kVp
Intussusceptions
Telescoping of bowel onto itself
More common in children
Necrosis in 48 hrs
Crohn’s Disease
Chronic inflammation causing fistulas between loops of SB - young adults
Ulcerative coilitis
Chronic inflammation & extreme dilation of colon
No barium administered