procedures exam4: abdomen

The abdominopelvic cavity consists of 2 parts:

1. Abdominal cavity, larger superior cavity

2. Pelvic cavity

How long is the abdominopelvic cavity

It extends from the diaphragm to bony pelvis

Abdominal cavity contains what?

Stomach, small intestines, large intestines, liver, gallbladder, spleen, pancreas, kidneys (in the back)

Pelvic cavity contains

Rectum, sigmoid, urinary bladder and reproductive organ

Double walled sac

Pleura

Inner layer of peritoneum

Visceral peritoneum

Outer layer of peritoneum

Parietal peritoneum

Peritoneum

Double walled membranous sac that encloses the cavity

Retroperitoneum

Space behind the peritoneum

Where do the kidneys and pancreas lie

Within the retroperitoneum

Tissue structures used to determine if xray is good

1. Lower liver border

2. Psoas muscles

3. Kidneys

4. Ribs

5. Transverse processes of lumbar vertebrae

When do you expose on abdomen xray?

On their second exhale(end)

X-rays for abdomen

1. Anteroposterior (AP), supine, upright

2. Posteroanterior (PA), upright

3. AP left lateral decubitus

4. Lateral, R/L

5. Lateral, R/L dorsal decubitus

3 view abdomen consists of what

1. AP supine

2. AP upright

3. PA chest, upright

2 view abdomen consists of what

1. AP supine

2. AP upright

If a patient cannot stand what X-ray position is performed?

A left lateral decubitus

AP Abdomen, supine

1. Pt is supine

2. Support knees to reduce strain

3. Pubic symphysis included in image

4. CR: perpendicular to IR

5. SID: 40 inches

6. Pt is on Midsagittal plane at level of iliac crest

7. Exposure made on second exhale

8. May need to take 2 images

9. 
   

AP abdomen: upright

1. Pt is standing

2. Arms out of way

3. SID: 40 inches

4. CR: horizontal, centered to IR

5. IR: centered 2 inches above iliac crests

6. *if another image/diaphragm CR enters at MSP at level 2 inches above iliac crests

How to tell if xray is upright or supine?

Your BB markers will indicate, flat lines for fluid levels.

PA abdomen: upright

1. Pt is upright

2. MSP centered to grid

3. CR: perpendicular to IR

4. SID: 40 inches

5. Collimate within shadows

6. Exposure made at end of second exhale

AP abdomen: decubitus

1. Lateral recumbent on R/L side

2. Arms above level of diaphragm

3. Knees flexed slightly

4. CR: horizontal and perpendicular to center of IR entering MSP at level 2 inches above iliac crests

5. Exposure made at end of second exhale

Iliac crest location

Right above hips. Hard part of bone.

Lateral abdomen image*not common/foreign body*

1. Pt is in recumbent R/L lateral

2. Knees flexed

3. Arms out of the way

4. IR centered at level of iliac crest or 2 inches above, if diaphragm is included

5. CR: perpendicular to IR, enters at MCP at level of crest or 2 inches above crest

Lateral abdomen: dorsal decubitus

1. Pt is supine on bed or stretcher

2. Sit for 5mins

3. R/L side is in contact with vertical grid

4. Grid id centered to the MCP 2 inches above iliac crests to IR

5. Arms crossed on upper chest or above head

6. CR: horizontal /perpendicular to IR

7. Exposure made at end of second exhale

What do you need to make sure is in the AP abdomen supine image

1. Pubic symphysis

2. Ribs are seen

3. Hips / wings are equal and visible

4. Pelvis is seen

5. Spinous processes is center with vertebrae

6. Psoas muscles

7. Possible kidneys

What needs to be included in an AP abdomen upright image?

1. Air fluid levels

2. Marker indicating upright (BB)

3. Pubic symphysis

4. Ribs, pelvis, wings shown

5. Spinal processes are seen

6. Psoas muscles

What needs to be included in an AP abdomen left lateral decubitus image?

1. Diaphragm

2. Both sides of the abdomen

3. Fluid levels

4. Abdominal wall

5. Flank structures

6. Spinous processes

7. Wings are symmetrical

What needs to be included in lateral abdomen dorsal decubitus image?

1. Proper collimation

2. Diaphragm

3. Patient elevated

4. Proper marker for which side is closest to the IR