Rad Pro 1 CH 4 Abdomen PP

the abdominopelvic cavity extends from

diaphragm to bony pelvis

two parts of the abdominopelvic cavity

abdominal cavity

pelvic cavity

the abdominal section in the abdominopelvic cavity is the _____

larger superior cavity

abdominal cavity contains

stomach

small intestines

large intestines

liver

gb

spleen

pancreas

kidneys

the pelvic cavity contains

rectum

sigmoid

urinary bladder

repro organs- male prostate, female uterus ovaries

the true pelvis lies

inferior to pelvic brim

the true pelvis encloses the

pelvic cavity

the true pelvis contains the

pelvic organs- bladder urethra rectum uterus vagina prostate

inlet + outlet

false pelvis area

within entire pelvic girdle

true pelvis area

below pelvic brim

large colon begins in the ___ and starts with the ____

RLQ

cecum

Parts of the colon

cecum

ascending colon

right colic flexure (hepatic flexure)

transverse colon

left colic flexure (splenic flexure)

descending colon

sigmoid colon

rectum

peritoneum - what is it?

double walled seromembranous sac that encloses the cavity

what are the layers of peritoneum?

visceral

parietal

visceral peritoneum

inner layer

parietal peritoneum

outer layer

retroperitoneum what is it ?

space behind peritoneum

what does the retroperitoneum contain?

kidneys

pancreas

aorta

ivc

ascending and descending colon

which of the following are located in the retroperitoneum?

rectum

kidneys

urinary bladder

pancreas

ovaries

spleen

kidneys

pancreas

rectum- except for distal one third

the pelvic cavity contains all of the following except ?

rectum

gb

urinary bladder

sigmoid colon

gb

which of the following is located in the abdominal cavity?

rectum

urinary bladder

ovaries

spleen

spleen

general procedural guidelines abdomen (slide 35)

exposure technique

- max ST differentiation

- most abd organs have similar tissue densities

- contrast resolution needs to be optimal

- right balance of exposure factors is critical

general procedural guidelines abdomen

list the bullet points

exposure technique

immobilization

IR/Collimated field size

SID

ID markers

radiation protection

pt instructions

exposure technique noncontrast exams

require max soft tissue differentiation

exposure technique ___ gray scale is desired

moderate

exposure technique

kVp

if the range is too high it will overpenetrate some structures

exposure technique

tissue structures used to determine

effective technique

what structures need to be visible? (slide 37)

lower liver border

shaply defined outlines of psoas muscles

kidneys

ribs

transverse processes of lumbar vertebrae

IR collimated field side

14×17

for smaller patients collimate within 1 inch of shadow of abdomen flanks

sometimes but not often ____ is used for abdomen

crosswise

use close collimation to

provide radiation protection and improve image quality

immobilization abd exams

prevent voluntary and involuntary motion

pt is comfortable

explain breathing

do not take exposures immediately after patient suspends breathing

abdomen ID markers

right or left side markers must be included on IR clear of anatomy of interest

other id markers must be in radiation field on final image

arrow indicating done upright or which side is up

ID markers

avoid using ______

digital annotation

radiation protection abdomen exams

shield male pediatric patients and patients of repro age

close collimation

optimum technique factors

follow recommended radiation field size

SID abdomen exams typically _____

40, if not specified in protocol, use 40 in

new research suggests a SID of ______

48

breathing instructions exposures for abdominal procedures generally made at

end of expiration to avoid compression of organs

essential projections

abdomen Supine AP

KUB

supine

flat plate

kub stands for

kidneys ureters bladder

essential projections

abdomen upright indicated when there could be

free air

pneumoperitoneum

essential projections

abdomen LLD is used when

when cant do upright

look for free air

positioning protocols

scout

upright + supine

three-way

three way abdomen or acute abdominal series is a ____ _____

common request

positioning protocols

Supine and upright two arrows at ____

90 degree angles

three way abdomen or acute abdominal series demonstrates

abdominal contents

presence of free air

air fluid levels

three way abdomen or acute abdominal series consist of what 3 images

upright

supine

pa chest

essential projections abdomen another common request other than a three-way abdomen is

2 way abdomen series

what does a two way abdomen series usually require

AP upright

AP supine

if the patient cant stand what position is used

LLD

abdominal sequencing

when free air is suspected and doing a LLD pt should be in LLD position for _______

10-20 min

LLD free air will _______ to be outlined by the ____ and ____

rise

liver

ribs

in LLD pathology ____ ____ be superimposed by gastric bubble in the stomach on the right side

will not

PA chest free air will rise to ____

right hemidiaphragm

dome of diaphragm

LLD AP projection

position of part

adjust the height of the vertical grid device so that the IR long axis is

centered to MSP

LLD AP projection

position of part

if the abd is too wide to include both flanks on one image what should you do?

adjust pt and IR height to include the side down when fluid is suspectued

include side up when pneumoperitoneum is expected

LLD AP projection

position the pt so that the ____________ is centered to the IR

level of the iliac crests

LLD AP projection

a slightly higher centering point 2 in may be necessary to . . .

ensure the diaphragm is included

LLD AP projection

adjust the pt to ensure that they are

at a true lateral position

essential projections abdomen list them all

AP supine upright

PA upright position

AP LLD

Lateral R or L

Lateral R or L dorsal decub

essential projections abdomen (what are we doing in lab)

AP upright

AP supine

AP abdomen supine this projection is often referred to as

KUB

AP abdomen supine pt position

supine without rotation

support knees to reduce strain

AP abdomen supine

IR centered to

iliac crests

check pubic symphysis is included

AP abdomen supine

CR is _____ to IR and enters pt

perpendicular

MSP at level of iliac crests

AP abdomen supine collimated field

14 × 17

small - collimate to 1 inch outside of skin shadow

AP abdomen supine body habitus considerations

hypersthenic

may require 2 crosswise projections

AP abdomen supine body habitus considerations, if the pt is tall

a separate bladder image may be required

AP abdomen supine exposure is made at the

end of expiration

AP abdomen upright

pt position

MSP ____ to grid

weight

arms ___ of radiation field

stand back against grid

centered

equally distributed on both feet

out

AP abdomen upright

IR centered

2 inches 5 cm above iliac crests

AP abdomen upright

need to make sure you include the ____

diaphragm

AP abdomen upright

*if bladder is included* center the IR to

iliac crests

AP abdomen upright

CR is centered to ___

for diaphragm enters pt on

IR

MSP 2 in above iliac crest

PA abdomens reduce

gonadal dose

PA abdomens should be considered when

kidneys are not primary interest

PA abdomen upright

pt position

weight

____ centered to grid

upright ant surface in contact with grid

equally distributed

MSP

PA abdomen upright

IR

2 in above iliac crests - high enough to include diaphragm

PA abdomen upright

CR is ____ to IR

enters pt on _____ above iliac crests

perpendicular

MSP at level of 2 in

preliminary evaluation image

scout

three way acute abdomen series is ordered to demonstrate what?

free air- bowel obstruction- infection

supine-upright lld- pa chest

supine and upright positioning protocols

KUB and upright

flat and upright

two arrows at 90 angles

intususception

one part of the intestine slides inside another adjacent segment

volvulus

loop of the intestine or colon twists around itself and its supporting mesentery, cutting off blood flow and causing a bowel obstruction

adhesions

bands of scar-like tissue that form between internal organs or tissues

herniation bowel

loop of the intestine pushes through a weak spot or tear in the abdominal wall- bulge

strangulated hernia

part of intestine or tissue gets trapped in hernia and loses its blood supply

lateral abdomen its not rotated when there is

superimposed ilia

superimposed lumbar vertebrae pedicle

open intervertebral foramina

AP LLD there is no rotation when what is demonstrated?

spinous processes in the center of the lumbar vertebrae

ischial spines of pelvis symmetric

alae or wings of ilia symmetric

in an AP abdomen LLD if the abdomen is too wide

side down when

side up when

fluid is suspected - ensure dependent side is included in collimated field

free air is suspected

AP abdomen LLD need to see

abdominal wall

flank structures

diaphragm

Lateral ABD Dorsal decub

the pt is ___ so the entire abd is shown

elevated

AP Abdomen Supine

soft tissue brightness and contrast show

flank stripe

psoas muscles

lower border of liver

kidneys

inferior ribs

transverse processes lumbar vert

AP ABD supine no rotation of pt when (4 things)

spinous processes in center of lumbar vertebrae

ischial spines symmetric

if visible alae / wings of ilia are symmetic

sacrum centered within pelvis

to include the diaphragm on upright positions AP projections of the abdomen, the central ray is centered to

2 in above iliac crests

which of the following might be used to demonstrate a pneumoperitoneum?

Upright AP projection

LLD

dorsal decubitus

all of above

all of above

Lateral ABD dorsal decubitus

align long axis of IR with

MCP