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What quadrant are the liver and gallbladder in?
RUQ
What quadrant are the stomach and spleen in?
LUQ
What are some indications/reasons for a supine abdomen x-ray?
evaluate gas patterns/constipation
evaluate placement of lines/tubes
foreign bodies
What is the kVp range for an AP supine abdomen?
70-90 kVp
Proper kV should demonstrate good soft tissue differentiation of ___
psoas muscles, lower liver, kidneys, transverse processes
How can you check for rotation on an abdomen x-ray?
spinous processes, obturator foramen, iliac wings, ischial spines
Explain the respiration for an abdomen image
on expiration (so organs are in their true position)
What are the 4 common abdomen routines?
1 view (AP supine)
KUB (urinary)
2 view (AP supine and upright)
abdomen series
Explain centering for an AP/PA abdomen
centered at MSP and at level of iliac crest with the bottom edge at pubic symphysis
What is the SID for an AP/PA abdomen x-ray?
40 inches
Should you mark at the bottom or top of an abdomen image?
bottom
Identify the images needed for the different body habituses
asthenic: 1 LW
hyposthenic: T-shot
sthenic: 2 CW
hypersthenic: quadrants
The pubic symphysis is about ___ inches below the ASIS
3
The pubic symphysis is at the same level as the ___
greater trochanter
The PA projection of the abdomen is used for ___
urinary and small bowel radiographs
KUB is only done in which position?
AP supine
A KUB needs to include from the ___ to the ___
top of kidneys to the pubic symphysis
How long should a patient stand before an AP upright image of the abdomen?
ideally 10-15, AT LEAST 5
Where should you center an AP upright abdomen x-ray?
MSP and 2 inches above iliac crest (top of IR should be at axilla)
An upright abdomen needs to include from the ___ to the ___
diaphragm to ASIS
Does an upright or supine abdomen x-ray need a higher technique?
upright
What are some reasons for doing an upright abdomen?
obstructions, perforation, infection
What does an abdomen series consist of?
PA CXR, upright abdomen, supine abdomen
How should a patient lay for an AP or PA decubitus abdomen?
always left side down (due to location of free air)
arms above head
lay for at least 5 minutes
Explain the centering for a left lateral decubitus abdomen
central ray is a horizontal beam with SID 40 inches
centered at MSP and 2 inches above iliac crest (need to include diaphragm)
marker on side down
A(n) ___ abdomen image needs to include the pubic symphysis
supine
What are some things that a decubitus abdomen can demonstrate?
intraperitoneal gas/free air
fluid levels
diaphragm
Explain patient positioning for a lateral abdomen
lateral recumbent position (either right or left)
arms above head
partially flex knees and hips
Explain centering for a lateral abdomen
MCP is perpendicular to IR
MSP is parallel to IR
centered at crest and MCP
may need 2 inches above crest to include diaphragm
SID 40 inches
What are some things a lateral abdomen can demonstrate?
foreign bodies
intra-abdominal calcifications
tumor masses
aortic aneurysms/calcification
What is the largest vessel in the human body?
aorta
Explain patient position for a dorsal/ventral decubitus abdomen
arms above head
built up if necessary
can be either right or left lateral (mark side closest to IR)
Explain centering for dorsal decubitus position
horizontal beam
centered slightly anterior to MCP and 2 inches above crest
SID 40 inches
What are some things that a dorsal decubitus position can demonstrate?
air fluid levels, dilation of small bowel loops, aneurysm, aorta calcification
Dorsal decubitus abdomens are most commonly done on what type of patient?
NICU babies
Explain patient positioning for an AP oblique abdomen x-ray
supine; rotated
shoulders and hips rotated the same amount
arms out of the field
Explain centering for AP oblique abdomen x-rays
center at iliac crest and 2 inches lateral from midline (toward elevated side)
SID 40 inches
The kidneys sit at a ___ angle with the MCP
30-35o
Explain the AP urinary oblique image
30-35o patient rotation
side up kidney will be parallel to IR and will be best demonstrated
side down kidney is perpendicular to IR
Explain the PA urinary oblique image
30-35o patient rotation
side down kidney will be parallel to IR and will be best demonstrated
side up kidney is perpendicular to IR
The best view of the left kidney will be in either the ___ or ___ position
RPO or LAO
The best view of the right kidney will be in either the ___ or ___ position
LPO or RAO
Explain technique for AP abdomen/KUB images
70-90 kVp
20 mAs
Explain technique for upright/L lat decub abdomen images
70-90 kVp
32 mAs