Abdomen anatomy and pathology

abdominal pelvic cavity contains what cavities

• abdominal cavity

• pelvic cavity

the abdominal cavity is the _____,______ portion

• large, superior

the pelvic cavity is the ____,_____ portion

smaller, inferior

where does the abdominal cavity extend

• from the diaphragm to superior aspect of bony pelvis

the abdominal cavity consists of

• stomach

• small and large intestines

• liver

• gallbladder

• spleen

• pancreas

• kidneys

the pelvic cavity lies within

• margins of bony pelvis

the pelvic cavity contains

• rectum and sigmoid regions of colon

• urinary bladder

• reproductive organs

Pelvic cavity boney positioning points

• iliac crest

• ASIS

• pubic symphysis

what does the abdominal peritoneum enclose

• the abdominopelvic cavity

the double walled membrane consists of:

• parietal peritoneum

• visceral peritoneum

the parietal peritoneum is the

• outer portion

  • lines cavity

the visceral peritoneum is the

• inner portion

  • surrounds organs

peritoneal cavity is

• in-between; contains fluid

retroperitoneum is the

• cavity behind the peritoneum

the retroperitoneum includes:

• kidneys

• pancreas

where does the right kidney lie compared to the left kidney

• lower

how does the right flexure of the colon lie compared to the left flexure

• lower

what is volvulus

• twisting of bowel on itself

what are the technical factors for volvulus

• typically subtractive

• may have to decrease technique due to abundance of air

• if known opaque obstruction, then increase technique

what is pneumoperitoneum

• free air in the peritoneal cavity

what is the technical factors for pneumoperitoneum

• subtractive

• decrease technique due to additional air

what is ascites

• accumulation of fluid in the peritoneal cavity

what is the technical factor for ascites

• additive

• may have to increase technique

what is a bowel obstruction

• partial or full blockage of large or small bowel that does not allow substances to pass through

what is the technical factor for a bowel obstruction

• depending on blockage, may need to increase/decrease technical factors

what is pica

• psychological disorder of intentional and craving consumption of non-nutritive substances over a period of time

what is the technical factor for pica

• depending on blockage, may need to increase technical factors

what is quadrant 1

• right upper quadrant (RUQ)

what is quadrant 2

• left upper quadrant (LUQ)

what is quadrant 3

• right lower  quadrant (RLQ)

what is quadrant 4

• left lower quadrant (LLQ)

what is region 1

• right hypochondriac region

what is region 2

• epigastric region

what is region 3

• left hypogastric region

what is region 4

• right lumbar region

what is region 5

• umbilical region

what is region 6

• left lumbar region

what is region 7

• right iliac region

what is region 8

• hypogastric region

what is region 9

• left iliac region

AP supine for GI concerns OR part of abdomen routine

• entire bowel pattern must be visualized if performed as part of an obstruction series or if KUB for bowel related concern such as obstruction, nausea, vomiting, or diarrhea

AP supine for urinary tract

• if kidneys, ureter and bladder are of primary concern that is all that needs to be included

criteria for AP supine

• area from public symph to the upper abdomen

  • two images may be necessary

criteria for AP erect

• Entire diaphragm without motion must be visualized (there should ne minimal amount of lung visualized)

• verterbral column should be in the center of the image

• ribs, pelvis, and hips should be equidistant to the edges of the image on both sides

• AP ERECT needs to be annotated on the image

left lateral decubitus

• diaphragm must be included without motion

• the right side should demonstrate free air if present

• abdominal wall, flank structures and the diaphragm should be visualized

• DECUBITUS annotation on the image

RH note for a left lateral decubitus

• only right side of the diaphragm is needed on left lateral decubitus view

criteria for transabdominal/ dorsal decubitus

• highest point of abdomen must be visualized without motion (RH)

• no rotation

  • superimposed ilia

  • superimposed lumbar vertegraw pedicles and open intervertebral foramina

• TRANS. ABD annotated on the image

what is merrils’s criteria for a TRANS ABD

• must have the whole diaphragm

Pediatric abdomen light field

• top of symph

• to right about the nipple line

if the patient is <5 ft how many inches from the jugular notch is symph found

• 21 inches

if the patient is 5-6 ft how many inches from the jugular notch is symph found

• 22 inches

if the patient is 6 ft how many inches from the jugular notch is symph found

• 24 inches

additional positioning aides

• greater trochanter is at level of pubic symphysis

what breathing is used on all abdomen views

• expiration

psoas muscles

• long shape muscle of the lower back, upper lumbar region all the way down through the pelvis and into the top of the femur, where the kidneys are located