Chp 3: Abdomen

the 2 large muscles found in the posterior abdomen adjacent to lumbar vertebra that are usually visible in AP radiograph are

psoas muscles

3 parts of small intestine are

1. duodenum (shortest & widest)

2. jejunum

3. ileum (longest)

Don’t Jump In

which of the following organs is part of lymphatic system?

a. liver

b. spleen

c. pancreas

d. gallbladder

b. spleen

3 accessory digestive organs

1. liver

2. gallbladder

3. pancreas

why is right kidney found in a more inferior position than left kidney?

bc of presence of liver

which endocrine glands are superomedial to each kidney?

adrenal glands

peritoneum

double walled membrane that lines abdominopelvic cavity

what are the 4 abdominal quadrants?

1. right upper quadrant (RUQ)

2. left upper quadrant (LUQ)

3. right lower quadrant (RLQ)

4. left lower quadrant (LLQ)

what are the 9 abdominal regions?

1. right hypochondriac

2. epigastric

3. left hypochondriac

4. right lateral (lumbar)

5. umbilical

6. left lateral (lumbar)

7. right inguinal (iliac)

8. pubic (hypogastric)

9. left inguinal (iliac)

topographic landmarks for abdomen xray?

• xiphoid process (T9-T10)

• ischial tuberosity

• symphysis pubis

• iliac crests (L4-L5)

• ASIS

• greater trochanter

• inferior coastal margins (L2-L3)

2 way acute abdomen series includes

• AP supine KUB

• erect AP abdomen OR left lateral decub if pt can’t stand

3 way acute abdomen series includes

• AP supine KUB

• PA chest

• erect AP abdomen

why is left lateral decub preferred over right lateral?

bc stomach is on left side. thus by having pt lay on left it prevents gastric bubbles from mixing with abnormal air bubbles pt may have that rise and might make it more difficult to tell air bubbles from gastric bubbles apart. by lying on left side only bubbles that rise will be due to pathology

ascites

abnormal accumulation of fluids in peritoneal cavity

pneumoperitomeum

free air or gas in peritoneal cavity

• best seen with erect abdomen or chest image where even small amount of air will be seen under diaphragm

small bowel obstruction

blockage of flow of intestinal content

types of small bowel obstruction

• intussusception

• volvulus

• ileus

intussusception

section of bowel slides into another loop

volvulus

twisting of a loop of intestine

ileus

non mechanical bowel obstruction caused by lack of intestinal motility

what organs are in the RUQ?

• liver

• gallbladder

• duodenum

• head of pancreas

• right kidney

• right adrenal gland

• right hepatic (colic) flexure

what organs are in LUQ?

• spleen

• stomach

• left colic (splenic) flexure

• tail of pancreas

• left kidney

• left adrenal gland

• 2/3 of jejunum

what organs are in RLQ?

• appendix

• cecum

• ascending colon

• 2/3 of ileum

• ileocecal valve

what organs are in LLQ?

• descending colon

• sigmoid colon

• more jejunum

• more ileum

what are 2 causes of voluntary movement?

1. movement

2. breathing

voluntary movement can be prevented by

careful breathing instructions to pt

what’s the primary cause for involuntary motion in abdomen?

peristalsis

what’s best mechanism to control involuntary motion?

short exposure time

exposure for an AP projection of abdomen should be taken on

expiration

parts of large intestine

1. appendix

2. cecum

3. ileocecal valve

4. ascending colon

5. right colic (hepatic) flexure

6. transverse colon

7. left colic (splenic) flexure

8. descending colon

9. sigmoid colon

10. rectum

11. anus

the kidneys are connected to the bladder by way of the

a. urethra

b. renal artery

c. ureter

d. renal vein

c. ureter

which structure stores & releases bile?

a. liver

b. spleen

c. pancreas

d. gallbladder

d. gallbladder

which of the following structures connects the small intestine to the posterior abdominal wall?

a. greater omentum

b. peritoneum

c. lesser omentum

d. mesentary

d. mesentery

when is dorsal decubitus AP abdomen done?

• replaces AP erect & left lateral decub if pt cannot stand nor turn to their side

• evaluates air/fluid levels, hernias, aneurysms, calcification of aorta, etc

• usually for severe trauma pts

in what position will seeing the psoas muscles be of greater importance?

supine AP abdomen (KUB)

in what position will seeing the diaphragm be of most importance?

erect AP abdomen, PA chest, & left lateral decub

for a left lateral decubitus how much time does the patient need to be in this position prior to the exposure and why?

• 5 min

• to give enough time so that the air can rise and the fluid can fall and level