wb 4

what is the commonly used acronym that refers to the AP projection of the abdomen?

KUB

What does KUB mean?

kidneys, ureters, bladder

what three projections usually comprise the three way or acute abdomen series?

AP supine

AP upright

PA chest upright

Why is an upright chest image included as part of the acute abdomen series?

to show free air that may accumulate under the diaphragm

In the acute abdomen series, what image should be substituted for the upright abdomen radiograph when the patient is unable to stand?

LLD

AP and PA projections abdomen

Which plane of the body should be positioned perpendicular to the IR? Parallel with the IR?

perpendicular - midsagittal

parallel- midcoronal

AP and PA projections abdomen

For the AP projection with the patient supine, which structure should be seen at the bottom of the image?

pubic symphysis

AP and PA projections abdomen

What structure of the upper abdomen should be seen on the abdomen image when the patient is upright? Explain why.

diaphragm

free air may rise up from the abd

AP and PA projections abdomen

what breathing instructions should be given to the patient?

suspend at the end of respiration

AP and PA projections abdomen

what is the advantage of exposing abdominal images at the suspension of the recommended phase of respiration compared with the other respiration phase?

the organs are not compressed

AP and PA projections abdomen

what two identification markers should be seen on the image when the patient is upright?

side marker and upright marker (arrow)

AP and PA projections abdomen

with reference to radiation protection, what is the advantage of PA projection over the AP projection?

less radiation exposure to gonads

circle the three evaluation criteria that indicate the patient was correctly positioned without rotation for a KUB image:

a) intervertebral foramina should be open

b) alae or wings of the ilia should be symmetric

c) lumbar vertebrae pedicles should be superimposed

d) if seen, ischial spines of the pelvis should be symmetric

e) spinous processes should be in the center of the lumbar vertebrae

B D E

AP LLD projection abdomen

What is the advantage of the left lateral decubitus position compared with the supine position in AP projection of the abdomen?

air- free fluid levels can be seen

AP LLD projection abdomen

Why is the left lateral decubitus position preferred over the right lateral decubitus position when the patient is unable to stand?

air can be seen better with liver as the background instead of being superimposed with the stomach

AP LLD projection abdomen

Why is it advisable to let the patient remain in the lateral recumbent for several minutes before making the exposure?

to allow air to rise up

AP LLD projection abdomen

what breathing instructions should be given to the patient

suspend breathing after inspiration

AP LLD projection abdomen

which side of the abdomen (the "up" side or the "down" side) should be demonstrated if only one side can be imaged and the patient may have free air in the abdomen?

the unaffected side should be down

the affected side is up

AP LLD projection abdomen

which side of the abdomen (the "up" side or the "down" side) should be demonstrated if only one side can be imaged and the patient may have fluid levels in the abdomen?

the affected side should be down

AP LLD projection abdomen

what structure of the upper abdomen should be demonstrated on the image?

diaphragm

AP LLD projection abdomen

what identification markers should be seen on the image?

side marker

arrow for which side is up

Lateral Projection Dorsal decub position

What is the name of the radiographic position that produces a lateral image of the abdomen with the patient in supine position?

dorsal decubitus

Lateral Projection Dorsal decub position

what purpose is served by having the patient slightly flex their knees?

relieve strain on the back

Lateral Projection Dorsal decub position

To what level of the patient should the long axis of the IR be centered?

2 in above iliac crest

midcoronal plane

Lateral Projection Dorsal decub position

Where should the central ray enter the patient?

2 inch above the iliac crest

True or False: Anatomists define the "true pelvis" as the portion of the abdominopelvic cavity inferior to a plane passing through the sacral promontory posteriorly and the superior surface of the pubic bones anteriorly.

true

Lateral Projection Dorsal decub position

True or false. The central ray should be directed horizontally and perpendicular relative to the center of the IR.

True

Lateral Projection Dorsal decub position

Circle the three evaluation criteria that indicate the patient was correctly positioned for a lateral projection while placed in the dorsal decubitus position.

a. The wings of the ilia should be symmetric.

b. The ilia should be superimposed.

c. The lumbar vertebrae pedicles should be superimposed and intervertebral foramina should be open.

d. As much of the remaining abdomen as possible when the diaphragm is included

e. The spinous processes should be seen in the center of the lumbar vertebrae.

f. The ribs and pelvis should be equidistant to the edge of the IR on both sides.

B C D

size of collimation field for abdomen x rays

14x17

small pt- 1 inch beyond lateral skin shadows

abdomen AP and PA

key patient and part positioning points

supine

upright

knees flexed

shoulders and hips aligned

abdomen AP and PA

anatomic landmarks and relation to the image receptor

MSP perpendicular to IR

MCP parallel to IR

abdomen AP and PA

CR orientation and entrance point

to include diaphragm on upright CR enters the MSP at 2 inch above the iliac crests

AP LLD abdomen

part / pt positioning points

left lat recumbent

vertical grid height at msp

shoulders and hips aligned perpendicular to cart

knees flexed

arms out of way

abdomen AP and PA

anatomic landmarks and relation to IR

MSP perpendicular to IR

MCP parallel

abdomen AP and PA

CR orientation and entrance point:

horizontal and perpendicular MSP

iliac crest 2 in above to include diaphragm

lateral projection dorsal decubitus abdomen

key pt part positioning points

supine

shoulders hips aligned

knees flexed

arms elevated

grid height of mcp

lateral projection dorsal decubitus abdomen

anatomic landmarks and relation to IR

msp - parallel

mcp- perpendicular

lateral projection dorsal decubitus abdomen

CR orientation and entrance point:

horizontal and perpendicular to IR mcp 2 in above iliac crests