Ch.3 Abdomen Bontrager

what are the 7 landmarks of the abdomen

xiphoid process at level t9 to t10, nferior costal rib margin at level l2 to l3, iliac crest at level l4 to l5, anterior superior iliac spine or ASIS at level s2, greater trochanter at same level as the superior border of the symphysis pubis,

thin crest shaped radiolucency underneath diaphragm

Pneumoperitoneum

true or false. a radiolucent pad should be placed underneath geriatric patients for added comfort.

true

distended loops of air filled small intestine

Crohn's disease

Intussusception

telescoping of a section of bowel into another loop of bowel

what is the recommended overlap when using two crosswise images for an anterior posterior projection of a supine abdomen of a broad hypersthenic type patient

3 to 5 cm or 1 to 2 inches

example of an ideal exposure for an anterior posterior abdomen of an average size adult

70 to 80 kilovolts, grid, 40 inches or 102 cm source image receptor distance

list the projections commonly performed for an acute abdominal series or three way abdomen series

Anterior posterior supine, anterior superior erect or lateral decubitus abdomen. also the posterior anterior erect chest

general abdominal haziness

Ascities

with the use of iodinated contrast media

CT is able to distinguish between a simple cyst or tumor of the liver

air filled coiled spring appearance

Intussusception

Situation: A patient in intensive care may have developed intra abdominal bleeding. The patient is in critical condition and cannot go to the radiology department. The physician has ordered a portable study of the abdomen. Which specific position or projection can be used to determine the extent of the bleeding?

a bedside portable left lateral decubitus projection could be performed to demonstrate any fluid levels in the abdomen

Volvulus

a twisting of a loop of bowel creating an obstruction

gonadal shielding for a female may be impossible for studies of the lower

abdominopelvic region

Ascites

abnormal accumulation of fluid in the peritoneal cavity

retroperitoneum

adrenal glands, kidney, duodenum, pancreas, ascending and descending colon

Situation: A patient with a history of ascites comes to the radiology department. which position best demonstrates this condition?

an erect anterior posterior abdomen position best demonstrates air fluid levels. Ascites produces free fluid in the intraperitoneal cavity.

why may the posterior anterior projection of a kidney ureter bladder generally be less desirable than an anterior posterior projection

because it increases object receptor distance of kidney on posterior anterior radiograph

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

because of location of liver on the right

Adynamic ileus

bowel obstruction caused by a lack of intestinal peristalsis

voluntary motion can best be prevented by

careful breathing instructions

Crohn's disease

chronic inflammation of the intestinal wall that may result in bowel obstruction

Situation: a patient comes for the E R with a large distended abdomen caused by an ileus. The physician suspects that the distention is caused by a large amount of bowel gas that is trapped in the small intestine. the standard analog technique for a K U B on and adult is 76 kV, 30 mAs. Should the tech change any of these exposure factors for this patient? (A E C is not being used)

decrease the mAs. because trapped air is easier to penetrate than soft tissue with x rays, reducing the mAs will prevent overexposing the radiograph

the sigmoid colon is located between the

descending colon and rectum of the large intestine

which decubitus position best demonstrates possible aneurysms, calcifications of the aorta, or umbilical hernias

dorsal decubitus

exposure for an anterior posterior projection of the abdomen should be taken on expiration or inspiration

expiration

true or false. because the liver margin is visible in the right upper quadrant of the abdomen, it is not necessary to place a right or left anatomic side marker on the cassette before exposure

false

true or false. for an adult abdomen, a collimation margin must be visible on all four sides of the radiograph

false

true or false. it is always acceptable during kidney ureter bladder imaging practice to indicate the side of the body with a digital marker

false

true or false the correct term for the radiographic study of the urinary system is intravenous pyelogram

false , it is the intravenous urogram

Pneumoperitoneaum

free air or gas in the peritoneal cavity

list the 3 accessory digestive organs

gallbladder, pancreas, liver

The medical prefix for stomach is

gastro

continuation of the 7 landmarks of the abdomen

ischial tuberosity located 1 and a half inches below or distal to the symphysis pubis, and the symphysis pubis

gonadal shielding should not be used during abdomen radiography if

it obscures essential anatomy

Situation: A child goes to radiology for an abdomen study. It is possible that he swallowed a coin. the E R physician believes it may be in the upper G I tract. Which of the following routings would best identify the location of the coin?

k u b and lateral abdomen . with any foreign body study, two projections 90 degrees opposite is recommended to pinpoint the location of the foreign body

which projection best demonstrates a possible aortic aneurysm in the prevertebral region of the abdomen

lateral position

what quadrant is the sigmoid colon in

left lower quadrant

Intraperitoneum

liver, spleen, transverse colon, stomach

what scale of contrast is recommended for visualization of the abdominal structures on an abdominal x ray

long scale

which of the following structures helps stabilize and support the small intestine? omentum, mesentery,peritoneum, viscera

mesentery

a k u b radiograph reveals that the symphysis pubis was cut off along the bottom of the image. is this an acceptable radiograph

no. a k u b must include the symphysis pubis on the x ray to ensure that the bladder is seen. the position error involves centering of the central ray to the iliac crest

which abdominal structure is not visible on a properly exposed kidney ureter bladder radiograph

pancreas

what are the two causes of voluntary motion

patient breathing and patient movement during exposure

what is the primary cause for involuntary motion in the abdomen

peristaltic action of the bowel

example of which projection requires a kilovolt setting of 110 to 125

posterior anterior , erect chest for free air under diaphragm

which projection of the three way acute abdominal series best demonstrates free air under the diaphragm

posterior anterior chest

is the pancreas located anteriorly or posteriorly to the stomach

posteriorly

the two large muscles found in the posterior abdomen adjacent to the lumbar vertebra and usually visible on an anteroposterior radiograph are called

psoas muscles

what quadrant is the appendix in

right lower quadrant

the prominence of the greater trochanter is about the same level of the

superior border of the symphysis pubis and the lower margins of the ischial tuberosities is about 1 and a half inches or 1 to 4 centimeters distal to the symphysis pubis

which endocrine glands are superomedial to each kidney

suprarenal adrenal glands

which topographic landmark corresponds to the inferior margin of the abdomen and is formed by the anterior junction of the two pelvic bones?

symphysis pubis

situation: A patient with a possible perforated duodenal ulcer enters the emergency room. the emergency room physician is concerned about the presence of free air in the abdomen. The patient is in severe pain and cannot stand. What positioning routine should be used to diagnose this condition?

the 2 way acute abdomen series, anterior posterior supine abdomen and left lateral decubitus

rotating can be determined on a kidney ureter bladder radiograph by the loss of symmetric appearance of

the iliac wings, the ischial spine, the obturator foramina if visible, and the outer rib margins

which decubitus position of the abdomen best demonstrates intraperitoneal air in the abdomen

the left lateral decubitus because the free air is best visualized in upper right abdomen in area of the liver

which of the following abdominal regions contains the rectum? is it the pubic, the inguinal, the umbilical, the epigastric, the hypochondriac, or the lumbar

the rectum is in the pubic region

a radiograph of an ap projection of an average size adult abdomen was produced using the following exposure factors: 90 kV, 400 mA, 1/10 second, grid, and 40 inch SID using film/screen (analog) imaging system. The overall density of the radiograph was acceptable, but the soft tissue structures, such as the psoas muscles and kidneys were not visible. which adjustment to the technical considerations will enhance the visibility of these structures on the repeat exposure?

the selected kilovoltage 90 kv was too high. the tech needs to lower the kilovoltage to between 70 and 80 kv . the miliamper and exposure time can be altered to maintain the density

why should a patient be placed in the decubitus position for a minimum of 5 minutes before exposure

to allow intraabdominal air to rise or abdominal fluids to accumulate

why is it recommended to take abdominal radiographs at the end of patient expiration

to increase the room for expansion of the abdominal organs within the abdominal cavity.

true or false. a tall asthenic patient may require two 14 by 17 inch image receptors placed lengthwise if the entire abdomen is to be included

true, because the thorax is narrow in width and shallow from front to back but is very long in its vertical dimension

the preferred imaging modality for examining the gallbladder quickly is

ultrasound

Situation: K U B radiograph reveals that the gonadal shielding is superior to the upper margin of the symphysis pubis. The female patient has a history of kidney stones. What is the next step the tech. should take?

Because the patient may have renal calculi in the distal ureters and urinary bladder, gonadal shielding cannot be used

deep air filled mucosal protrusions of colon wall

Ulcerative colitis

large amount of air trapped in sigmoid colon with a tapered narrowing at the sit of the obstruction

Volvulus

gonadal shielding for females involves placing the top of the shield at or slightly above the level of the

anterior superior iliac spine with the bottom at the symphysis pubis

to ensure the diaphragm is included on an erect abdomen projection, the central ray should be at the level of 2 inches or 5 centimeters above the iliac crest which places the top of the 14 by 17 image receptor at the level of the

axilla

which of the following structures helps stabilize and support the small intestine? greater omentum, peritoneum, viscera, mesentery

greater omentum

what quadrant is the liver in

right upper quadrant

list the 3 parts of the small intestine

duodenum, jejunum, ileum

which type of body habitus may require two crosswise images to be taken if the entire abdomen is to be included

hypersthenic body type, because patient has a thorax that is very broad and very deep from front to back but is shall in vertical dimensions

which portion of the small intestine is considered to be the longest

ileum

the central ray is centered to what level of the abdomen for a supine anterior posterior projection?

iliac crest

which topographic landmark is found at the level of l2 to l3?

inferior costal rib margin

Ulcerative colitis

inflammatory condition of the colon

the iliac crest is at the level of the

interspace between l4 and l5

Situation: the emergency room physician suspects a patient has a kidney stone. The patient is sent to the radiology department to confirm the diagnosis. What specific positioning routine would be used to rule out the presence of a kidney stone?

k u b would be performed with the correct exposure factors to visualize the possible stone

what quadrant is the left colic flexure in

left upper quadrant

what quadrant is the spleen in

left upper quadrant

what quadrant is the stomach in

left upper quadrant

what quadrant is the two thirds of jejunum in

left upper quadrant

a radiograph of an AP abdomen reveals the left iliac wing is more narrowed that the right. what specific positioning error caused this?

patient was rotated into a slight right posterior oblique position. the downside ilium will appear wider

the double walled membrane lining the abdominopelvic cavity is called

peritoneum

Situation: a hypersthenic patient comes to the radiology department for a K U B. The radiograph reveals that the symphysis pubis is included on the image, but the upper abdomen, including the kidneys, is cut off. what is the next step the tech. should take

repeat the exposure using two 14 by 17 inch cassettes placed crosswise. the hypersthenic patient often requires this type of image receptor placement for abdomen studies

the organs located posteriorly to or behind the serous membrane lining of the abdominopelvic cavity are referred to as

retroperitoneal

the large intestine begins in the

right lower quadrant and cecum of the large intestine

which of the following technical considerations is essential when performing abdomen studies on a young pediatric patient?

short exposure times, high speed image receptor, reduced kilovolts and milliamps per second

which of the following organs is not directly associated with the digestive system, gallbladder, spleen, jejunum, or pancreas

spleen

which one of the following organs is considered to be part of the lymphatic system, is it the liver, spleen, pancreas, or gallbladder

spleen

Situation: A patient with a possible ileus enters the emergency room. the patient is able to stand. The physician has ordered an acute abdominal series. What specific positioning routine should be used?

the 3 way acute abdominal series, including the anteroposterior supine and erect abdomen and posteroanterior erect chest projections

a radiographic image of an AP projection of the abdomen demonstrates motion. the following exposure factors were selected: 78kV, 200 mA, 2/10 second, grid, and 40 SID. The tech is sure that the patient did not breathe or move during the exposure. what may have caused this blurriness? what can be done to correct this problem on the repeat exposure?

the blurriness may be caused by involuntary motion. to control this motion, the technologist needs to increase the miliamperage and decrease the exposure. example 400 mA at 1/10 second

which positioning routine should be used for an acute abdominal series if the patient is too ill to stand

two way abdomen, anterior posterior supine abdomen, and a left lateral decubitus

which modality is being used to evaluate patients with acute appendicitis?

ultrasound

what is the correct name for the abdominal region found directly in the middle of the abdomen? is it the epigastric, inguinal, umbilical or pubic

umbilical

infraperitoneum

uqurinary bladder, reproductive organs ovaries and testes

what is the best mechanism to control involuntary motion?

use the shortest exposure time possible