Abdomen

Why do we want a short exposure time on an abdomen?

peristalis

What do you want to visualize on an upright abdomen

the diaphragms

What do you want to visualize on a KUB

the pubic symphysis

Where do you center for an upright abdomen? how about a KUB? why do you center there?

upright- 2" above iliac crest to visualize diaphragms KUB- ilac crest to visualize pubic symphysis

To ensure the diaphragm is included on an erect abdomen projection, the CR should be at the level of 2" above the iliac crest which places the top of the 14x17" (35x43 cm) IR at the level of the axilla.

True

An AP supine, an AP erect or a lateral decubitus abdomen plus a PA erect chest are commonly preferred for an acute abdominal series.

True

Gonadal shielding can often be used with male patients for the AP supine abdomen projection

True

Inflammatory condition of the colon (most frequently involves rectosigmoid region)

Ulcerative colitis

The iliac crest is at the level of the interspace between L3-4 vertebra.

False

List all 7 landmarks and their level if applicable

1) xiphoid process (T9-10) 2) inferior costal margin (L2-3) 3) iliac crest (L4-5) 4) Anterior superior iliac spine (S1-2) 5) greater trochanter (pubic symphysis) 6) pubic symphysis (greater trochanter) 7) ischial tuberosity

If working on an obese patient how far from the jugular notch would you center for someone who is 4 ft 9", 5 ft 5", and 6 ft 2"

21" 22" 24"

What is an average technique for a abdomen?

75@32

What is the average technique for an upright abdomen?

75@40

Bowel obstruction caused by a lack of intestinal motility

Adynamic

Abnormal accumulation of fluid in the peritoneal cavity

Ascites

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

Crohn's disease

Because the liver margin is visible in the right upper quadrant of the abdomen, it is not necessary to place a right or left film maker on the cassette before exposure.

False

Exposure for an AP projection of the abdomen should be taken on inspiration.

False

Gonadal shielding can be used for a KUB abdomen projection on an adolescent female with possible urinary stones

False

Peristaltic action of the bowel is the primary cause for voluntary motion in the abdomen.

False

The CR is centered to the level of the symphysis pubis for a supine AP projection of the abdomen.

False

The CR must be centered to the level 2" above the iliac crest for an AP supine projection of the abdomen as part of the acute abdominal series

False

The kidneys do not necessarily have to be visible on a KUB.

False

The latissimus dorsi muscles should be demonstrated on a well-exposed abdomen projection on an average size patient?

False

The pancreas is located anteriorly to the stomach

False

The technologist must decrease manual exposure factors for a patient with severe ascites

False

The term gastro refers to the intestine.

False

To ensure that the inferior margin of the abdomen is included on a KUB radiograph, the technologist should palpate the ASIS

False

Telescoping of a section of bowel into another loop of bowel

Intussusception

Free air or gas in the peritoneal cavity

Pneumoperitoneum

A radiolucent pad should be placed underneath the geriatric patient for added comfort.

True

Motion of the patient's diaphragm can be stopped by providing proper breathing instructions.

True

Patient movement during exposure and patient breathing can cause voluntary motion.

True

The most common type of involuntary motion in the abdomen is peristalsis.

True

The symphysis pubis is the topographic landmark which corresponds with the inferior margin of the abdomen and is formed by the anterior junction of the two pelvic bones.

True

Using the shortest exposure time possible is the best mechanism to control involuntary motion.

True

A twisting of a loop of intestine creating an obstruction

Volvulus

For an upright AP abdomen projection, the 1) ASISs are positioned at equal distances from the IR. 2) patient remains in an upright position at least 5 to 20 minutes before the image is obtained. 3) symphysis pubis should be included. 4) patient is instructed to take a deep inspiration before the image is obtained. a) 1 and 2 only b) 2 and 3 only c) 3 and 4 only d) 1, 2 and 3 only

a) 1 and 2 only

Voluntary motion can 1) result from patient breathing. 2) be controlled by using a short exposure time. 3) result from peristaltic activity. 4) be identified as sharp bony cortices and blurry gastric and intestinal gases. a) 1 and 2 only b) 2 and 3 only c) 3 and 4 only d) 1, 2, and 4 only

a) 1 and 2 only

A supine AP abdomen projection obtained with the patient in an LPO position demonstrates: 1) the sacrum and coccyx aligned with the symphysis pubis. 2) a distance from the pedicles to the spinous processes that is narrower on the right side than on the left side. 3) the sacrum rotated toward the patient's right side. 4) the symphysis pubis rotated toward the patient's right side. a) 2 and 3 only b) 2 and 4 only c) 1 and 4 only d) 1, 2, and 3 only

a) 2 and 3 only

A morbidly obese patient has come to the department for an x-ray. You cannot locate any of the standard palpable landmarks. You decide you will locate her pubic symphysis and use that to make sure the bottom of your cassette is in the correct place. If the patient was 5 feet, 1 inch tall, how far would you measure from the jugular notch? a) 22 inches b) 23 inches c) 24 inches d) 21 inches

a) 22 inches

A patient enters the ED with a possible ascites. The patient is ambulatory. Which of the following projections of the abdomen will best demonstrate this condition? a) AP erect b) AP supine c) PA prone d) PA erect chest

a) AP erect

Which aspect of the small intestine is considered the shortest? a) Duodenum b) Jejunum c) Cecum d) Ileum

a) Duodenum

Which of the following conditions is NOT considered a clinical indication for an acute abdominal series? a) Kidney stone b) Obstruction c) Infection d) Intra-abdominal mass

a) Kidney stone

Which of the following abdominal regions would contain the right colic (hepatic) flexure? a) Right lateral lumbar b) Right inguinal c) Right hypochondriac d) Epigastric

a) Right lateral lumbar

A radiograph of an anteroposterior (AP) abdomen demonstrates elongation (widening) of the right iliac wing and narrowing of the left iliac wing. Which one of the following positioning errors produced this radiographic outcome? a) Rotation to the right (right posterior oblique) b) Left hip was internally rotated more than right hip c) CR off center to the left d) Rotation to the left (left posterior oblique)

a) Rotation to the right (right posterior oblique)

The most inferior positioning landmark on the abdomen/pelvis is the: a) ischial tuberosity. b) symphysis pubis. c) anterior superior iliac spine (ASIS). d) iliac crest.

a) ischial tuberosity

Which of the following kV ranges is recommended for a KUB on an adult? a) 50 to 60 b) 70 to 80 c) 90 to 100 d) 110 to 120

b) 70 to 80

7-year-old Lucinda Jackson enters the emergency department (ED) with a possible kidney stone. She complains of severe pain in the left lower pelvic region and a 2 view abdomen (upright and supine) is ordered. Which of the following options should be taken in regard to gonadal shielding? a) Ask the patient or her parents for their permission to not shield the gonads. b) Do not place the shielding on her abdomen or pelvic region. c) Turn the shield diagonally and have it up high enough to shield her ovaries. d) Shield her pelvic region on the supine view only, then remove it for the upright view.

b) Do not place the shielding on her abdomen or pelvic region

In which region or compartment of the peritoneum is the spleen located? a) Retroperitoneum b) Intraperitoneum c) Infraperitoneum d) Extraperitoneum

b) Intraperitoneum

Why is the right kidney usually lower in the abdomen than the left kidney? a) Presence of right colic flexure b) Presence of the liver c) Presence of the stomach d) Presence of right suprarenal gland

b) Presence of the liver

In which region or compartment of the abdomen is the pancreas located? a) Intraperitoneal b) Retroperitoneal c) Infraperitoneal d) Extraperitoneal

b) Retroperitoneal

Which of the following organs is considered to be part of the lymphatic system? a) Liver b) Spleen c) Pancreas d) Gallbladder

b) Spleen

A radiograph of an AP erect abdomen reveals that the diaphragms and symphysis pubis are both completely demonstrated. The obturator foramen are clipped bilaterally. What centering adjustments should the technologist make to improve this image? a) Use two 35 × 42 cm (14 × 17 inch) cassettes crosswise. b) This radiograph is correctly centered. No centering adjustments are necessary. c) Open up the collimators to include the ischial tuberosities. d) Center the cassette 2 inches (5 cm) below the iliac crest.

b) This radiograph is correctly centered. No centering adjustments necessary

Which aspect of the large intestine is found between the left and right colic flexures? a) Descending colon b) Transverse colon c) Ascending colon d) Sigmoid colon

b) Transverse colon

The prominent protuberance found on the anterior aspect of the ilium is the: a) ischial tuberosity. b) anterior superior iliac spine (ASIS). c) symphysis pubis. d) iliac crest.

b) anterior superior iliac spine (ASIS)

Which of the following manual exposure factors would produce the desired qualities for an abdominal projection on an average-sized adult? a) 90 kV, 600 mA, 1/20 sec, grid, 60-inch (153 cm) SID b) 75 kV, 600 mA, 1/30 sec, nongrid, 72-inch (183 cm) SID c) 75 kV, 800 mA, 1/20 sec, grid, 40-inch (102 cm) SID d) 75 kV, 400 mA, 1/10 sec, grid, 40-inch (102 cm) SID

c) 75 kV, 800 mA, 1/20 sec, grid, 40-inch (102 cm) SID

Which radiographic landmark is most reliable to evaluate the posteroanterior (PA) projection of the abdomen for rotation? a) Xiphoid process b) Symphysis pubis c) Ala of ilium d) ASIS

c) Ala of ilium

Why is the PA projection of the abdomen less desirable for a KUB than the AP projection? a) There is an increased gonadal dose with the PA projection. b) The PA projection is less comfortable for the patient. c) Kidneys are farther from the image receptor with PA projection. d) It is not less desirable, but is the radiographer's choice.

c) Kidneys are farther from the image receptor with PA projection

The iliac crest corresponds with what vertebral level? a) L1-L2 b) S1-S2 c) L4-L5 d) L2-L3

c) L4-L5

What is the name of the double-walled tissue that lines the abdominopelvic cavity? a) Mesentery b) Omentum c) Peritoneum d) Viscera

c) Peritoneum

In which of the four major quadrants of the abdomen would the cecum be found? a) Right upper quadrant b) Left upper quadrant c) Right lower quadrant d) Left lower quadrant

c) Right lower quadrant

In which of the four major quadrants of the abdomen would the gallbladder be found? a) Left upper quadrant b) Left lower quadrant c) Right upper quadrant d) Right lower quadrant

c) Right upper quadrant

Which of the following organs is NOT considered an accessory organ for digestion? a) Liver b) Gallbladder c) Spleen d) Pancreas

c) Spleen

The xiphoid process is at the vertebral level of: a) L2-3. b) T2-3. c) T9-10. d) T5-6

c) T9-10

A supine AP abdomen projection with accurate positioning demonstrates the 1) outline of the psoas major muscles and kidneys. 2) symphysis pubis. 3) spinous processes aligned with the midline of the vertebral bodies. 4) long axis of the vertebral column aligned with the long axis of the collimated field. a) 1 and 2 only b) 3 and 4 only c) 1, 2, and 3 only d) 1, 2, 3, and 4

d) 1, 2, 3 and 4

Which term describes an abnormal accumulation of fluid in the peritoneal cavity of the abdomen? a) Adynamic ileus b) Volvulus c) Intussusception d) Ascites

d) Ascites

Which of the following factors must be observed for an AP erect abdomen projection taken on an average sized adult? a) Use a higher kV technique. b) Use two 14x17 IRs placed crosswise. c) Center 2" above the ASIS. d) Center 2" above the iliac crest.

d) Center 2" above the iliac crest

A patient comes to the department for a 2 view abdomen series (erect abdomen, supine abdomen.) The patient arrives recumbent on a stretcher and is too dizzy to stand or sit. Which of the following would describe the best course of action for your exam? a) Have someone lead up to help her to stand to do the erect abdomen, then do the supine abdomen. b) Do the supine abdomen first, then have someone lead up to help her to stand to do the erect abdomen. c) Do the supine abdomen first, then do a right lateral decubitus abdomen. d) Do the supine abdomen first, then do a left lateral decubitus abdomen.

d) Do the supine abdomen first, then do a left lateral decubitus abdomen

Which of the following solid organs is the largest found in the abdomen? a) Spleen b) Kidneys c) Pancreas d) Liver

d) Liver

Which of the following structures helps stabilize and support the small intestine? a) Mesentery b) Viscera c) Peritoneum d) Omentum

d) Omentum

What type of respiration should be employed during the exposure for the anteroposterior (AP) kidneys, ureter, and bladder (KUB) abdomen projection? a) Suspend on first inspiration b) Either inspiration or expiration c) Suspend on second inspiration d) Suspend on expiration

d) Suspend on expiration

To ensure that the diaphragm is included on the erect abdomen projection, the top of the image receptor should be at the approximate level of the: a) inferior costal margin. b) jugular notch. c) xiphoid process. d) axilla.

d) axilla