PRO1101 Ch. 3 Abdomen (Review Questions)
In which direction is the pancreas with relation to the stomach?
posterior
What is the term for an inflammatory condition of the colon?
Ulcerative Colitis
What is the term for deep air-filled mucosal protrusions of the colon wall?
Ulcerative Colitis
What is the proper projection routine for any foreign body?
2 Projections at 90-degrees to one another (AP/PA and lateral)
Which decubitus position of the abdomen best demonstrates intraperitoneal air in the abdomen?
Left Lateral Decubitus (free air is best seen in the upper right area of the liver)
On a cross-sectional slide, which organ is the spleen closest to?
Left kidney (slightly posterior and lateral)
What is the term for free air or gas in the peritoneal cavity?
Pneumoperitoneum
Which pathology shows up as a thin crest-shaped radiolucency underneath the diaphragm on an x-ray?
Pneumoperitoneum
What are the two large muscles that are found in the posterior abdomen adjacent to the lumbar vertebra? (visible on AP abdomen)
Psoas muscles
which abdominal region contains the rectum?
Pubic (hypogastric)
in which quadrant is the appendix located?
RLQ
In which quadrant does the large intestine begin?
RLQ right lower quadrant
in which quadrant is the liver located?
RUQ
Which LUQ organ is located superior to the Jejunum?
Stomach
which endocrine glands are superomedial to each kidney?
Suprarenal (adrenal)
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
Along which vertebrae is the xiphoid process horizontally aligned as a palpable landmark?
T9-T10
What is the rule of thumb regarding patient rotation and iliac wing shape on an AP abdominal projection?
Downside iliac wing will appear wider
Which part of the Duodenum is attached directly to the stomach?
Duodenal Bulb
what is the most lateral positioning landmark on the femur?
Greater Trochanter
What is the best projection routine for a child who has swallowed a coin that is lodged in the upper GI tract?
KUB and Lateral Abdomen
What is the ideal projection position for identifying free air with a patient who cannot stand?
Left Lateral Decubitus
What is the positioning routine for a 3-way acute abdominal series if a patient is too ill to stand?
1.2-way Abdomen 2.AP Supine abdomen 3.Left Lateral Decubitus
How far inferior to the level of the symphysis pubis is the ischial tuberosity?
1.5 inches (3-4cm)
How far superior to the level of the symphysis pubis is the superior margin of the greater trochanter?
1.5 inches (3-4cm)
What is the specific positioning routine for a 3-way acute abdominal series on an ambulatory patient?
1.AP Supine 2.AP Abdomen Erect 3.PA Chest Erect
What are the three commonly performed projections for a 3-way acute abdominal series?
1.AP Supine 2.AP Erect (or lateral decubitus abdomen) 3.PA Erect Chest
What is the proper positioning routine for a 2-way acute abdominal series on a patient in too much pain to stand? (MD wants to check for free air in abdomen)
1.AP Supine Abdomen (KUB) 2.PA Chest or Left Lateral Decubitus (unable to stand)
what are the three parts of the small intestine?
1.Duodenum 2Jejunum 3.Ileum
What are the five pathological indications for conducting an Acute Abdomen Series (3-way Acute Abdomen)?
1.Ileus 2.Ascites 3.Perforated Hollow Viscus 4.Intraabdominal Mass 5.Post-op (abdominal surgery)
Which four bony landmarks can be used to identify unwanted rotation on a KUB radiograph? (loss of symmetric appearance)
1.Iliac Wings 2.Ischial Spines 3.Obturator Foramina (if visible) 4.Outer Rib Margins
Which six abdominal structures are considered retroperitoneal?
1.Kidneys 2.Ascending Colon 3.Descending Colon 4.Duodenum 5.Pancreas 6.Adrenal Glands
Which five abdominal structures are intraperitoneal?
1.Liver 2.Spleen 3.Transverse Colon 4.Stomach 5.Gall Bladder
what are the three accessory digestive organs?
1.Pancreas 2.Liver 3.Gallbladder
What are the two causes of voluntary motion during projection?
1.Patient Breathing 2.Patient moving during exposure
What are the three essential technical factors when performing abdominal studies on young pediatric patients?
1.Short exposure time 2.High-speed IR 3.High milliamperage
What are the five organs of the urinary system?
1.Suprarenal (adrenal) glands 2.Kidneys 3.Ureter 4.Urinary Bladder 5.Uretha
Which 2 structures must be included in an acceptable KUB image?
1.Symphysis pubis 2.Bladder
Why should a patient be placed in the decubitus position for a minimum of 5 minutes before exposure? (2 reasons)
1.To allow intraabdominal air to rise 2.To allow abnormal fluid to accumulate
Which three abdominal structures are infraperitoneal?
1.Urinary Bladder 2.Ovaries 3.Testes
Where should the CR be centered on an erect abdomen projection to ensure that the diaphragm is included in the image?
2" above the iliac crest
What is the gonadal dose range for an average-sized female patient with an AP projection of the abdomen?
35 to 75 mrad
What is the SID for almost all radiographs performed on a table? (recumbent)
40 inches
What is the typical or ideal exposure factor for abdominal radiographs?
70-80 kVp @ 20-40 mAs (40-80 mAs on Lateral projections)
What is the ideal exposure factor for an AP abdomen of a small to average sized adult?
75kV, 600mA, 1/30 sec, grid, 40" SID
what is the most anterior landmark of the pelvis?
ASIS - anterior superior iliac spine
What is the term for a bowel obstruction caused by a lack of intestinal perstalsis?
Adynamic Ileus
What does a technologist add to a radiograph after exposure that is not legally binding?
Annotations (none are legal)
On a cross-sectional image, where is the stomach with relation to the Pancreas?
Anterior
What is the term for the abnormal accumulation of fluid in the peritoneal cavity?
Ascites
Which pathology is the cause for general abdominal haziness on an x-ray?
Ascites
Where should the CR be centered for a supine AP projection of the abdomen?
At the level of the Iliac Crest
Where should be CR be centered to achieve an acceptable KUB image?
At the level of the iliac crest
What is the best modality and projection for an ICU patient with possible intraabdominal bleeding who is in critical condition?
Bedside portable x-ray, Left lateral decubitus to demonstrate fluid levels in the abdomen
what is the term for fantastic?
Brandi
Which imaging modality should be performed with iodinated contrast media to distinguish between a simple cyst or tumor of the liver?
CT
What is the best prevention method for voluntary motion to the patient?
Careful Breathing Instructions
What is the term for the saclike area where the large intestine begins?
Cecum
When using AEC systems, which ionization chambers should be activated for an average to large sized patient getting an AP projection of the abdomen?
Center and Upper Left
Which decubitus position best demonstrates possible aneurysms, calcifications of the aorta, or umbilical hernias?
Dorsal Decubitus
What is the term for the chronic inflammation of the intestinal wall that may result in bowel obstruction?
Crohn's Disease
Which pathology appears as distended loops of air-filled small intestine on an x-ray?
Crohn's Disease
What change should be made on a repeat KUB projection if the psoas muscles are not visible?
Decrease kVp
If the overall density of an AP abdominal projection is acceptable, but the soft tissue structures like psoas and kidneys are not visible, what can the technologist do to correct for this on the repeat?
Decrease kVp to 70-80
For a patient with distended ileum due to trapped gas, what should be changed in the exposure before shooting the projection? (no AEC)
Decrease mAs (trapped gas or air is easier to penetrate)
When performing a projection to identify free air in the abdomen, which organ must be included in the image?
Diaphragm
What is the name of the first part of the small intestine immediately after the stomach in the path of a pill?
Duodenum
What is the best projection position for a patient with a history of ascites?
Erect AP abdomen (to check level of free fluid in abdomen)
During which type of breath should an exposure of an AP projection of the abdomen be taken?
Expiration
Which abdominal projection generates the largest gonadal dose?
Female AP abdominal
For which gender is it possible to require no gonadal shielding during studies of the lower abdominopelvic region?
Females
On a cross-sectional slide, which organ is closest to the liver?
Gall Bladder
what is the prefix for stomach?
Gastro-
Which omentum connects to the transverse colon to the greater curvature of the stomach?
Greater Omentum
what is the name of the double-fold structure of peritoneum that connects the transverse colon to the greater curvature of the stomach?
Greater Omentum
Which bony structure should be just above the bottom of the cassette on an acceptable KUB? (technologist must palpate)
Greater Trochanter
Which type of body habitus may require two crosswise images to be taken if the entire abdomen is to be included?
Hypersthenic
What does a technologist add to a radiograph before exposure that is legally binding?
IR Markers (all are legal)
When should gonadal shielding not be used during an abdominal radiograph?
If it obscures essential anatomy
Which part of the digestive system is at the junction of the Ileum and the Large Intestine? (limits reflux of colonic contents into ileum)
Ileocecal valve
Which part of the digestive system takes up most of the space on an x-ray and is typically located between the wings of the Iliac bones?
Ileum
which portion of the small intestine is considered to be the longest?
Ileum
What is the term for the pathology which is either a partial or complete obstruction in the small intestine?
Ileus
Which topographical landmark is found at the level of the interspace between L4 and L5?
Iliac Crest
what is the most superior landmark of the pelvis?
Iliac Crest
How can blurriness due to involuntary motion on an AP abdomen projection be corrected?
Increase mA (from 200 to 400) and Decrease Sec (2/10 to 1/10)
Why may the PA projection of a KUB generally be less desirable than the AP projection?
Increased OID of kidneys on PA projection diminishes detail
Which topographic landmark is found at the level of L2-L3?
Inferior Costal Margin
with relation to the peritoneum, what is the location of the ovaries?
Infraperitoneum
with relation to the peritoneum, what is the location of the testes?
Infraperitoneum
with relation to the peritoneum, where is the urinary bladder?
Infraperitoneum
with relation to the peritoneum, what is the location of the spleen?
Intraperitoneum
with relation to the peritoneum, what is the location of the stomach?
Intraperitoneum
with relation to the peritoneum, what is the location of the transverse colon?
Intraperitoneum
with relation to the peritoneum, where is the liver?
Intraperitoneum
What is the term for the telescoping of a section of bowel into another loop of bowel?
Intussusception
Which pathology shows up as an air filled "coiled spring" appearance of the bowels?
Intussusception
what is the most inferior part of the pubic bone?
Ischial Tuberosity
Which organ has a feathery appearance on an x-ray?
Jejunum
What is another term for an AP Abdomen (supine) projection?
KUB (kidneys, ureters, bladder)
What is the best modality and positioning for a female with a history of kidney stones?
KUB with NO gonadal shielding (would block calculi in distal ureter)
What is the proper positioning routine to rule out kidney stones in a patient?
KUB with correct exposure factors to visualize the possible stone
Along which vertebrae is the inferior costal margin horizontally aligned as a palpable landmark?
L2-L3
Along which vertebrae is the iliac crest horizontally aligned as a palpable landmark?
L4-L5
in which quadrant is the sigmoid colon located?
LLQ
in which quadrant is the left colic flexure located?
LUQ
in which quadrant is the spleen located?
LUQ
in which quadrant is the stomach located?
LUQ
in which quadrant is two-thirds of the jejunum located?
LUQ
Which position best demonstrates a possible aortic aneurysm in the prevertebral region of the abdomen?
Lateral
Which omentum extends superiorly from the lesser curvature of the stomach to the liver?
Lesser Omentum
When performing a chest x-ray, which body part should be shielded?
Lower body (gonads)
Which biological system is the spleen a part of?
Lymphatic
What is the term for the double-fold of peritoneum that holds the small intestine in place?
Mesentery
what is the name of the structure of epithelial tissue that helps stabilize and support the small intestine?
Mesentery
What is the term for the peritoneum that attaches the colon to the posterior abdominal wall across the entire transverse colon?
Mesocolon
Must a collimation margin be visible on all four sides of an adult abdominal radiograph?
No
What is the term for the double fold of the peritoneum which connects the stomach to other organs to hold it in place?
Omentum
Which position of the 3-way acute abdominal series best demonstrates free air under the diaphragm?
PA Chest
Which projection involves a kV setting of 110 to 125?
PA Chest (erect for free air under diaphragm)
Which abdominal structure (organ) is not visible on a properly exposed KUB?
Pancreas
What is the primary cause for involuntary motion in the abdomen?
Peristaltic action of the bowel
Which abdominal cavity contains serous fluid?
Peritoneal Cavity
what is the name of the double-walled membrane that lines the abdominopelvic cavity?
Peritoneum
what is the directional term for organs located posteriorly to (behind) the serous membrane lining of the abdominopelvic cavity?
Retroperitoneal
with relation to the peritoneum, what is the location of the adrenal glands?
Retroperitoneum
with relation to the peritoneum, what is the location of the ascending and descending colon?
Retroperitoneum
with relation to the peritoneum, what is the location of the duodenum?
Retroperitoneum
with relation to the peritoneum, what is the location of the kidneys?
Retroperitoneum
with relation to the peritoneum, what is the location of the pancreas?
Retroperitoneum
which part of the colon is located between the descending colon and the rectum?
Sigmoid colon
If an AP abdominal projection reveals that the left iliac wing is more narrowed than the right, what positioning error occurred?
Slight RPO rotation
What does SBFT stand for?
Small Bowel Follow Through
Which type of body habitus would require two 14" x 17" IR's to placed end to end lengthwise in order to include the entire abdomen?
Tall Asthenic patient
What is the purpose for performing an erect AP abdomen?
To identify free air in the abdomen
When shielding female gonads, where should the top and bottom of the shield be located?
Top at or slightly above ASIS, bottom at the symphysis pubis
What is the best imaging modality for evaluating patients with acute appendicitis?
Ultrasound
What is the preferred imaging modality for quickly examining the gall bladder?
Ultrasound
what is the term for the abdominal region found directly in the middle of the abdomen?
Umbilical
When performing an abdominal projection, which body parts should be shielded?
Upper body (breasts, thryoid - men and women)
If a KUB of a hypersthenic patient includes the symphysis pubis, but not the kidneys or upper abdomen, what must be done on repeat?
Use 2 14" x 17" cassettes stacked crosswise to include entire abdomen
What is the best mechanism to control involuntary motion?
Use the shortest exposure time possible
What is the term for a large amount of air trapped in the sigmoid colon with a tapered narrowing at the site of obstruction?
Volvulus
What is the term for a twisting loop of a bowel creating an obstruction?
Volvulus
Does a larger patient receive a greater amount of skin and midline dose compared to a smaller patient during AP projection of the abdomen?
Yes
Is is necessary to place a right or left anatomical marker on a cassette even if the liver is already visible in the RUQ?
Yes
Should a radiolucent pad be placed underneath geriatric patients for added comfort?
Yes
Where will the top of a 14" x 17" cassette be if the CR is centered 2" above the iliac crest? (erect abdomen projection)
at the level of the axilla
which pelvic landmark should not be used?
symphysis pubis
why is the right kidney found in a more inferior position than the left kidney on a radiograph?
the liver is on the right, pushes kidney down
