Chapter 3

What is another common term for the greater omentum? Mesentery Adipose layer Fatty apron Peritoneum

Fatty apron

Which of the following topographic landmarks corresponds to the L2-3 vertebral level? Xiphoid process Inferior costal margin Jugular notch ASIS

Inferior costal margin

In which region or compartment is the spleen located? Intraperitoneum Retroperitoneum Infraperitoneum Extraperitoneum

Intraperitoneum

Match the correct pathologic indicator with the definitions or descriptions. (Use each choice only once.) Telescoping of a section of bowel into another loop of bowel

Intussusception

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

Kidney stone

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

Kidneys are farther from the image receptor with PA projection

The iliac crest corresponds with the ____ vertebral level. L1 L2-3 T12 L4-5

L4-5

At what level should the central ray (CR) be placed for a left lateral decubitus projection of the abdomen? Iliac crest 2 inches (5 cm) above iliac crest ASIS Umbilicus

2 inches (5 cm) above iliac crest

What CR centering should be used for a dorsal decubitus projection of the abdomen (if the diaphragm is to be included)? At level of umbilicus 2 inches (5 cm) above iliac crest At level of iliac crest Place bottom of image receptor at level of ASIS.

2 inches (5 cm) above iliac crest

Where is the CR centered for the AP erect projection of the abdomen? Level of iliac crest Xiphoid process 2 inches (5 cm) above iliac crest 2 inches (5 cm) below iliac crest

2 inches (5 cm) above iliac crest

Which of the following analog exposure factors would produce the desired qualities for an abdominal projection on an average-size adult? 75 kV, 400 mA, 1/20 seconds, nongrid, 40-inch (102-cm) SID 90 kV, 600 mA, 1/20 seconds, grid, 40-inch (102-cm) SID 75 kV, 400 mA, 1/15 seconds, grid, 60-inch (153-cm) SID 75 kV, 600 mA, 1/30 seconds, grid, 40-inch (102-cm) SID

75 kV, 600 mA, 1/30 seconds, grid, 40-inch (102-cm) SID

Which of the following kV ranges (digital system) is recommended for a KUB on an adult? 50 to 60 70 +/- 5 kV 80 +/- 5 kV 110 to 120

80 +/- 5 kV

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

AP erect

A patient comes to radiology with a clinical history of pneumoperitoneum. The patient is able to stand and lie recumbent. Which one of the following projections will best demonstrate the severity of this condition? AP KUB AP erect abdomen Right lateral decubitus Dorsal decubitus

AP erect abdomen

Which of the following landmarks is often easier to palpate to locate the lower abdomen on the obese patient? ASIS Iliac crest Symphysis pubis Umbilicus

ASIS

Match the correct pathologic indicator with the definitions or descriptions. (Use each choice only once.) Bowel obstruction caused by a lack of intestinal motility

Adynamic ileus

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

Ala of ilium (wings)

Which of the following clinical indications would suggest the need for a dorsal decubitus abdomen position? Aneurysms Umbilical hernias Calcification of the aorta All of the above

All of the above

Which of the following conditions can produce a dynamic bowel obstruction? Fibrous adhesions Crohn's disease Intussusception All of the above

All of the above

Why is the left lateral decubitus preferred over the right lateral decubitus abdomen for an acute abdomen series? It is more comfortable for the patient. Any intraperitoneal air will be visualized along the spleen. Any intraperitoneal air will be visualized along the lower liver margin. It allows any gas in the large intestine to move toward the liver.

Any intraperitoneal air will be visualized along the lower liver margin.

Match the correct pathologic indicator with the definitions or descriptions. (Use each choice only once.) Abnormal accumulation of fluid in the peritoneal cavity

Ascites

Which term describes an abnormal accumulation of fluid in the peritoneal cavity of the abdomen? Adynamic ileus Volvulus Intussusception Ascites

Ascites

Which of the following imaging modalities often requires the use of intravenous, iodinated contrast media for studies of the abdomen, especially for possible neoplasms? CT Nuclear medicine Sonography Magnetic resonance

CT

Match the correct pathologic indicator with the definitions or descriptions. (Use each choice only once.) Chronic inflammation of the intestinal wall that may result in bowel obstruction

Crohn's disease

A 16-year-old female patient enters the emergency department (ED) with a possible kidney stone. She complains of pain in the right lower pelvis region. Which of the following options should be taken in regard to gonadal shielding? Do not use it. Use it on all projections if correctly placed. Use it on the preliminary projection only. Ask the patient or her parents for their permission to not shield the gonads.

Do not use it

A patient comes to radiology with a clinical history of a possible abdominal aortic aneurysm. Which of the following abdominal projections would best demonstrate this condition? Dorsal decubitus Left lateral decubitus Right lateral decubitus AP erect

Dorsal decubitus

A patient comes to radiology with a clinical history of an umbilical hernia. Which one of the following abdomen projections would best demonstrate it? AP erect abdomen Left lateral decubitus KUB Dorsal decubitus

Dorsal decubitus

Which aspect of the small intestine is considered the shortest? Duodenum Jejunum Cecum Ileum

Duodenum

A patient enters the ED with a possible perforated duodenal ulcer. The patient is ambulatory. Which of the following projections will best demonstrate free intraperitoneal air in the abdomen? AP supine Right lateral decubitus Dorsal decubitus Erect PA chest

Erect PA chest

What type of respiration should be employed prior to exposure for the anteroposterior (AP) kidneys, ureter, and bladder (KUB) abdomen projection? Inspiration Expiration Shallow breathing during exposure Either inspiration or expiration

Expiration

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

False

The term gastro refers to the intestine. True/False

False

The use of low kV and high mAs is the ideal combination of exposure factors to reduce patient dose. True/False

False

A patient comes to radiology with possible bleeding within the abdomen. The patient is unable to stand or sit for any projections. Which of the following projections would be most effective in demonstrating fluid within the abdomen for this patient? AP KUB AP supine chest Right lateral dorsal decubitus Left lateral decubitus

Left lateral decubitus

A patient is in the intensive care unit after abdominal surgery. The surgeon is concerned about a possible perforated bowel. The patient cannot stand or sit. Which of the following positions will best demonstrate any possible intra-abdominal free air? Right lateral decubitus Dorsal decubitus Ventral decubitus Left lateral decubitus

Left lateral decubitus

Where must the CR be centered for an AP supine projection of the abdomen as part of the acute abdominal series? 2 inches (5 cm) above iliac crest Level of iliac crest Level of umbilicus Level of axilla

Level of iliac crest

Which of the following structures helps stabilize and support the small intestine? Mesentery Viscera Peritoneum Omentum

Mesentery

Which of the following factors must be followed for an AP erect abdomen projection? Collimate lower border to level of ASIS. Use a higher kV technique. Patient needs to be upright a minimum of 5 minutes before imaging. Increase SID to 72 inches (183 cm) to minimize magnification.

Patient needs to be upright a minimum of 5 minutes before imaging

What is the name of the double-walled tissue that lines the abdominopelvic cavity? Mesentery Omentum Peritoneum Viscera

Peritoneum

Match the correct pathologic indicator with the definitions or descriptions. (Use each choice only once.) Free air or gas in the peritoneal cavity

Pneumoperitoneum

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

Presence of the liver

Which of the following muscles should be demonstrated on a properly exposed abdomen projection on an average-size patient? Latissimus dorsi Erector spinae Psoas major Quadratus lumborum

Psoas major

In which region or compartment of the abdomen is the pancreas located? Intraperitoneal Retroperitoneal Infraperitoneal Extraperitoneal

Retroperitoneal

A dorsal decubitus abdomen is ordered on a patient. The patient is placed on his back on a cart. The CR will enter the left side of the patient with the patient's right side against the image receptor. What type(s) of marker(s) should be used? Right and decubitus markers Left and decubitus markers Write "dorsal decubitus" on image after processing. Do not use any right or left markers, only a decubitus.

Right and decubitus markers

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

Right lateral lumbar

In which of the four major quadrants of the abdomen would the cecum be found? Right upper quadrant Left upper quadrant Right lower quadrant Left lower quadrant

Right lower quadrant

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

Rotation to the left (left posterior oblique)

What is the best method to control involuntary motion during abdominal radiography? Short exposure time Second breath hold Careful breathing instructions to patient Use of small focal spot

Short exposure time

Which of the following organs is NOT considered an accessory organ for digestion? Liver Gallbladder Spleen Pancreas

Spleen

Which of the following structures is part of the lymphatic system? Suprarenal glands Inferior vena cava Kidneys Spleen

Spleen

The xiphoid process is at the vertebral level of: L2-3. T2-3. T9-10. T5-6.

T9-10

A radiograph of an AP KUB reveals that the obturator foramina are cut off from the bottom of the image. The kidneys and symphysis pubis are demonstrated. What centering adjustments should the technologist make to improve this image? Use two 35- × 42-cm (14- × 17-inch) cassettes landscape. Center the cassette 2 inches (5 cm) below the iliac crest. Open up the collimators to include the ischial tuberosities. This radiograph is correctly centered. No centering adjustments are necessary.

This radiograph is correctly centered. No centering adjustments are necessary

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

Transverse colon

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

True

The AP abdomen for the obese patient often requires two separate exposures with the IR placed landscape. True/False

True

The Pigg-O-Stat is recommended for erect abdomen projections on young pediatric patients. True/False

True

The lateral abdomen position will best demonstrate the prevertebral region. True/False

True

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

True

The pancreas is located posterior to the stomach. True/False

True

Match the correct pathologic indicator with the definitions or descriptions. (Use each choice only once.) Inflammatory condition of the colon (most frequently involves rectosigmoid region)

Ulcerative colitis

A 3-year-old patient comes to radiology for an abdominal study. Even with careful instructions and immobilization, the patient is having difficulty holding still. Which of the following should be done to minimize motion on the radiograph? Increase kV. Decrease SID. Use a shorter exposure time. Ask an older experienced radiographer to hold the patient.

Use a shorter exposure time

A radiograph of a supine KUB on an obese patient reveals that the symphysis pubis is cut off along the bottom of the radiograph. The top of the left kidney is also cut off along the top of the radiograph. What modifications does the technologist need to make for the repeat exposure? - Center the cassette lower and make the exposure on inspiration. - Use two 35- ´ 43-cm (14- ´ 17-inch) cassettes landscape, one centered lower and the other one higher. - Use two 35- ´ 43-cm (14- ´ 17-inch) cassettes portrait, one centered lower and one centered higher. - Center the cassette higher and use a second smaller cassette to include the bladder region.

Use two 35- ´ 43-cm (14- ´ 17-inch) cassettes portrait, one centered lower and one centered higher

Match the correct pathologic indicator with the definitions or descriptions. (Use each choice only once.) A twisting of a loop of intestine creating an obstruction

Volvulus

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

anterior superior iliac spine (ASIS)

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: inferior costal margin. jugular notch. xiphoid process. axilla.

axilla

Ileus is the formal term for: perforated bowel. bleeding in the abdomen. bowel obstruction. free air in the peritoneal cavity.

bowel obstruction

The technologist most often ____ manual, analog exposure factors for the patient with a large ileus. increases does not change decreases switches to AEC instead of

decreases

The suprarenal glands are part of the _____ system. exocrine endocrine lymphatic urinary

endocrine

The greater omentum extends from the transverse colon to the: posterior abdominal wall. greater curvature of the stomach. inferior margin of the liver. duodenum.

greater curvature of the stomach

To ensure that the inferior margin of the abdomen is included on a KUB radiograph, the technologist should palpate the: iliac crest. ASIS. greater trochanter or symphysis pubis. inferior costal margin.

greater trochanter or symphysis pubis

The technologist most often ____ manual, analog exposure factors for a patient with severe ascites. increases does not change decreases switches to automatic exposure control (AEC) instead of

increases

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Lower rectum

infraperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Reproductive organs

infraperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Urinary bladder

infraperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Jejunum

intraperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Liver

intraperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Sigmoid colon

intraperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Spleen

intraperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Transverse colon

intraperitoneal

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

ischial tuberosity

The prefix pyelo refers to the: urinary bladder. ureter. renal pelvis. renal cortex.

renal pelvis

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Adrenal glands

retroperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Ascending and descending colon

retroperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. C-loop of duodenum

retroperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Kidneys

retroperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Major abdominal blood vessels (abdominal aorta and inferior vena cava)

retroperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Pancreas

retroperitoneal

Identify the following as being either intraperitoneal, retroperitoneal, or infraperitoneal structures. Proximal ureters

retroperitoneal

The preferred imaging modality for examining the gallbladder is: sonography. nuclear medicine. barium enema study. MRI.

sonography