Chapter 3 Section B

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

Dorsal decubitus

Exposure for an AP projection of the abdomen should be taken on?(inspiration or expiration).

Expiration

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

Lateral position

Which decubitus position of the abdomen best demonstrates intraperitoneal air in the abdomen?

Left lateral decubitus

What is the recommended overlap when using two landscape-placed image receptors for an AP projection of a supine abdomen of an obese patient?

1 to 2 inches (3 to 5 cm)

Match the following definitions to the correct clinical indication: A. Volvulus B. Adynamic (paralytic) ileus C. Ascites D. Ulcerative colitis E. Pneumoperitoneum F. Intussusception G. Crohn disease ______ 1. Free air or gas in the peritoneal cavity ______ 2. Inflammatory condition of the colon ______ 3. Telescoping of a section of bowel into another loop of bowel ______ 4. Abnormal accumulation of fluid in the peritoneal cavity ______ 5. Bowel obstruction caused by a lack of intestinal peristalsis ______ 6. A twisting of a loop of bowel creating an obstruction ______ 7. Chronic inflammation of the intestinal wall that may result in bowel obstruction

1. E 2. D 3. F 4. C 5. B 6. A 7. G

Match each of the following radiographic appearances of the abdomen to its corresponding type of pathologic condition: A. Ascites B. Volvulus C. Pneumoperitoneum D. Ulcerative colitis E. Intussusception F. Crohn disease ______ 1. Distended loops of air-filled small intestine ______ 2. Air-filled "coiled spring" appearance ______ 3. General abdominal haziness ______ 4. Thin crest-shaped radiolucency underneath diaphragm ______ 5. Deep air-filled mucosal protrusions of colon wall ______ 6. Large amount of air trapped in sigmoid colon with a tapered narrowing at the site of obstruction

1. F 2. E 3. A 4. C 5. D 6. B

To ensure the diaphragm is included on an erect abdomen projection, the central ray should be at __________________________, which places the top of the 14- × 17- inch (35- × 43-cm) IR at the level of the __________________________.

2 inches (5 cm) above iliac crest; axilla

Rotation can be determined on a kidney, ureter, and bladder (KUB) radiograph by the loss of the symmetric appearance of: A. ______________ B. ______________ C. ______________ D. ______________

A. Iliac wings B. Obturator foramina (if visible) C. Ischial spines D. Outer rib margins

Gonadal shielding should not be used during abdomen radiography if: A. It obscures essential anatomy B. The patient requests that it not be used C. The technologist does not elect to use it D. The patient is 40 years or older

A. It obscures essential anatomy.

The preferred imaging modality for examining the gallbladder quickly is: A. Ultrasound B. Nuclear medicine C. Barium enema study D. MRI

A. Ultrasound

__________________________ is used to evaluate patients with acute appendicitis. A. Ultrasound B. Nuclear medicine C. CT D. MRI

A. Ultrasound

List the projections commonly performed for an acute abdominal series or three-way abdomen series.

AP supine AP erect or lateral decubitus abdomen PA erect chest

Gonadal shielding for females involves placing the top of the shield at or slightly above the level of the ___________, with the bottom at the _______________.

ASIS; Symphysis pubis

Gonadal shielding for __________________ may be impossible for studies of the lower abdominopelvic region. A. Males B. Females C. Both males and females D. Small children

B. Females

What scale of contrast is recommended for visualization of the abdominal structures on an abdominal x-ray? A. Short scale B. Long scale

B. Long scale

Which of the following exposure considerations would be most ideal for an AP abdomen of an average-sized adult using a digital radiographic system? A. 110-120 kVp, grid, 40-inch (100-cm) SID B. 95-105 kVp, grid, 40-inch (100-cm) SID C. 80-85 kVp, grid, 40-inch (100-cm) SID D. 60-70 kVp, grid, 40-inch (100-cm) SID

C. 80-85 kVp, grid, 40-inch (100-cm) SID

With the use of iodinated contrast media,__________________________ is able to distinguish between a simple cyst and a tumor of the liver. A. Ultrasound B. Nuclear medicine C. CT D. MRI

C. Computed tomography (CT)

Which of the following projections requires a kVp setting of 110 to 125? A. Erect abdomen for ascites B. Supine abdomen for intra-abdominal mass C. PA, erect chest for free air under diaphragm D. Dorsal decubitus abdomen for calcified aorta

C. PA, erect chest for free air under diaphragm

Which of the following abdominal structures is not visible on a properly exposed KUB? A. Kidneys B. Margin of liver processes C. Pancreas D. Lumbar transverse processes

C. Pancreas

Voluntary motion can best be prevented by ____________ to the patient.

Careful breathing instructions

Which of the following technical considerations is essential when performing abdomen studies on a young pediatric patient? A. Short exposure times B. High-speed image receptor C. Reduced kVp and mAs D. All of the above

D. All of the above

True/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/False: For a KUB, it is accepted practice to indicate the side of the body during postprocessing after the exposure has been completed. The liver is always on the right side of the body.

False

True/False: For an adult abdomen, a collimation margin must be visible on all four sides of the radiograph.

False

True/False: The image receptor should be placed in portrait alignment for an abdomen study on an obese patient.

False

True/False: The patient best controls peristalsis by holding his or her breath during exposure.

False

True/False: The umbilicus ("belly button") is a reliable, alternative landmark to use for the bariatric patient.

False

Which type of body habitus might require two landscape-aligned image receptors to be taken so the entire abdomen is included?

Hypersthenic

The central ray (CR) is centered to the level of the __________________________ for a supine AP projection of the abdomen.

Iliac crest

Why may the PA projection of a KUB generally be less desirable than the AP projection?

Increased (OID) of kidneys on PA

Which projection of the three-way acute abdominal series best demonstrates free air under the diaphragm?

PA chest

What are the two causes of voluntary motion?

Patient breathing Patient movement during exposure

What is the primary cause for involuntary motion in the abdomen?

Peristaltic action of the bowel

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

To allow intra-abdominal air to rise or abnormal 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/False: A radiolucent pad should be placed underneath geriatric patients for added comfort.

True

True/False: A tall asthenic patient may require two 14- × 17-inch (35- × 43-cm) image receptors placed portrait so the entire abdomen is included.

True

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

Two-way abdomen; AP supine abdomen, and left lateral decubitus

What is the best mechanism to control involuntary motion?

Use the shortest exposure time possible.