PRO1101 Ch. 3 Abdomen (Review Questions)

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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


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