Bontrager Workbook: Chapter 3-Abdomen
What is the preferred length of time a patient should lie on his or her side prior to a lateral decubitis projection?
10-20 mins
True/False The correct term for the radiographic study of the urinary system is intravenous pyelogram (IVP)
False (IVU)
Exposure for an AP projection of the abdomen should be taken on ___.
expiration
True/False It is always acceptable during KUB imaging practice to indicate the side of the body with a digital marker
false
Gonadal shielding for ___ may be impossible for studies of the lower abdominopelic region.
females
Which one of the following structures is a double fold of peritoneum that connects the transverse colon to the greater curvature of the stomach?
greater omentum
Which type of body habitus may require two crosswise images to be taken if the entire abdomen is to be included?
hypersthenic body type
What scale of contrast is recommended for visualization of the abdominal structures on an abdominal x-ray?
long scale
Which one of the following structures helps stabilize and support the small intestine?
mesentery
Which one of the following abdominal structures 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
The double-walled membrane lining the abdominopelvic cavity is called the
peritoneum
Free air or gas in the peritoneal cavity; appearance- thin crest-shaped radiolucency underneath diaphragm
pneumoperitoneum
The two large muscles found in the posterior abdomen adjacent to the lumbar vertebra and usually visible on an anteroposterior (AP) radiograph are called the
Psoas
What 2 large abdominal muscles extend next to the lumbar spine and are indicators of a well-exposed KUB?
Psoas major
Location: Appendix
RLQ
Location: Liver
RUQ
True/False A tall asthenic patient may require two 14x17in image receptors placed lengthwise if the entire abdomen is to be included
true
Bowel obstruction caused by a lack of intestinal peristalsis
adynamic ileus
The sigmoid colon is located between the ___ and ___ of the large intestine.
descending colon, rectum
Which decubitus position best demonstrates possible aneurysms, calcification of the aorta, or umbilical hernias?
dorsal decubitus
Where is the CR centered for an AP erect abdomen projection as part of an acute abdomen series?
1-2 in (5cm) above iliac crest
List the projections commonly performed for an accurate abdominal series or three-way abdomen series.
1. AP supine 2. AP erect or lateral decubitus abdomen 3. PA erect chest
List the three parts of the small intestine
1. duodenum 2. jejunum 3. ileum
Rotation can be determined on a KUB radiograph be the loss of symmetric appearance of?
1. iliac wings 2. obturator foramina 3. ischial spines 4. outer rib margins
List the three accessory digestive organs
1. pancreas 2. liver 3. gallbladder
What are the two causes of voluntary motion?
1. patient breathing 2. patient movement during exposure
To ensure the diaphragm is included on an erect abdomen projection, the central ray should be at the level of ___, which places the top of the 14x17in IR at the level of the ___
2in above the illiac crest; axilla
What is the recommended overlap when using two crosswise images for an AP projection of a supine abdomen of a broad hypersthenic-type patient?
3-5cm (1-2in)
Which one of the following exposure considerations would be most ideal for an AP abdomen of an average-size.
70-80 kV, grid, 40-in SID
The ER physician suspects a patient has a kidney stone. The patient is sent to the radiology department to confirm the diagnosis. What specific positioning routine would be used to rule out the presence of a kidney stone?
A KUB would be performed with the correct exposure factors to visualize the possible stone
A patient in ICU may have developed intra-abdominal bleeding. The patient is in critical condition and cannot go to the radiology department. The physician has ordered a portable study of the abdomen. Which specific position or projection can be used to determine the extent of the bleeding?
A bedside portable left lateral decubitis projection could be performed to demonstrate any fluid levels in the abdomen
A patient with a history of ascites comes to the radiology department. Which one of the following positions best demonstrates this condition?
Erect AP abdomen
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 an adult abdomen, a collimation margin must be visible on all four side of the radiograph.
False
The transverse colon is classified as a(n) ___ structure
Intraperitoneal
A child goes to radiology for an abdomen study. It is possible that he swallowed a coin. The ER physician believes it may be in the upper GI tract. Which of the following routines would best identify the location of the coin?
KUB and lateral abdomen
The sigmoid colon is located in the ___ quadrant.
LLQ
Which projection of the three-way acute abdominal series demonstrates free air under diaphragm?
PA chest
Which one of the following projections requires a kV setting of 110-125?
PA, erect chest for free air under diaphragm
The pancreas is classified as a(n) ___ structure.
Retroperitoneal
A radiograph of an AP abdomen reveals the left iliac wing is more narrowed than the right. What specific positioning error caused this?
The patient was rotated into a slightly right posterior oblique (RPO) position.
A patient with a possible dynamic ileus enters the ER. The patient is able to stand. The physician has ordered an acute abdominal series. What specific positioning routine should be used?
The three-way acute abdominal series, including the AP supine and erect abdomen and PA chest
True/False A radiolucent pad should be placed underneath geriatric patients for added comfort?
True
A pathologic condition in which twisting of a loop of intestine creates an obstruction in termed.
Volvulus
A patient comes from the ER with a large distended abdomen caused by an ileus. The physician suspects that the distention is caused by a large amount of bowel gas that is trapped in the small intestine. The standard analog technique for a KUB on an adult is 76kV, 30 mAs. Should the technologist change any of these exposure factors for this patient? (AEC is not being used.)
Yes. Decrease the mAs
abnormal accumulation of fluid in the peritoneal cavity; appearance- general adbominal haziness
ascites
Voluntary motion can best be prevented by___ to the patient
careful breathing instructions
Chronic inflammation of the intestinal wall that may result in bowel obstruction; appearance- distended loops of air-filled small intestine
crohn's disease
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. reduce kV and mAs d. all of the above
d. all of the above
Which portion of the small intestine is considered to be the longest?
ileum
The central ray is centered to the level of the ___ for a supine AP projection of the abdomen.
illiac crest
Why may the PA projection of a KUB generally be less desirable than the AP projection?
increased OID of kidneys on PA
Which topographic landmark is found at the level of L2-L3?
inferior costal margin
Urinary bladder, ovaries, testes
infraperitoneum
The iliac crest is at the level of the ___ vertebra
interspace between L4-L5
Liver, spleen, transverse colon, stomach
intraperitoneum
telescoping of a section of bowel into another loop of bowel; appearance- air-filled "coiled spring"
intussusception
Gonadal shielding should not be used during abdomen radiography if:
it obscures essential anatomy
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 (free air best visualized in upper right abdomen in area of liver)
Which one of the following abdominal regions contains the rectum?
pubic
The organs located posteriorly to, or behind, the serous membrane lining of the abdominopelvic cavity are referred to as
retroperitoneal
Kidneys, duodenum, adrenal glands, pancreas, ascending and descending colon
retroperitoneum
The large intestine begins in the ____ quadrant with a saclike area called the ___
right lower, cecum
Which one of the following organs is considered to be part of the lymphatic system?
spleen
Which one of the following organs is not directly associated with the digestive system?
spleen
The prominence of the greater trochanter is about the same level of the ___ of the symphysis pubis, and the lower margins of the ischial tuberosities is about ___inches ___ to the symphysis pubis.
superior border, 1.5, distal
Which endocrine glands are superomedial to each kidney?
suprarenals (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
Why should a patient be placed in the decubitus position for a minimum of 5 minutes before exposure?
to allow intraabdominal air to rise or abnormal fluids to accumulate
Why is it recommended to take abdominal radiographs at the end of patients expiration?
to increase the room for expansion of the organs within the abdominal cavity
Which positioning routine should be used for an accurate abdominal series if the patient is too ill to stand?
two-way abdomen: AP supine abdomen and left lateral decubitus
inflammatory condition of the colon; appearance- deep air-filled mucosal protrusions of colon wall
ulcerative colitis
The preferred imaging modality for examining the gallbladder quickly is:
ultrasound
____ is being used to evaluate patients with acute appendicitis
ultrasound
What is the correct for the abdominal region found directly in the middle of the abdomen?
umbilic
What is the best mechanism to control involuntary motion?
use the shortest exposure time possible
A twisting of a loop of bowel creating an obstruction; appearance- large amount of air trapped in sigmoid colon with a tapered narrowing at the site of obstruction.
volvulus
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
With the use of iodinated contrast media, ___ is able to distinguish between a simple cyst or tumor of the liver.
CT
The medical prefix for stomach is
Gastro
Location: Spleen, left colic flexure, stomach, two-thirds of jejunum
LUQ
Which of the following projections will best demonstrate intraperitoneal free air?
Left lateral decubitus
What is the name of the double-fold of peritoneum that extends from the lesser curvature of the stomach to portions of the liver?
Lesser omentum
A hypersthenic patient comes to the radiology department for a KUB. The radiograph reveals that the symphysis pubis is included on the image, but the upper abdomen , including the kidneys, is cut off. What is the next step the technologist should take?
Repeat exposure. Use two 14inx17 IRs crosswise to include the entire abdomen.
A KUB radiograph reveals that the gonadal shielding is superior to the upper margin of the sympysis pubis. The female patient has a history of kidney stones. What is the next step the technologist should take?
Repeat the exposure without using gonadal shielding
Which of the following is NOT one of the accessory organs for digestion?
Spleen
The pancreas is located ___ to the stomach
posteriorly
Why is the right kidney found in a more inferior position than the left kidney?
presence of the liver on right
