Chapter 3: Abdomen

At what level should the central ray (CR) be placed for a left lateral decubitus projection of the abdomen?

2 inches (5 cm) above iliac crest

What CR centering should be used for a dorsal decubitus projection of the abdomen?

2 inches (5 cm) above iliac crest

Where is the CR centered for the left lateral decubitus projection of the abdomen?

2 inches (5 cm) above iliac crest

Where must the CR be centered for an AP supine projection of the abdomen as part of the acute abdominal series?

at level of iliac crest

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:

axilla

The suprarenal glands are part of the _____ system.

endocrine

The prefix pyelo refers to the:

renal pelvis

Bowel obstruction caused by a lack of intestinal motility

Adynamic ileus

Abnormal accumulation of fluid in the peritoneal cavity

Ascites

Chronic inflammation of the intestinal wall that may result in bowel obstruction

Crohn's disease

In which region or compartment of the peritoneum is the spleen located?

Intraperitoneum

Telescoping of a section of bowel into another loop of bowel

Intussusception

The iliac crest corresponds with the ____ vertebral level.

L4-5

Free air or gas in the peritoneal cavity

Pneumoperitoneum

In which region or compartment of the abdomen is the pancreas located?

Retroperitoneal

The xiphoid process is at the vertebral level of:

T9-10

Inflammatory condition of the colon (most frequently involves rectosigmoid region)

Ulcerative colitis

A twisting of a loop of intestine creating an obstruction

Volvulus

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

a. AP erect

Which of the following imaging modalities often requires the use of intravenous, iodinated contrast media for studies of the abdomen? a. CT b. Nuclear medicine c. Sonography d. Magnetic resonance

a. CT

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? a. Do not use it. b. Use it on all projections if correctly placed. c. Use it on the preliminary projection only. d. Ask the patient or her parents for their permission to not shield the gonads.

a. 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? a. Dorsal decubitus b. Left lateral decubitus c. Right lateral decubitus d. AP erect

a. Dorsal decubitus

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

a. Kidney stone

Which of the following structures helps stabilize and support the small intestine? a. Mesentery b. Viscera c. Peritoneum d. Omentum

a. Mesentery

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

a. Right lateral lumbar

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? a. Rotation to the left (left posterior oblique) b. Rotation to the right (right posterior oblique) c. CR off center to the left d. Left hip was internally rotated more than right hip

a. Rotation to the left (left posterior oblique)

The prominent protuberance found on the anterior aspect of the ilium is the:

anterior superior iliac spine (ASIS).

Which of the following kV ranges is recommended for a KUB on an adult? a. 50 to 60 b. 70 to 80 c. 90 to 100 d. 110 to 120

b. 70 to 80

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? a. AP KUB b. AP erect abdomen c. Right lateral decubitus d. Dorsal decubitus

b. AP erect abdomen

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

b. Inferior costal margin

An ileus is the formal term for:

bowel obstruction

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

c. Ala of ilium

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

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

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

c. Kidneys are farther from the image receptor with PA projection.

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

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

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

c. Psoas major

Which of the following organs is NOT considered an accessory organ for digestion? a. Liver b. Gallbladder c. Spleen d. Pancreas

c. Spleen

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? a. Increase kV. b. Decrease SID. c. Use a shorter exposure time. d. Ask an older experienced radiographer to hold patient.

c. Use a shorter exposure time.

A radiograph of a supine KUB on a hyposthenic 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? a. Center the cassette lower and make the exposure on inspiration. b. Use two 35 43 cm (14 17 inch) cassettes crosswise, one centered lower and the other one higher. c. Use two 35 43 cm (14 17 inch) cassettes lengthwise, one centered lower and one centered higher. d. Center the cassette higher and use a second smaller cassette to include the bladder region.

c. Use two 35 43 cm (14 17 inch) cassettes lengthwise, one centered lower and one centered higher.

Which of the following manual exposure factors would produce the desired qualities for an abdominal projection on an average-sized adult? a. 75 kV, 400 mA, 1/20 sec, nongrid, 40-inch (102 cm) SID b. 90 kV, 600 mA, 1/20 sec, grid, 40-inch (102 cm) SID c. 75 kV, 400 mA, 1/15 sec, grid, 60-inch (153 cm) SID d. 75 kV, 600 mA, 1/30 sec, grid, 40-inch (102 cm) SID

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

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

d. All of the above

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

d. All of the above

Which term describes an abnormal accumulation of fluid in the peritoneal cavity of the abdomen? a. Adynamic ileus b. Volvulus c. Intussusception d. Ascites

d. Ascites

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

d. Dorsal decubitus

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

d. Erect PA chest

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? a. AP KUB b. AP supine chest c. Right lateral dorsal decubitus d. Left lateral decubitus

d. 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? a. Right lateral decubitus b. Dorsal decubitus c. Ventral decubitus d. Left lateral decubitus

d. Left lateral decubitus

Which of the following solid organs is the largest found in the abdomen? a. Spleen b. Kidneys c. Pancreas d. Liver

d. Liver

Which of the following structures is part of the lymphatic system? a. Suprarenal glands b. Inferior vena cava c. Kidneys d. Spleen

d. Spleen

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? a. Use two 35 42 cm (14 17 inch) cassettes crosswise. b. Center the cassette 2 inches (5 cm) below the iliac crest. c. Open up the collimators to include the ischial tuberosities. d. This radiograph is correctly centered. No centering adjustments are necessary.

d. This radiograph is correctly centered. No centering adjustments are necessary.

The technologist must ____ manual exposure factors for the patient with a large ileus.

decrease

Which aspect of the small intestine is considered the shortest?

duodenum

What type of respiration should be employed during the exposure for the anteroposterior (AP) kidneys, ureter, and bladder (KUB) abdomen projection?

expiration

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

false

T/F: The term gastro refers to the intestine.

false

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

false

What is another common term for the greater omentum?

fatty apron

The greater omentum extends from the transverse colon to the:

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:

greater trochanter or symphysis pubis.

The technologist must ____ manual exposure factors for a patient with severe ascites.

increase

The most inferior positioning landmark on the abdomen/pelvis is the:

ischial tuberosity

What is the name of the double-walled tissue that lines the abdominopelvic cavity?

peritoneum

Why is the right kidney usually lower in the abdomen than the left kidney?

presence of the liver

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 of marker should be used?

right and decubitus markers

In which of the four major quadrants of the abdomen would the cecum be found?

right lower quadrant

In which of the four major quadrants of the abdomen would the gallbladder be found?

right upper quadrant

The preferred imaging modality for examining the gallbladder is:

sonography

Which aspect of the large intestine is found between the left and right colic flexures?

transverse colon

T/F: Gonadal shielding can often be used with male patients for the AP supine abdomen projection.

true

T/F: Motion of the patient's diaphragm can be stopped by providing proper breathing instructions.

true

T/F: The Pigg-O-Stat is recommended for erect abdomen projections on young pediatric patients.

true

T/F: The lateral abdomen position will best demonstrate the prevertebral region.

true

T/F: The most common type of involuntary motion in the abdomen is peristalsis

true

T/F: The pancreas is located posterior to the stomach.

true