Week 6: Abdomen

Volvulus

Twisting of a loop of intestine creating an obstruction

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

ischial tuberosity.

Using the shortest exposure time possible is the best mechanism to control involuntary motion.

True

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

True

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

True

Which aspect of the small intestine is considered the shortest?

Duodenum

Which radiographic landmark is most reliable to evaluate the posteroanterior (PA) projection of the abdomen for rotation?

Ala of ilium

What vertebral levels correspond to the iliac crest?

L4-L5

For an upright AP abdomen projection, the 1. ASISs are positioned at equal distances from the IR. 2. patient remains in an upright position at least 5 to 20 minutes before the image is obtained. 3. symphysis pubis should be included. 4. patient is instructed to take a deep inspiration before the image is obtained.

1 and 2 only

Voluntary motion can 1. result from patient breathing. 2. be controlled by using a short exposure time. 3. result from peristaltic activity. 4. be identified as sharp bony cortices and blurry gastric and intestinal gases.

1 and 2 only

A supine AP abdomen projection with accurate positioning demonstrates the 1. outline of the psoas major muscles and kidneys. 2. symphysis pubis. 3. spinous processes aligned with the midline of the vertebral bodies. 4. long axis of the vertebral column aligned with the long axis of the collimated field.

1, 2, 3, and 4

A supine AP abdomen projection obtained with the patient in an LPO position demonstrates: 1. the sacrum and coccyx aligned with the symphysis pubis. 2. a distance from the pedicles to the spinous processes that is narrower on the right side than on the left side. 3. the sacrum rotated toward the patient's right side. 4. the symphysis pubis rotated toward the patient's right side.

2 and 3 only

A morbidly obese patient has come to the department for an abdomen x-ray. You cannot locate any of the standard palpable landmarks. You decide you will locate his pubic symphysis and use that to make sure the bottom of you cassette is in the correct place. If the patient was 5 feet, 9 inches tall, how far would you measure from his jugular notch?

22 inches

Which of the following kV ranges is recommended for a KUB on an adult?

70 to 80

Which of the following technical factors would produce the desired qualities for an abdominal projection on an average-sized adult?

80 kV, 900 mA, 1/30 sec, grid, 40 inch SID

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?

AP erect

Ascites

Abnormal accumulation of fluid in the peritoneal cavity

Which term describes an abnormal accumulation of fluid in the peritoneal cavity of the abdomen?

Ascites

Adynamic ileus

Bowel obstruction caused by a lack of intestinal motility

Which of the following factors is true in regards to an AP erect abdomen abdomen projection taken on an average sized adult?

Center 2 inches above the iliac crest

Crohn's disease

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

A 14 year old female patient checks into the radiology department for an acute abdomen series the indication given on the order is "question kidney stone". She complains of pain in the left lower pelvis region. What should your course of action be in regards to gonadal shielding?

Do not shield the patient's ovaries

Because the liver margin is visible in the right upper quadrant of the abdomen, it is not necessary to place a right or left film maker on the cassette before exposure.

False

Exposure for an AP projection of the abdomen should be taken on inspiration.

False

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

False

Peristaltic action of the bowel is the primary cause for voluntary motion in the abdomen.

False

T or F The iliac crest is at the level of the interspace between L3-4 vertebra.

False

T or F The pancreas is located anteriorly to the stomach.

False

The CR is centered to the level of the symphysis pubis for a supine AP projection of the abdomen.

False

The CR must be centered to the level 2" above the iliac crest for an AP supine projection of the abdomen as part of the acute abdominal series.

False

The kidneys do not necessarily have to be visible on a KUB.

False

The latissimus dorsi muscles should be demonstrated on a well-exposed abdomen projection on an average size patient?

False

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

False

The term gastro refers to the intestine.

False

To ensure that the inferior margin of the abdomen is included on a KUB radiograph, the technologist should palpate the ASIS.

False

Pneumoperitoneum

Free air or gas in the peritoneal cavity

Ulcerative Colitis

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

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

Intraperitoneum

Which of the following conditions is NOT considered a clinical indication for an acute abdominal series?

Kidney stone

Why is the PA projection of the abdomen less desirable for a KUB than the AP projection?

Kidneys are farther from the image receptor with PA projection.

Which of the following solid organs is the largest found in the abdomen?

Liver

Which of the following structures helps stabilize and support the small intestine?

Mesentery

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

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

Retroperitoneal

Which of the following abdominal regions would contain the right colic (hepatic) flexure?

Right lateral lumbar

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

Which of the following organs is NOT considered an accessory organ for digestion?

Spleen

Which of the following organs is considered to be part of the lymphaticsystem?

Spleen

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

Suspend on expiration

The xiphoid process is at the vertebral level of:

T9-10.

Intussusception

Telescoping of a section of bowel into another loop of bowel

A radiography of an AP KUB (supine abdomen) reveals that both diaphragms are cut off from the top of the image. The bowel pattern, kidneys and symphysis pubis are demonstrated. What adjustment should the technologist make to improve this image?

The radiograph is correctly centered. no centering adjustments are necessary

A radiograph of an anteroposterior (AP) abdomen demonstrates a narrowing of the right obturator foramen and elongation (widening) of the right iliac wing. Which one of the following positioning errors produced this radiographic outcome?

There was rotation to the right (RPO)

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

Transverse colon

A radiolucent pad should be placed underneath the geriatric patient for added comfort.

True

An AP supine, an AP erect or a lateral decubitus abdomen plus a PA erect chest are commonly preferred for an acute abdominal series.

True

Patient movement during exposure and patient breathing can cause voluntary motion.

True

T or F The symphysis pubis is the topographic landmark which corresponds with the inferior margin of the abdomen and is formed by the anterior junction of the two pelvic bones.

True

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

True

To ensure the diaphragm is included on an erect abdomen projection, the CR should be at the level of 2" above the iliac crest which places the top of the 14x17" (35x43 cm) IR at the level of the axilla.

True

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

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:

axilla.