Rad 112 - Unit 3

Front 1

Other common names for AP supine abdomen

Back 1

1. KUB
2. Flat plate
3. Scout
4. Prelim (preliminary film)

Front 2

What are AP supine abdomen X-rays used for?

Back 2

1. r/o certain pathologies
2. check bowel prep prior to contrast studies (may require centering changes)
3. check positioning and technique prior to contrast studies

Front 3

Acute Abdomen Series are performed on who?

Back 3

Patients with acute abdominal pain or distress

Front 4

Indications for performing an Acute Abdominal Series?

Back 4

looking for air/fluid levels, accumulations of intestinal gas, or the presence of free air in the abdominal cavity:
1. perforated intesting (hollow viscus) 2. intestinal obstruction 3. abdominal infection 4. intra-abdominal mass 5. ascites 6. Post-op abdominal surgery

Front 5

Ambulatory patient

Back 5

Patient can stand unaided = 3-way abdomen series {3-view}
a. PA chest (standard criteria)
b. AP Upright Abdomen (to include diaphragm
c. AP Supine Abdomen

Front 6

Non-ambulatory patient

Back 6

Patient CAN NOT stand unaided = 2-way abdomen series {2-view}
a. AP Supine Abdomen
b. Lt. Lateral Decubitus Abdomen (to include diaphragm & side up) or Dorsal Decubitus Abdomen

Front 7

Abdominal Muscles

Back 7

1.) Diaphragm
2.) Psoas (major) Muscles

Front 8

Digestive System includes?

Back 8

Oral Cavity, Pharynx, Esophagus, Stomach, Small Intestine (duodenum, jejunum & ileum) and Large intestine

Front 9

Subdivisions of the stomach

Back 9

a. fundus
b. body
c. pyloric antrum

Front 10

How long is the small intestine?

Back 10

15-18 feet (extends from pyloric orifice to ileocecal valve)

Front 11

Openings of the Stomach

Back 11

a. cardiac orifice (esophagogastric junction)
b. pyloric orifice (pylorus)

Front 12

Stuctures w/in Stomach

Back 12

a. rugae
b. gastric canal

Front 13

The small intestines is divided into what three main parts?

Back 13

Duodenum, Jejunum (2/5ths), Ileum (3/5ths)

Front 14

Duodenum

Back 14

duodenal bulb or cap, shortest & wides portion, 10" (25 cm) in length, C-loop, Ligament of Treitz

Front 15

Large Intesting (haustra) contains?

Back 15

ileocecal valve, cecum, appendix, ascending colon, right colic (hepatic) flexure, transverse colon, left colic (splenic) flexure, sescending colon, rectum and anus

Front 16

Does the pancreas show up on radiographs?

Back 16

not usually, it is posterior to the stomach

Front 17

What are the accessory digestive organs?

Back 17

Pancreas, Liver and Spleen

Front 18

Structure of the spleen

Back 18

head, body and tail

Front 19

Function of the spleen

Back 19

endocrine - hormone: insulin
exocrine - digestive juices

Front 20

Stomach is mainly in which quadrant?

Back 20

LUQ

Front 21

The liver is mainly in which quadrant?

Back 21

RUQ

Front 22

Structure of the liver

Back 22

right lobe, left lobe and divided by Falciform ligament

Front 23

Function of the liver

Back 23

chemical factory, over 3,000 chemical reactions & balances.
Waste by product - bile: used in digestion of fat

Front 24

Associated structures & organs of the liver

Back 24

Gallbladder & Bile Ducts (rt & lt. hepatic ducts, common hepatic duct, cystic duct, common bile duct and sphincter of Oddi

Front 25

The spleen is mainly in which quadrant?

Back 25

LUQ

Front 26

Function of the spleen

Back 26

NOT part of digestive system, part of lymphatic system, RBC

Front 27

Trauma to the spleen

Back 27

laceration or rupture (can be fatal if untreated)

Front 28

Urinary system contains?

Back 28

2 Kidney's, 2 Ureters, bladder, urethra and also included but not part of system: suprarenal (adrenal) glands: endocrine

Front 29

Urinary system function

Back 29

Eliminartion of waste and regulation of waste

Front 30

Urinary system examinations

Back 30

1.) excretory urogram (EU or XU) or intravenous Urogram (IVU)
2.) IVP (or intravenous Pyelogram is technically improper terminology)

Front 31

Parietal peritoneum covers?

Back 31

abdominal wall

Front 32

Visceral peritoneum covers?

Back 32

mesentry double fold that surrounds abdominal organs & omentum double fold that stabilize and support abdominal organs

Front 33

space between peritoneum is?

Back 33

Peritoneal cavity

Front 34

Quadrants

Back 34

RUQ, RLQ, LUQ and LLQ

Front 35

Lines of division for quadrants?

Back 35

1.) transverse plane at umbilicus
2.) mid-sagittal plane

Front 36

Nine abdominal regions

Back 36

Upper: Rt. & Lt. Hypochondriac, epigastric
Middle: Rt. & Lt. Lateral, Umbilical
Lower: Rt. & Lt. Inguinal (iliac), Pubic (hypogastric)

Front 37

Lines of division for 9 regions

Back 37

1.) 2 sagittal planes halfway between ASIS and mid-sagittal
2.) 2 transverse planes: lower border L1 and body L5

Front 38

Topographical Landmark:
Xyphoid Tip

Back 38

T9/T10

Front 39

Topographical Landmark:
Inferior Costal margin:

Back 39

(book says L2-L3); More common L3

Front 40

Topographical Landmark:
Iliac Crest

Back 40

L4/L5 interspace

Front 41

Topographical Landmark:
ASIS (ant. sup. iliac spine)

Back 41

S1

Front 42

Topographical Landmark:
Greater Trochanter of Femur:

Back 42

1-1.5" above symphysis pubis

Front 43

Topographical Landmark:
Symphysis Pubis

Back 43

4-4.5" Below ASIS

Front 44

Topographical Landmark:
Ischial tuberosity

Back 44

(bony structure you sit on)
1-1.5" below symphysis pubis

Front 45

Topographical Landmark:
Vertebra1 Column

Back 45

Lumbar - 5
Sacrum - 5 fused
Coccyx - 3-5 fused

Front 46

how much can organs vary?

Back 46

6-8 in. in position, both transversely & horizontally

Front 47

Asthenic

Back 47

10% - extremely slender (poor tone)
Thorax & organs long & narrow, diaphragm is low, stomach low extending well below iliac crest heart long and narrow, gb low & verticle, colon folds onto itself.

Front 48

General patient prep for Abdominal x-ray

Back 48

1.) remove all clothing & opaque objects
2.) give patient hospital gown & explain how to put it on (opening in back)
3.) Shoes & socks may be left on

Front 49

kVp for abdominal x-rays

Back 49

a.) General survey: 70-80
b.) Contrast media: iodinated IV - 70-80, Iodinated Gastro- 90 max.
c.) Barium & Air: 90
d.) Barium: 110 - 120

Front 50

AEC Sensors for Ab Xray

Back 50

All three sensors, if can only select one or the other, use center sensor

Front 51

Structures shown in AP supine abdomen?

Back 51

liver, spleen, abnormal masses, calcifications or accumulations of gas, pelvis, lumbar spine, sacrum, coccyx, lower ribs and hip joints

Front 52

Technical Factors for AP supine abdominal

Back 52

Film size: 14x17 in (35x43cm) lengthwise, blocker down.
Grid: yes
kVp Range: 70-80
SID: 44"

Front 53

Sheilding for AP supine Abdominal?

Back 53

Use gonad shielding (will vary per dept.)

Front 54

Where should arms be for abdominal xray?

Back 54

at sides or above head

Front 55

How should the body be positioned for AP supine abdominal?

Back 55

centered transversely on the table, no tilt, no rotation

Front 56

Central Ray for AP Supine Abdomen?

Back 56

Iliac Crest, Mid-sagittal

Front 57

Collimation for AP supine abdomen?

Back 57

transversely to lat. cost. margins, longitudinal max. diaphragm & ischial tuberosity

Front 58

Respiration for AP supine abdomen?

Back 58

full expiration (can vary w/ procedure)

Front 59

Evaluation Criteria for AP supine, what needs to be included?

Back 59

Symphysis pubis & up

Front 60

Spine needs to be centered to the film how?

Back 60

transversely

Front 61

how to evaluate rotation for AP supine?

Back 61

Upper - lateral costal margins equal distance to spine
lower - coccyx & symphysis pubis in line or pelvis symmetrical

Front 62

6 points to evaluate density on AP supine

Back 62

skin line
liver shadow
kidney shadow
psoas muscles
transverse processes
spinous processes through the vertebral bodies

Front 63

how to evaluate penetration on AP supine

Back 63

ribs through the diaphragm or ribs through liver shadow. spinous processes through the vertebral bodies. head of femur seen through the acetabulum.

Front 64

Marker placement

Back 64

side (anatomical) preferred in hip area.
positional marker if other than supine - placement same as side marker

Front 65

Lateral Decubitus abdomen

Back 65

a.) patient in true left lateral position

Front 66

What is the CR for Lt. Lat. Decub Abdomen?

Back 66

2-3" above iliac crest, mid-sagittal, include diaphragm and side up

Front 67

what is the central ray for AP erect abdomen?

Back 67

2-3" above iliac crest, mid-sagittal, include diaphragm

Front 68

Structures shown in a dorsal decub abdomen? (aka ventral decub abdomen)

Back 68

abnormal masses
accumulations of gas or air fluid levels
aneurysms
calcifications of aorta or other vessels
umbilical hernias

Front 69

Film size for dorsal decub abdomen

Back 69

14x17, long axis film, blocker down

Front 70

kVp range for dorsal decub. abdomen

Back 70

70-80

Front 71

SID for dorsal decub abdomen?

Back 71

44"

Front 72

mAs for dorsal decub abdomen?

Back 72

x4 AP or 4 cm rule

Front 73

CR for Dorsal Decub abdomen

Back 73

2-3" above iliac crest, mid-coronal

Front 74

respiration for dorsal decub abdomen?

Back 74

end of full inspiration

Front 75

Evaluation criteria for dorsal decub abodmen?

Back 75

diaphragm and anterior surface (post. surface for ventral decub)
posterior borders of bertebral bodies superimposed and no motion.

Front 76

Acute Abdomen 3 view series includes?

Back 76

PA chest
AP Erect abdomen
AP Supine abodmen

Front 77

Acute Abdomen 2 view series includes?

Back 77

Lt. Lateral Decub
AP supine abdomen

Front 78

At what level of the spine is the Xiphoid Tip?

Back 78

T9 or T10

Front 79

At what level of the spine is the Inferior Costal Margin?

Back 79

L3

Front 80

At what level of the spine is the Iliac Crest?

Back 80

L4 L5 Interspace

Front 81

What does ASIS stand for?

Back 81

Anterior Superior Iliac Spine

Front 82

What is the name of the large muscles found in the posterior abdomen adjacent to the lumbar vertebra which are usually visible on an AP Abdomen radiograph?

Back 82

Psoas

Front 83

What is the medical terminology prefix for stomach?

Back 83

Gastro-

Front 84

List the three parts of the small intestine.

Back 84

jejunum, duodenum, ileum

Front 85

List the three parts or divisions of the stomach.

Back 85

Body, Fundus, Pylorus

Front 86

In which quadrant is the spleen?

Back 86

LUQ

Front 87

What is the name of the region in the far upper right corner?

Back 87

right hypochondriac

Front 88

What is the name of the region in the middle of the top row?

Back 88

epigastric

Front 89

What is the name of the region in the middle of the middle row?

Back 89

umbilical

Front 90

What is the name of the region in the middle of the bottom row?

Back 90

hypogastric

Front 91

The double-walled membrane lining the abdominopelvic cavity is called the:

Back 91

peritoneum

Front 92

What is the name of the region in the middle of the top row?

Back 92

epigastric

Front 93

What is the name of the region in the middle of the middle row?

Back 93

umbilical

Front 94

What is the name of the region in the middle of the bottom row?

Back 94

hypogastric

Front 95

The double-walled membrane lining the abdominopelvic cavity is called the:

Back 95

peritoneum

Front 96

For all abdominal projections/positions for air-fluid levels or free air the Central Ray is altered in two ways. List them.

Back 96

center 2-3" above crest, horizontal beam

Front 97

What projections/positions are done for an acute abdomen series on an ambulatory (walking) patient?

Back 97

AP Erect Abdomen, PA Chest, AP Supine Abdomen

Front 98

What projections/positions are done for an acute abdomen series on a non-ambulatory patient

Back 98

AP Supine Abdomen , Left Lateral Decub

Front 99

What must be included on all abdominal projections or positions for air-fluid levels, abnormal accumulations of intestinal gas, or free air that is NOT required to be included in an AP supine abdomen?

Back 99

diaphragm

Front 100

Your instructor says for all abdominal projections or positions for air-fluid levels, abnormal accumulations of intestinal gas, or free air what phase of respiration should be the exposure be made?

Back 100

inspiration

Front 101

List the six clinical indications for doing an Acute Abdominal Series.

Back 101

perforated hollow viscus, intra-abdominal mass, Ascities , abdominal infection, obstruction, post-op abdominal surgery

Front 102

A radiographic image of an upright abdomen taken to R/O (rule out) free air in the abdomen, reveals that the symphysis pubis is cut off. Is this an acceptable image?

Back 102

yes

Front 103

A radiographic image of an AP Abdomen reveals that there is blurriness seen in areas on the image.The following exposure factors were selected: 80 kVp, 200 mA, 0.2 sec., table bucky, 44 in. SID.The technologist states that they are sure that the patient didn't breathe or move during the exposure. What may have caused this blurriness?

Back 103

involuntary motion

Front 104

A radiographic image of an AP Abdomen reveals that the left iliac wing is narrower than the right side. What specific positioning error was committed?

Back 104

rotation

Front 105

A patient enters the ER with a possible bowel obstruction. The ER physician has ordered an acute abdominal series. The patient is able to stand. What specific positioning routine should be performed?

Back 105

3 view abdomen series

Front 106

A patient enters the ER with a possible perforated duodenal ulcer. The ER physician is concerned about the presence of free air in the abdomen. The patient is in severe pain and can not stand. What positioning routine would be performed to diagnose this condition?

Back 106

2 view abdomen series

Front 107

A patient in intensive care may have developed intra-abdominal bleeding. He is in critical condition and can't come to radiology. The physician has ordered a portable study of the abdomen. What specific position or projection can be performed to determine the extent of the bleeding?

Back 107

left lateral decub, dorsal decub

Front 108

An AP Supine Abdomen is ordered on a patient who is wider than the IR when positioned lengthwise, and is longer than the IR when positioned crosswise. What would you do? (You are the only technologists in the department.)

Back 108

do splits

Front 109

What is the central ray for an AP supine abdomen, if the diaphragm is NOT included?

Back 109

iliac crest, mid-sagittal

Front 110

On a radiographic image of an AP Abdomen what is the check point for rotation? 1) upper abdomen 2) lower abdomen

Back 110

Symphysis Pubis and coccyx in line, lateral costal margins equal distant to spine, pelvis symetrical

Front 111

On a radiographic image of an AP Abdomen what are the three check points the judge penetration?

Back 111

see ribs through the liver, see spinous processes through the vertebral bodies, see head of femur in the acetabulum

Front 112

What is the kVp range for an AP Abdomen?

Back 112

70-80

Front 113

What is the size of an IR for an adult AP abdomen?

Back 113

14 x 17 in.

Front 114

For an AP abdomen image what are the six check points for density?

Back 114

kidney shadow, psoas muscles, liver shadow, transverse processes, skin line, spinous processes

Front 115

Where is the best place to place your side marker (R/L) on the IR for an AP abdomen?

Back 115

lower right corner