Module 4 Abdomen Flashcards
(37 cards)
RUQ ORGANS
Liver ( right lobe) Gallbladder Pylorus ( of stomach) Duodenum ( part1 through 3) Pancreas ( head) Right kidney and suprarenal gland Colon ( distal ascending colon, hepatic flexure and right half of transverse colon )
LUQ ORGANS
Liver left lobe Spleen Stomach Jejunum and proximal ileum Pancreas ( body and tail) Left kidney and suprarenal gland Colon ( left half of transverse colon, splenic flexure and superior part of descending colon)
RLQ ORGANS
Majority of the ileum
Caecum with vermiform appendix
Proximal ascending colon
Proximal right ureter
LLQ ORGANS
Distal descending colon
Sigmoid colon
Left ureter
ACUTE ABDO SERIES INDICATIONS
- Perforation
- Bowel obstruction
- Infection
- Abdominal mass/ calcifications
- Visceroptosis ( prolapse or falling down of abdominal viscera, seen on
an erect or decubitusimage ) - Ascites
- General survey for GI tract, liver, spleen, kidneys
ERECT AXR STRUCTURES DEMONSTRATED
- Diaphragm
- Air/ fluid levels if present
Visceroptosis
SUPINE AXR HYPERSTHENIC PATIENT
Two I mages done=
- One centred at iliac crest to include symph
- Second centred above the iliac crest to include the upper abdomen and diaphragm
SUPINE AXR STRUCTURES DEMONSTRATED
- Symphysis Pubis
- Liver
- Spleen
- Kidneys
- Air filled stomach
- Bowel
- Psoas muscle
AXR DORSAL DECUBITUS STRUCTURES DEMONSTRATED
- Diaphrams
- Calcified aorta
- Aneurysms
- Air/fluid levels if present
- Vertebral region
PEDIATRIC ABDOMINAL SERIES
- AP SUPINE AND ERECT-ONLY
AXR GENERAL POSITIONING RITERIA
- Abdo images are taken on expiration
- Abdo images should include diaphragm to symphysis pubis
- CR at the iliac crest for supine images
- CR 5cm above the iliac crest for erect and decubitus
- Appreciate marker placed
- Radiopaque articles removed
AXR TECHNICAL CONSIDERATION
- 75- 85 kVp
- Utilise all 3 photocells or chambers
- Use a grid
- Decrease mAs by 30-50% or kVp by 5-8% if patient has an accumulation of air
- Increase mAs or kVp if patient has a accumulation of fluid
- Increase exposure for erect
SUPINE AXR CRITERIA
- Adequate density and contrast
- Out line of the solid Abdo organs
- Spinous process in the mid line with pedicels equal distance to the spinous processes
- Image include T11 to symph
- For hypersthenic body habitus patients 2 images done
ERECT AXR RADIOGRAPHIC CRITERIA
- Adequate density and contrast
- All solid abdominal organs outlined
- No rotation
- NB- Diaphragm must be visualised
LIVER CIRRHOSIS
Chronic irreversible condition of the liver when liver cells die and get replaced by scar tissue,commonly caused by alcoholism, obesity, hepatitis
CLINICAL SIGNS AND IMAGING OF LIVER CIRRHOSIS
- Jaundice
- Ascites
- Esophageal varices due to portal hypertension
- Splenomegaly
Imaging= CT
RADIOGRAPHIC APPEARANCE OF LIVER CIRRHOSIS
- Much darker than usual liver appearance
- Dilated Portal Vein, portal hypertension
- Decreased size of right liver lobe
- Splenomegaly
PRIMARY LIVER CANCER/ HEPATO CELLULAR CARCINOMA
Cancer of the liver which predominantly occurs in patients with previous damage to liver cells, e.g alcoholism, hepatitis, cirrhosis
CLINICAL SIGNS AND IMAGING OF HEPATO CELLULAR CARCINOMA
- RUGpain
- Weight loss
- Haemorrhage into peritoneal cavity
- Complications of essophageal varices
Imaging- CT
RADIOGRAPHIC APPEARANCE OF HEPATO CELLULAR CARCINOMA
Unenhanced CT=
- Most are solitary mass which is hypodense or isodense
- Mass projects beyond the normal borders of the liver
Enhanced CT=
- Non uniform enhancement of the tumour
CLINICAL SIGNS AND IMAGING OF LIVER METASTASES
Clinical signs
- Nausea, unexplained weight loss
- Jaundice and/ Ascites
Imaging
CT
MRI
RADIOGRAPHIC APPEARANCE OF LIVER METASTASIS
UN enhanced CT
- Usually numerous lesions, well marginated less dense than normal liver tissue
Enhanced CT
- Lession have a higher density than surrounding liver tissue
PANCREATITIS
Acute or chronic inflammatory condition when the pancreatic enzymes destroy their own pancreatic tissue, mainly caused by alcoholism or gallstones
CLINICAL SIGNS AND IMAGING OF PANCREATITIS
Clinical signs
- Nausea and vomiting
- Pain after eating or drinking
- Diarrhea
Imaging
- Ultrasound
- CT
