U3 Abdomen

Question 1

Landmarks

Answer 1

Iliac crest (L4/5)
ASIS (2+/- lower than crests)

Question 2

Photocells & breathing

Answer 2

-side cells
-suspended expiration
( deep breath in, blow it out, hold it out- raises diaphragm)

Question 3

Exposure factors

Answer 3

• high kV 75-85
• mAs juvenile
• 20-30 mAs average adult
• 100+ mAs bariatric
• avg. 80 kV, 20 mAs (40” and portable/table)
• avg. 80 kV, 60 mAs (72” and up rt)

Question 4

Grids

Answer 4

• more technique
• stop scattered X-rays (from patient) from reaching IR
• between patient and IR

Question 5

Supine abdomen

Answer 5

• flat plate abdomen
• KUB (kidneys, ureters, bladders)

Question 6

Abdomen protocols

Answer 6

• entire abdomen
• symphysis to diaphragm
• may need 1 or 2+ (14x17)

Question 7

Supine Abdomen 1

Answer 7

• 1 shot (KUB)
• CR at/below crest
• must include symphysis ( may lose diaphragm)

Question 8

Supine Abdomen 2

Answer 8

• symphysis to diaphragm
• t shot
• landscape x2 ( large pt )

Question 9

Upright Abd

Answer 9

• air-fluid levels
• pneumoperitoneum
• must include diaphragm
• ULB at armpit

Question 10

Pneumoperitoneum

Answer 10

• free air
• bowel gas and bowel fluids leaking out of bowel
• pt should be up rt for 5+ minutes prior to exam
• between diaphragm and liver (rt side)

Question 11

Supine

Answer 11

Things spread out

Question 12

Left lateral decubitus

Answer 12

• alternative to upright abd
• same techniques and requirements
• AP/PA is acceptable
• any air under rt side is free air

Question 13

Dorsal decubitus

Answer 13

• pt on back/posterior
• air rises to anterior

Question 14

NG tube placement

Answer 14

• high abdomen
• goes back the diaphragm

Question 15

Feeding tube placement

Answer 15

• small bowel
• high abdomen
• below diaphragm
• pasted through the stomach into duodenum
  -weighted tip at end
  -thinner than NG

Question 16

Non-mechanical/adynamic

Answer 16

-ileus (involuntary constriction of bowel stops)
- causes: post general anesthesia, medications (opiates), infections

Question 17

Mechanical bowel obstruction

Answer 17

• physical obstruction
  -ex. Twisting, adhesions, masses, fecal impaction

Question 18

Volvulus

Answer 18

-twisting of the loop of the bowel
- obstructs bowel and blood supply to intestine

Question 19

Intussusception

Answer 19

-“telescoping”
- when one part of the intestine folds into another part
- obstructs bowel and blood supply to intestine

Question 20

Constipation

Answer 20

-stool has a “speckled” appearance on XR
- dense gray with more lucent bowel gas intermixed

Question 21

Adhesion

Answer 21

• mechanical
  -scar tissue that binds abdominal structures that should be free to move
• # 1 leading cause of obstruction
• causes: post op, infections, medications, radiation tx.

Question 22

Inflammatory Bowel Disease

Answer 22

• Causes GI pain, bleeding, distress, obstructions
• diagnostic: upper & lower GI studies, surgery
• ex
  
  • crohn’s disease
  • ulcerative colitis

Question 23

Ascites

Answer 23

• caused by liver disease & some cancers
• free fluid in peritoneal cavity
• distended stomach
• air-filled bowel, float anteriorly to spine when supine

Question 24

Abdomen series

Answer 24

1. PA chest
2. Up right abd.
3. Supine abd.

Question 25

Abdomen Survey

Answer 25

1. Up right abd. 2. supine abd.

Question 26

Abdomen 1- view

Answer 26

KUB