Podcast
Questions and Answers
What anatomical structures are specifically evaluated in a KUB radiographic image?
What anatomical structures are specifically evaluated in a KUB radiographic image?
- Gallbladder, bile ducts, and liver
- Liver, spleen, and pancreas
- Kidneys, ureters, and bladder (correct)
- Stomach, small intestine, and large intestine
What is the purpose of visualizing the borders of the psoas major muscles in an AP abdomen radiograph?
What is the purpose of visualizing the borders of the psoas major muscles in an AP abdomen radiograph?
- To evaluate the gallbladder's condition.
- To assess the liver size.
- To evaluate the spleen's position.
- To assess the technical quality and positioning of the radiograph. (correct)
Which of the following organs is part of the digestive system?
Which of the following organs is part of the digestive system?
- Ureter
- Kidney
- Bladder
- Pharynx (correct)
What is the largest organ in the abdominal cavity?
What is the largest organ in the abdominal cavity?
Which anatomical description accurately describes the relative location of the pancreas?
Which anatomical description accurately describes the relative location of the pancreas?
Which of the following correctly pairs an accessory organ with its primary function?
Which of the following correctly pairs an accessory organ with its primary function?
Why is cholelithiasis typically not diagnosed using X-ray imaging?
Why is cholelithiasis typically not diagnosed using X-ray imaging?
How do the length proportions of the jejunum and ileum compare within the small intestine?
How do the length proportions of the jejunum and ileum compare within the small intestine?
Which anatomical feature characterizes the duodenum compared to other sections of the small intestine?
Which anatomical feature characterizes the duodenum compared to other sections of the small intestine?
Which of the following structures is located in the periphery of the abdomen?
Which of the following structures is located in the periphery of the abdomen?
Which of the following organs is part of the urinary system?
Which of the following organs is part of the urinary system?
What term describes the membrane lining the inside of the abdominal and pelvic cavities?
What term describes the membrane lining the inside of the abdominal and pelvic cavities?
What is the outermost layer that covers the abdominal and pelvic walls, as well as the diaphragm?
What is the outermost layer that covers the abdominal and pelvic walls, as well as the diaphragm?
What is the primary function of the mesentery within the abdominal cavity?
What is the primary function of the mesentery within the abdominal cavity?
Which of the following organs is classified as retroperitoneal?
Which of the following organs is classified as retroperitoneal?
The liver, gallbladder, and right kidney are primarily located in which abdominal quadrant?
The liver, gallbladder, and right kidney are primarily located in which abdominal quadrant?
Which topographic landmark is typically located at the level of the L4-L5 vertebrae?
Which topographic landmark is typically located at the level of the L4-L5 vertebrae?
Where should the upper edge of the gonadal shielding be placed for male patients during abdominal radiography?
Where should the upper edge of the gonadal shielding be placed for male patients during abdominal radiography?
When is ovarian shielding typically considered for female patients during abdominal radiography?
When is ovarian shielding typically considered for female patients during abdominal radiography?
What is the typical kVp range used for analog/digital abdominal radiography?
What is the typical kVp range used for analog/digital abdominal radiography?
Why is it important to use a short exposure time during abdominal radiography?
Why is it important to use a short exposure time during abdominal radiography?
Exposing an abdomen x-ray at the end of expiration does what?
Exposing an abdomen x-ray at the end of expiration does what?
Which positioning landmark is typically used for centering during an AP supine abdomen radiograph?
Which positioning landmark is typically used for centering during an AP supine abdomen radiograph?
What anatomical structure should be visible on a well-positioned KUB radiograph to ensure adequate coverage?
What anatomical structure should be visible on a well-positioned KUB radiograph to ensure adequate coverage?
Which specific views are typically included in a '3-way' acute abdomen series?
Which specific views are typically included in a '3-way' acute abdomen series?
Which radiologic view is essential to include the diaphragm?
Which radiologic view is essential to include the diaphragm?
What duration should a patient be laying down for, to allow air-fluid levels to regulate?
What duration should a patient be laying down for, to allow air-fluid levels to regulate?
Why is a PA Erect chest included in a 3-way acute abdominal series?
Why is a PA Erect chest included in a 3-way acute abdominal series?
Which of the following is a clinical indication for ordering an acute abdomen series?
Which of the following is a clinical indication for ordering an acute abdomen series?
If the Diaphragm isn't included for images from an acute abdomen series what needs to happen?
If the Diaphragm isn't included for images from an acute abdomen series what needs to happen?
What is the central ray (CR) placement for a left lateral decubitus abdomen radiograph?
What is the central ray (CR) placement for a left lateral decubitus abdomen radiograph?
In a properly positioned lateral decubitus abdomen radiograph, which anatomical area must be demonstrated to evaluate for free air?
In a properly positioned lateral decubitus abdomen radiograph, which anatomical area must be demonstrated to evaluate for free air?
What is an evaluation criteria that needs to be met for a Right Lateral Abdomen?
What is an evaluation criteria that needs to be met for a Right Lateral Abdomen?
What is the minimum time a patient should stand or sit upright to visualize free air?
What is the minimum time a patient should stand or sit upright to visualize free air?
Which of the following exposures should be made on expiration?
Which of the following exposures should be made on expiration?
What needs to be visible for evaluation criteria when looking at the Symphysis Pubis?
What needs to be visible for evaluation criteria when looking at the Symphysis Pubis?
When doing an AP Abdomen on a hypersthenic patient, what might you have to do?
When doing an AP Abdomen on a hypersthenic patient, what might you have to do?
What's the CR placement for a PA Abdomen?
What's the CR placement for a PA Abdomen?
Why is the visualization of the kidneys generally limited on a standard KUB radiograph?
Why is the visualization of the kidneys generally limited on a standard KUB radiograph?
Which muscles must be defined to determine if you have a diagnostic KUB?
Which muscles must be defined to determine if you have a diagnostic KUB?
Which set of organs comprises the digestive system?
Which set of organs comprises the digestive system?
Which role does the liver serve within the abdominal digestive system?
Which role does the liver serve within the abdominal digestive system?
What positional context defines the location of the pancreas?
What positional context defines the location of the pancreas?
What describes how the liver functions as an accesory organ?
What describes how the liver functions as an accesory organ?
Why are gallstones not typically diagnosed using standard X-ray imaging?
Why are gallstones not typically diagnosed using standard X-ray imaging?
What describes the comparative lengths between the jejunum and ileum?
What describes the comparative lengths between the jejunum and ileum?
Which characteristic is most distinctive about the duodenum compared to other parts of the small intestine?
Which characteristic is most distinctive about the duodenum compared to other parts of the small intestine?
Which component of the digestive system is located most peripherally within the abdominal cavity?
Which component of the digestive system is located most peripherally within the abdominal cavity?
Which set of organs correctly represents the urinary system?
Which set of organs correctly represents the urinary system?
Which of the following describes the peritoneum's role within the abdominal cavity?
Which of the following describes the peritoneum's role within the abdominal cavity?
Which layer constitutes the parietal peritoneum?
Which layer constitutes the parietal peritoneum?
What primary role does the omentum serve in the abdominal cavity?
What primary role does the omentum serve in the abdominal cavity?
What defines a retroperitoneal organ?
What defines a retroperitoneal organ?
What location primarily contains the liver, gallbladder, and right kidney?
What location primarily contains the liver, gallbladder, and right kidney?
When performing abdominal radiography, at which palpable landmark is the central ray typically centered for a supine AP projection?
When performing abdominal radiography, at which palpable landmark is the central ray typically centered for a supine AP projection?
When performing male gonadal shielding during abdominal radiography, where should the superior border of the shield be placed?
When performing male gonadal shielding during abdominal radiography, where should the superior border of the shield be placed?
Which condition justifies the use of ovarian shielding during radiography?
Which condition justifies the use of ovarian shielding during radiography?
What is the standard kVp range for abdominal radiography utilizing analog or digital systems?
What is the standard kVp range for abdominal radiography utilizing analog or digital systems?
Why is utilizing a short exposure time important in abdominal radiography?
Why is utilizing a short exposure time important in abdominal radiography?
What effect does exposing an abdomen radiograph at the end of expiration have on the resulting image?
What effect does exposing an abdomen radiograph at the end of expiration have on the resulting image?
When performing an AP supine abdomen radiograph, which anatomical landmark is typically used for centering the central ray?
When performing an AP supine abdomen radiograph, which anatomical landmark is typically used for centering the central ray?
What anatomical benchmark verifies sufficient coverage for a properly positioned KUB radiograph?
What anatomical benchmark verifies sufficient coverage for a properly positioned KUB radiograph?
For an acute abdomen series, what series of views would make-up a 3-way?
For an acute abdomen series, what series of views would make-up a 3-way?
In the context of acute abdomen imaging, which radiologic view is crucial for visualizing the presence of free air under the diaphragm?
In the context of acute abdomen imaging, which radiologic view is crucial for visualizing the presence of free air under the diaphragm?
What is the minimum amount of time a patient must lay down, in order to allow air-fluid levels to stabilize?
What is the minimum amount of time a patient must lay down, in order to allow air-fluid levels to stabilize?
Why is a PA erect chest radiograph often included in an acute abdomen series?
Why is a PA erect chest radiograph often included in an acute abdomen series?
What makes a series a Two-Way Acute Abdomen?
What makes a series a Two-Way Acute Abdomen?
Flashcards
What does KUB stand for?
What does KUB stand for?
Kidneys, ureter and bladder.
What does AP Abdomen (KUB) demonstrate?
What does AP Abdomen (KUB) demonstrate?
It demonstrates the borders of psoas major muscles.
What is Cholelithiasis?
What is Cholelithiasis?
It is the presence of one or more calculi (gallstones) in the gallbladder.
List the 6 organs of the digestive system.
List the 6 organs of the digestive system.
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Name the accessory organs of the digestive tract.
Name the accessory organs of the digestive tract.
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What is the function of the pancreas?
What is the function of the pancreas?
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What is the function of the liver?
What is the function of the liver?
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What is the function of the gallbladder?
What is the function of the gallbladder?
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What is the function of the spleen?
What is the function of the spleen?
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Where is the pancreas located?
Where is the pancreas located?
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What is the mesentery?
What is the mesentery?
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What is Visceral peritoneum?
What is Visceral peritoneum?
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What are the abdominal quadrants?
What are the abdominal quadrants?
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Name the organs located in the RUQ.
Name the organs located in the RUQ.
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Name the organs located in the LUQ.
Name the organs located in the LUQ.
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Name the organs located in the RLQ.
Name the organs located in the RLQ.
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Name the organs located in the LLQ.
Name the organs located in the LLQ.
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List the organs that are retroperitoneal.
List the organs that are retroperitoneal.
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List the organs that are intraperitoneal
List the organs that are intraperitoneal
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Describe patient preparation for abdominal imaging.
Describe patient preparation for abdominal imaging.
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What are important positioning considerations for abdominal x-rays?
What are important positioning considerations for abdominal x-rays?
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Where should gonadal shielding be placed on a male for abdominal imaging?
Where should gonadal shielding be placed on a male for abdominal imaging?
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When to use ovarian shielding in female abdominal imaging?
When to use ovarian shielding in female abdominal imaging?
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List the exposure factors for abdominal imaging.
List the exposure factors for abdominal imaging.
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What is the routinely done abdominal xray?
What is the routinely done abdominal xray?
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What are the evaluation criteria for abdominal imaging?
What are the evaluation criteria for abdominal imaging?
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Describe how to center a patient for the AP Abdomen Supine position.
Describe how to center a patient for the AP Abdomen Supine position.
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What are the evaluation criteria Left Lateral Decubitus Position?
What are the evaluation criteria Left Lateral Decubitus Position?
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What are the evaluation criteria Erect AP Abdomen?
What are the evaluation criteria Erect AP Abdomen?
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CR placement for Left Lateral Decubitus?
CR placement for Left Lateral Decubitus?
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List 5 Clinical Indications for Acute Abdomen Series
List 5 Clinical Indications for Acute Abdomen Series
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3-Way series consists of?
3-Way series consists of?
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2-Way series consists of?
2-Way series consists of?
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Study Notes
KUB (Kidneys, Ureters, Bladder)
- X-rays are not typically the modality of choice for visualizing the kidneys.
- Radiography demonstrates the kidneys, ureter, and bladder.
AP Abdomen (KUB)
- Radiographs demonstrate the borders of the psoas major muscles.
Digestive System Anatomy
- The digestive system contains six organs:
- Oral cavity
- Pharynx
- Esophagus
- Stomach
- Small intestine
- Large intestine
Accessory Organs of Digestion
- Accessory organs aid in digestion.
- Liver: Largest organ in the abdomen.
- Gallbladder: Sits under the liver.
- Pancreas
Pancreas Location
- Pancreas is located posterior to the stomach
- It sits between the duodenum and the spleen
- The head of the pancreas is nestled in the C-loop of the duodenum
- Its tail extends toward the upper left quadrant, near the spleen
Functions and Roles of Accessory Organs
- Pancreas: Located in the right upper quadrant, produces hormones like insulin, and regulates blood sugar.
- Liver: Located in the right upper quadrant, it breaks down fat and produces bile.
- Gallbladder: Located in the right upper quadrant, it contracts and releases stored bile to break down fats.
- Spleen: Located in the left upper quadrant, it controls the level of white blood cells, red blood cells, and platelets.
Cholelithiasis
- Cholelithiasis is the presence of one or more calculi (gallstones) in the gallbladder.
- Cholelithiasis is typically not diagnosed on X-ray.
Stomach and Small Intestine
- The order of the stomach and small intestine:
- Stomach
- Duodenum: Shortest and widest portion.
- Jejunum: 2/5 of the small intestine.
- Ileum: 3/5 of the small intestine.
Large Intestine Anatomy
- The large intestine includes:
- Anus
- Appendix (vermiform)
- Ascending colon
- Cecum
- Descending colon
- Ileocecal valve
- Left colic (splenic) flexure
- Rectum
- Right colic (hepatic) flexure
- Sigmoid colon
- Transverse colon
Urinary System
- The urinary system consists of:
- Two kidneys
- Two urinary ureters
- One urinary bladder
- One urethra
Anatomic Relationships
- Parietal peritoneum: Covers the abdominal and pelvic walls, as well as the diaphragm, and is the outermost layer.
- Peritoneal cavity: A membrane that lines the inside of the abdomen and pelvis.
- Visceral peritoneum: The layers of tissue that cover the outer surface of most organs in the abdomen, including the intestines.
Abdominal Cavity
- Omentum: A fold of the peritoneum that surrounds the stomach and other organs in the abdomen.
- Mesentery: The double fold of peritoneum that extends anteriorly from the posterior abdominal wall, enveloping a loop of small bowel, connecting small intestine to the posterior abdominal wall.
Location of Organs
- Retroperitoneal organs:
- Right adrenal gland
- Right kidney
- Pancreas
- Duodenum
- Ascending colon
- Inferior vena cava
- Aorta
- Descending colon
- Ureter
- "Intra" peritoneal organs:
- Liver
- Gallbladder
- Spleen
- Stomach
- Jejunum
- Ileum
- Cecum
- Transverse and sigmoid colon
- Infraperitoneal organs:
- Bladder
- (Lower rectum)
Abdominal Quadrants
- The four abdominal quadrants:
- RUQ (Right Upper Quadrant)
- LUQ (Left Upper Quadrant)
- RLQ (Right Lower Quadrant)
- LLQ (Left Lower Quadrant)
Anatomy per Abdominal Quadrant
- RUQ: Liver, Gallbladder, Right colic (hepatic) flexure, Duodenum (C-loop), Head of pancreas, Right kidney, Right suprarenal gland.
- LUQ: Spleen, Stomach, Left colic (splenic) flexure, Tail of pancreas, Left kidney, Left suprarenal gland.
- RLQ: Ascending colon, Appendix (vermiform), Cecum, 2/3 of ileum, Ileocecal valve.
- LLQ: Descending colon, Sigmoid colon, 2/3 of jejunum.
Topographic Landmarks
- Mid and upper abdomen landmarks:
- Xiphoid process (T9-T10)
- Inferior costal margin (L2-L3)
- Iliac crest (L4-L5)
- Lower abdomen and pelvic landmarks:
- ASIS (Anterior Superior Iliac Spine)
- Greater trochanter
- Symphysis pubis
- Ischial tuberosity
Positioning of Abdomen
- Abdomen positioning includes:
- KUB (Kidneys, Ureters, Bladder)
- Acute abdomen series:
- AP supine abdomen
- AP erect abdomen
- PA erect chest
- Decubitus positions:
- Lateral decubitus
- Dorsal decubitus
Patient Preparation for Abdomen Radiography
- Remove all clothing
- Remove opaque objects
- Patient wears a hospital gown
- Use a pillow for the head and clean linen on the table
- Cover the patient for warmth and modesty
Abdomen Radiography Positioning Considerations
- Expose on expiration
- Utilize IR markers
- Always use collimation
Gonadal Shielding
- Males: Shield at the upper edge of the symphysis pubis.
- Females: Ovarian shield is used only if it does not obscure essential anatomy.
Abdomen Radiography Exposure Factors
- Analog/Digital kVp: 70-80
- Short exposure time
- Adequate mAs
Abdomen Radiographic Procedures
- Routine: AP supine (KUB)
- Special:
- PA prone
- Lateral decubitus (AP)
- AP erect
- Dorsal decubitus (lateral)
AP Abdomen Supine
- Center to the iliac crest
- Use a 14x17 image receptor
- Set kVp to 70-85
- Instruct patients to expose at end of respiration
- Hypersthenic patients may require additional imaging.
AP Abdomen Supine Evaluation Criteria
- Symphysis pubis visible
- Kidneys and lower liver margin included
- No rotation
- No motion
- Optimal exposure factors
PA Abdomen
- Center the Central Ray (CR) and Image Receptor (IR) to the iliac crest
Criteria for PA Abdomen Radiograph
- Symphysis pubis is visible
- Kidneys and lower liver margin are included
- No rotation
- No motion
- Exposure factors are optimal
Left Lateral Decubitus Position
- Center the CR 2 inches (5 cm) above the iliac crest
- Patients must lie down for a minimum of 20 minutes to allow air-fluid levels to regulate
Left Lateral Decubitus Position - Evaluation Criteria
- Diaphragm demonstrated
- Both sides of body included
- No rotation
- No motion
- Exposure factors
Erect AP Abdomen
- CR should be 2 inches (5 cm) above the iliac crest
- Expose at the end of respiration
- Use a 14x17 image receptor
- kVp should be set to 70-85
- Patient must be in an upright position for a minimum of 5 minutes
Erect AP Abdomen Evaluation Criteria
- Diaphragm included, unless a PA chest was taken
- No rotation
- No motion
- Exposure factors are optimal
Dorsal Decubitus - Right Lateral Position
- The CR should be 2 inches (5 cm) above the iliac crest, directed to the midcoronal plane
Dorsal Decubitus - Right Lateral Position Evaluation Criteria
- Diaphragm is included
- No rotation
- No motion
- Exposure factors
Right Lateral Abdomen
- Evaluation Criteria:
- Diaphragm included.
- No rotation
- No motion
- Exposure factors
Clinical Indications for Acute Abdomen Series
- Ileus
- Ascites
- Perforated hollow viscus
- Intra-abdominal mass
- Post-op abdominal surgery
Acute Abdomen Series - Imaging
- The 3-Way series includes:
- AP supine
- AP erect
- PA chest
- The 2-Way series includes:
- AP supine
- AP erect or left lateral decubitus where the diaphragm must be included.
Quiz Answer Key
- Quiz 1: D. Psoas major
- Quiz 2: A. Spleen
- Quiz 3: B. retroperitoneal
- Quiz 4: B. Volvulus
- Quiz 5: C. 10 to 20 minutes
- Quiz 6: C. 1 to 2 inches (5 cm) above iliac crest
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