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115 Cards in this Set
- Front
- Back
Other common names for AP supine abdomen
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1. KUB
2. Flat plate 3. Scout 4. Prelim (preliminary film) |
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What are AP supine abdomen X-rays used for?
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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 |
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Acute Abdomen Series are performed on who?
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Patients with acute abdominal pain or distress
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Indications for performing an Acute Abdominal Series?
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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 |
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Ambulatory patient
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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 |
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Non-ambulatory patient
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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 |
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Abdominal Muscles
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1.) Diaphragm
2.) Psoas (major) Muscles |
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Digestive System includes?
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Oral Cavity, Pharynx, Esophagus, Stomach, Small Intestine (duodenum, jejunum & ileum) and Large intestine
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Subdivisions of the stomach
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a. fundus
b. body c. pyloric antrum |
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How long is the small intestine?
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15-18 feet (extends from pyloric orifice to ileocecal valve)
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Openings of the Stomach
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a. cardiac orifice (esophagogastric junction)
b. pyloric orifice (pylorus) |
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Stuctures w/in Stomach
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a. rugae
b. gastric canal |
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The small intestines is divided into what three main parts?
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Duodenum, Jejunum (2/5ths), Ileum (3/5ths)
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Duodenum
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duodenal bulb or cap, shortest & wides portion, 10" (25 cm) in length, C-loop, Ligament of Treitz
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Large Intesting (haustra) contains?
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ileocecal valve, cecum, appendix, ascending colon, right colic (hepatic) flexure, transverse colon, left colic (splenic) flexure, sescending colon, rectum and anus
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Does the pancreas show up on radiographs?
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not usually, it is posterior to the stomach
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What are the accessory digestive organs?
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Pancreas, Liver and Spleen
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Structure of the spleen
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head, body and tail
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Function of the spleen
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endocrine - hormone: insulin
exocrine - digestive juices |
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Stomach is mainly in which quadrant?
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LUQ
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The liver is mainly in which quadrant?
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RUQ
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Structure of the liver
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right lobe, left lobe and divided by Falciform ligament
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Function of the liver
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chemical factory, over 3,000 chemical reactions & balances.
Waste by product - bile: used in digestion of fat |
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Associated structures & organs of the liver
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Gallbladder & Bile Ducts (rt & lt. hepatic ducts, common hepatic duct, cystic duct, common bile duct and sphincter of Oddi
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The spleen is mainly in which quadrant?
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LUQ
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Function of the spleen
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NOT part of digestive system, part of lymphatic system, RBC
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Trauma to the spleen
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laceration or rupture (can be fatal if untreated)
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Urinary system contains?
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2 Kidney's, 2 Ureters, bladder, urethra and also included but not part of system: suprarenal (adrenal) glands: endocrine
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Urinary system function
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Eliminartion of waste and regulation of waste
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Urinary system examinations
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1.) excretory urogram (EU or XU) or intravenous Urogram (IVU)
2.) IVP (or intravenous Pyelogram is technically improper terminology) |
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Parietal peritoneum covers?
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abdominal wall
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Visceral peritoneum covers?
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mesentry double fold that surrounds abdominal organs & omentum double fold that stabilize and support abdominal organs
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space between peritoneum is?
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Peritoneal cavity
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Quadrants
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RUQ, RLQ, LUQ and LLQ
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Lines of division for quadrants?
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1.) transverse plane at umbilicus
2.) mid-sagittal plane |
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Nine abdominal regions
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Upper: Rt. & Lt. Hypochondriac, epigastric
Middle: Rt. & Lt. Lateral, Umbilical Lower: Rt. & Lt. Inguinal (iliac), Pubic (hypogastric) |
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Lines of division for 9 regions
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1.) 2 sagittal planes halfway between ASIS and mid-sagittal
2.) 2 transverse planes: lower border L1 and body L5 |
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Topographical Landmark:
Xyphoid Tip |
T9/T10
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Topographical Landmark:
Inferior Costal margin: |
(book says L2-L3); More common L3
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Topographical Landmark:
Iliac Crest |
L4/L5 interspace
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Topographical Landmark:
ASIS (ant. sup. iliac spine) |
S1
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Topographical Landmark:
Greater Trochanter of Femur: |
1-1.5" above symphysis pubis
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Topographical Landmark:
Symphysis Pubis |
4-4.5" Below ASIS
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Topographical Landmark:
Ischial tuberosity |
(bony structure you sit on)
1-1.5" below symphysis pubis |
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Topographical Landmark:
Vertebra1 Column |
Lumbar - 5
Sacrum - 5 fused Coccyx - 3-5 fused |
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how much can organs vary?
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6-8 in. in position, both transversely & horizontally
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Asthenic
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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. |
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General patient prep for Abdominal x-ray
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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 |
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kVp for abdominal x-rays
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a.) General survey: 70-80
b.) Contrast media: iodinated IV - 70-80, Iodinated Gastro- 90 max. c.) Barium & Air: 90 d.) Barium: 110 - 120 |
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AEC Sensors for Ab Xray
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All three sensors, if can only select one or the other, use center sensor
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Structures shown in AP supine abdomen?
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liver, spleen, abnormal masses, calcifications or accumulations of gas, pelvis, lumbar spine, sacrum, coccyx, lower ribs and hip joints
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Technical Factors for AP supine abdominal
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Film size: 14x17 in (35x43cm) lengthwise, blocker down.
Grid: yes kVp Range: 70-80 SID: 44" |
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Sheilding for AP supine Abdominal?
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Use gonad shielding (will vary per dept.)
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Where should arms be for abdominal xray?
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at sides or above head
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How should the body be positioned for AP supine abdominal?
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centered transversely on the table, no tilt, no rotation
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Central Ray for AP Supine Abdomen?
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Iliac Crest, Mid-sagittal
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Collimation for AP supine abdomen?
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transversely to lat. cost. margins, longitudinal max. diaphragm & ischial tuberosity
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Respiration for AP supine abdomen?
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full expiration (can vary w/ procedure)
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Evaluation Criteria for AP supine, what needs to be included?
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Symphysis pubis & up
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Spine needs to be centered to the film how?
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transversely
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how to evaluate rotation for AP supine?
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Upper - lateral costal margins equal distance to spine
lower - coccyx & symphysis pubis in line or pelvis symmetrical |
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6 points to evaluate density on AP supine
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skin line
liver shadow kidney shadow psoas muscles transverse processes spinous processes through the vertebral bodies |
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how to evaluate penetration on AP supine
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ribs through the diaphragm or ribs through liver shadow. spinous processes through the vertebral bodies. head of femur seen through the acetabulum.
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Marker placement
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side (anatomical) preferred in hip area.
positional marker if other than supine - placement same as side marker |
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Lateral Decubitus abdomen
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a.) patient in true left lateral position
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What is the CR for Lt. Lat. Decub Abdomen?
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2-3" above iliac crest, mid-sagittal, include diaphragm and side up
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what is the central ray for AP erect abdomen?
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2-3" above iliac crest, mid-sagittal, include diaphragm
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Structures shown in a dorsal decub abdomen? (aka ventral decub abdomen)
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abnormal masses
accumulations of gas or air fluid levels aneurysms calcifications of aorta or other vessels umbilical hernias |
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Film size for dorsal decub abdomen
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14x17, long axis film, blocker down
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kVp range for dorsal decub. abdomen
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70-80
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SID for dorsal decub abdomen?
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44"
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mAs for dorsal decub abdomen?
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x4 AP or 4 cm rule
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CR for Dorsal Decub abdomen
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2-3" above iliac crest, mid-coronal
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respiration for dorsal decub abdomen?
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end of full inspiration
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Evaluation criteria for dorsal decub abodmen?
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diaphragm and anterior surface (post. surface for ventral decub)
posterior borders of bertebral bodies superimposed and no motion. |
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Acute Abdomen 3 view series includes?
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PA chest
AP Erect abdomen AP Supine abodmen |
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Acute Abdomen 2 view series includes?
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Lt. Lateral Decub
AP supine abdomen |
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At what level of the spine is the Xiphoid Tip?
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T9 or T10
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At what level of the spine is the Inferior Costal Margin?
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L3
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At what level of the spine is the Iliac Crest?
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L4 L5 Interspace
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What does ASIS stand for?
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Anterior Superior Iliac Spine
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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?
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Psoas
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What is the medical terminology prefix for stomach?
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Gastro-
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List the three parts of the small intestine.
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jejunum, duodenum, ileum
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List the three parts or divisions of the stomach.
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Body, Fundus, Pylorus
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In which quadrant is the spleen?
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LUQ
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What is the name of the region in the far upper right corner?
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right hypochondriac
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What is the name of the region in the middle of the top row?
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epigastric
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What is the name of the region in the middle of the middle row?
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umbilical
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What is the name of the region in the middle of the bottom row?
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hypogastric
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The double-walled membrane lining the abdominopelvic cavity is called the:
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peritoneum
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What is the name of the region in the middle of the top row?
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epigastric
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What is the name of the region in the middle of the middle row?
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umbilical
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What is the name of the region in the middle of the bottom row?
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hypogastric
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The double-walled membrane lining the abdominopelvic cavity is called the:
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peritoneum
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For all abdominal projections/positions for air-fluid levels or free air the Central Ray is altered in two ways. List them.
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center 2-3" above crest, horizontal beam
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What projections/positions are done for an acute abdomen series on an ambulatory (walking) patient?
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AP Erect Abdomen, PA Chest, AP Supine Abdomen
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What projections/positions are done for an acute abdomen series on a non-ambulatory patient
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AP Supine Abdomen , Left Lateral Decub
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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?
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diaphragm
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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?
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inspiration
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List the six clinical indications for doing an Acute Abdominal Series.
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perforated hollow viscus, intra-abdominal mass, Ascities , abdominal infection, obstruction, post-op abdominal surgery
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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?
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yes
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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?
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involuntary motion
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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?
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rotation
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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?
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3 view abdomen series
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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?
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2 view abdomen series
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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?
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left lateral decub, dorsal decub
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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.)
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do splits
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What is the central ray for an AP supine abdomen, if the diaphragm is NOT included?
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iliac crest, mid-sagittal
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On a radiographic image of an AP Abdomen what is the check point for rotation? 1) upper abdomen 2) lower abdomen
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Symphysis Pubis and coccyx in line, lateral costal margins equal distant to spine, pelvis symetrical
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On a radiographic image of an AP Abdomen what are the three check points the judge penetration?
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see ribs through the liver, see spinous processes through the vertebral bodies, see head of femur in the acetabulum
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What is the kVp range for an AP Abdomen?
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70-80
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What is the size of an IR for an adult AP abdomen?
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14 x 17 in.
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For an AP abdomen image what are the six check points for density?
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kidney shadow, psoas muscles, liver shadow, transverse processes, skin line, spinous processes
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Where is the best place to place your side marker (R/L) on the IR for an AP abdomen?
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lower right corner
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