Chapter 3
Abdomen
Abdominal Systems
• Digestive– ___________– Small and Large Intestines– ___________– Gall Bladder– Pancreas*
The Other Systems
• Urinary– __________– 2 Ureters– Urinary bladder– _________
• Lymphatic– Spleen
Peritoneum
• Double walled membrane sac– ___________Peritoneum
• Attached to abdominal wall
– ____________ Peritoneum • Covering an organ
– Peritoneal ___________• Space between parietal and visceral peritoneum
Peritoneum
• Lubricated for _________ movement– ___________
• Abnormal collection of fluid
• ____________of peritoneum– Bind abdominal organs to each other and the walls of
the abdomen– Blood, lymph vessels, and nerve supplies
Mesentery
• _____________peritoneal fold
– Extends anteriorly from the posterior abdominal wall
– Connects ____________to abdominal wall
Mesocolon
• ___________ peritoneal
• Four parts – ________– Transverse– _____________– Sigmoid
Omentum
• ____________ peritoneal fold
• __________Omentum• Extends from lesser curvature to liver
• __________ Omentum• Connects transverse colon to greater curvature• Over small bowel and forms an anterior abdominal
apron (Fatty Apron)
Greater and Lesser Sac
• ___________ Sac– Largest portion of peritoneum (peritoneal
cavity)
• __________ Sac (Omentum Bursa)– Posterior to stomach– Area that the __________ encompasses
Retroperitoneal and InfraperitonealTable on Page ______
• _____________– Organs behind the peritoneum– Less mobile
• _____________– Organs below the peritoneum
Quadrants
• Four Abdominal quadrants– Right _________ Quadrant– Right Lower Quadrant– Left __________ Quadrant– Left Lower Quadrant
• Important when diagnosing organ involved• ____________Table
Regions
• “Tic-Tac-Toe” board on the abdomen.
• Made by:– Right and left ___________(vertical)
• Between ASIS and midsagittal plane
– ______________ plane (horizontal)• Level of L1
– _____________ plane (horizontal)• Level of L5
9 Regions
1) Right ____________2) Epigastric3) Left Hypochondriac4) Right Lateral (Lumbar)5) _______________6) Left Lateral (Lumbar)7) Right Inguinal (Iliac)8) ____________ (Hypogastric)9) Left inguinal (Iliac)
____________
Topographical Landmarks
• _______________(T9-10)– Superior portion of abdomen
• Inferior Costal Margin (L2-3)– Gallbladder, Stomach
• _____________(L4-5)– Mid Abdomen
• Anterior Superior Iliac Spine (ASIS)– Slightly inferior Abdomen
More Landmarks
• Greater ____________– Off of Femur– Just superior to symphysis pubis
• ____________Pubis– Inferior margin of Abdomen
• Ischial Tuberosity– Inferior to symphysis pubis
Shooting the Abdomen
• Remove all clothing with _____________ materials– Buttons– Snaps – Zippers– Underwire
• ____________– Patient probably won’t want to
Patient Instructions
• Hold breath on _____________– “Take in a breath, blow it all the way out and
hold your ______________”
• Hold Still
Technical factors
• Mid kV range ___________• Short time due to breath hold• mA accordingly• May need to use ___________ for
pediatric patients.
Abdominal Series
• 3 Way Abdomen– ____________– ___________– Upright Abdomen
KUB
• Plain Film, Flat Plate
• K – ____________
• U – Ureters
• B - ___________
The KUB
• 14 x 17 LW• ___________• In Bucky/Grid• Patient is ___________• Palpate _____________• Center midline at iliac crest• Film must have inferior ribs and
Symphysis ___________
Abdomen Anatomy
• Muscles seen on X-ray– _____________
• Should be motionless
– _____________• Flanking the Spine
AP Erect Abdomen
• Detects _____________Levels• Patient is Erect• 40” SID• 14 x 17 LW in Bucky• CR is midline and __________iliac crest• Film must have _________and majority of
pelvis. Symphysis pubis not important.
Prone Abdomen
• Patient is Prone• 14 x 17 in Bucky• 40” SID• CR is midline at _____________
Left Lateral DecubitusLLD
• For intraperitoneal ____________levels• 14 x 17 XW• 40” SID• Patient in Left Lateral Decub• CR directed midline __________iliac crest• May need ___________ if patient cannot
roll.