Ch. 3 - Abdomen

• The abdominopelvic cavity extends from diaphragm to bony pelvis
• The 2 parts of the Abdominopelvic Cavity:

  • Abdominal Cavity
  • Pelvic Cavity
• The abdominal cavity is the larger superior cavity in the abdominopelvic cavity
• Accessory organs of the digestive system:

  • Liver
  • Gallbladder
  • Pancreas
• The esophagus begins at C5-6 and ends at T11 (it's 9 3/4 inches long)
• stricture: closed
• The 2 indentations in the Esophagus:

  • Aortic arch
  • Left primary bronchus
• The esophagogastric junction is also called the Gastro Esophageal Sphincter
• Order of Stomach and Small Intestine

  1. Stomach
  2. Duodenum (short and wide)
  3. Jejunum (2/5 of SI)
  4. Ileum (3/5 of SI)
• The most important muscles in an abdominal x-ray:

  • Left/Right Psoas Major
  • Diaphragm
• Primary organs of digestion:

  • Oral cavity
  • Pharynx
  • Esophagus
  • Stomach
  • Small Intestine
  • Large Intestine
• Organs of urinary system:

  • Kidneys
  • Bladder
  • Ureters
  • Urethra
• The peritoneum lines the abdominal cavity
• The parietal layer is the outer layer of the peritoneum and adheres to the abdominal wall.
• The visceral layer is the inner layer of the peritoneum and lines the organs
• Mesentery: A type of double fold peritoneum that loosely connects the small intestine to the posterior abdominal wall
• Omentum: A double-fold peritoneum that extends from the organ to another organ, referred to as the apron of the stomach
• List the 7 landmarks for abdomen:

  • Xiphoid process: T9-10
  • Inferior costal margin: L2-3
  • Iliac crest: L4-5
  • ASIS (Anterior Superior Iliac Spine)
  • Greater Trochanter
  • Symphysis Pubis
  • Ischial Tuberosity
• What are the breathing/respiration instructions for abdominal radiography?

  Expose at the end of expiration.
• The kVp range for the abdomen is 70-85 and the kidneys, liver, and psoas muscles should be visible.
• Ascites: the accumulation of fluid in the peritoneal cavity, causing abdominal swelling.
• Pneumoperitoneum: The presence of air or gas in the peritoneal cavity.
• Ileus: a painful obstruction of the ileum or other part of the intestine.
• A 2-way acute abdominal series:

  • AP Supine
  • AP Erect/left lateral decub
• A 3-way acute abdominal series:

  • AP Supine
  • AP erect
  • PA chest
• An erect abdomen is taken 2" above the iliac crest to visualize air-fluid levels below the diaphragm
• A KUB should include the pubic symphysis
• KUB stands for Kidney, Ureter, and Bladder
• Where does the CR enter on a KUB?

  CR should be centered at the iliac crest (L4 or L5)
• Where does CR enter on erect abdomen?

  CR is centered 2” above the iliac crest
• Where does CR enter for left lateral decub abdomen?

  CR is centered 2” above the iliac crest
• We always do left lateral decub for abdomen because of air in the stomach
• The SID for abdomen is 40"
• Where is the top of the IR approximately located on erect abdomen radiograph?

  At the level of the axilla
• A dorsal decub or lateral abdomen is best to demonstrate soft tissue masses, umbilical hernia, calcifications, AAA, foreign body
• There are 4 main quadrants

  
• Major organs in the RUQ:

  • Liver
  • Gallbladder
  • Duodenum
  • Right kidney
  • Right suprarenal gland
  • Right colic
  • Head of pancreas
• Major organs in the LUQ

  • Spleen
  • Stomach
  • Left kidney
  • Left suprarenal gland
  • Left colic
  • Tail of pancreas
• Major organs in RLQ:

  • Ascending colon
  • Appendix
  • Cecum
  • Ileum
  • Illeocecal valve
• Major organs in LLQ:

  • Descending colon
  • Sigmoid colon
  • Jejunum