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.